According to the Affordable Care Act (ACA), you can’t be denied insurance coverage if you smoke. However, Wisconsin state law allows tobacco users to be charged up to 50 percent more for premiums.
Tobacco use is defined as the use of any tobacco product four or more times a week within the past six months. This includes cigarettes, cigars, chewing tobacco, snuff, and pipe tobacco. Some health insurance plans may offer tobacco users a break on the premium if they enroll in a program, but this is not required by law.
How Does Smoking Impact the Cost of Private Health Insurance?
Tobacco use costs at least $133 billion in direct medical care for adults annually. Private health insurance costs will impact smokers in two main ways –
- Higher premiums – The first difference you’ll see is the cost of insurance premiums. Depending on the private plan, you may pay up to several hundred dollars more per month if you smoke or use other tobacco products
- Potential higher out-of-pocket costs – Tobacco users generally use more health care services. That means they may pay more in copays and coinsurance simply because they visit doctors more often. For example, more than 16 million Americans suffer from a disease caused by smoking, requiring them to visit the doctors more frequently. In addition, children of smokers get sick more often, which also increases the use of health care services1
SO HOW MUCH MORE DOES PRIVATE HEALTH INSURANCE REALLY COST FOR SMOKERS?
To easily compare the cost difference for a smoker vs. non-smoker, look at how these private health insurance quotes differ for the same person depending on his smoking status. A 50-year-old from Sauk City, Wisconsin is quoted premiums for a bronze plan –
- Non-smoker ($372.81 / month)
- Smoker ($466.01 / month)
In this situation, the smoker will pay $93.20 more each month than he would have had he not been a smoker. That adds up to over $1,100 extra a year, and that's just the difference in his monthly premium. If he requires more health care services for problems associated with smoking, he could be paying a lot more.
TOBACCO CESSATION BENEFITS
Fortunately, there is some good news. ACA-compliant plans must offer smoking cessation treatments as an essential health benefit. These plans also offer tobacco cessation drugs and counseling as well as tobacco use screenings at no out-of-pocket cost to you. In addition, coverage must include tobacco cessation counseling for women who smoke during pregnancy.
All Unity plans are ACA-compliant, which means you get tobacco cessation benefits included automatically – learn more about our tobacco cessation benefits.
Concerned about what private health insurance for smokers in Wisconsin might cost you? Talk directly to a knowledgeable customer service representative at 608.644.3430, 7 a.m. – 7 p.m., Monday through Friday.