There is abundant evidence that many COVID-19 vaccines, e.g. from Moderna, Pfizer, AstraZeneca-Oxford etc., dramatically reduce morbidity and mortality.

They thus reduce costs to medical insurance companies.

Is it legal for an insurance company to pass such savings on to their customers, and give them incentive to stay healthy, by giving a premium discount to customers who get vaccinated?

  • 1
    Mortality is very unfortunate for you, but nowhere near as unfortunate for the insurance company. Death can by quite cheap.
    – gnasher729
    Commented Feb 27, 2021 at 15:25
  • @gnasher729 That is probably true for some diseases,but seems dubious for COVID-19. Got any data? And of course we'd be very dubious of companies that gave discounts for not getting a vaccination....
    – nealmcb
    Commented Feb 27, 2021 at 21:28
  • @nealmcb: Gnasher's point is that health insurance companies don't have to pay further claims once a patient dies. Thus, health insurers are primarily paying based on morbidity, not mortality. Mortality just means they've lost a customer (and one who was sick and thus perhaps not even profitable).
    – Brian
    Commented Mar 3, 2021 at 15:30

1 Answer 1


Assuming that this is in the US, 45 CFR 147.102 narrowly defines what are "fair premiums", and disallows higher premiums based on properties of an individual except for a few demographics such as age and address, and tobacco use. That only restricts charges "in accordance with §156.80 of this subchapter for health insurance coverage offered in the individual or small group market", which is most if not all plans. For such insurance plans, vaccination-based premiums would not be legal.

  • Could you be a bit more explicit as to whether your answer is a 'yes it's legal' or a 'no it's not'?
    – brhans
    Commented Feb 27, 2021 at 2:19
  • @brhans, §147.108 says that rates can't be based on pre-existing conditions. How can that be true? Wouldn't all the already very sick people get insurance, making the premiums prohibitively expensive for normally healthy people? And why would healthy people bother getting insurance until after they become sick? This seems like the opposite of what insurance is supposed to be. What am I missing? Commented Feb 27, 2021 at 14:28
  • 3
    @RayButterworth The purpose of insurance is to make sure everyone can lead a normal life. Including people with pre-existing conditions.
    – gnasher729
    Commented Feb 27, 2021 at 15:27
  • 2
    @RayButterworth: I think that that requirement was added by ACA (Obamacare), where plans under ACA cannot deny coverage or charge more for pre-existing conditions. The issue of people only getting insurance after they get sick was supposed to be offset by 2 things: 1) the individual mandate (you have to pay a tax if you don't have insurance), but that was later eliminated by Republicans for 2019 and later years, and 2) the fact that you can only sign up once a year during the open enrollment period, or when there are certain kinds of qualifying life changes.
    – user102008
    Commented Feb 28, 2021 at 23:41

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