How Obesity Affects Individual Health Insurance Rates


First Lady Michelle Obama has begun her fight against childhood obesity. In a nation where nearly one-third of Americans are overweight and another one-third are obese, it is important to nip the obesity epidemic in the bud. After all, it is easier to prevent weight gain in the first place than to lose the weight. Obesity can result in serious health problems, including Type 2 diabetes and heart disease. For this reason, it can also impact your experience buying health insurance.

If you have group insurance through your employer, you will most likely get coverage regardless of your weight. However, if you must buy individual health insurance, being overweight or obese can affect your eligibility for insurance and the premiums you are charged. When you buy an insurance policy, most insurance companies ask you for your height and weight. Those statistics allow them to calculate the body mass index (BMI) of a prospective customer.

A BMI higher that 25 indicates that a person is overweight, whereas a BMI over 30 means that he or she is obese. BMIs are based on the average American, and may not apply to serious athletes with extraordinary amounts of muscle–but they are nevertheless used as a guide by individual health insurance providers.

Obese individuals with no other pre-existing conditions will often be subject to a medical exam when purchasing insurance. They then face health coverage rates that are 20% to 100% higher than people who at a healthy weight. The rates vary among individual health insurance plan, so it’s important to shop around for one that fits your budget. See if you are at risk with our free BMI calculator.

Finding individual health insurance can be even more difficult for those with a BMI of over 35, which is considered severely obese. Underwriters may decline you altogether! Since obesity is associated with many potentially expensive health issues, it may be more profitable for health insurers to refuse someone they consider to be at high risk for filing more medical claims.

If you are in that predicament, there are guaranteed issue individual health insurance options available. Those plans are legally required to cover all applicants, no matter how much they weigh. Such plans tend to be a bit more expensive than standard insurance, but reduce the stress being uninsured can cause.

Unfortunately, health insurance companies do not take a person’s weight trajectory into account when setting rates or deciding whether to approve coverage. In other words, you will not pay lower insurance premiums if you are on a proven weight loss plan and making process. Weight loss is good for your health, and losing even 10% of your weight will prevent or even reverse many pre-existing conditions that make it even harder to get individual health insurance. Even if you are still considered overweight or obese for your height after that initial loss, you may be able to stop taking expensive prescription medications for high cholesterol, for example.

Yamileth Medina is an up and coming expert on individual health insurance and healthcare reform. She aims to help people realize that they can find affordable health insurance right now. Yamileth lives in Miami, FL