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{"id":4271,"date":"2018-12-18T15:23:42","date_gmt":"2018-12-18T20:23:42","guid":{"rendered":"http:\/\/www.decisionfish.com\/?p=4271"},"modified":"2023-08-09T17:56:11","modified_gmt":"2023-08-09T21:56:11","slug":"time-to-choose-your-health-insurance-dont-make-a-9000-mistake","status":"publish","type":"post","link":"https:\/\/www.decisionfish.com\/time-to-choose-your-health-insurance-dont-make-a-9000-mistake\/","title":{"rendered":"Time To Choose Your Health Insurance: Don&#8217;t Make A $9,000 Mistake"},"content":{"rendered":"\n<p>Is there any financial decision that we dread more than the annual chore of choosing a health insurance plan? It\u2019s got everything we hate: choice and information overload, time pressure, ambiguity and confusion, consequences worth thousands, uncomfortable scenarios involving disease and injury, inscrutable jargon coming at a time of the year full of other business, family and personal obligations.&nbsp;<\/p>\n\n\n\n<p><a href=\"https:\/\/www.decisionfish.com\/health-insurance\/\" target=\"_blank\" rel=\"noreferrer noopener\">I have written before<\/a>&nbsp;about how there\u2019s no rational way for people without serious financial programming experience to choose the best health plan under these conditions. The experience is especially bad on the&nbsp;<a href=\"https:\/\/nystateofhealth.ny.gov\/\" target=\"_blank\" rel=\"noreferrer noopener\">New York Marketplace<\/a>&nbsp;where the self- and unemployed go to pick from dozens of plans without an HR benefits professional to help. I tried calling the marketplace and found&nbsp;their operators were limited in the advice they could provide.<\/p>\n\n\n\n<p>So what do we do? Like any hard decision, we try to replace it with an easier one. Instead of optimizing \u2014 trying to find the best plan \u2014 we\u2019ll just try to avoid picking one that\u2019s worse than what we\u2019ve got right now. We\u2019ll stick with the status quo or go with the default or &#8220;do nothing&#8221; option. Or perhaps we\u2019ll ask some friends who may not be any more qualified than we are. The trouble with these short-cuts is that they could leave several thousand dollars on the table.<\/p>\n\n\n\n<p>What we really need is a tool that projects our total healthcare spending \u2014 including insurance premiums \u2014 under every available plan, so we could simply pick the lowest&nbsp;<em>total cost<\/em>&nbsp;plan. We might also consider a worse-case scenario to get a sense of how risky each plan is. Indeed, the lowest cost bronze plans have the highest deductibles: in some scenarios, they could have a higher total cost than silver plans.<\/p>\n\n\n\n<p>Because I can\u2019t bear to pay insurance companies more than is absolutely necessary, I built an Excel model that calculates my family\u2019s total out of pocket spending plus premiums for many of the plans on the marketplace, in a base case and in a worst case. Here\u2019s how the results came in for my family this year:<\/p>\n\n\n\n<figure class=\"wp-block-image\"><img loading=\"lazy\" decoding=\"async\" width=\"960\" height=\"831\" src=\"https:\/\/i0.wp.com\/www.decisionfish.com\/wp-content\/uploads\/2019\/01\/F2868793-2DFD-4AA8-873D-BA3A18AE7F9E.jpeg?resize=960%2C831&#038;ssl=1\" alt=\"This chart plots 23 of plans on the New York marketplace based on the projected total cost under a base case (vertical axis) and under a worse case (horizontal axis) for my family. We picked a plan in the bottom-left corner. SOURCE: BRETT WHYSEL, DECISIONFISH.COM\" class=\"wp-image-4273\" srcset=\"https:\/\/i0.wp.com\/www.decisionfish.com\/wp-content\/uploads\/2019\/01\/F2868793-2DFD-4AA8-873D-BA3A18AE7F9E.jpeg?w=960&amp;ssl=1 960w, https:\/\/i0.wp.com\/www.decisionfish.com\/wp-content\/uploads\/2019\/01\/F2868793-2DFD-4AA8-873D-BA3A18AE7F9E.jpeg?resize=300%2C260&amp;ssl=1 