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Does Gender Affect Health Insurance Premium?
Paying health insurance premiums is essential to receive medical coverage against planned and emergency healthcare expenses. Several factors influence premiums, including age, location, medical history, and overall health status, leading to price variations for different applicants. However, one factor that often sparks debate is gender. Let us explore whether gender plays a role in determining health insurance premiums.
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Articles - IHI
- Why Health Insurance Premium Is Gender Based
Does Gender Have an Impact on Health Insurance Premiums?
Yes
Gender can influence the premium of a health insurance policy. While gender is not always a primary factor, it can indirectly affect insurance costs due to different health risks associated with men and women at different life stages.
For instance, women in their late 20s and 30s may have to pay a higher premium if they opt for maternity cover. This happens because women at this age are more likely to claim medical expenses related to pregnancy and reproductive health. Similarly, women with a family history of major conditions like breast cancer, cervical cancer, osteoporosis, etc., may have to pay more for medical coverage.
On the other hand, men tend to pay higher premiums as they age, particularly after their 50s or 60s. This is because they become more susceptible to serious health conditions, such as cardiovascular diseases, hypertension, and diabetes. Moreover, the prevalence of smoking and drinking is higher among Indian men, resulting in increased premiums.
Why Does Gender Affect Health Insurance Premium?
Check out some of the reasons why gender affects the premium of a mediclaim policy:
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Life Expectancy Rates
Insurers consider the life expectancy rate of both men and women when calculating premiums of mediclaim policies. According to the World Health Organization (WHO), women in India have a higher life expectancy than men. This is because men are at a higher risk of developing major illnesses like heart diseases, resulting in higher health insurance premiums.
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Medical Conditions
Certain diseases affect men and women differently. For instance, women have higher chances of suffering from conditions like osteoporosis and breast cancer, while men are more prone to heart disease and stroke at younger ages. Hence, insurers may consider the applicant's gender and increase the premium price.
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Maternity Expenses
Women generally require additional medicare related to their reproductive health, pregnancy and childbirth. Since maternity care involves significant medical expenses, some health insurance companies may charge a higher premium to women opting for maternity coverage.
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Lifestyle Risks
Men engage more in smoking, alcohol consumption, and hazardous occupations compared to women. As per the Global Adult Tobacco Survey (GATS-2), 42.4% of men smoke in India compared to 14.2% of women. Similarly, according to the National Health Family Survey (NHFS-5), 19% of men (aged 15 years & above) consume alcohol compared to 1% of women. Since smoking increases the likelihood of health insurance claims, insurers charge higher premiums for men.
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Claims Pattern
Insurers consider claim patterns when pricing health insurance premiums. Women generally visit doctors more frequently for preventive care and screenings compared to men, leading to higher claim rates. As a result, women may end up paying increased premiums.
When is Health Insurance Premium Higher for Men than Women?
Here are the different conditions when men pay more health insurance premiums than women:
- Men are more prone to lifestyle-related illnesses like heart disease, diabetes, and high blood pressure. These conditions lead to higher medical expenses, increasing insurance premiums.
- On average, men have a shorter lifespan than women. This increases the risk for insurers, leading to higher premium rates.
- Men are more likely to engage in risky activities, such as adventure sports and hazardous jobs. This raises the chances of accidents and injuries, thereby increasing premiums.
- Men in India smoke and consume alcohol more than women. These habits increase health risks, thus resulting in higher mediclaim insurance costs.
When is Health Insurance Premium Higher for Women than Men?
Women are more likely to pay higher health insurance premiums than men in the following conditions:
- Women in their childbearing age tend to pay more medical insurance premiums than men as they incur hefty medical expenses related to pregnancy, childbirth, and newborn care.
- Women visit doctors more often than men for preventive care, gynaecological check-ups, and screenings. Regular consultations and treatments increase medical expenses, causing insurers to charge higher premiums.
- Women are more prone to health conditions like breast cancer, osteoporosis, thyroid disorders, autoimmune diseases, etc. These illnesses usually require expensive treatments, leading to higher medical insurance premiums.
FAQs
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Q1. Which gender pays more for health insurance?
Ans: Both men and women may have to pay higher health insurance premiums but in different conditions. Men often pay more due to lifestyle-related habits, such as smoking, alcohol consumption, etc., and a greater risk of serious illnesses like heart attacks. On the other hand, women pay more during childbearing age as they may incur maternity expenses and have a higher vulnerability to diseases like breast cancer, autoimmune diseases, etc. -
Q2. At what age is health insurance most expensive?
Ans: Health insurance is usually most expensive for older people, especially those above 50 or 60 years. As people age, they are more likely to develop health issues, resulting in increased claims. Hence, insurance companies charge higher premiums for elderly people to cover these additional risks. -
Q3. What is gender rating?
Ans: Gender rating is a practice where insurance companies charge different premiums based on the gender of the applicant. -
Q4. Does gender matter when it comes to insurance?
Ans: Yes. Your gender may be considered while deciding your health insurance premium, as different genders are more vulnerable to certain diseases and indulge in specific lifestyle habits that may increase healthcare costs. For instance, women are more prone to diseases like breast cancer, and men in India smoke more than women.
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