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We study how couples in the Medicare Part D program choose an insurance
plan. Over 70 percent of enrollees choose the same plan as their spouse. Even
among those with differing healthcare needs, well over half do so. Discrete-choice models suggest beneficiaries value being on the same plan as their spouse
at hundreds of dollars per year. A regression-discontinuity design shows that
quasi-random variation in an older spouse's choice of plan affects their younger
spouse's choice. We present a decomposition exercise to assess how much the
tendency for couples to choose the same plan contributes to overspending in
the program.
