These 10 Things Determine the Cost of Your Health Insurance

RSS

by Daniel McClain on Nov 10, 2016

Did you know that your age may affect the price of your health insurance? Also, where you live can have a big impact.

Here are ten factors that are used to determine the cost of your health insurance.

1. Age, Gender, Marital/Family Status

The biggest factors in determining your health insurance options and the price of premiums are your age, gender, and marital/family status.

Age: The younger you are, the lower your premiums. This is simply because younger people typically have fewer health conditions than older people. They are also less likely to go to the doctor or to require prescription medication, both of which lower the costs for insurance companies.

Gender: Before the Affordable Care Act became law in 2014, many insurance companies were charging women higher prices compared to men, even when maternity care was excluded from the plan. The reason? Women are more likely to visit a doctor for illnesses and generally have more complicated health issues. 

Although gaps in insurance costs between men and women do still exist, particularly with maternity care, insurance companies must now provide coverage to both genders for the same premium.

Marital/Family Status: Whether you are single, married, or have dependent children is a huge determinant in which coverage plan you should purchase. The more people you have under your plan, the more it will cost.  

2. Location

There are a few location factors that will affect your insurance premiums. They are:

  • Climate

  • Risk profile (A lack of healthy food options, cultural aversion to exercise, etc.)

  • Cost of living

  • Local laws (If it is expensive for insurance companies to comply with local laws, they are likely to pass the costs on to you.)

Keep in mind that the insurance industry is highly regulated so you shouldn’t see much disparity between exact plans from different companies in the same location. However, there are many little details that may change from plan to plan which will give a difference in cost.

3. Health and Family History

The Affordable Care Act ensures that people with pre-existing conditions can no longer be denied coverage or charged higher premiums. However, this rule does not apply to grandfathered individual health insurance policies “that you bought before March 23, 2010 and has not changed in specific ways that reduce benefits or increase costs to consumers.”

Smoking and chewing tobacco, on the other hand, may still add up to a 50% surcharge to your premium, depending on your state. You may be able to lower your surcharge by enrolling in a smoking-cessation program.

Other factors in raising your premium may be a high body mass index (BMI) and a family history of cancer, high blood pressure, or other hereditary medical conditions.

4. Occupation

If you have a high-risk occupation, your health insurance premium may be affected. High risk can be defined as:

1) Exposure to toxic chemicals and contaminants

2) Exposure to bacteria and viruses

3) Risk of falls, burns, cuts, or bites

4) Sitting sedentary for the majority of the day

5. Income

It has been shown that income has a direct correlation with an individual’s health due to poor diet, lack of sufficient healthcare, and higher stress levels. For these reasons, Premium Tax Credits are offered to households with incomes between 100% and 400% of the Federal Poverty Level. These credits don’t affect the cost of your premium, but they do reduce the amount that you pay via subsidies.

6. Hobbies

Depending on the state in which you live, you may pay more money for insurance coverage if you participate in any of the following hobbies:

  • Martial arts

  • Marathon running

  • Scuba diving

  • Paragliding

  • Mountain climbing

  • Riding a motorcycle

7. Pets

You may be issued a surcharge on your insurance premium if you own an exotic pet or a dog listed on the unofficial vicious/aggressive breed list. Most often, this will affect your homeowner’s insurance but occasionally health insurance providers will take your pets into account as well.

8. Previously Uninsured

If you are a first-time buyer of health insurance, you may be charged a higher premium. The assumptions are that you may not have had regular checkups and follow-up care for various ailments which will give you lower general health, along with exacerbating any existing conditions.  

9. Plan Category

Each insurance provider offers a variety of plans from which to choose for your personal coverage. Depending on which plan you purchase, your premiums will change. However, no matter which plan you pick, under the Affordable Care Act they must all provide a set of ten essential benefits. The scope and quantity of services offered under each category can vary.

10. The Combination of Your Premium and Your Deductible

Your premium is the monthly payment to your insurance provider. Your deductible is the amount you pay for health care services before your health insurance coverage kicks in. If you choose an insurance plan with a high premium, your deductible will be lower. If you choose an insurance plan with a high deductible, your premium will be lower.

To answer your questions and learn more about your health insurance options in the San Pedro area, contact Insurance Center Associates today for a free consultation.

Bookmark and Share

Bookmark and Share

« Back to all news


Refer a friend & earn a gift

If we write your friend's insurance, we'll send you two movie tickets.

Refer someone today

We represent fine companies like

Safeco Insurance, Member of Liberty Mutual Group



Visit our mobile site on your phone today and bookmark it for future use.


Not sure where to start? Browse our Information Center to learn all about your insurance options.


50% of our business comes from client referrals. Contact us today and we'll show you why that is.

Our locations:

Harbor Insurance
1622 S. Gaffey #104
San Pedro, CA 90731

310-832-5311

C & S Insurance
3220 Sepulveda Blvd #202
Torrance, CA 90505

310-517-8255