300w, https:\/\/i0.wp.com\/www.decisionfish.com\/wp-content\/uploads\/2019\/01\/F2868793-2DFD-4AA8-873D-BA3A18AE7F9E.jpeg?resize=768%2C665&amp;ssl=1 768w, https:\/\/i0.wp.com\/www.decisionfish.com\/wp-content\/uploads\/2019\/01\/F2868793-2DFD-4AA8-873D-BA3A18AE7F9E.jpeg?resize=192%2C166&amp;ssl=1 192w\" sizes=\"(max-width: 960px) 100vw, 960px\" data-recalc-dims=\"1\" \/><figcaption class=\"wp-element-caption\">This chart plots 23 of plans on the New York marketplace based on the projected total cost under a base case (vertical axis) and under a worse case (horizontal axis)&nbsp;<em>for my family<\/em>. We picked a plan in the bottom-left corner. SOURCE: BRETT WHYSEL, DECISIONFISH.COM<\/figcaption><\/figure>\n\n\n\n<p>Here are some observations:<\/p>\n\n\n\n<ul>\n<li>The cost of making a mistake remains around $9,000 per year (the total cost difference between the average plan and the lowest cost one, at least for us)<\/li>\n\n\n\n<li>Our total costs are up about 4% since last year<\/li>\n\n\n\n<li>The doctor networks of some nonprofit plans like Fidelis Care seem have expanded, at least in New York<\/li>\n\n\n\n<li>You still can\u2019t rely on insurers or the state\u2019s database to tell which doctors accept a given plan: you\u2019ve got to call the doctors\u2019 offices<\/li>\n\n\n\n<li>Many gold and platinum plans seem to have negative value in most realistic scenarios, i.e., we\u2019d be better off uninsured than to pick one of these<\/li>\n<\/ul>\n\n\n\n<p>State marketplaces, unions and companies really should offer tools like ours so people can make rational decisions. We know that<a href=\"https:\/\/www.apa.org\/news\/press\/releases\/2015\/02\/money-stress.aspx\" target=\"_blank\" rel=\"noreferrer noopener\">&nbsp;financial stress is epidemic<\/a>&nbsp;in the US and that many people&nbsp;<a href=\"https:\/\/www.earnin.com\/data\/waiting-feel-better\" target=\"_blank\" rel=\"noreferrer noopener\">delay needed healthcare to avoid copays<\/a>. Until we fundamentally reform healthcare, a decision tool is a relatively easy and low-cost way to mitigate these consequences.<\/p>\n\n\n\n<p>In the meantime, what can non-Excel nerds do? Here\u2019s an algorithm that might work better than simply sticking with&nbsp;the default (your mileage may vary; this is intended to provide some ideas and may not work for everyone):<\/p>\n\n\n\n<figure class=\"wp-block-image is-resized\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/i0.wp.com\/www.decisionfish.com\/wp-content\/uploads\/2019\/01\/8E2580B6-D170-40EF-8F0E-5EA95274FFD9.png?resize=410%2C1024&#038;ssl=1\" alt=\"Infographic: How to pick health insurance.\n1. ElImination #1: DOCS: Eliminate plans that your doctor doesn\u2019t a accept you\u2019re plan.\n2. Elimination #2: MOOP: Toss out plans where premium plus Maximum out of pocket is so high that in a worst case scenario you would have tried unless paying it.\n3. Elimination #3: POSH: In most cases, Gold and Platinum plans have higher MOOP+Premium. Remove these.\n4. Pick Bronze or Silver. Choose Bronze if your spending is likely to be lower than the deductibles in the Silver plan.\n5. READ: Invest time to read the summary of benefits and drug formulary to make sure you are getting the medical and pharmaceutical coverage you need.\n6. ADVOCATE: Ask your state government or employer for better decision tools to select your health insurance with confidence next year.