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Inspired by the new regulations set in place by the exclusive Portuguese civil servant\u2019s insurance scheme designated by ADSE, this study proposes a novel approach based on real options for an individual that needs to choose between a private health insurance and the apparently cheaper option provided by ADSE. Starting from the net present value approach, we subsequently show that, depending on some life changing events that may occur, it would be more beneficial for the individual to either abandon the health system or enter it at a later date. By incorporating the value of these options in the net present value calculation, decisions taken are not only more flexible, but also more realistic.<\/jats:p>","DOI":"10.1007\/s43546-023-00489-2","type":"journal-article","created":{"date-parts":[[2023,5,31]],"date-time":"2023-05-31T10:02:16Z","timestamp":1685527336000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Real options in health insurance decisions: the Portuguese ADSE system"],"prefix":"10.1007","volume":"3","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5668-0285","authenticated-orcid":false,"given":"Raquel J.","family":"Fonseca","sequence":"first","affiliation":[]},{"given":"Lu\u00edsa","family":"Cunha","sequence":"additional","affiliation":[]}],"member":"297","published-online":{"date-parts":[[2023,5,31]]},"reference":[{"key":"489_CR1","doi-asserted-by":"publisher","first-page":"316","DOI":"10.1016\/j.ejor.2017.09.010","volume":"266","author":"AH Ansaripoor","year":"2018","unstructured":"Ansaripoor AH, Oliveira FS (2018) Flexible lease contracts in the fleet replacement problem with alternative fuel vehicles: a real-options approach. 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