Although insurers can’t charge more for health status, they can charge up to 50% more for smoking status. On the flip side, all ACA ("Obamacare") plans include smoking cessation therapy (including medication) as a free preventive service.
ACA Smoker Facts
- ObamaCare makes it so you can’t be denied coverage for being a smoker now or in the past.
- ObamaCare requires all plans sold after September 23, 2010 cover smoking cessation therapy (including smoking cessation drugs) at no out-of-pocket cost.
- Small group plans offered by small employers must also cover smoking cessation. Typically Medicaid, Medicare, and large group plans also offer smoking cessation therapy. See this fact sheet from the American Lung Association to Learn more about smoking cessation under the ACA.
- Short term plans and other plans not considered major medical coverage don’t have to follow the same rules in regards to smoking. As such you can be denied short term coverage for being a smoker and don’t have to be given free cessation therapy.
- Extra specialized cessation therapy is offered to pregnant women.
- In general you count as a smoker if you use tobacco four or more days a week for the past 6 months. If you are quitting, or smoke once in a while, or use tobacco for ceremonies, you may not qualify as a smoker.
- You must report whether or not you are a smoker. Giving the information is based on the honor system, however you can be denied coverage due to fraud or misrepresentation, so answer honestly.
- ObamaCare says smokers can be charged up to 50% more for their premiums. This is due to a “tobacco surcharge”.
- Those on employer health plans can avoid the surcharge by joining an employer based tobacco cessation program.
- Due to a “ObamaCare smoking glitch” where programmers couldn’t get the charge to calculate correctly the tobacco surcharge wasn’t implemented until 2015 in many states.
- The tobacco premium surcharge is calculated after cost assistance, not before.
- Statistically, lower-income Americans are the most likely group to smoke.
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