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Health insurance, like all insurance, is not free. By covering you, the insurance company agrees to pay some or all of your medical costs. You will owe the insurer residual costs because it assumes costs for your medical care so you don’t have to. Officially, your health insurer calls your bill a premium.

This premium helps the insurer continue to provide services to you. Indeed, if you fail to pay for your coverage, many health insurers can terminate your plan. Therefore, keeping your bill paid is important for your own security. It is important for all insured individuals that you enroll in a plan you can afford. This helps ensure that you can maintain your coverage.

Why do premium prices differ from person to person?

Health InsurancePeople may find that they pay different premiums for the same type of plan. This is because insurance companies use various demographics to help them determine how much someone should pay. These may include:
  • The age of the insured
  • The insured’s location. Available insurance plans and local insurance law often impact prices.
  • The type of insurance you receive. Different plans offer different coverage. Therefore, prices will often vary.

Someone’s tobacco use history. Tobacco use is often detrimental to health. Insurers might charge more for someone who has a long history of tobacco use.

Nevertheless, insurers cannot use certain information to determine someone’s premiums. For example, they cannot use a person’s current health or the existence of a pre-existing condition as grounds to charge that person more for coverage.

Still, how much premium someone pays is usually due to the risk profile of that individual. One way to think of a risk profile is how likely someone is to file a health insurance claim. In other words, it's how often the insurer will have to pay for medical care. One person’s risk profile will differ considerably from another person’s.

For example, a 60 year old will likely need more medical care than a 22 year old. Therefore, the 60 year old will probably have a different risk profile. So, when the 60-year-old enrolls in health insurance, they might find themselves paying a higher premium than the younger person. This might be because the insurer determined that the 22-year-old is a lower risk to insure. This is just one of the ways that premiums may vary from person to person.

If you have concerns about the cost of your premiums, talk to your health insurance agent. They can often help you determine how to choose a policy that will best meet your costs needs.


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Posted 1:09 PM

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