3

Can a company provide health insurance just for a particular gender? For example by giving different premiums for different genders. I think they can give different premiums for different age groups.

Is this legal in USA? I am leaving aside arguments about who is a man and who is a woman.

This is a hypothetical question. I was thinking since different genders have different health needs may be some can benefit from low premium.

Improve this question
4
  • 1
    Can you give some background on this question? As it's asked, it's hypothetical with little relation to personal finance.
    – JTP - Apologise to Monica
    Jul 10, 2016 at 13:41
  • Yes it is a hypothetical question, since men and women have different health needs.
    – seek
    Jul 10, 2016 at 14:36
  • Remember that playing with the pool if insured individuals may (a) have unexpected results (it isn't at all clear whether this would be good or bad for the women in question) and (b) cuts both ways (you can't extract a lower-risk group without leaving a higher-risk group behind). And as Joe says, this is either Legal or Economics, not personal finance.
    – keshlam
    Jul 10, 2016 at 16:25
  • @JoeTaxpayer Could you please transfer this to the Law forum in that case?
    – seek
    Jul 10, 2016 at 17:01

1 Answer 1

Reset to default
6

From healthcare.gov:

How premiums are set

Under the health care law, insurance companies can account for only 5 things when setting premiums.

Age: Premiums can be up to 3 times higher for older people than for younger ones.

Location: Where you live has a big effect on your premiums. Differences in competition, state and local rules, and cost of living account for this.

Tobacco use: Insurers can charge tobacco users up to 50% more than those who don’t use tobacco.

Individual vs. family enrollment: Insurers can charge more for a plan that also covers a spouse and/or dependents.

Plan category: There are five plan categories – Bronze, Silver, Gold, Platinum, and catastrophic. The categories are based on how you and the plan share costs. Bronze plans usually have lower monthly premiums and higher out-of-pocket costs when you get care. Platinum plans usually have the highest premiums and lowest out-of-pocket costs.

Factors that can’t affect premiums

Insurance companies can’t charge women and men different prices for the same plan.

They also can’t take your current health or medical history into account. All health plans must cover treatment for pre-existing conditions from the day coverage starts.

https://www.healthcare.gov/how-plans-set-your-premiums/

Improve this answer
6
  • Thank you. Is this the new law under president Obama? Or has that always been the case?
    – seek
    Jul 10, 2016 at 14:37
  • I know the medical history part is new, but I believe the gender part has always been in effect. I can't say with 100% certainty though.
    – BobbyScon
    Jul 10, 2016 at 14:39
  • 1
    That's interesting. Apparently gender can be taken into account in car insurance.
    – Peter K.
    Jul 10, 2016 at 14:42
  • 1
    @PeterK. that's correct. Life insurance as well.
    – BobbyScon
    Jul 10, 2016 at 14:44
  • 2
    @Seek: The "Factors that can't affect premiums" were imposed under the Affordable Care Act. Prior to that, a woman of childbearing age with otherwise identical risk factors would often be charged more than a man.
    – feetwet ♦
    Jul 10, 2016 at 21:23

You must log in to answer this question.