Health insurance claim formIt’s common knowledge that if you get into a lot of accidents (and therefore make a lot of claims), your cost for auto insurance will go up. If you file a homeowner’s insurance claim, your premiums may also rise – sometimes by hundreds of dollars! With many types of insurance, the more claims you file, the more expensive your insurance becomes.

This is not the case with health insurance. Your premiums won’t fluctuate throughout the year, so if you see a doctor two times or twenty times, you’ll still be paying the same premiums each month. You should never be afraid to go to the doctor, even if it’s just for a check-up. If you’re proactive, your physician will be better able to spot any warning signs or conditions before they get worse.

So how does a health insurance company decide how much your premium will be? The Affordable Care Act says that companies can only consider these factors:

  • Age – If you are older, you can be charged up to three times more for premiums than younger people. States can also limit how much this factor (and the others) influence premiums.
  • Location – Where you live will also impact your premiums. States regulate premiums differently, and if you live in an area with a higher cost of living, you might have to pay more for health insurance.

While you don’t have much control over your age and you probably aren’t going to change where you live, you do have control over the last three factors affecting your premiums:

  • Tobacco Use – If you’re a smoker or you use tobacco, insurance companies can charge you up to 50% more on your premiums.
  • Individual vs. Family Enrollment – As you might expect, it costs more money to cover more people. Your health insurance premiums are likely to be lower if you are the only one covered. If you want coverage for your spouse and/or your dependents, insurance companies can increase your premiums.
  • Plan Category – Health plans typically fall into one of five categories: bronze, silver, gold, platinum, and catastrophic. Each category splits the cost of healthcare between you and the health insurance company differently. Bronze plans typically have lower premiums (but higher out-of-pocket costs), while platinum plans tend to have higher premiums (and lower out-of-pocket costs). For more information, see our infographic about health plan categories.

These are the only five things that insurance companies can consider when setting the costs of your premium. It doesn’t matter if you’re male or female, pregnant, epileptic, dyspeptic, or diabetic. Insurers cannot charge you more money for any conditions you had before your coverage started.

If you’re not feeling well, don’t ever hesitate to see a medical professional. The Affordable Care Act was designed to protect consumers from escalating healthcare costs, so you can receive quality care at an affordable price.

At HealthMarkets, we know that health insurance can be confusing. We can help make shopping for health insurance simple. Call us today at (800) 304-3414 and speak to a licensed professional who knows the regulations in your area.



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