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Buying health insurance when you're overweight Posted: October 26th, 2010

By Maryalene LaPonsie

In a society that glorifies skinny figures, there is little doubt that being overweight comes with more than its fair share of difficulties. Not the least of which is the fact that being overweight can significantly increase your health insurance costs and reduce the quality of your care. Understanding how your weight affects health insurance premiums is the first step toward finding affordable health insurance.


How weight affects health insurance

According to figures compiled by the Centers for Disease Control and Prevention (CDC), medical costs related to being overweight or obese account for 9.1 percent of all health care in the nation. With more than half of Americans considered overweight or obese, the cost of treating weight-related conditions is expected to skyrocket in the coming years.

The Department of Health and Human Services has launched a Healthy People 2010 initiative to improve the nation's health in a number of different areas. Among the leading indicators of good health targeted by the department is maintaining a healthy weight. According to the Healthy People 2010 initiative, being overweight increases your risk of:

  • High blood pressure
  • Mental health issues prompted by low self-esteem
  • High cholesterol
  • Type 2 diabetes
  • Stroke
  • Heart disease
  • Gallbladder disease
  • Breathing problems
  • Sleep disorders
  • Certain kinds of cancer
  • Arthritis

Health insurance companies are also well aware of the health risks posed by excess weight. Insurers set premium rates by using mathematical formulas that determine how likely someone is to make an insurance claim and how much that claim will cost. Because treatment of these conditions can be costly, insurance companies increase premium amounts to compensate for the increased risk that an overweight person will make a claim.

Defining overweight and obese

While weight may seem relative, the government uses a person's Body Mass Index (BMI) to determine whether they are underweight, a healthy weight, overweight or obese. To determine your BMI, take your weight in pounds and divide it by your height in inches. The resulting number is your BMI.

The CDC uses the following BMI classifications:

  • Less than 18.5 - Underweight
  • 18.5 to 24.9 - Healthy Weight
  • 25 to 29.9 - Overweight
  • Greater than 30 - Obese

While health insurance companies may use their own measures, your BMI is a good indicator of whether your weight may be increasing your health insurance premiums.

Health insurance options for overweight individuals

Although the health care reform legislation passed earlier this year changes the landscape of health insurance in 2014, the current system divides private health plans into group insurance and individual insurance. Group plans are not allowed to deny coverage to individuals based upon factors such as weight. However, individual plans can refuse medical coverage to overweight and obese individuals.

If you are overweight, your most cost-effective health insurance option may be an employer sponsored group plan. If you are unemployed, self-employed or work at a business that does not offer health benefits, you may be able to find group coverage through:

  • Your spouse's employer
  • Trade group or business organization such as your local Chamber of Commerce
  • Alumni association
  • Student health insurance by enrolling in a class at a local college

Finally, if you are unable to find group coverage and have been denied individual health insurance, you may be eligible for medical insurance through a state or federally administered high-risk pool. Each state is mandated to have a high-risk pool by the health care reform legislation. These high-risk pools are open to those who have been denied medical insurance in the private market; unfortunately, the premiums can be quite costly.

A less expensive solution may be a catastrophic health insurance plan. These policies are offered as supplemental health insurance and often have high deductibles. Many plans do not limit policies based upon weight. Catastrophic health insurance may not provide comprehensive coverage for regular and preventive care, but it can act as a safety net in case you should ever be hospitalized.