Work insurance premiums based on health?

busymom2006July 11, 2007

Right now, at many companies, workers pay health insurance premiums based on the number of people in their family (Individual, married, family of 3, etc.). There is no price break for being healthy. And, to my understanding, there isn't any additional charge for having a "health condition." Those costs are distributed to the group as a whole, allowing everyone to pay the same amount.

But I've been hearing on the news lately that many plans might start factoring health conditions into the premiums that workers pay. How much difference in premiums could a "healthy" worker expect to pay vs. an "unhealthy" worker. How much will the health conditions of family members factor in? What health conditions will cause rates to go up the most?

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From what I have read, it would be women of reproductive age who would have the highest insurance if group insurance was based solely on projected costs. Preemies can easily cost a million dollars in care.

    Bookmark   July 13, 2007 at 7:16PM
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Someone else I was talking to was just mentioning something like this. It was more like if you have a healthy lifestyle you pay less but if you are overweight, don't take your medications, don't have preventive medical care, etc. you pay more. People who take care of themselves would pay less. It's an interesting concept.

    Bookmark   July 16, 2007 at 11:03PM
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Cindy Noll

Does anyone really think they will make it cheaper for anyone? Go to the doctor once too often, stop by McDonalds once too often, have a family history of any disease (your grandmother etc.), live by a major polluter and your rates will go up. Healthy will be defined by the shirts at the insurance company who are out to make even more money then they already do. One miss step and you are no longer considered healthy. Yea, they only want to penalize the people who are NOT healthy. So when all the "unhealthy" people drop insurance because they can no longer afford it, healthcare will be cheaper right? The system is broken and it's not going to be fixed anytime soon.

    Bookmark   July 17, 2007 at 6:28AM
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Rumor has it at my company that next year we'll be paying medical insurance premiums based on our ages (to me, that sort of translates into our general health). There are work groups at our place that are traditionally older folks and other groups that are younger. The rumor is that our insurance premiums will vary by group. Probably won't know until annual enrollment this fall if this is true, but once the rumors start, truth probably isn't far behind.

    Bookmark   July 17, 2007 at 6:29AM
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I've self-insured for the last few years and have simply put my estimated premiums into a separate account to defray medical bills when they occur. If all the "healthy "folks did that,then the insurance companies would be left with the unhealthy clients -- (serves them right!) Whenever I've needed medical attention, I haven't had to ask permission for a procedure or a test, I simply take out the checkbook.

This IS a gamble -- but the odds are significantly in the AVERAGE person's favor. I expect to re-think this strategy as I age and my health likely will deteriorate, but I now have the premiums stashed away to cover that event when the time comes.....
In my opinion, we've all been scared into overpaying for insurance in all areas of our lives. Seems we've forgotten what insurance companies exist for -- profit. They calculate the typical risk and set rates to make money off the "average" client. Can't fault them for that, it's their raison d'etre!

    Bookmark   July 17, 2007 at 9:56AM
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Thanks everyone! I guess there has never been more incentive to live a "healthy lifestyle." It will be interesting to see what the fall will bring....

    Bookmark   July 20, 2007 at 2:50PM
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Premiums should be based on one's health.

What they have in Massachusetts, to me, is very infair. They have mandated health insurance, while everyone pays the same premium (unless they can't afford it). Seems to me that they want to sign up healthy people, and have us subsidize the chronically ill. Like Dave, I'm "self insured". I'm in my 50's, and have sepent $740 in the past 35 years for unscheduled (other than exams) health care.

    Bookmark   July 27, 2007 at 9:14AM
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Cindy Noll

To add to my last post, I don't necessarily think this approach is wrong, I just know that it will benefit the insurance companies and no one else. Everybody should live a healthy lifestyle, but have you all considered what will happen to the person that is born unhealthy? How about all of us that could be walking around with some unknown genetic defect that will only show itself at 40? What if your defect manifests itself at 40 & then the insurance company disallows your dependent children that appear perfectly healthy, but have this newly discovered defect?? Group insurance came about for a reason, to spread the risk and once it goes, there will be a long period of turmoil & suffering for many people and hefty profits for the insurance companies. I'm sure it will not affect anyone here, however!

    Bookmark   July 28, 2007 at 9:08AM
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Would health based premuims result in "discriminatory" practices? I don't see how it would ever work. Just playing devil's advocate here.

    Bookmark   July 30, 2007 at 2:50PM
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We are discussing some of this on another thread that started out about retirement advice. No surprise soaring health care costs would come up there, eh?

If a smoker pays more for life insurance and a driver with a bad record pays more for auto insurance, why shouldn't someone who *chooses* an unhealthy lifestyle (overeating, smoking, drug abuse) pay more for health insurance?

Why should those who choose healthy lifestyles subsidize these people? (I'm leaving the funding for Public Health out of this because it benefits all of society.)

Please, let's not inflame this with Sky Is Falling rhetoric about punishing people with bad genes who have, say Huntington's, and won't be insurable! This is about *choices* people make in their lives that affect their health -- and should, IMO, affect their insurance costs.

Your doctor tells you to: loose weight; exercise; stop smoking; stop drinking; stop other drugs. You don't do it because...your family 'runs to fat'; you don't have time to exercise; if you quit smoking you'll gain weight; you 'need to relax with alcohol'; you're too stressed without 'recreational' drugs. He's not asking you to change your genes, but to make changes individuals CAN and DO make. If you won't change, should the rest of the people in your insurance "pool" (who very well may have had to make hard changes themselves) pay for the unhealthy risks you take?

    Bookmark   August 4, 2007 at 11:57AM
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