do doctors report to health insurance about smoking habits of patient

by Shany Schimmel 10 min read

Smoking and Health Insurance: Everything You Need To …

2 hours ago  · Yes, When you apply for health insurance, the doctor is obligated to report whether you are a smoker or not. Following a regular blood and urine examination, the doctor will possibly document tobacco use in the medical records. >> Go To The Portal


Yes, When you apply for health insurance, the doctor is obligated to report whether you are a smoker or not. Following a regular blood and urine examination, the doctor will possibly document tobacco use in the medical records. The paper trail may be uncovered and marked while the insurer examines the condition before you pay the bills.

If you're a smoker, depending on the circumstances, you might end up paying a higher premium. And even though your doctor can't explicitly tell them you smoke, the insurance company can still uncover the information. However, this doesn't mean that you can't find reasonable coverage.

Full Answer

Do doctors and other doctors smoke?

With their detailed knowledge of the risks of smoking, it’s not surprising that most doctors and other medical professionals usually don’t smoke. But some do, despite many having first-hand experience of its dangers. The question is: why?

Will my health insurance company know if I smoke?

Although it’s nearly unheard of for an insurer or employer to actively investigate whether you smoke, your doctor will probably note tobacco use in your medical records as a result of routine blood and urine analysis. That paper trail could be uncovered and flagged as your insurer is reviewing your treatment before paying your bills.

Should doctors help patients stop smoking?

Helping patients stop smoking is more consistent with physicians' affirmative duty to act in the best interest of patients than refusal of treatment. Furthermore, refusal to treat patients who smoke could have the harmful effect of delaying time-sensitive treatment while patients connect with new physicians.

Will smoking affect my health insurance policy?

Several smokers think that insurers may consider any future illnesses or diseases as the result of smoking and do not cover themselves or their family with a comprehensive health insurance policy. That should not be the case.

How does health insurance company know if you smoke?

Although it's nearly unheard of for an insurer or employer to actively investigate whether you smoke, your doctor will probably note tobacco use in your medical records as a result of routine blood and urine analysis.

Can a doctor tell if a patient smokes?

Yes, your doctor can tell if you smoke occasionally by looking at medical tests that can detect nicotine in your blood, saliva, urine and hair. When you smoke or get exposed to secondhand smoke, the nicotine you inhale gets absorbed into your blood.

How do life insurance companies know if you smoke or not?

A primary method of verification is with a life insurance medical exam, which typically includes taking blood and urine samples. These samples will reveal cotinine in your system, which is a byproduct of nicotine. Cotinine can also be detected in saliva and hair samples. But testing for cotinine isn't foolproof.

Can a doctor refuse treatment because you smoke?

Physicians are discouraged from refusing treatment simply because they disagree with their patients' decisions or lifestyles. The authors contend that active smoking is not an appropriate basis for refusal of therapeutic treatment.

Can smokers be denied health care?

Coverage cannot be denied to current or former smokers. This means smokers have prevention and treatment options available to them through their insurance. Additionally, the law includes smoking cessation therapy as part of the 10 essential benefits, which is available to smokers at no cost.

How long after quitting smoking are you considered a non smoker?

One Month to One Year After Becoming a Non-Smoker Your lung functioning begins to improve after just 30 days without smoking. As your lungs heal from the damage, you will likely notice that you experience shortness of breath and cough less often than you did when you smoked.

How long does it take for nicotine to leave your system for insurance?

It takes at least three days for nicotine to leave your blood, but insurance providers test for another compound — cotinine — that's formed after nicotine enters your body. Cotinine can stay in your body for up to three weeks or longer.

What happens if I lie about smoking while applying for a health insurance policy?

In case the insurance company asks you to go through a medical test and the insurer gets to know that you have lied about your smoking habit, then...

Does the health insurance premium go up if I smoke?

Yes, the premium is slightly higher compared to a premium offered to a non-smoker. The insurance company will consider all risks before offering a...

I do not smoke a lot, do I still need to disclose that I am a smoker while buying health insurance?

Yes, you need to disclose that you do smoke. It is better to inform your insurer about your smoking habits so that the insurer can offer the right...

I started smoking after I purchased health insurance. Should I inform my insurance company?

It is important to keep your insurance company informed about your smoking habits to avoid any rejection of claims. Even if you have started smokin...

Is smoking one cigarette considered a smoking habit while buying health insurance?

Whether you smoke one or more cigarettes, smoking is injurious to health and it is important to disclose your smoking habits to the insurance company.

How is nicotine tested for group health insurance?

During this exam, nicotine use can be tested through a blood or urine sample.

