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10 Factors That Determine the Premium Amount of Health Insurance Plans

Published On Dec 20, 2019 5:30 AM By Gunjan Anand

In our country, health insurance has started gaining a lot of significance. Life in urban India is turning to unpredictably worse due to an unhealthy lifestyle. Due to this, people are buying medical coverage or mediclaim from different insurance providing firms so that they can pay for hospitalisation or medical-related costs. The premium amount paid for insurance is computed by counts made by insurers.

While making the purchase for medical coverage policy, one ought to know about the components that can influence his/her premium amounts. These elements incorporate family medical history, pre-existing medical conditions, gender, age, Body Mass Index (BMI), marital status, etc. The factors that influence your premium amount pertaining to health insurance are:

1. Pre-existing Illness: 

The policyholders or candidates are required to give their health records to guarantee that they don’t own any previous ailments. In any case, someone doesn’t have pre-existing conditions, at that point of time, the organisation can decide to either permit it or can even deny to cover it. If the insurance agency chooses not to cover it under the medical coverage, then the policyholder will have to bear the expenses, which will ultimately be going to expand the costs and influence the premium. 

2. Family Medical History:

If the family of policyholder has certain medical diseases,  their premiums might go higher than others. Nobody can do anything with their genes. Hence, if the policyholder's family is suffering from any or some ailments historically, for example, heart illnesses, cancer and so on, that puts the person at a hazard and contributes to the enhancement of premium amount. 

3. Weight Index (BMI):

Individuals with high BMI have an altogether higher pace of premium than individuals with normal BMI. The major cause for this enhancement is that it can stimulate different illnesses, for example, heart issues, joint issues, diabetes, and some more. Individuals with higher BMI may even need particular treatments even in normal medical conditions such as pregnancy. Along these lines, making even basic procedures somewhat dreary can influence the premium rates. 

4. Injurious Substances:

Most insurance agencies increase their amount of premium for their health insurance plans and sometimes even decline to safeguard individuals who have the propensity for chewing tobacco, smoking habits, or snuff. Since they are generally inclined towards getting hazardous diseases like cancer, the premiums of the plans get affected.  

5. Gender:

Many insurers offer a distinction in health insurance premium rates between men and women. The prime reason behind this policy is that women visit specialists more, they take seek more medical consultations and fall more prey to chronic ailments. 

6. Age:

Younger people get policies at much lower premium rates since they have less recognised and unidentified diseases than more aged people. Young policyholders are fewer chances to have medical issues and own lesser possibility to visit a doctor. 

7. Occupations:

Policyholders working in conditions with dangerous substances, radiation, pollution and chemical, and employments with a high danger of wounds like constructions need to pay higher premiums according to insurance agencies since they're more inclined to the danger of cardiovascular ailments. 

8. Marital Status:

It’s still unclear if married people live longer and healthier lives, but the insurance premiums generally lower in rates. The men generally reap better benefits with this status change.

9. No Insurance Yet:

If someone has never been insured in life, the insurance agencies by and large charge a higher premium from them. Health insurance providers believe that uninsured people would make frequent visits to doctors and clinics to avail the benefits and rewards of medical coverage. On this note, the insurers enhance the premium to cover all costs. 

10. Location:

There are numerous insurance organisations who base their premiums on the area where the individual resides. Numerous organisations feel that common atmosphere, absence of healthy food options, social aversion for practice and so forth, frequently originate from same zones. Hence, due to these similarities, the insurers charge higher from the policyholders.


These are the factors that can influence the amount of premium for policyholders of health insurance policies. Anyone seeking a health plan should consider these elements to buy a health plan at a lower premium. 

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