Overweight people being charged more for insurance

candoit05
candoit05 Posts: 11 Member
in Health and Weight Loss
When I decided to lose weight I found out my insurance didn't pay for anything regarding weight loss. Not even a nutritionalist. It made me wonder if they would rather have you sick? Wouldn't be more cost effective to help people loss weight before they started to have health problems? Or, to help them get off medications for high blood pressure or diabetes, etc. Yes, I understand that for the most part being overweight/obese is our doing.
But, the doctors/insurance industry should help. Food is an addiction just like drugs, smoking, etc.
I don't have any major issues with being obese. My cholesterol is a little high but not enough for the need for medication. Overweight/obese doesn't necessarily mean a lot of medical issues. There's no way to determine what medical issues you may have regardless of how overweight or how healthy.
For example, not everyone that has diabetes is overweight. I'm overweight and diabetes runs in my family but I don't have it. I consider myself lucky.

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Replies

  • fuzzylop72
    fuzzylop72 Posts: 651 Member
    I think some insurance companies will pay for a dietition if your bmi is larger than a certain value. I suspect the reason some don't is weight loss services don't necessarily have a great long term success rate.
  • VintageFeline
    VintageFeline Posts: 6,771 Member
    There's another pages long discussion of this just a few threads down.......
  • fuzzylop72
    fuzzylop72 Posts: 651 Member
    CSARdiver wrote: »
    Would you expect insurance to pay you to stop speeding? Or send a speed limit counselor? Desired behavior results in rewards. No one is going to preemptively reward you for good behavior - at least no successful business would.

    If weight causes health issues which result in larger insurance claims, then I'd expect insurance companies to pay for weight loss in many cases -- and in many cases, they do. Example policies from one state:

    http://www.mddhelp.com/insurance.html

    Many will only pay if your bmi is at a high-risk level (obese class 2 or 3, for example), though.
  • candoit05
    candoit05 Posts: 11 Member
    @csardiver "Would you expect insurance to pay you to stop speeding? Or send a speed limit counselor? Desired behavior results in rewards. No one is going to preemptively reward you for good behavior - at least no successful business would."

    They do have driver education. So your point?
    People do drugs and they have rehab. Insurance pays for substance abuse. It was their choice to do drugs. (I'm not saying that they shouldn't be able to get help)
    As, far as a business preemptively rewarding. That is not I was saying. Most people have illnesses from being overweight. Or, are close to having diabetes for example. It's a known fact by losing weight will prevent diabetes or allow somene to get off medications for diabetes and blood pressure.
    Some do reward, there was another member stating their company gives out gift cards. Some insurance companies will pay or give you a discount on a gym membership. Some insurance companies will pay for a nutritionist.
    What? "No successful business would"

    People are overweight for various reasons.
    You don't know what is causing the person to be overweight. So just leave your judgemental comments out. I think most people know that being overweight causes a variety of problems. Nobody is lying to themselves. My point was not
    everyone is the same.

    If you can't see the bigger picture that prevention is more cost effective then treating several illnesses then maybe you should educate yourself. I'm sure the insurance industry is aware of the cost effectiveness. But, just like most things, it doesn't work like it should. Insurance companies are in business to make money.
    My point of the post is if someone reaches out for help it would be great for the insurance company to provide the service. I am paying for it. Maybe, people need help with what and how much to eat. Maybe, some people need
    counseling for underlying causes.
    There's no predetermination of what illness someone may get. Someone that is healthy can get Cancer. Some people smoke for all their lives but don't get lung cancer. Some people exercise regularly and have a heart attack. You can't single out a group of people and charge them more for insurance.
  • candoit05
    candoit05 Posts: 11 Member
    @sijomiial.
    So if the do an DNA test on you and find out you have genes that will cause you to be predisposed to certain diseases should they charge you more? Where is the cut off to who and how much insurance can charge?
    If they are interested in their profit margin then
    they would help people get and stay healthy instead of throwing pills at everything. Yeah the insurance companies and pharmaceuticals are making plenty of profits.

    I have been mostly healthy for most of my life.
    At almost 45 years, I'm only on one medication. Blood pressure and blood sugar good. There are people who are overweight and can run 10 miles and there are people who are skinny that can't run a mile. So, let's put some of these "healthy people" on a treadmill and see how far they can run? Size doesn't equate to healthy.

