A Basic Explanation

If you’re a regular tobacco user, you may have to pay more for your health insurance. In some states your premium could be as much as 50 percent higher. (On average, though, tobacco users pay about 10 percent more than nonusers.)

The following products are considered to be tobacco:

  • Cigarettes
  • Cigars
  • Pipe tobacco
  • E-cigarettes or “vapes”
  • Chewing tobacco
  • Snuff
  • Any other tobacco product

Generally, you’re considered a regular tobacco user if you’ve used any of these products four or more times a week during the past six months (excluding religious or ceremonial use).

Expert Advice About Tobacco Use and Health Insurance

Thanks to the new healthcare reform law, you’ll never be charged more for health insurance if you have a pre-existing health condition.

But you can be charged more if you’re a regular tobacco user.


  • Regular tobacco use puts you at greater risk for health issues like heart disease, stroke, and cancer.
  • These health issues are expensive to treat.
  • That means the insurance company will have to spend more on your healthcare.
  • Since you’re likely to have expensive healthcare, insurance companies want to charge you more for your health insurance.

So, in states where it’s allowed, insurance companies can charge you extra — a tobacco surcharge — because you’re a tobacco user. And you have to report this on your health insurance application. If you don’t and your insurance company finds out, they can’t cancel your coverage, but they can start adding the tobacco surcharge to your premium. They can also ask you to pay the surcharge for the months that have passed since you first enrolled

What else you need to know

1. You can’t use tax credits to pay the tobacco surcharge. If you’re one of 26 million Americans who qualifies for tax credits (government dollars to help pay for health insurance), you won’t be allowed to use them to cover the extra costs associated with tobacco. You’ll have to pay the tobacco surcharge on your premium directly.

2. You must provide tobacco-use information for everyone in your household. If you’re a household of one, answering the question will be easy: You already know whether or not you smoke and how often. But if you’re buying health insurance with your spouse or dependents over the age of 18, you’ll need to provide their tobacco-use information as well. Be sure to get this information from them before completing your application.

3. Where you live matters. Some states have decided to let insurance companies charge tobacco users a higher premium for their health insurance. Other states have not. Here are the states where tobacco use may affect your health insurance rates:

Alabama, Alaska, Arizona, Arkansas, Colorado, Connecticut, Delaware, Florida, Georgia, Hawaii, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Mexico, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington, West Virginia, Wisconsin, and Wyoming.

4. How frequently you use tobacco matters, too. Let’s say you have a cigar on rare occasions, maybe once or twice a year. In that case, you’re not a regular tobacco user. On the other hand, if you’re smoking four cigarettes a week, you are considered a tobacco user.

5. You must report your tobacco use even if you’re planning to quit. If you’re ready to give up tobacco — congratulations! You’ll be saving yourself a lot of money — on tobacco products, on healthcare, and maybe on health insurance, too. Just remember that insurance companies typically want to know about the past six months. So if you were a tobacco user during that period, you still need to report it — even if you quit today.

6. Don’t lie. When you apply for health insurance, you’ll have to attest that you’re telling the truth by signing your application. Some tobacco users might be tempted to downplay their habits. After all, the insurer isn’t there to count how many cigarettes you smoke in a given week. But there is a risk. If the insurance company finds out that you are a smoker after all, they can demand that you start paying the tobacco surcharge. This can result in a huge hike in your monthly premium. They also have the right to go back and collect the surcharge retroactively — in other words, they can ask you to pay them the surcharge for the months that have already gone by since you first enrolled.