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Health Insurance for Smokers

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It’s your usual week. You faced too much stress during work, and you took multiple smoking breaks. Over the weekend, you attended a couple of parties, where you smoked along with consuming drinks. This lifestyle continued for a year, and one day, you started coughing a lot. You had to get hospitalised and thought that your health insurance policy would cover the treatment expenses, but as it turned out, it did not. When you reached out to the insurer, you learned that it was rejected because the ailment was a result of smoking, and you hadn’t declared that you were a smoker while buying the policy. Such a situation begs the question — can smokers get health insurance, and would you have received the benefits if you didn't withhold the information? Let’s find out.

Why should smokers get health insurance?

Smoking, as we all know, is the leading cause of cancer and many other health problems. Smokers are 2 to 4 times more vulnerable to heart attacks, and about 80% of Chronic Obstructive Pulmonary Disease (COPD) cases are due to smoking. Considering these health risks that smokers are exposed to, health insurance for smokers is a must for financial security in case of medical emergencies or planned procedures. Opting for an add-on cover like critical illness insurance is advisable for adequate protection against the high treatment costs of critical ailments like cancer and cardiac ailments.

Importance and benefits of buying health insurance for smokers

Health insurance offers numerous benefits for smokers and non-smokers alike. Some key benefits are –

1. Financial security:

This is the biggest benefit of having a health insurance policy. It provides financial security against medical expenses, during exigencies as well as planned treatments. As smokers have high health risks, health insurance will help reduce the financial burden by taking care of the hospital bills.

2. Free health check-ups:

Many health insurance providers offer free annual health check-ups during policy renewal. This will help monitor your health and detect any potential health issues due to smoking.

3. Tax benefits:

As per the Income Tax Act, smokers are eligible for a tax deduction of up to Rs 25,000 on the premium paid towards health insurance. If you are paying for your senior citizen parent, you can claim an additional Rs 50,000.

4. Cashless insurance:

If you seek treatment at any network hospital pan India, you can avail of cashless health insurance and not worry about paying anything upfront. This is particularly helpful during an emergency.

The cost of health insurance for smokers vs non-smokers

Smokers are at a greater risk of health problems like respiratory illnesses, critical ailments such as cancer, etc. So, the probability of filing claims is higher, and for this reason, the premium charged is higher for smokers. According to the National Library of Medicine, the cost of health insurance for smokers is 30%-40% more than that of non-smokers. However, because of higher premiums, smokers should not refrain from buying a health insurance policy as it will provide them financial protection in medical emergencies.

The IRDAI will consider you a smoker if you have consumed tobacco in the last 12 years from the date of application.

Tobacco use and health insurance premiums

If you consume nicotine in any form, such as cigars, cigarettes, e-cigarettes or vapes, or tobacco chewing, you will be categorised as a smoker. The health insurance premium will be higher for a smoker because they have higher health risks and shorter life expectancy. However, the premium is not the same for all smokers. It depends on the smoking habit, health status, if the smoker has any pre-existing conditions, etc. The premium will be highest for an active chronic smoker.

How does smoking affect your health insurance premium amount?

Smoking affects your health insurance premium in the following ways –

• As smokers are vulnerable to critical illnesses and have a shorter life expectancy, insurers charge higher premiums from them to cover the risk of insuring them.

• The premium is calculated based on five parameters – age, location, use of tobacco, number of dependents, and type of health insurance plan.

• Smoking habits, such as the number of cigarettes and frequency of smoking, also affect your premium amount.

• If a person consumes more than 10 cigarettes a day, the premium will be very high.

How do insurance companies know if you smoke?

When you apply for a health insurance policy, the insurer usually asks two questions – `Do you smoke?’ and `Have you smoked in the past six months’? A smoker is classified as someone who consumes tobacco or nicotine in any form for at least 6 months. The insurers expect you to honestly disclose whether you are a smoker.

Here are some ways through which insurance companies can figure out if you smoke –

• They will ask you to undergo medical tests to identify if you are a habitual smoker. Nicotine traces can be found in urine, blood, saliva, and hair. Based on the reports, the insurer will decide the cost of the policy.

• The insurer has the right to investigate your smoking habits which can be revealed from urine and blood tests.

If you don’t disclose your smoking habits, it can lead to rejection of claims and may also land you in legal trouble.

What if you are a smoker with existing health problems?

If you are a smoker and have pre-existing medical conditions, such as diabetes and hypertension, you may have to undergo further medical tests to check for any health complications. These pre-existing ailments may or may not be related to smoking. The premium will be decided depending on the severity of the health condition. Also, there is a waiting period of up to 3 years (depending on the insurer) for pre-existing ailments during which you cannot raise any claim. The waiting period is the same for smokers and non-smokers.

What happens if you lie about smoking on health insurance applications?

You will land in trouble for lying about smoking on health insurance applications. Here are some consequences you can face for not disclosing your smoking habits –

• The insurer can reject related claims and you will have to bear all expenses from your pocket.

• The insurer has the right to reject your application or cancel the policy (if already issued) if they find out from medical tests that you have lied about smoking.

• Lying can be considered fraud and lead to legal troubles.

Be honest about your smoking habits, including how often you smoke. The premium will be high, but it is worth considering, as medical inflation can drain your savings.

How to improve health and lower health insurance premiums?

To improve health and reduce health insurance premiums, here are some things you can do –

1. Quit Smoking:

If you leave smoking for at least 2 years during the policy term, your insurer may consider reducing the premium.

2. Join Smoking Cessation Programs:

If you are unable to quit smoking on your own, you can enrol in smoking cessation programs to help you quit smoking. The condition, again, remains the same to lower the premiums – at least 2 years of no smoking during the policy tenure. Many health insurance companies have tie-ups with healthcare establishments, clinics, or organisations offering such programs.

3. Explore other insurance companies:

Due to the high number of smokers in India, some insurance companies offer policies at competitive rates for smokers. You can explore such insurers offering affordable rates.

Conclusion

Do not hide your smoking habits from the insurer, fearing high premiums. It can lead to claim denials or even cancellation of your application. Higher premiums should not also deter you from buying a health plan. The best way to reduce the premium is by quitting smoking and staying healthy.

FAQs

1. Can smokers get a health insurance policy?

Yes, the IRDAI has mandated insurance companies to offer coverage to smokers, though the cost, terms, and conditions may vary from insurer to insurer.

2. Do I have to pay a higher premium for smoking?

Yes. A health insurance policy costs more for smokers because they are at an increased risk of health problems like cancer, respiratory issues, stroke, cancer, etc. To cover these risks, insurers charge higher premiums for smokers.

3. Should I disclose my smoking habits to the insurer? What if the premium increases?

You must disclose your smoking habits and medical history while applying for health insurance. The premium will be high considering the health risks of smokers, but this should not be the reason for hiding any information. If the insurer finds out about it from medical tests, your claims can get denied, your policy can get cancelled, and you may also face legal issues.

Disclaimer: The above information is for illustrative purposes only. For more details, please refer to the policy wordings and prospectus before concluding the sales.

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