Why your health insurance premium varies by gender
Updated: Apr 7
Today’s world is premised on two concepts: efficiency and convenience. With the world circling around these two entities, its functionings, and actions all intended to contribute, we now find ourselves indulging in a sedentary lifestyle, devoid of any major physical exercise or activities. As a result, while our investments in short term materialistic comfort increases, our financial and physical investment in our health has taken a steep nosedive. In this situation, wherein the population is more vulnerable to various physical ailments, illnesses, and diseases, medical bills, could quickly build up into a hurricane of financial burdens and shortcomings.
Health insurance was created to mitigate precisely this situation. Health insurance policies are essentially a contract between the insurance provider and the policyholder in which the latter pays a routine (monthly, yearly, etc) payment called the premium to the provider in exchange for financial coverage in the case of medical emergencies or conditions requiring treatment. This cover can be availed of during an illness, accident, or contraction of disease (depending on the fine print of your policy, something you should pay keen attention to), in order to account for the various medical bills brought on by said ailment.
Health insurance has since further been refined, tweaked, and developed to suit the needs of almost all individuals or groups. Individual health insurance is best suited for those who are living by themselves, family floaters cover an entire family. While senior citizen health plans are more suited to the needs of the elderly, a specific illness plan ensures you have cover against any potential life-changing diagnosis. There are even specific health insurance plans solely for women.
However, even in a standard healthcare plan, these factors are taken into account. This largely manifests in the premium paid by the policyholder, which essentially reflects how risky the provider thinks they are, i.e How likely the policy-holder is to make a claim against their policy and how much that expense could be to the provider. As such, individual premiums can differ greatly and one of the key factors for the same is one’s gender.
This article will dive deep into the functionings and fine print of health policies in an attempt to assess whether your health insurance premium payment could vary based on your gender.
How is the premium calculated?
Before correctly understanding the impact of gender on premium payments, we must first ascertain what a premium payment is and how it is calculated.
Premium payment is a routine payment made by customers to their insurance companies for their healthcare plans. This payment works as a fee for the service and transfers the risk from the insured (the customer) to the insurance. Company. In the event that the insured falls sick, the insurance company is accountable for their medical bills so long as they fall within the terms and conditions of the policy. It is also due to this transfer of risk that insurance policy companies assess premium payments on an individual basis: the premium payment for every individual varies based on a number of factors. These factors include, but are not limited to and vary from company to company, Body mass index (BMI), existing health conditions or illnesses, consumption of alcohol or tobacco as well as family medical history. Insurance providers, however, also take into account factors that lie beyond the medical sphere. Oftentimes, your location of residence, income, and yes, gender will have an impact on the premium you pay.
Studies and surveys have shown that among two individuals of the opposite sex with identical physical and mental conditions, the female is more likely to pay a higher premium despite being virtually identical to her male counterpart.
Let's look into why that is.
Gender-related factors that influence premiums :
The most evident and obvious reason as to why health insurance premiums vary based on gender and sex is the fact that only one of the two sexes can give birth. While purchasing medical insurance, the aim is to strike a balance between the lowest possible premium that provides the maximum cover: the best service for the least possible cost to cover all your health and medical needs. For women, however, these needs vary from men based on the fact that they could go through maternity. Since your healthcare plan is supposed to cater to all your medical needs, health insurance for women also takes into account maternity which comes alongside a number of medical bills as well as hospital stays. Due to what insurers consider increased risk, females are more likely to have to endure higher premiums for their health insurance compared to men.
Medical illnesses and checkups
Various studies have shown that women, when compared to men are predisposed to a higher possibility of contracting a wide range of illnesses or medical complications. While the most obvious one is women are more susceptible to contracting breast cancer, that is not the sole reason for possibly higher health insurance premiums. According to reports, 38% of women are more likely to develop chronic illnesses, while men have a 30% less chance, at a mere 8%. Furthermore, women are also more predisposed to a number of other illnesses such as thyroid and PCOD.
During the process of growing up, females are also much more likely to require more frequent visits to the doctor for health and medical checkups, and this is maximized during the reproductive ages of 15 to 44. As a result, medical insurance companies as mentioned earlier perceive this higher predisposition to medical complications as a higher risk, and they are more likely to reflect this in the higher premiums they would offer females.
The lifestyle of males and females, especially in India vary to great lengths. Naturally, this has an effect on premium rates. As mentioned earlier, women are more likely to have to make more frequent visits to a doctor and medical facilities due to the arguably more complex aging process they have to go through. Women could possibly require a gynecologist consultation during puberty and an obstetrician, pediatricians, and OB/GYNS later in their life, especially during childbirth. This is likely to have an adverse effect on the premium rates, as an increased requirement of medical facilities and consultations means an increased risk for the insurance company.
Life expectancy is another possible contributing factor to a variation in premium rates based on gender. Insurance premiums also take an individual's life expectancy into account while calculating their medical insurance premiums. The higher. Studies show that in India, there are about 4.05 crore individuals who are women above the age of 65. In contrast, the figure for men over 65 stands at 3.6 crore, more than half a crore less than women. With a higher life expectancy comes an increased demand for medical insurance so long as the individual is still alive. Additionally, as one’s age progresses, so does their propensity to contract more illnesses. Therefore, with a higher life expectancy, insurance premium payments are also likely to be higher and since women in India on average have a higher life expectancy than men, the premiums they are made to endure are also likely to be higher.
Furthermore, the influence of gender on premium payments can range beyond physicality and medicine. ‘Gender rating’ is the practice of having different charge sheets for men and women, the result of which is women being charged higher premiums simply due to being women. A study into this concept by policy analyst at National Women's Law Center Brigette Courtot revealed that insurance companies vary premium rates for company group medical insurance based on the gender makeup of the workforce: A company with a higher percentage of the female workforce could potentially pay exponentially higher premiums than those with a male-dominant workforce. Studies have also shown that upon conducting surveys, it was revealed that 35% of working female professionals felt that the healthcare plans provided by their employers have been poor, while 55% percent believe it as adequate. An astonishing 63& of working females believed that maternal healthcare costs amount to about 40% of any household's non-subsistence income.
Health insurance is an essential commodity for any individual in today’s day and age and yet, studies show that in 2018, only 35% of the population was covered under a health insurance plan. Furthermore, various countries and institutions are also fighting day and night to ensure more equal healthcare for the genders, as healthcare should be a basic necessity that is not hindered by something an individual is not in control of; their gender. It is essential that one have health insurance, but it is also a requirement for the insurance premium to be within a feasible budget. If you’re looking for a comprehensive plan that provides hospitalization coverage and provides exclusive discounts and access to things such as doctors consultations, diagnostic tests, prescription medicine, and coverage for treatments such as Mental health treatments which are usually excluded from many health plans, then Kenko’s 699/month and 199/month plans may be great for you. What’s more, these monthly subscription plans are fixed, meaning that you won’t be turned into a risk model, and won’t have to face any specific charges for coverage. What you see, is what you pay and what you get.