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Does health insurance cost more for overweight people and smokers?

By on December 21st, 2011
Filed: Facts, Health and Wellness, Health Insurance

When it comes to individually-purchased health insurance plans, the answer is yes.

eHealth recently published some surprising data on how smoking status or body mass index (BMI) affects average individual health insurance premiums. You can read the full report here. It was published as an addendum to our larger ‘Cost and Benefits ’ which came out in November.

Here are the highlights:

  • Smokers pay an average monthly premium of $207, 14% higher than the average monthly premium paid by non-smokers ($181)
  • The average monthly premium paid by women smokers ($240) is 23% higher than the average premium paid by non-smoking women ($195)
  • Policyholders in the ‘Obese’ BMI category pay an average monthly premium 22.6% higher than those in the ‘Normal’ BMI category ($164 compared to $201)
  • The average monthly premium paid by men in the ‘Obese’ category ($187) is 30.8% higher than the average premium paid by men in the ‘Normal’ category ($143)
  • The average monthly premium paid by men in the ‘Underweight’ BMI category ($157) is 9.8% higher than those for men in the ‘Normal’ category ($143)

Read the full Smoking and BMI report for more information.

Since reports of this sort are always complicated to assemble, it’s worth saying a few things about the methodology involved:

Underwriting decisions that may influence an individual applicant’s approval or final monthly health insurance premium are not made by eHealth or eHealthInsurance but by the insurance carrier selected by the consumer when visiting eHealthInsurance.com. Decisions may be based in part on smoking status or BMI. However, other factors (such as an individual’s medical history or the presence of a pre-existing condition) may also play a role. In many states it is possible to be declined coverage for individual health insurance coverage due to a high BMI.

In eHealth’s smoking and BMI report, comparisons of average premium costs relative to the applicant’s BMI were derived from a sample of more than 229,000 individual major medical policies purchased through eHealthInsurance with coverage in effect as of February 2011. Results are based only on adults aged 20 or older who provided their height and weight on the health insurance application. BMI was calculated based on this height and weight data according to a formula published by the Centers for Disease Control (CDC). The BMI categories (Underweight, Normal, Overwight, Obese) used in this report also follow CDC guidelines.

Comparisons of average premium costs for smokers and non-smokers in the report were derived from a sample of more than 274,000 individual major medical policies purchased through eHealthInsurance with coverage in effect in February 2011. The status of “smoker” or “non-smoker” is determined during the application process. When collecting personalized quotes and filling out the online application form during the shopping process, eHealthInsurance customers are asked to indicate if they have smoked tobacco within the past twelve months.

Image via Flickr user Julie Bocchino.

About Carrie McLean


Carrie McLean has been in the health insurance field for 7 years and is licensed in all 50 states. She is often seen in the media discussing health insurance trends and issues from an insider’s perspective and as a consumer advocate, having personally helped thousands of individuals and families search for and find affordable health insurance.

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