What factors affect the cost of health insurance for smokers vs non smokers?

Under the Affordable Care Act (ACA), health insurance premiums are based on the following factors: plan category, the number of individuals on the policy, age, location, and tobacco use. Many insurance companies can factor in tobacco use in order to increase health insurance rates for smokers.

What Describes Tobacco Use?

The Centers for Medicaid and Medicare Services (CMS) for defines ‘tobacco use’ as the “use of a tobacco product or products four or more times per week within no longer than the past 6 months by legal users of tobacco products (generally those 18 years and older) and includes all tobacco products.” 1 The term smoking, however, can extend to other types of products.

What is the practice of charging tobacco users more?

The practice of charging tobacco users more is called tobacco rating . The ACA allows for insurance companies to charge smokers up to 50% more (or premiums that are 1.5 times higher) than non-smokers through a tobacco surcharge. 4,5 Although this is allowed, it doesn’t mean that all states have decided to implement this charge. As demonstrated below, tobacco surcharges can vary from state to state.

How much does a pack of cigarettes cost?

The average cost of a pack of cigarettes in the U.S. is $6.28. In states with higher tobacco taxes, the cost can be even higher. 8 But smoking has been known to cost people dollars through more than just cigarettes. For instance, smoking can:

Is it important to have health insurance for smokers?

Because there are health complications that can arise from current or former tobacco use , it is important to have coverage. Begin reviewing your options with HealthMarkets today.

Does smoking affect health insurance?

Smoking and health insurance don’t exactly go hand-in-hand. But understanding how one relates to the other will help you identify how tobacco use can affect your finances. You’re probably curious how smoking can affect the cost of medical coverage.

When Does Tobacco Rating Apply?

Truly casual smokers may be able to avoid tobacco surcharges. Tobacco use must rise to a certain level before health insurance companies can penalize you.

How many people smoke in 2016?

Despite the deadly dangers of smoking — with lung cancer now the No. 1 cancer threat to men and women — 34 million Americans still smoke regularly (14% ) and another 6 million use vaping nicotine inhalers. The Federal Drug Administration labeled inhalers as “tobacco products” in 2016, and, therefore, so do most health insurers.

What is the practice of demanding a surcharge for tobacco use?

Your tobacco use. The practice of demanding a surcharge for tobacco use is known as tobacco rating. Insurance companies and some experts justify the large surcharge acts as an incentive to convince smokers to quit.

Why is it important to be truthful with your insurance company?

By being truthful with your insurance company, you can save yourself all sorts of onerous complications down the road.The potentially grave consequences for misrepresenting your tobacco use should convince you to always be transparent.

Can insurance investigate if you smoke?

Although it’s nearly unheard of for an insurer or employer to actively investigate whether you smoke, your doctor will probably note tobacco use in your medical records as a result of routine blood and urine analysis. That paper trail could be uncovered and flagged as your insurer is reviewing your treatment before paying your bills.

Do you have to understand the law if you smoke or vape?

With that ruling, you can say the old tobacco policies went up in smoke. So if you smoke or vape, you need to understand the legislation and the probable higher costs of your health insurance. Not to be cheeky, but you’ll pay through the nose.

Can you lose your insurance if you smoke?

If you’re not honest about tobacco, you risk being charged with insurance fraud. Even such “soft fraud” is considered a misdemeanor and can result in sentences of probation, community service — or even time in jail. Not to mention, you’ll very likely lose your insurance or at least be charged all the back money you owe as a smoker.

Why is it important to keep your insurance company informed about your smoking habits?

It is important to keep your insurance company informed about your smoking habits to avoid any rejection of claims. Even if you have started smoking after you bought the insurance policy, you need to disclose all details to the insurance company. You may call them or write to them and disclose your smoking habit.

How does smoking affect health insurance?

How Does Smoking Affect Your Health Insurance Premium: The health insurance premium for a smoker is certainly higher compared to a non-smoker. A smoker is more susceptible to the following illnesses or diseases, which prompts insurance providers to increase the premium for smokers: Respiratory illnesses/diseases. Stroke.

How Can a Smoker Get Health Insurance Policy?

A smoker is defined as one who consumes nicotine in any form by insurance companies. They may insist on medical tests to determine the insurance premium for health insurance coverage. While purchasing health insurance, insurers ask about your smoking habits and probably the usage of nicotine over a fixed period of time. They may even ask you about the number of cigarettes you smoke and if there are any medical conditions due to the use of nicotine.

How Do Insurance Companies Know If You Smoke?

