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This study examines the consistency in risk aversion between hypothetical and actual choices in medical insurance. Utilizing a unique survey in which individuals in Japan are asked about their perception of a hypothetical necessary amount for hospitalization benefits and the actual insurance contract amount at the time of hospitalization, the study identifies that the gap between the hypothetical and actual domains is not constant. Even between two similar domains of hospital benefits selection, the gap is found to vary depending on respondents’ anxiety about future medical expenses, their level of financial literacy, and other personal attributes such as age and occupation. The results of this study strongly suggest a need for exercising caution when using the degree of risk aversion obtained by hypothetical questions, questionnaire surveys, and experiments to predict actual behavior.

Factors Widening the Gap between Hypothetical and Actual choices—Empirical Evidence from the Japanese Medical Insurance Market—