Medical Insurance: How Do Rates Change Based on Health and Other Factors?

Calculating the medical insurance rates that apply to your specific case can be a challenging task. As this is an informational type of article, we won’t be talking about the exact formula. However, we will go over things that have an impact on the rates the insurance company is going to charge you, including the health-related reasons.

  1. Are you a smoker?

Then we might have some bad news for you; not only is it an unhealthy habit you need to shake off as soon as possible, it’s also something that insurance companies will hold against you. In fact, tobacco users are often charged up to 50% more than those who don’t smoke it.

  1. Are you getting older?

We are all getting older – it’s the inevitable process of nature. However, those who are considered to have reached their elderly years are typically charged up to three times more than those who are considered young.

  1. Does your insurance plan cover your spouse?

Naturally, if your plan only includes you as an individual and your loved ones are exempt from it, you’re not going to pay as much for it. Even though this is not directly correlated to the state of your health, it’s a common factor that influences the rates, and thus, needs to be mentioned.

  1. What is your plan category?

Depending plan category you’ve chosen (bronze, silver, gold, premium, catastrophic), you can expect to have different kinds of health-related expenses covered. The more unstable the state of your health tends to be (or the safer you’re inclined to play it in life), the higher-level plan you’ll usually end up taking.

There are several websites and companies who can help you explain how it all works, and GoMedigap is one of them. If you’d like to read more information about GoMedigap, you can visit their official website. But as a rule of thumb, higher-end medical insurance plans will cover more than the lower-priced ones, where you can expect to pay quite a bit of costs out of your own pocket.

  1. Your location

Depending on where you live, the insurance companies can charge a completely different insurance premium. The average living costs of the area are a huge factor.

Both genders are treated equally

In case you were wondering, your gender does not play a role in how your insurance rates are calculated. Too many people make the mistake of believing this is a factor – it is not.

Your current health does not affect medical insurance rates

Before concluding this article, here’s one final piece of advice we can share – the insurance companies can’t take the current state of your health into account. From day one and onwards, all insurance plans are required to cover treatment for pre-existing health conditions you may have.   This is also the case if you’re purchasing a Medicare supplemental plan, – but be sure to check your local state regulations.  Not all state plans are created equally, so you’ll want to do sufficient due diligence.


Hopefully, we’ve managed to clear up a great deal of confusion regarding health insurance rates and plans, as well as how it all ties together with the state of your health. But again, every state has its own set of rules, and although these general pointers will guide you well, it’s best to do a local search before making the final judgment call.

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