Premiums

In most markets today, insurance carriers who offer individual health may charge individual can rate premiums, exclude pre-existing conditions, issue exclusion riders, and even deny coverage based on an applicant’s health status. After 1/1/2014, this will no longer be the case.

The cost of coverage for a person will be determined based on the plan selected, as well as a person’s age, tobacco use, and residence address. In the case of tobacco use, an insurance carrier can charge an individual no more than 50% over the standard rate.

Children age 21 or older will pay the same rate as an adult. Children under age 21 will pay a child’s rate and a family will be charged for no more than 3 children under the age of 21.

Under the new law the difference in cost between ages is also specified, although states do have some flexibility to modify this.  In Tennessee, where I live, the cost for a 64 year old person can be no more than 3 times the cost for a 21 year old. The cost for a child under the age of 21, will be about 63% of the cost for a 24 year old.  Males & females will pay the same rate.

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