Affordable Care: No rewards for healthy lifestyle

“Are there affordable health insurance plans exclusively for healthy individuals?  Are there plans that, for example, offer cheaper premium for those who qualify a more rigorous health/lifestyle criteria and medical exams? As a consumer, it doesn’t make sense to be charged the same premium for those who take less initiative to stay healthy and fit.”

Fit and Healthy

Dear Fit and Healthy,

If you are buying your health insurance from the exchanges or marketplaces, then the answer is no. These plans are prohibited from charging different (higher) premiums to people who have or have had illness in the past. The exception is that plans on the exchange can charge smokers more than non-smokers.

The idea is to spread the cost of medical care more evenly across a whole population, rather than charging certain people more because of their health.  This is called “community rating.”

The flip side is that healthy people, as you point out, pay more than they otherwise might. A healthy, fit person could, at a moment’s notice, become a high-cost case due to an accident, or a long-standing, undetected defect. Not all illness is prevented by a healthy lifestyle, in other words.

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Linda Riddell

About Linda Riddell

A published author and health policy analyst with 25 years’ experience, Linda Riddell's goal is to alleviate the widespread ailment of not knowing what your health plan can do for you.