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Lack of exercise and foods rich in calories can cost us our health. But they can cost us insurance money, too.

This is especially the case when you’re shopping for individual health insurance. If you’re severely overweight or obese, insurance companies may charge you higher rates – assuming you find coverage.

weight loss“In the purchase of individual health insurance plans, weight is one of the factors that determines what the premium will be,” says Susan Pisano, vice president of communications for America’s Health Insurance Plans in Washington, D.C., an association representing health insurance companies.

Some insurers may refuse to sell a health insurance policy to seriously overweight people. “If the condition were so severe, it could be that [people] might not be offered coverage,” Pisano says. “In the current system, it isn’t a requirement that everyone be covered.”

The health care reform legislation that President Obama signed into law in March 2010 prohibits insurance companies from denying coverage based on pre-existing conditions — and that could include obesity. However, for adults, the change doesn’t go into effect until 2014. (For children, it started right away.) And the health reform law doesn’t eliminate pricing based on risk factors like obesity.

In the meantime, the potential for health insurance coverage denial may affect a significant number of American adults. 

How to determine if you’re overweight or obese

How is BMI calculated and interpreted?

Calculation of BMI
BMI is calculated the same way for both adults and children. The calculation is based on the following formulas:

Measurement UnitsFormula and Calculation

Kilograms and meters (or centimeters)

Formula: weight (kg) / [height (m)]2

With the metric system, the formula for BMI is weight in kilograms divided by height in meters squared. Height is commonly measured in centimeters. To obtain height in meters,  divide height in centimeters by 100.

Example: Weight = 68 kg, Height = 165 cm (1.65 m)

Calculation: 68 ÷ (1.65)2 = 24.98

Pounds and inches

Formula: weight (lb) / [height (in)]2 x 703

Calculate BMI by dividing weight in pounds (lbs) by height in inches (in) squared and multiplying by a conversion factor of 703.

Example: Weight = 150 lbs, Height = 5’5″ (65″)

Calculation: [150 ÷ (65)2] x 703 = 24.96

Interpretation of BMI for adults
For adults 20 years old and older, BMI is interpreted using standard weight status categories that are the same for all ages and for both men and women.

The following table shows the standard weight status categories associated with BMI ranges:

Weight RangeBMIWeight Status
124 lbs or lessBelow 18.5Underweight
125 lbs to 168 lbs18.5 – 24.9Normal
169 lbs to 202 lbs25.0 – 29.9Overweight
203 lbs or more30.0 and AboveObese

Here is the weight ranges, the corresponding BMI ranges, and the weight status categories for a sample height.

HeightWeight RangeBMIWeight Status
5′ 9″124 lbs or lessBelow 18.5Underweight

Source: CDC

Physicians define obesity using a formula known as the body mass index (BMI). To calculate your BMI, divide your weight in kilograms by your height in meters. According to the Centers for Disease Control and Prevention, a BMI of 25 to 30 places you in the overweight category. Anything over 30 is considered obese. For example, if you are 5 feet 5 inches tall and weigh 180 pounds, you would have a BMI of 30 and would be considered obese.

Pisano says that actuarial firms develop charts that take into account an individual’s height and weight and insurers use them to set rates.

A growing problem

Obesity is on the rise in America, with many experts saying the trend has reached epidemic proportions. According to a Centers for Disease Control and Prevention study published in January 2010 in the Journal of the American Medical Association (JAMA), 68 percent of adults are overweight or obese. That’s more than two out of every three adults.

The percentage of overweight and obese is smaller for children and adolescents. An accompanying JAMA study of children showed that 31.7 percent of those age 2 through 19 were classified as having a high BMI (a BMI at or above the 85th percentile for their age). But even those statistics are alarming, because studies show that children with high BMI often grow up to become obese adults.

Why health insurance companies charge more for obesity

Obesity can cause or exacerbate a host of medical conditions, including heart disease, certain cancers, Type 2 diabetes, stroke, arthritis, breathing problems and psychological disorders such as depression — all of which can be costly to treat.

Based on statistics, health insurance companies assume that overweight people are more likely to need medical services and charge them accordingly, Pisano says. If you’re an overweight smoker with certain medical conditions, such as high cholesterol or high blood pressure, you may have even more difficulty finding an affordable health insurance policy, she says.

Buying health insurance if you are obese

If you’re obese and looking for an individual health insurance plan, try contacting an experienced health insurance broker. An experienced broker will know how different insurers underwrite for obesity and should be able to match you with the best company for your situation.

If you’re overweight but otherwise healthy, you may want to ask your doctor to write a letter supporting your application for health insurance. Your broker may have you fill out a prescreen application, which he or she can use to shop around on your behalf. The key is to avoid being declined; once you’re declined, it’s harder to find a health insurance plan.

Losing excess weight, quitting smoking and adopting a moderate exercise routine will help lower your health insurance premiums. It’s not only good for your wallet. It’s good for your health.