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Those extra doughnuts and super-sized fries aren't just bad for your waistline. If you’re overweight, you might have to pay higher health insurance premiums. If your weight is too high, you might have difficulty getting a health policy.
Obesity has reached epidemic proportions in the United States. Sixty percent of all adults and 13 percent of children are overweight or obese, according to Office of the Surgeon General. The Surgeon General also claims more than 300,000 Americans a year die from illnesses caused or worsened by obesity.
It’s the relationship between obesity and health problems that concerns health insurers about issuing individual health policies to heavier applicants. Obesity causes or worsens more than 30 medical conditions, including breast cancer, cardiovascular disease and diabetes, according to the American Obesity Association. This means an individual health insurer might have to pay out numerous claims over many years for just one obese person.
Doctors generally use body mass index (BMI) to determine whether you're obese. The index is a simple mathematical computation, applies to both men and women, and is recommended by the National Institutes of Health. To determine your BMI, divide your weight in kilograms by your height in meters squared. A BMI of 25 to 29.9 is considered overweight and 30 is considered obese.
For example, someone who is 5 feet 7 inches tall and weighs 190 pounds would have a BMI of 30 and would be considered obese. According to the BMI, one in five Americans is obese, while an additional one in three is overweight.
How is obesity measured?
Body mass index (BMI) is commonly used to measure obesity. Although this method might misclassify some individuals, it yields generally good results, according to Rand, a nonprofit think tank that studies health issues. BMI is your weight in kilograms divided by your height in meters squared. Here are some examples, stated in pounds (pounds are rounded off):
|
Height |
Normal |
Overweight |
Obese |
5'3" |
104-140 |
141-168 |
169 or more |
5'6" |
115-154 |
155-185 |
186 or more |
5'9" |
126-168 |
169-202 |
203 or more |
6' |
137-183 |
184-220 |
221 or more |
Source: Rand Health |
Smoking, or having medical conditions such as high cholesterol or high blood pressure, put an overweight or obese person at even greater risk for higher premiums or denial of coverage. The reason? Because "the sickest 1 percent of your policyholders can comprise between 40 to 50 percent of all your claims," says health insurance consultant Kathy Thomas. "That's what makes health insurance such a risky business." It's the reason why individual health insurers are so picky when it comes to reviewing your application.
Thomas believes more insurers will use BMI to set premiums and screen applicants. "It's widely accepted by doctors, easier to justify, and less complicated to calculate," says Thomas. "It's also more black-and-white than older tables that used to take into account not only your height and weight but your build as well."
If you think your weight might prevent you from getting individual health insurance, there are a few things you can do to improve your chances. Find an experienced health insurance broker who knows the underwriting criteria of several individual insurers. The broker might increase your chances of acceptance. If you're denied, ask your doctor to write a letter supporting your reapplication, particularly if you are overweight but otherwise healthy.
In the long term, lifestyle changes such as losing weight, lowering your cholesterol and blood pressure, and quitting smoking will improve your chances of obtaining individual health insurance, not to mention the health benefits you’ll experience.
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