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How Does Tobacco Use Impact Your Medigap Coverage?

If you smoke or use tobacco in any way, you will likely pay more for Medigap coverage. Medigap — officially called Medicare Supplement insurance — is private insurance that closes some of the expense gaps between what Original Medicare pays and what you don’t want to pay out-of-pocket. While Medigap coverage can reduce your out-of-pocket expenses, your premium can increase because of tobacco use.

The following are a few considerations to take into account if you smoke or use tobacco in some other way when you’re ready to apply for Medigap coverage.

How Does Your Insurance Company Know About Your Tobacco Use?

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Medicare Supplement insurance companies take tobacco use into account when deciding what premium you will pay for Medigap coverage. When you apply for a Medigap plan, you will be asked about tobacco use.

Self-reporting your tobacco use is important because if you don’t claim to be a smoker and the insurance company finds out otherwise, you could be on the hook for fraud. Insurance companies communicate with your physicians, for instance, and if your doctor labels you a smoker on your medical reports, that information becomes discoverable.

Why Do You Pay More For Insurance Because Of Smoking?

Nearly 9 percent of people age 65 and older smoke, according to the CDC, and every six seconds, someone dies from a disease related to tobacco use. Smoking causes or contributes to diseases like lung cancer, throat cancer, COPD, emphysema, and others.

Private insurance companies that offer Medigap coverage understand the health risks of smoking. Consequently, they increase their premiums for people who use tobacco to offset the risks of insuring that person.

How Does Underwriting Work?

Underwriting is an accounting term related to mitigating risk. All businesses want to reduce risk for themselves and their assets. Insurance companies are no different.

A health insurance company reduces risk by charging more money in premiums for beneficiaries who are more likely to cost the insurance company money. Smokers and tobacco users, for instance, may have a greater likelihood of developing health problems than non-tobacco users.

Each insurance company sets its own underwriting protocol. It hires underwriters who are well-versed in using software programs and other tools to predict the risk a specific beneficiary represents.

However, when it comes to Original Medicare and Medigap coverage, underwriting doesn’t apply for things like pre-existing conditions, chronic illness, and similar issues. It does apply to tobacco use.

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What About Your Open Enrollment Period?

If you apply for Medigap coverage during your open enrollment period, insurance companies can’t increase their premiums for pre-existing conditions and the like. However, they can take your tobacco use into account.

Your open enrollment period for Medicare Supplement insurance begins when you’re 65 and enrolled in Original Medicare Part B. It lasts for six months. During that period, you can apply for Medigap coverage without worrying about underwriting.

Even if you smoke, a Medicare Supplement insurance company can’t deny you coverage based on tobacco use. It can, however, offer a higher premium than a non-smoker would pay. Again, this is because of the perceived increased risk of healthcare expenses in the future.

What If You Sign Up Outside Of Your Open Enrollment Period?

If your open enrollment period lapses and you still want Medigap coverage, you can apply just like you would during your enrollment period. However, during this time, insurance companies can take more than tobacco use into account.

A Medicare Supplement insurance provider can, for instance, deny you coverage based on your tobacco use. While this is unlikely, you might see a much greater increase in your premium.

The insurance company can also increase your premiums based on pre-existing conditions because they present more risk to the insurer. This is why it’s so important to take care of your Medigap coverage during the open enrollment period.

What If You Quit Smoking?

Maybe you’re nearing age 65 and smoke cigarettes. You don’t want to pay more for Medigap coverage, so you decide to quit smoking.

Many resources exist for smoking cessation. In fact, insurance companies often provide extra help if you’re willing to quit. If you have group coverage now, consider talking to your healthcare provider about smoking cessation tools, which range from medications to nicotine supplements.

If you quit smoking well before you become eligible for Medigap coverage, you won’t have to worry about increased premiums. The insurance company may ask if you have smoked in the last six months, for instance, or the last five years. Every company has different protocols related to tobacco use.

Quitting smoking can impact more than your health. Saving more on Medigap coverage is just the beginning. Since you don’t smoke, you won’t have to pay for cigarettes, which can add much-needed cash to your budget. Plus, you reduce the risk of developing tobacco-related diseases, which can lower your out-of-pocket medical expenses as well.


Smoking is a dangerous activity that could cause serious health problems. People die of tobacco-related diseases every day, and insurance companies are well aware of the risks.

If you want Medigap coverage and you don’t want to pay a higher premium, quitting smoking immediately can have endless benefits. You’ll pay less for healthcare, and you might live longer and enjoy a better quality of life.

Research Medicare Supplement insurance to determine which of the 10 Medigap plans might work best for you. Whether you smoke or not, you can use Ensurem’s handy Medigap Quoter to get immediate quotes from insurance companies that offer your desired plan in your area. Educating yourself about tobacco use and Medigap coverage can have long-lasting benefits.

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Education is crucial in finding the right Medicare solution for you. With so many Medicare resources out there, it can be difficult finding a source you can trust. That’s why Ensurem has a Compliance Program dedicated to ensuring our Medicare content meets Centers for Medicare & Medicaid Services (CMS) regulations. So, you can rest assured you’re getting the information you need to make the right coverage decisions.

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Denise Austin, 65, Ensurem Ambassador

Best-Selling Author, Creator of Fit Over 50 Magazine

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