Happy New Health Plan: Choosing a Plan for an Uncertain 2018

It’s that time of year again: Open enrollment for marketplace health plans, and the choices are no less daunting this year. If you recall last year, Decision Fish published an article, Health Insurance Enrollment: A Superhuman Decision in which we noted that people tend to respond to the choice and information overload presented by this type of decision with (biased) short-cuts (heuristics), procrastination and a general feeling of unhappiness.

This year’s decision is exacerbated by a much shorter enrollment period and uncertainty regarding subsidies the government would make available to insurance companies, which in turn led companies to price their plans without a clear picture of the actual costs. Insurers are passing along that uncertainty to subscribers in the form of much higher premiums. In our case, our current plan has been eliminated and the closest plan for 2018 is going to be about $600 more per month in premiums, albeit with a slightly lower deductible.

If you are purchasing a health insurance plan for 2018 through a State or Federal marketplace, open enrollment is November 1 to December 31 in most areas. Where we live in New York, enrollment was extended with a start date of November 16.

The NY State of Health marketplace websites lists 23 companies and 48 pages of plans. At ten plans per page, that’s nearly 500 options. If you are purchasing a family plan with a subsidy, your choices narrow to seven pages, but that is still 70 plans to review.

For most people a much shortened period, compared with last year, as well as additional barriers such as mandatory maintenance of the Federal Healthcare.gov site on most Sundays during the enrollment period, means subscribers have less time to evaluate an increasingly complex set of services and much more chance of succumbing to cognitive biases that can impair an optimal choice.

So, how does one make an effective choice?

We recommend following a similar process outlined in last year’s article. We were somewhat gratified that our 2017 plan was discontinued as it likely mean we picked one that favored subscribers. But even if it hadn’t been eliminated it makes sense to re-evaluate our situation based on our expectation of upcoming expenses.

Consider changes in your personal and family makeup, such as a new job, new baby or a child entering college that can affect your coverage needs. As can reaching the age 50 bump which means fun new tests or treatment (colonoscopy, anyone?) or reaching an age where Medicare becomes available.

Given the uncertainty of the healthcare market and the uncertainty of our own earnings for 2018, we selected the least expensive plan that will cover all of the likely procedures and doctor visits we expect for the new year. This frees up funds that we can invest or have on hand for emergencies and allows us to afford an occasional out of network visit, if needed.

Best of health to you in 2018!