Factors That Affect Your Health Insurance Premium

Health insurances are generally designed to protect a person’s health by providing financial assistance for the expenses incurred during medical treatment ranging from routine checkups to more critical surgeries or stays at hospital. People buy the insurance to reduce their risk of having to pay higher fees from their pockets for this care, but in return health insurance companies also gauge their risk of covering a person.

In order to calculate this risk of covering a person, insurance companies look at stored data to create risk profiles to decide whether or not they will provide coverage and at what cost. If the insurance company provides coverage, there are some obvious factors that companies bring into consideration in deciding the premium costs that generally include physical, medical, lifestyle and personal risk factors.

Some of the physical and medical risk factors that can play a role in health covers include:

  • Body mass
  • Tobacco use
  • Gender
  • Age
  • Pre-existing medical conditions
  • Family history

Generally, people those who have high body mass indexes need to bear higher premiums than those who are at normal levels. Obesity can lead to diseases like diabetes, sleep apnea and heart and joint problems. Insurance companies may take not of this and charge a person more for their health insurance because of the increased risk of these diseases and medical problems.

The particular gender and age of the customer also play a significant role. Women usually pay higher medical premiums than men because they typically have more reason to visit the doctor regularly, tend to take more prescription medication and have a higher risk of certain chronic diseases. Younger individuals tend to have lower premiums because they tend to not need to visit the doctor as regularly, have fewer diagnosed conditions and are less likely to develop health problems.

The medical condition which are pre-existing and family history can also play a role in health insurance premium costs. When the insurance company sees a pre-existing condition on a person’s risk factors they know that it can be costly to them. The insurance company may not cover the condition but because the person may be increasingly likely to have additional issues related to the condition, the insurance company may raise premium costs. People who have a family history of cancer or other hereditary illnesses will likely have increased premiums.

Other factors generally considered are lifestyle that impact insurance costs. What the customer does for a living can impact cover. For example if you work in a factory or lab where you are exposed to hazardous chemicals or have an increased risk of injury, your health insurance will be more expensive than if you have an office job that has limited risk to your health.

Insurance companies take into due consideration the statistics on health trends in specific areas, meaning that where you live may impact your cover costs. If their data shows that people are healthier in your area than in others, than your health cover cost may be lower than if you lived in an area that was seen as a high health risk.

If you are buying health insurance coverage for the first time and have previously been uninsured, then your rates will likely be higher. Research shows that people who are married live longer and are healthier people than those who are not married, which is why married couples see a drop in their premiums.


These are some of general factors that can impact your health insurance premiums. When sitting down with your local independent health insurance agent, one should ask about these factors and how they may impact various coverage options. HDFC ERGO’s health insurance policies assure to give more benefits at affordable prices.

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