Medical Insurance and Tobacco Use



 

It is fairly common knowledge that when enrolling in health insurance, you are asked “have you used any tobacco products in the last twelve months,” it is an obvious consideration to speak on behalf of your bank account in fear of outrageous premiums and say “no.”

Many people find this a gray area, as there are plenty of forums featuring questions with non-habitual smokers who probably feel much more confident about their “no,” because a few on the weekend doesn’t count. So, what are the consequences of lying about smoking when applying for a health plan? Naturally, if you have been a regular, every day smoker for several years, and health problems later arise that are related to smoking, your insurance company has the right to not pay claims to treat the condition. If such an illness happens within the first two years of coverage, you are still within the contestable period, which means your insurer can rescind your policy at any time with good enough reason within that time frame.

If you feel that you have not used enough tobacco products to cause long-term damage (at least ones that will present symptoms in the next few years), you may be in the clear. By insurance standards, you are still a smoker even if you have had only an occasional cigar, e-cigarette, dip, or any other form of tobacco – just once in an entire year. To many this seems preposterous, but to insurance companies it is entirely viable, as they want their clients in peak condition, as healthy as possible. Though you will likely pass a test with an undetectable level of cotinine in your urine as soon as three days after your last smoke, you are still risking health problems that no one but you will pay for later on.

Non-Smoker vs. Smoker Premium Rates

Let us also consider the financial consequences of being honest: premium rates. If you do want coverage and do not have the ability to predict the future of your health, you could take responsibility and pay the rate assigned to tobacco users. To give you an accurate idea of what premiums for smokers are like compared to what a person in “good health” will be paying, a quote was created for a 30-year-old male resident of Boca Raton, Florida. This sample client takes the occasional opportunity to smoke a few cigarettes here and there, but maintains a healthy lifestyle otherwise, so is in quandary as to what his response will be.

The following comparison shows how much this client will pay if they are honest, and how much it would cost if they had not been a smoker by insurance definition. Identical plans were chosen at a $2,500 deductible on both sides, with the lowest premium rates for that deductible. The quote was also run on two different websites to ensure accuracy.

In Florida, Aetna is the only company that does not adjust its rates based on tobacco use. Every other company has a significant increase even for an otherwise healthy client. View the plan comparisons below.

 

Non-Smoker Rates

 

Smoker Rates