    Also, there's nothing wrong with my mindset. I'm doing just fine in my journey. I was giving examples of why people are overweight from a perspective you obviously don't know anything about. It's easy to judge if you haven't been there.
    You picked out one thing from what I said instead of addressing why insurance companies will pay for one treatment and not another? Even though they are both choices that people make. Why insurance companies seem to keep people from becoming healthy? By not giving them the tools they need to succeed.
    I read that we are the one county that has the most overweight/obese people. Yes, it starts with the person taking responsibility, but the doctors/insurance companies also need to play a role.
  • sijomial
    sijomial Posts: 19,809 Member
    Still missing the point - it's a business not a charitable foundation.
    Don't like the way they do business, then take your money elsewhere. They are offering a service, you as the customer decide if the price is worth it.
    They can charge whatever they like but as a business they need to be competitive or they lose customers. Vote with your feet if you don't like the price/cover on offer.

    Differential pricing based on known risk models is entirely sensible. It's generally fair but not universally so to every individual.
    So when I set up my own business I went shopping for health cover but got hit by complete spinal exclusion clauses due to my history, they would be happy to take my money but if my back went out I wasn't covered.
    From their perspective - sensible business. From mine - unfair as I managed my injuries well enough to continue working and no surgery required to date.
    So I engaged directly with the underwriters to negotiate a personal not general deal based on my specific history rather than a generic risk model. They came up with a price, I decided if I thought the cover was worth the price.
    Can apply the same to using BMI - fair for the majority, unfair for minority like me who for most of their life have been fitter than most, healthier than most but over the BMI normal category for weight.
    Life isn't fair and the expectation that it is really isn't helpful or realistic.

    They pay for one treatment but not another based on cost/return. Get someone back to work quicker, reduce size of the claim... Clearly they don't share your belief that providing the education or support you wish for is cost effective.

    In my country N.I.C.E. (National Institute for Healthcare and Excellence) despite their name make exactly the same value judgements and it's not even a for profit environment. New, very effective but dreadfully expensive new wonder drug that gives terminally ill a few more months isn't going to get funding.

    Some insurance providers give incentives for healthy behaviours though, discounts on gym memberships etc. But there's also the incentive if that you change from being a high risk category (smoker, overweight...) then you pay less next renewal. That's if financial incentive is actually a significant driver for an individual....

    PS - you have posted in the Debate forum, don't expect that everyone will share your views or you will be very disappointed!

    PPS - of course I judge you based on what you write. Just as you have judged me and leaped to a conclusion.
  • tomteboda
    tomteboda Posts: 2,171 Member
    bmitchelmfp wrote: »
    I think some insurance companies will pay for a dietition if your bmi is larger than a certain value. I suspect the reason some don't is weight loss services don't necessarily have a great long term success rate.

    They also were a huge scam in the 1970s with things like Club Med originally being a weight loss "resort" where insurance companies paid the bill.
  • Geocitiesuser
    Geocitiesuser Posts: 1,429 Member
    Just a by the by, all of my health plans available all include some sort of incentive for gym memberships. Either a discount, a reimbursement, or outright free membership to various gyms.

    With modern insurance plans obese people DO end up paying more, because deductibles/spend downs are sky high.... I rarely need to go to the doctor, so spend very little on health costs. Just check ups and the occasional ailment. Insurance is there if I get "really" sick.
  • comptonelizabeth
    comptonelizabeth Posts: 1,701 Member
    As someone has already mentioned,even here in the UK where healthcare is free at the point of delivery,treatment can be withheld/postponed until the patient changes their behaviour (stops drinking/smoking/overeating) I suffer from a chronic health condition and have funding for an expensive medication. To get funding agreed I had to be assessed for lifestyle (smoking,alcohol,diet,compliance with other treatments ) There is help and support available for quitting smoking and drinking and for weight loss,however.
    The only private health insurance I have is for when I travel and I have found most insurers won't cover me for existing conditions. My illness is not caused by anything I have knowingly done so I'd be pretty peeved to find that things like obesity were disregarded.
  • ninerbuff
    ninerbuff Posts: 48,976 Member
    It's insurance. All have differences. You make the choice on who to get. Realize that insurance is in the business of making money like anyone else and there's no guarantee that an obese person will lose weight or for that matter keep it off and look to insurance again to pay for another attempt at it.

