Health Insurance for Smokers

Health Insurance for Smokers

There is a common misconception that health insurance providers tend to deny coverage to smokers and tobacco users. But this is not true. Many health insurance companies are ready to cover those who have some, but usually at higher premiums and further terms and conditions. Smoking is a primary cause of various health diseases, such as respiratory ailments, lung infections, oral cancer, lung cancer, and various other critical illnesses. Due to its injurious nature, smoking can affect the cost of medical coverage and other healthcare expenses. But as smokers are more likely to be prone to lifestyle diseases than non-smokers, it is more important for them to be covered by a health insurance policy. One will also be required to provide details of his/her smoking habits, such as how many cigarettes he/she smokes in a day. This information is used by the insurance provider to assess the amount of coverage the policy-seeker will need and the premium amount that he/she will have to pay for the insurance coverage. Let us take a look at how smoking can affect the cost of health insurance premiums.

What Is The Definition Of a Smoker According To Health Insurance?

According to health insurance providers, a smoker is anyone who consumes tobacco in any form, such as cigarettes, cigars, gums, chewing tobacco, etc. A person consuming tobacco continuously for six months, more than 4 times a week, is classified as a smoker. Insurers often check the daily consumption of tobacco by smokers to find out how risky their profile is. The insurer also inquires about any existing respiratory or lung diseases because of the usage of nicotine. At times, the insurer may ask the policy-seeker to undergo medical screening. It helps the insurance company to assess the coverage and health insurance premiums. It is recommended to be honest about the smoking habit and not hide any information so that the policy-seeker can get the right coverage and the claims are not rejected in the future.

Can a Smoker Get Health Insurance?

As mentioned above, yes, many health insurers will provide coverage to smokers. The IRDAI even has mandated that smokers have a right to apply for health insurance. However, the terms, conditions, and costs of premiums vary from insurer to insurer. While an individual is in the process of buying any health insurance policy, the insurer asks about his/her lifestyle habits. If the person is identified as a smoker by the insurer, they might ask the person to take a few medical tests to ascertain health before deciding on the premium, especially if the person is over 40 years of age or he/she wants a higher sum insured amount.

Why Is It Important For Smokers To Have a Health Insurance Policy?

Here is why health insurance is important if the insured person is a smoker.

  • Smoking kills millions of people in India every year. It is not just the smoker, whose health gets affected, but people around him are also affected due to passive smoking. It causes many life-threatening diseases like Chronic Obstructive Pulmonary Disease (COPD), respiratory diseases, heart diseases, oral cancer, etc. As it affects many organs, including the lungs, insurance for smokers is a necessity to deal with the harmful consequences of smoking. Smoker health insurance provides the much-needed financial support to cover the cost of medical treatment in case a smoker is diagnosed with an illness.
  • Apart from these illnesses, a health insurance policy also covers certain illnesses, injuries, and diseases that the insured individual may suffer from in case of an accident.
  • A cashless hospitalization facility ensures that the insured gets immediate medical attention without worrying about finances.
  • Free annual health check-ups provided by the insurer are a good way to monitor health and keep a check on smoking habits.
  • Coverage for family ensures that your family’s medical needs are also taken care of, even when you are not well.
  • Tax Benefits can be availed on the premiums paid towards the health insurance.

How Does Smoking Affect Your Health Insurance Premium?

There are no special health insurance policies available for smokers. The major difference between health insurance plans for smokers and non-smokers is the premium amount. The premiums are higher for smokers compared to non-smokers for the same health insurance policy. Let us see how smoking affects health insurance premiums.

  • The high premium is because smokers are at a higher risk of falling sick and, thus, are more likely to claim health insurance.
  • Smokers have a high chance of getting critical illnesses like cancer, lung diseases, etc., due to the severe side effects of smoking.
  • Hence, premiums are decided based on their present health condition and the risk of possible health issues due to smoking.
  • If a smoker has a pre-existing disease, the insurer may ask him to undergo medical check-ups to assess the severity of his health condition. The premium is determined according to the health condition.
  • If one has started smoking after getting health insurance, inform the concerned insurer about it so that he can determine the premium value according to the frequency of smoking. If the insurer finds out on his own, he can reject the claims and charge the individual with insurance fraud.

How Can a Smoker Get Health Insurance At a Low Premium?

Since smokers face higher premiums for their health insurance, there are a few things they can do to change this.

  • Quit Smoking: If the insured person quits smoking for at least 2 years during the policy period, health insurers may consider this and lower the premium amount accordingly.
  • Joining a Smoking Cessation Program: If the insured person is unable to quit on his/her own, many health insurance companies offer or have tie-ups with smoking cessation programs that can help to do so. Again, the person must show at least 2 years without smoking before his/her premium changes.
  • Look at Different Insurance Companies: Since there is a large population of smokers in India, a few health insurance companies offer policies to them with comparatively lower premium amounts. One can research and look for such companies.
  • Type of Policy: Opting for a higher deductible or a multi-year policy can also help in reducing the premium value.

Scenario For Smokers With Pre-existing Health Conditions When Applying For Health Insurance

Suppose a smoker has a pre-existing ailment (diabetes or hypertension). In that case, whether or not it is related to their smoking habit, insurers may request further medical testing to disclose any health consequences. The premium will then be determined based on the severity of these health issues. Furthermore, a 1 to 4-year waiting period may be imposed before these pre-existing conditions are covered under health insurance. This period is the same for smokers and non-smokers. However, smokers may have to pay more premiums than non-smokers.

Frequently Asked Questions

Yes. While buying insurance, smokers should make a formal assertion about their habits. Even an occasional smoker should make this declaration. Insurance companies have the power to reject the applications of persons giving incorrect information or those hiding details. They can also dismiss applications of persons making fraudulent or false claims.

It is good housekeeping practice to keep the insurer up to date about any changes in your lifestyle that may directly impact your health. If you pick up smoking after getting an insurance policy, inform the insurer as soon as possible, especially if you want a hassle-free claim settlement process. You can write to them or speak to a customer care executive to inform the change in status. Depending on the frequency of your smoking, the insurance company makes modifications to your premium amount. The insurance company may also ask you to undergo medical tests to determine your current state of health.

Some insurers also have quit-smoking programs and may offer you to join the same to help you kick the habit. If you successfully stay off smoking for a period of two years at least, the insurers may offer to reduce your premium. However, this varies on a case-to-case basis, and your medical history plays a significant role too.

The insurance companies conduct basic medical tests to learn about the smoking habits of the buyer. They are basic blood and urine tests used to determine the nicotine level in the body.

Do not hide your tobacco use details from the insurance provider. Disclose your smoking habits while applying for the insurance policy. Hiding such information may cause legal trouble. The insurance companies find your tobacco consumption habits through their medical examinations before issuing the insurance. The insurance company will reject your application if you lie about your smoking habits.

While in most cases, smokers who have a few cigarettes a day and are generally fit can easily avail of a health policy. However, heavy smokers who smoke more than 20 to 40 cigarettes a day, chain smokers, and those with smoking-related health complications may face a rejection of their proposal.

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