How do Health Insurance Companies Know If You Smoke?

When applying for a new health insurance policy, one of the first (and most important) questions to answer is “do you smoke?” – an inquiry that could make your benefits riskier and more expensive.

Despite the dangers of smoking, an estimated 34 million Americans still smoke regularly. Health insurers have policies that penalize smokers and, as a result, can increase their rates due to the high risk of lung cancer or other illnesses related to smoking.

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How do insurance companies know if you smoke?

Health insurers consider you a smoker – and subject to hefty premium surcharges if you used any tobacco products four or more times in the past six months.

Some policyholders may be tempted to keep their tobacco use a secret, but this isn’t wise. If they don’t disclose their smoking habit, they could lose their health insurance or face other penalties because of fraud.

Most health insurance providers will know if you smoke based upon routine blood and urine analysis.

The best way to ensure you receive the health coverage you need is by being honest when answering enrollment questions.

What is a tobacco rating, In Case  You Smoke?

Health insurance premium rates depend on five key factors:

  • Your age
  • Where you live
  • Plan category
  • Your number of dependents
  • Your tobacco use

Insurance companies sometimes add surcharges for tobacco use. The reward is a financial incentive to try and quit smoking.

When Does Tobacco Rating Apply?

If you smoke occasionally, your smoking habits may not be detected by health insurance companies. For an insurance company to assess a higher premium surcharge due to tobacco use, your level of usage must reach a certain degree.

The U.S. Department of Health and Human Services reports that companies consider individuals “tobacco users” if they use tobacco products on an average four or more times a week in the past six months.

The FDA is issuing a ruling against smoking.

One exemption to this ruling is for religious or ceremonial uses of tobacco products, for example, by American Indians and Alaska Natives.

The Few States Moderate Tobacco Rating Even If You Smoke

Some states prohibit insurers from charging smokers more for health insurance than non-smokers.

  • California
  • Connecticut (plans sold on state Marketplace only)
  • Massachusetts
  • New Jersey
  • New York
  • Rhode Island
  • Vermont
  • Washington D.C.

Three other states allow a surcharge of less than 50% :

  • Arkansas – 20%
  • Colorado – 15%
  • Kentucky – 40%

In other 40 states, insurers can charge smokers 50% more for monthly premiums due to their higher medical costs. However, this difference does not qualify them for health insurance premium subsidies through the ACA.

Costs for Smokers Versus Non-Smokers

Smokers beware: it’s hard to find an insurance company that’ll cover you!. Health insurers can charge a 50% premium in most states for smokers. But if you’re looking for “smoker-friendly” options, check out different companies before settling on one (especially since they don’t always have the best rates)!

Smoking and the Affordable Care Act

This is kind of a weird law, but the ACA can make sure that no one who smokes gets rejected. But they do get to charge them more for their insurance premiums!

If you are looking to quit smoking, the ACA provides a benefit for quitting. Because it is considered preventive care and not as something that needs to be paid out-of-pocket. In addition, if there’s someone in your life who smokes or has smoked before but wants to stop, this could be a great opportunity for them!

Juuls, E-cigarettes, and Vaping

Vaping and Health Insurance

These devices are harmful. They can contain addictive nicotine, and more than 2,000 people from age 13 and up last year got sick because of them, while 50 died! Authorities have been studying these products for years now.

Would you be a smoker if you used e-cigarettes? It’s unclear because inhaler products lack tobacco. If that is the case and it goes under your insurance company umbrella as “smoking,” they may ask for more information about your smoking habits – like whether or not you’re using an inhaler product to help quit cigarettes.

The idea that you might be able to quit smoking just by using nicotine inhalers is a tough one when considering the insurance industry. Studies show that 67% of people who tried quitting with an inhaler were unsuccessful, which leaves them addicted and breaks from paying for expensive treatments like these on their own or going back to cigarettes–which are less costly than having your health insurer foot the bill for something they won’t cover anyway!

Once You Join a Plan as a Tobacco User

If you start smoking again after joining a health insurance plan, you must tell your company when you renew. Being truthful with them will help saving yourself all sorts of onerous complications down the road – from unnecessary medical expenses to higher premiums for example. You should also remember that tobacco smoke is still one of the leading preventable causes of death. So there are free cessation programs out there worth looking into!