The impact of lifestyle factors on your health insurance coverage


May 29 2023



Since childhood, we have heard the saying: “All work and no play makes Jack a dull boy”. The same thing affects your health insurance premiums. If you have been working long hours, following a sedentary lifestyle, abusing alcohol and smoking, etc., your health insurance company will not like it and charge you a higher premium than others or even reject your health insurance plan application. Lifestyle factors play a significant role in whether the health insurance company will accept your health insurance application and at what premium. In this article, we will understand these lifestyle factors and what you can do to improve them so that it doesn't impact your health insurance premium adversely.


Impact of lifestyle factors on health insurance plans in India


1)    Sedentary lifestyle and BMI

While evaluating your health insurance application, the insurance company will assess whether you are living an active lifestyle or a sedentary lifestyle. An active lifestyle involves some form of exercise, such as walking, running, weight training, cardio, Yoga, functional training, sports, dance, or any other physical activity. Some insurance companies reward people who live an active lifestyle with reward points. These reward points can be redeemed for doctor consultations, diagnostic tests, medicines, a discount on renewal premiums, etc.

On the other hand, if you are living a sedentary lifestyle while evaluating your health insurance application, the insurance company may charge you a higher premium than other applicants. For example, if your Body Mass Index (BMI) is:

a. Up to a certain range, the insurance company may charge the regular premium as charged to other applicants, other things being the same.

b. Higher than the normal range, the insurance company may charge a higher premium than other applicants.

c. Substantially higher than the normal range, the insurance company may reject the application.

The other factors that the insurance company may consider while evaluating your application may include your sleep hours and pattern, your diet, whether you are involved in any recreational activities, etc. All these lifestyle factors play a role in determining your health insurance coverage.

2)    Bad habits

Almost all insurance companies have differential rates for smokers and non-smokers. So, if you are a smoker, be prepared to pay a higher premium for your health insurance plan. The insurance company will ask you about how many cigarettes you smoke daily. If you consume alcohol, the insurance company will ask you how much alcohol you consume daily.

Smoking, drinking alcohol, chewing tobacco, etc., increase the risk of illnesses such as cancer, ulcers, lung diseases, liver diseases, heart ailments, etc. Insurance companies rate people who smoke and/or consume alcohol as high risk and accordingly charge a higher premium to offer health insurance coverage to these people.

3)    Occupation

Your occupation can impact your health insurance premium. For example, people working in a bank, IT company, retail shop, etc., are rated as standard risks, other things being equal, and are charged a standard premium.

However, people working in hazardous occupations, such as mines, chemical industries, construction sites, factories manufacturing arms/ammunition/explosives, etc., are not rated as standard risks. These people are considered higher risk than others and accordingly charged a higher premium.

4)    Hobbies

Some people are involved in high-risk hobbies, such as mountain hiking, scuba diving, car/bike racing, or other adventure sports. If you are involved in any of these adventure sports, the insurance company will apply additional loading to your application. Accordingly, the company will charge a higher premium compared to other individuals.

5)    Pre-existing diseases

If you suffer from any pre-existing lifestyle or any other disease, it will adversely affect your health insurance plan premium. You will have to pay a higher premium than others. Also, there may be 1-4 years waiting period before you can make any claim for treatment of pre-existing diseases.

These days, the number of people suffering from lifestyle diseases, such as high blood pressure, diabetes, obesity, thyroid, etc., is rising. The prevalence of these lifestyle diseases is increasing due to people's unhealthy diets, sedentary lifestyles, stress, long working hours, bad habits, etc.

6)    Family medical history

If there is a history of illnesses, such as cancer, heart disease, diabetes, etc., running in your family, the insurance company may consider your case risker than standard cases. You cannot do much in this case except maintain a healthy lifestyle so that you don't fall prey to diseases running in your family.

7)    Geographical location

The location where you stay may influence the premium that you have to pay. For example, the Delhi, NCR, etc. region experiences high pollution, especially during winter. People staying in these areas are vulnerable to respiratory illnesses. The cost of treatment in metros and Tier I cities is higher than in Tier II and III cities. Hence, the pricing may be different for these cities. Also, people staying in bigger cities may be more vulnerable to lifestyle diseases than those in smaller towns.

The insurance company may divide the country into separate zones based on various parameters like the ones mentioned above. If you are staying in one of these areas, the insurance company may consider your case riskier than others and price the premium for health insurance plans accordingly.

8)    Age

The insurance company categorises people into different age brackets. The premium increases as an individual's age increases with every passing year, and they move from one age bracket to another. The premium increase applies to all people belonging to a specific age bracket.

Age is not in your control; hence you cannot do anything about the increase in premium due to the increase in age. However, with increasing age, you may be vulnerable to various illnesses. Hence, you may adopt a healthy lifestyle.


Maintain a healthy lifestyle to keep your health insurance premiums in check


In this article, we have seen the various lifestyle factors that can impact your health insurance premium adversely. However, you can follow a healthy lifestyle to keep your health insurance premiums in check. You can follow a healthy diet by reducing or avoiding refined foods like sugar, oil, salt, etc. Do regular exercise, such as walking, running, cardio, weight training, Yoga, etc.

It is nice to engage oneself in some hobby, such as dancing, gardening, sports, etc., that keeps an individual active and in touch with friends and colleagues. You may keep stress levels within control by maintaining a work-life balance, taking regular breaks from work to enjoy family vacations, getting involved in community activities, practising meditation, mindfulness, etc. You may do well to avoid bad habits, such as smoking, drinking alcohol, consuming tobacco, etc.

When you follow a healthy lifestyle, you can enjoy life to the fullest. These days, some insurance companies reward you for maintaining a healthy lifestyle. You can redeem these reward points for various things/activities, including getting a discount on your health insurance renewal premium.