When you initiate the process of buying health insurance, the insurer will ask you if you smoke and may even ask if you have been consuming tobacco in the last six months. While the penalty for not disclosing that you are a smoker is not serious, the insurance company will still consider it as insurance fraud. But the most important aspect of not disclosing that you are a smoker could lead to a rejection of claims, especially if the treatment is related to illnesses due to smoking or due to the consumption of nicotine substances. It is important you declare everything about your health, including that you are a smoker to get the right policy to protect you in case of hospitalisation.

What If You Are a Smoker with Existing Health Problems?

The cost of healthcare is increasing every day and it is important to have access to an excellent health insurance policy. Even if you are a smoker with existing health problems, you need to cover yourself and your family with health insurance. While you may have to pay a higher premium, you can be assured that the insurance will protect you financially if you are hospitalised. It will certainly save you a lot of money since the insurance will take care of the medical expenses. Additionally, you can opt for the critical illness add-on to increase the coverage in your insurance policy even further.

How does insurance determine if you are a smoker?

As a smoker, you must declare it to your insurance company before you buy the policy so that you can avoid rejection or dispute of claims. The insurance company will decide the premium based on the severity of your health conditions and will consider any pre-existing illnesses or conditions such as diabetes or hypertension. Once the insurance company determines your smoking habits and your health condition, they will offer health insurance plans along with the premiums for the same.

Why do smokers need health insurance?

A smoker must consider buying health insurance to financially protect against critical illnesses which may be the cause of smoking. Illnesses such as stroke, hypertension, lung cancer, heart disease, chronic obstructive pulmonary disease and respiratory illness are some of the diseases affecting a smoker.

How Do Health Insurance Companies Know if You Smoke?

It may seem a little strange to learn, but health insurance companies don’t typically actually screen you or run any tests to see if you’re a smoker. They will usually just ask you during the application process whether you smoke or not and go on from there. So it isn’t like when you’re signing up for health insurance, you’ll need to take some sort of test or they’ll actively monitor you to see if you’re a smoker.

What Happens if You Lie to Your Insurance Company About Smoking?

The two biggest consequences for lying to your health insurance company about smoking are their refusal to cover your medical bills and the potential of being charged with insurance fraud.

Can insurance companies refuse to pay medical bills if you smoke?

Once they see that you are a smoker, the insurance company will be able to refuse to pay your medical bills based on a policy that you’ve voided. If you carefully read through the terms and conditions of your policy, there’s a good chance that somewhere in the fine print it says something about the policy being voided if fraudulent information is provided to them. So they can cite the fraudulent information and legally refuse to pay your bills, leaving you with a potentially huge medical bill that you weren’t prepared for.

Can insurance see if you are not a smoker?

Even if you tell your health insurance company that you are not a smoker, they will sift through your medical records if it ever comes time for them to cover any of your medical bills. So while you might have lied to them about your smoking habits, you probably haven’t lied to your doctor (s) your entire life about smoking as well. So as they are going through your medical records, they’ll likely see that your doctors have noted that you’re a smoker when you came to visit them last. This is when it could all start to unravel and go downhill.

Do smokers pay higher premiums?

As a smoker you might be paying higher premiums for health insurance, so it’s time you understand how companies know if you smoke and what that means for you .

Do insurance companies charge extra for smoking?

With that in mind, they can (and do) charge extra premiums for smokers. The process of charging extra based on tobacco use is called tobacco rating.

Can insurance companies charge you for medical fraud?

Not only will you potentially have to cover big medical expenses out of pocket, but the insurance company can also charge you with insurance fraud. Healthcare insurance fraud is a crime in all fifty states and is also illegal under federal law, so it is no joke of a crime. You could potentially face serious prison time on top of having to pay fines and your medical bills based on how serious the insurance fraud is.

What if I start smoking after getting health insurance?

If you start smoking after your health insurance policy is in force, your premiums won’t go up ; however, picking up the habit is not advisable.

How will insurance know if I smoke?

Health insurance companies define a smoker as a person who uses nicotine in any form. Insurers insist on medical tests to detect regular smokers and determine the premiums for coverage. Traces of nicotine can be detected in your blood, urine, hair, and saliva.

Do doctors report smoking to insurance?

Although it’s nearly unheard of for an insurer or employer to actively investigate whether you smoke, your doctor will probably note tobacco use in your medical records as a result of routine blood and urine analysis.

Why smokers should pay more for health insurance?

By charging smokers higher health insurance rates, insurance companies can make people pay a price for the risks they take. … Moreover, if smokers are charged higher rates, then other higher-risk groups should also be charged higher rates, since it would be unfair to single out smokers.

