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Does Smoking Impact Medigap Rates?

Whether or not tobacco use will affect Medigap rates depends on when you sign up for a policy. Learn more about tobacco use and Medigap.

Christian Worstell

by Christian Worstell | Published October 25, 2023 | Reviewed by John Krahnert

Yes, tobacco use can impact Medigap rates. In fact, tobacco use is one of many personal health factors that could potentially impact how much you pay for Medicare Supplement Insurance (if you sign up outside of your open enrollment period).

Your Medigap open enrollment period is the six-month period that begins the day you are both 65 and enrolled in Medicare Part B. During this time, insurance companies cannot deny you coverage or charge you more for a policy based on your medical history.

During Open Enrollment 

Medical underwriting is a process used by insurance companies that examines a person’s health status to determine how much he or she should be charged for health insurance. Typically, tobacco use is one of the factors that insurance companies take into account when reviewing an underwritten application.

However, if you sign up for a Medigap policy during your Medigap open enrollment period,  At this time, insurance companies are legally required to accept your application and charge you the same price for your policy as all other Medigap applicants in your area.

During your open enrollment period (and at a few other select times), you have something called guaranteed issue rights, which are meant to protect you against paying more for health insurance because of your health status.

Why Do Smokers Pay More For Health Insurance?

Increasing charges for tobacco users is known as tobacco rating. As per the ACA regulations, insurance companies are permitted to apply a tobacco surcharge, allowing them to raise premiums for smokers by as much as 50% or 1.5 times higher than non-smokers.

Beyond Open Enrollment

If you have a history of tobacco use and miss your open enrollment period, you could end up paying more for your Medigap policy. Once you miss your six-month window, insurers are allowed to use underwriting to deny you coverage or charge you more for the same policy.

At this time, insurers look at factors such as age, location, gender and tobacco use. Tobacco use has been shown to increase the risk of serious health problems (including cancer, heart disease and strokes), so insurance companies generally charge users more to reflect the higher health care costs they will likely have to pay down the road.

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