Health Insurance Cost Factors That Affect The Premium Cost

If you are looking to buy health insurance policy, you would be surprised to know that it is one of the most complicated insurance products to purchase in terms the number of factors that affects its cost. Every insurance company have their own policies that determine the premium amount, however, some of the basic factors that affect the insurance cost are discussed below:

The area where you live:

Each state in US has its own insurance rules and regulations and the premium amount of the health insurance policies differ accordingly. Thus, depending on the locality where you live, your premium amount would be more or less.

Pre-existing Health Condition:

Majority of the insurance companies that offer health insurance policies determine the premium amount depending on your existing health condition. Most of the insurance companies require you to declare your health status to the company if you are healthy your premium amount is likely to be low. However, if you are suffering from any chronic diseases such as cancer or if you are prone to constant illness, your premium amount is likely to be high. This is because of you are suffering pre-existing disease you would have to visit doctors frequently for seeking treatment. The insurance company sees this as risky situation since they have to provide coverage for the expenses.


The age of the health insurance applicant is a major factor considered by the insurance company while calculating the monthly premium amount. Typically, most insurance have lower premium amount for youngsters who are likely to suffer only from minor health issues such as cold, flu or infections. However, for old aged people the premium is much higher. This is because old aged people are more vulnerable to suffer from critical medical conditions. Thus, the cost of covering the expenses for the old aged people is risky for the insurance company and to cover the charge they hike the premium amount.


Just like age, gender too is a vital factor that affects the health insurance premium cost. Unlike life insurance policies, where the premium amount is same for both men and women, the health insurance companies charge higher premium for women than for men. This is because of the fact that women visit doctors more often than men for various reasons they have to consult specialist doctors like Gynecologist for maternal treatment and also are prone to take more prescription drugs. Besides, women are subject to chronic diseases during prenatal and postnatal stages. This increase the coverage cost for insurance companies and therefore the premium amount for women is higher.

Lifestyle habits:

The kind of lifestyle you lead also has a significant effect on your health insurance premium amount. If you are one of those people who smoke, drink or use tobacco in any other form you are at a higher risk of falling victim to various health ailments including cancer. Since it is a known fact that tobacco or alcohol consumption reduces the lifespan of the person, it would have its effect on the premium amount, you would have to pay higher premium. In some cases the insurance company would provide an incentive to help the policy holder to quit smoking.