Is vaping the same as smoking for insurance?

Insurers rarely distinguish between vaping and smoking. They do not consider e-cigarettes a smoking cessation aid, but a tobacco product. Smokers pay more than non-smokers for health and life insurance. The details change from policy to policy, but vapers usually pay as much as smokers.

How can you tell if someone smokes?

Stains. Nails and fingers: Nails and fingers of smokers may take a yellow stain due to repeated exposure to smoke and tar in smoke. …

Can a doctor tell if you smoke?

There are already ways to detect whether someone is a smoker, according to Reddy. Doctors can test a person’s breath, blood or saliva.

How many people quit smoking each year?

Fewer than one in three adults who smoke use cessation counseling or FDA-approved medications when trying to quit. Fewer than one in 10 U.S. adults successfully quit smoking each year.

How much does smoking cost the United States?

Additionally, smoking-related illnesses continue to cost the nation more than $300 billion every year.

What is the best way to quit smoking?

Smoking cessation medications approved by the FDA and behavioral counseling are cost-effective cessation strategies. Cessation medications approved by the FDA and behavioral counseling increase the likelihood of successfully quitting smoking, particularly when used in combination. Using combinations of nicotine replacement therapies can further increase the likelihood of quitting.

How does smoking cessation affect your life?

Smoking cessation: Reduces the risk of premature death, improves health, and enhances quality of life. Quitting can add as much as a decade to life expectancy. Reduces the risk for many adverse health effects, including poor reproductive health outcomes, cardiovascular diseases, chronic obstructive pulmonary disease (COPD), and 12 types of cancer.

How can healthcare professionals help patients quit?

Healthcare professionals can help patients quit by: Advising them to quit. Offering brief counseling. Prescribing cessation medications. Connecting them to additional resources, like a quitline. Following up with continued support to help prevent relapse. Every member of the care team can help.

How effective is counseling and medication?

Counseling and medication —Each is effective when used alone, and using them together can more than double the chances of quitting.

Is smoking prevalence a disparity?

Considerable disparities exist in the prevalence of smoking across the U.S. population, with higher prevalence in some subgroups. Similarly, the prevalence of key indicators of smoking cessation—quit attempts, receiving advice to quit from a health professional, and using cessation therapies—also varies across the population, with lower prevalence in some subgroups.

What Percentage of Doctors Smoke?

The simplest question you may have is “what percentage of doctors smoke?” Physicians have the lowest smoking rate out of all medical professionals, according to research. A study published in the Journal of the American Medical Association (JAMA) found that in 2010 to 2011, 1.95% of doctors were current smokers. This is much lower than the corresponding rate in the general population, which was 16.08% at the time. It’s also lower than the overall rate among medical professionals, at 8.34%.

Why Do Medical Professionals Smoke?

After learning about smoking among doctors and nurses, you might be wondering why people who understand all of the risks of smoking continue to do it. This question has been investigated by research with regards to nurses. The evidence shows that nurses often start smoking before undertaking their training, and do so for many of the same reasons other young women (and people in general) start smoking. Being a nurse (or a doctor) can also be very stressful, so this likely has a role to play too.

Why don't nurses quit smoking?

The reason they don’t quit is also the same as for the general population. Quitting smoking is very challenging, and combined with a stressful work environment this explains why their medical education doesn’t lead all doctors and nurses to quit. However, smoking rates in doctors and registered nurses are declining.

What was the smoking rate in 2010?

Among registered nurses, the smoking rate was 7.09% in 2010 to 2011. Earlier studies put the estimate at around 8.4%. For licensed practical nurses, the smoking rate was much higher, at almost 1 in 4 in 2010 to 2011.

How many doctors smoke in 2011?

A study published in the Journal of the American Medical Association (JAMA) found that in 2010 to 2011, 1.95% of doctors were current smokers. This is much lower than the corresponding rate in the general population, which was 16.08% at the time. It’s also lower than the overall rate among medical professionals, at 8.34%.

Can doctors quit smoking?

Doctors and nurses can quit smoking using the same methods as everybody else, but they have the benefit of not only understanding the importance of quitting, but also having better access to medications to help with quitting smoking. Although the smoking rate in doctors and nurses is lower than in the general population, encouraging those who do smoke to quit and including quitting aids in medical industry insurance plans could bring the smoking rate down even further.

Is smoking a professional issue?

There are ethical and professional issues relating to smoking by doctors and nurses. For ethical issues, the most obvious is that it could be seen as hypocritical. Doctors and nurses smoking is seen by some people as undermining their credibility when telling patients about the dangers of smoking and why they should quit.