    A.C.E. Certified Personal and Group Fitness Trainer
    IDEA Fitness member
    Kickboxing Certified Instructor
    Been in fitness for 30 years and have studied kinesiology and nutrition
    9285851.png
  • candoit05
    candoit05 Posts: 11 Member
    @ninerbuff
    Actually, I don't get much choice on who I get for insurance. My choice is what my employer provides. Which I pay premiums. Yes, there's no guarantee but if half of the people were successful at keeping it off then that would be a start. Also, if the parents are obese the kids are usually obese. At least, that is what I have noticed. Which means another generation of obese people. Obesity really has become an epidemic. Just a side note. I didn't have a weight issue until I got older.

    Yes, insurance is a business and will always make money. There are plenty of sick people. But, if they did a little more to help people get healthy then they would make less money. Most times they just want to throw pills at you instead of addressing the issue. Hence, is why I say insurance companies/doctors are just in it to make money. Yes, there are times and ailments for which people do need the medication.
    Sometimes even running unnecessary test.
    I'm not saying all Dr's are like this, but from my personal experience I dealt with this.
    I've seen a few good Dr's that actually listen to what you are saying.
    They have programs for drug addiction but there's no guarantee that they won't do drugs again. So what's the difference?
  • candoit05
    candoit05 Posts: 11 Member
    @sijomial
    No, you are missing the point. Yeah, we all know they are a business. They make millions of dollars. Yes, insurance group plans are based on risk models. Now, your going into getting and individual plan for yourself verses what I have which is a insurance plan through my employer. I don't have any say in. There's no walking away. You got to negotiate your plan. You can't compare the two. That's two different things.
    Not all insurance has incentives. ( I wish)
    You were making judgments "As, being fitter than most", as you said, you don't know what it's like being overweight. Also, your BMI is over the chart for being healthy because you probably have a lot of muscle. The BMI charts are not realistic. It doesn't account for you are muscular. According, to that chart I should be 110. I would look sick if I was at that weight.

    I don't expect everyone to agree with me. But, if we are to have a discussion then address the statements and not pick out one thing and judge me on that.
    PS. What country do you live in?
    Off to the gym.....
  • Gisel2015
    Gisel2015 Posts: 4,185 Member
    http://community.myfitnesspal.com/en/discussion/10550963/do-you-think-obese-overweight-people-should-pay-more-for-health-insurance/p1
  • sijomial
    sijomial Posts: 19,809 Member
    candoit05 wrote: »
    @sijomial
    No, you are missing the point. Yeah, we all know they are a business. They make millions of dollars. Yes, insurance group plans are based on risk models. Now, your going into getting and individual plan for yourself verses what I have which is a insurance plan through my employer. I don't have any say in. There's no walking away. You got to negotiate your plan. You can't compare the two. That's two different things.
    Not all insurance has incentives. ( I wish)
    You were making judgments "As, being fitter than most", as you said, you don't know what it's like being overweight. Also, your BMI is over the chart for being healthy because you probably have a lot of muscle. The BMI charts are not realistic. It doesn't account for you are muscular. According, to that chart I should be 110. I would look sick if I was at that weight.

    I don't expect everyone to agree with me. But, if we are to have a discussion then address the statements and not pick out one thing and judge me on that.
    PS. What country do you live in?
    Off to the gym.....
    You have judged me and made a huge assumption. I came to MyFitnessPal because I was fat, I stayed because of the fitness side.

    I was fat for 20 years before I ditched the excuses and lost the excess weight.
    A bit of victim mentality if you like, I blamed the car driver who mangled my knee for making me fat (true to a degree). But he didn't make me eat too much for twenty years - that was my fault. Quite embarrassing really!
    Maybe others can avoid the mistake I made of not taking responsibility for their own weight?

    After my injury I was just plain fat. Maybe the support/counselling you suggest could have helped me sort out my head much earlier but really I don't see it was the insurance company's responsibility at all. They helped me through the operation and rehab phase but when I resumed work I regarded it as being all on me. That is why my employer at the time subsidised (to a degree) private health cover - to minimise the time being unable to work.

    Got my fitness back and stayed fit (but still fat) through hard work in the gym and the squash court - it wasn't given to me on a plate. Yes I probably have more muscle than most old farts - again I've earned it. One of those personal responsibility choices again, TV or gym...

    The BMI charts are actually pretty good guide for the vast majority of people - yes I also used the excuse for a long time "I've got some muscle, BMI doesn't apply to me". My current best weight is actually right on the cusp of normal/overweight.