\n\" class=\"wp-image-4275\" style=\"width:410px;height:1024px\" width=\"410\" height=\"1024\" srcset=\"https:\/\/i0.wp.com\/www.decisionfish.com\/wp-content\/uploads\/2019\/01\/8E2580B6-D170-40EF-8F0E-5EA95274FFD9.png?resize=410%2C1024&amp;ssl=1 410w, https:\/\/i0.wp.com\/www.decisionfish.com\/wp-content\/uploads\/2019\/01\/8E2580B6-D170-40EF-8F0E-5EA95274FFD9.png?resize=120%2C300&amp;ssl=1 120w, https:\/\/i0.wp.com\/www.decisionfish.com\/wp-content\/uploads\/2019\/01\/8E2580B6-D170-40EF-8F0E-5EA95274FFD9.png?resize=768%2C1920&amp;ssl=1 768w, https:\/\/i0.wp.com\/www.decisionfish.com\/wp-content\/uploads\/2019\/01\/8E2580B6-D170-40EF-8F0E-5EA95274FFD9.png?resize=77%2C192&amp;ssl=1 77w, https:\/\/i0.wp.com\/www.decisionfish.com\/wp-content\/uploads\/2019\/01\/8E2580B6-D170-40EF-8F0E-5EA95274FFD9.png?w=960&amp;ssl=1 960w\" sizes=\"(max-width: 410px) 100vw, 410px\" data-recalc-dims=\"1\" \/><figcaption class=\"wp-element-caption\">Try these steps to pick a better health insurance plan. This is provided for educational purposes and is not financial advice. SOURCE: BRETT WHYSEL, DECISIONFISH.COM<\/figcaption><\/figure>\n\n\n\n<blockquote class=\"wp-block-quote is-layout-flow wp-block-quote-is-layout-flow\">\n<p><em>When you think about the situations that bankrupt people, it really is about total bills exceeding [their] ability to pay.&nbsp;<\/em><\/p>\n\n\n\n<p>\u2014 Matt Wallaert, Chief Behavioral Officer at Clover Health<\/p>\n<cite><br><\/cite><\/blockquote>\n\n\n\n<p>In sum, we pay a lot for health insurance and health care in general. Under current conditions, we can\u2019t hope to pick the very best plan, but we may be able to do better than just sticking with the default. Try the six steps above; they may save you thousands.<\/p>\n\n\n\n<p><em>This&nbsp;article&nbsp;originally&nbsp;appeared&nbsp;on&nbsp;December&nbsp;12,&nbsp;2018&nbsp;on&nbsp;<a href=\"https:\/\/www.forbes.com\/sites\/brettwhysel\/2018\/12\/12\/time-to-choose-your-health-insurance-dont-make-a-9000-mistake\/#796157ae66cb\" target=\"_blank\" rel=\"noreferrer noopener\" aria-label=\"Forbes.com (opens in a new tab)\">Forbes.com<\/a>.<\/em><\/p>\n\n\n\n<p><br><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Is there any financial decision that we dread more than the annual chore of choosing a health insurance plan? It\u2019s got everything we hate: choice and information overload, time pressure, ambiguity and confusion, consequences worth thousands, uncomfortable scenarios involving disease and injury, inscrutable jargon coming at a time of the year full of other business, &#8230; <a title=\"Time To Choose Your Health Insurance: Don&#8217;t Make A $9,000 Mistake\" class=\"read-more\" href=\"https:\/\/www.decisionfish.com\/time-to-choose-your-health-insurance-dont-make-a-9000-mistake\/\" aria-label=\"More on Time To Choose Your Health Insurance: Don&#8217;t Make A $9,000 Mistake\">Read more<\/a><\/p>\n","protected":false},"author":3,"featured_media":4279,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"content-type":"","_exactmetrics_skip_tracking":false,"_exactmetrics_sitenote_active":false,"_exactmetrics_sitenote_note":"","_exactmetrics_sitenote_category":0,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","enabled":false}}},"categories":[2],"tags":[4,5,38,10,11,13,41,14,39,83,22,117,116,60,35,28],"jetpack_publicize_connections":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v21.5 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Time To Choose Your Health Insurance: Don&#039;t Make A $9,000 Mistake &#8211; Decision Fish: Decide For Yourself<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.decisionfish.com\/time-to-choose-your-health-insurance-dont-make-a-9000-mistake\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Time To Choose Your Health Insurance: Don&#039;t Make A $9,000 Mistake &#8211; Decision Fish: Decide For Yourself\" \/>\n<meta property=\"og:description\" content=\"Is there any financial decision that we dread more than the annual chore of choosing a health insurance plan? It\u2019s got everything we hate: choice and information overload, time pressure, ambiguity and confusion, consequences worth thousands, uncomfortable scenarios involving disease and injury, inscrutable jargon coming at a time of the year full of other business, ... 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