Consumers and Choice

If open enrollment taught us anything this year, it was that American consumers had different needs when it comes to their health care coverage and the choices they made. Here are examples of consumers whose choices for 2021 were affected by the pandemic:

  • Budget mindful who lived paycheck to paycheck or—for one retiree—on a fixed budget. She enrolled in a Medicare Advantage plan because she couldn’t afford the risk of unpredictable costs with Traditional Medicare. She understood that the plan had a limited network, but made the tradeoff for predictable costs.
  • Security conscious who worried about being hit by … COVID-19. A sole proprietor’s business had suffered in the pandemic, and he had dropped coverage to save money. He reenrolled in a high deductible health plan on the federal marketplace to protect his financial health in case of a catastrophic illness or injury.
  • Provider picky who could afford the doctor of her choice. Another retiree had a serious medical condition that required a specialist with specific expertise. She enrolled in Traditional Medicare in order to ensure coverage by her specialist. She also had a supplemental plan through a retiree health benefits program.
  • Medically needy who had an ill family member. A working mom recently diagnosed with cancer thought she wanted treatment at the biggest medical center in town. “I was just a number,” so she switched to a hospital where “everyone knows my name” even during the pandemic. Her plan gave her the flexibility she needed. 
  • Satisfaction savvy who had bad service. Parents fought with an insurance carrier about a bill for out-of-pocket expenses that they just received for their son’s hospitalization nearly two years ago. Given changes in their job-based insurance, the parents couldn’t afford to pay, nor could they get a straight answer anywhere.

On this New Year’s Eve, not all Americans have choices and the resources to get covered. Others were lucky enough to have both, but it didn’t mean that it was easy for them. In other words, these consumers are Mastering Health Insurance.

  • Source: Asparity Decision Solutions
  • Photo: Japanese Macaques who chose to hover together from the cold and snow at the Lincoln Park Zoo