    (I'm in the UK.)
  • lemurcat12
    lemurcat12 Posts: 30,886 Member
    candoit05 wrote: »
    what I have which is a insurance plan through my employer. I don't have any say in. There's no walking away.

    You don't have to use your employer plan. For example, I have a co-worker who does not, because her husband is a police officer and she's better off on his family plan. (I happen to agree that it would be better to have insurance less tied to work, but the reason we don't have that is that for most people employer-based insurance is better than having to get it on your own (especially BECAUSE of such things as pre-existing conditions which you could avoid any problems with by having employer-based even before the law changed (and before whatever may happen next).
    The BMI charts are not realistic. It doesn't account for you are muscular. According, to that chart I should be 110. I would look sick if I was at that weight.

    This does not make sense, there is no one right weight with BMI. For example, the healthy weight range for me is something like 105 to 140.

    If weight loss treatment makes a difference to future costs, the insurance companies would be sensible to pay for it (I believe this is why wellness programs are promoted). Right now, I think there's a genuine, reasonable debate as to whether weight loss treatment makes a difference. Personally, I lost a bunch of weight without it, and don't see why it would have been particularly helpful. Better to figure it out on your own, since it's essentially personal behavioral changes, IMO.
  • MKEgal
    MKEgal Posts: 3,250 Member
    "Food is an addiction just like drugs, smoking, etc."

    No.
    Food is a necessity.
    Alcohol, tobacco, and other drugs are choices.

    Using any of them to try to ignore / cope with feelings will not turn out well,
    but food is the one we must have, so is the hardest to get under control -
    can't "just say no" or stop eating, right?
    And the stuff that's bad for us (lots of fat / sugar / salt) tastes the best.
  • richardgavel
    richardgavel Posts: 1,001 Member
    Unfortunately for most businesses, it simply easier to raise costs to the customer as opposed to reduce expenses. Especially when the former will maintain profits and the latter MIGHT. Add to that the lack of competition created by the fact that most health insurance is employer provides, and so goes mostly unseen by the consumer. I'd love the ability to get a raise for my employer not to purchase health insurance and then get the same tax benefit they do. That would be a real implementation of free market principles.
  • Old_Cat_Lady
    Old_Cat_Lady Posts: 1,193 Member
    Companies not hire fat people. My company pays 50% of my health insurance cost.
  • chibir1ku
    chibir1ku Posts: 6 Member
    I just want to add my 2 cents: offering services like nutritional advice/personal trainers and stuff like that would be very costly because almost everybody would want those, overweight or not. It is the same reason they don't ofer therapists for everyone (except patients with a history of proven mental health issues). It is very easy to exploit the system specially with services as popular as these so they only offer them for extreme cases.
  • ninerbuff
    ninerbuff Posts: 48,976 Member
    candoit05 wrote: »
    @ninerbuff
    Actually, I don't get much choice on who I get for insurance. My choice is what my employer provides. Which I pay premiums.
    You DON'T have to go with who your employer offers. There are outside services too. Yes, there's no guarantee but if half of the people were successful at keeping it off then that would be a start. Also, if the parents are obese the kids are usually obese. At least, that is what I have noticed. Which means another generation of obese people. Obesity really has become an epidemic. Just a side note. I didn't have a weight issue until I got older.[/quote] People getting fat is due to HABITUAL BEHAVIOR. Fat kids because of fat parents is because the kids follow the parents behavior of eating. That can be CHANGED without need of medical or health insurance.
    Yes, insurance is a business and will always make money. There are plenty of sick people. But, if they did a little more to help people get healthy then they would make less money. Most times they just want to throw pills at you instead of addressing the issue. Hence, is why I say insurance companies/doctors are just in it to make money. Yes, there are times and ailments for which people do need the medication.
    Sometimes even running unnecessary test.
    I'm not saying all Dr's are like this, but from my personal experience I dealt with this.
    I've seen a few good Dr's that actually listen to what you are saying.
    They have programs for drug addiction but there's no guarantee that they won't do drugs again. So what's the difference?
    Drug addiction not only affects the person, but also others around them. They could unintentionally hurt someone, stealing, burglary and other forms of obtaining money illegally comes into play, etc. I don't disagree about doctors looking to mostly solve the symptom and not always address the real problem.
    The reality in life is that the medical business in America really don't want people to get healthy because it's a booming business.
    In my business, I work with people daily to help them get fit and lose weight. My GOAL is to get rid of them because then I know I've hopefully given them the information they need to do it right the rest of their life and also helped them reach a goal. And people are consistently coming in so I pretty much have an endless chance at income. If people were fit and healthy and knew how to do it, I'd not have a PT job. I think the difference is though is that I enjoy and look forward to actually helping people succeed, whereas many in the health care business just want to get people in and get them out as fast a possible.

