Even if they are in good health, for someone who enjoys an occasional sky or scuba dive, rock climb, or has a job that puts their health at risk, their health insurance eligibility is thoroughly challenged. While some activities considered a hazard to insurance companies may seem more normal and every day, even healthy, it could cause as much damage to your health insurance application as being an anxiety-ridden smoker with hypertension and high cholesterol.
Whether your risky behavior is simply a fond hobby or your source of employment, it is important to inform the insurer on your application of anything that could be considered as such. Unfortunately, it will cause premium rate increases or even rejection of coverage like any other risk. Why? Because to an insurance company you are viewed as a potentially expensive health care user if any injuries occur. Like smoking, risky activities are seen as a voluntary hazard placing you in danger of needing serious medical attention.
What happens if you say “yes” to participating in risky activities on your health insurance application?
If you agree, and explain in detail what your interests are, how often they take place, and to what extent you partake, this can help the insurer decide whether or not you are a mild or an extreme investment. Based on the information you provide, it could result in a complete decline of coverage, an increased premium, an exclusion, or nothing at all. It also depends on the insurance company’s willingness to accept a slight risk or consider all risks equal and potentially costly.
Also, you will be likely to fill out a form for a supplemental insurance policy and be rated based on the danger of the activity. If the insurance company accepts you for a plan, it is likely they will make note to cover standard benefits and not pay for any care for injuries or illness received from placing yourself in harm’s way.
What happens if you say “no” to participating in risky activities on your health insurance application?
If you know that something you enjoy doing puts you at risk of some sort of injury (which is an incredibly broad definition, and could technically include crossing a busy city street, though insurers have more specific ideas), and say “no” on your application, you will most likely not be covered for any activity-related injuries.
Hazardous Hobbies and Activities
Anything considered thrill-seeking will result in lack of coverage for injuries received as a result of your activity of choice, and higher premiums. If you travel to foreign countries that are at war, you are also considered a risk. Speeding tickets and car accidents are also considered to evaluate your inclination toward high-risk behavior. There are often exclusions made by insurer for skydiving, rock climbing, bungee jumping, racing, and professional sports among other activities. Obvious considerations are unhealthy behaviors such as drugs, alcohol, and smoking.
For healthier activities, you may purchase an additional policy (usually travel insurance with a sports rider not available through major carriers) for specific events that are not covered by your regular medical insurance. Extreme sports, professional sports, and traveling activities are able to receive coverage to a certain extent by purchasing such an additional plan. Supplemental accident plans are available through most private health insurers, and cover anything from slipping on ice to getting hit in the face with a basketball. You must rely on whatever terms are associated with the temporary coverage as it will not be connected to your individual policy. Travel insurance typically covers a limited amount of activities, that medical insurance will not, which include:
- Contact sports e.g. baseball, basketball, tennis, volleyball
- Non contact sports e.g. swimming, golf, cycling, rollerblading, skateboarding
- Running (sprint, long distance, jogging, and marathons)
- Scuba diving (maximum depth of 30 meters) under 14 days
- Trekking (under 2000 meters)
- Bungee jumping (up to 3 times)
- Water activities e.g. canoeing, water polo, water skiing, white/black water rafting (grades 1-4), windsurfing, yachting, snorkeling
Based on on-the-job fatalities, the following are considered some of the most dangerous occupations according to the Bureau of Labor Statistics. These professions are likely to cause an increase in health insurance premiums or altogether rejection of coverage. According to one health insurance broker, a construction worker applying for a plan with their firm was rated up about $25 per month.
- Fishers and related fishing workers
- Logging workers
- Aircraft pilots and flight engineers
- Farmers and ranchers
- Mining machine operators
- Drivers/sales workers and truck drivers
- Industrial machinery installation, repair, maintenance workers
- Police and sheriff’s patrol officers
In recent news, seasonal firefighters petitioned to receive health benefits as other full-time federal employees do. Because of their wages as well as their risk level, the occupation made these individuals unable to get a private plan. In quick response to the petition, such workers will now receive health insurance coverage thanks to the President.
In summary, make sure you are aware of the effect your activities or profession may have on your health insurance application in order to avoid unpleasant surprises. Be prepared for at the very least an exclusion or a rate increase if you alert your health insurance company to your lifestyle. Though it may be your livelihood, it is seen as a major expense to them.
Certain measures must be taken by both parties to make sure all goes well. Insurers need to protect themselves in case an individual has the potential to abuse their policy and require lots of medical care, and the insured person needs to protect themselves with additional insurance in case anything does happen in a very extreme case.