    A.C.E. Certified Personal and Group Fitness Trainer
    IDEA Fitness member
    Kickboxing Certified Instructor
    Been in fitness for 30 years and have studied kinesiology and nutrition
    9285851.png
  • dragonshimmer81
    dragonshimmer81 Posts: 1 Member
    edited July 2017
    The insurance provided by my employer actually does charge a higher premium if you don't meet certain requirements such as being under a certain BMI (or at least losing 5% of your weight each year if over that BMI), being a nonsmoker, and other requirements. It irritates me, but I also understand it since being obese does make a patient higher risk for many expensive medical conditions in the long run. You might not fall into the category of people that have any of the conditions that are normally associated with obesity, and that's great. I don't either. Unfortunately, there's data to support obesity being a risk factor for certain health conditions.

    Our insurance will help pay some of the cost of dietician visits; however, the coverage is for a limited number of visits, and most people I've met have not had much (if any) success with visits with a dietician. I have noticed that people who pay a large sum of money for services such as Metabolic Research Center plans do seem to lose a large amount of weight (though they don't seem to keep it off long-term), and I have to wonder if it's because they've invested so much money. When insurance helps to cover the cost of services such as dietician visits, I'm inclined to say that we might not be quite as invested because we're not losing as much financially, and I suspect some of that may be taken into account on the part of the insurance industry.
  • Mr_Healthy_Habits
    Mr_Healthy_Habits Posts: 12,588 Member
    Since when did Business Trump being good people...

    Yeah insurance companies should help people struggling to lose weight... I don't care what that means for profits and no one else should either...

    How is this even debatable...

    People just want to deny others something they have so they can feel somehow superior.
  • Alatariel75
    Alatariel75 Posts: 18,211 Member
    Mr_Healthy_Habits wrote: »
    Since when did Business Trump being good people...

    Yeah insurance companies should help people struggling to lose weight... I don't care what that means for profits and no one else should either...

    How is this even debatable...

    People just want to deny others something they have so they can feel somehow superior.

    Since business became business, as far as I can tell.
  • lemurcat12
    lemurcat12 Posts: 30,886 Member
    Mr_Healthy_Habits wrote: »
    Since when did Business Trump being good people...

    Yeah insurance companies should help people struggling to lose weight... I don't care what that means for profits and no one else should either...

    How is this even debatable...

    People just want to deny others something they have so they can feel somehow superior.

    It took me forever to realize the capitals weren't supposed to mean anything, so I was trying to parce that with Trump as a name. LOL.

    Having resolved that interpretation issue, my answer:

    For real people, hopefully it has not.

    For insurance companies (which ARE businesses), what do they have to do with being "good people"? They aren't charities. They have to be concerned with profits. You don't like it? Maybe it's not a great idea to give insurance companies such a key role in health care policy.

    However, this actually is arguably one of the win-win situations that can come about in that insurance companies WANT to reduce long-term costs (as it's in their own self interest if they are limited in what they can charge riskier insureds). Thus, if treatment actually reduced long-term costs (by reducing obesity), they would have a strong reason to encourage it (that's the argument for preventative care in general as a policy focus).

    It probably doesn't work that well, that's the problem.

    And I have no clue whether I have access to medical weight loss treatment through my insurance or not, it never crossed my mind to check, as I figured I could lose weight without it (and did), and did not think I would be better able to lose weight by relying on someone else's plan rather than figuring it out for myself. It's not exactly that complicated.
  • CSARdiver
    CSARdiver Posts: 6,252 Member
    edited July 2017
    Mr_Healthy_Habits wrote: »
    Since when did Business Trump being good people...

    Yeah insurance companies should help people struggling to lose weight... I don't care what that means for profits and no one else should either...

    How is this even debatable...

    People just want to deny others something they have so they can feel somehow superior.

    There are all manner of ways to feeling superior, such as dictating what business should and should not do.

    Put your money where your mouth is and start up an insurance company with this business model.

    Warning - You will likely have to debate your position to your investors, partners, clients, and shareholders.

  • inertiastrength
    inertiastrength Posts: 2,343 Member
    since losing weight is free I'm really not sure how you expect them to do that.

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