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Effects of Alcohol Consumption on Health Insurance Premiums & Coverage

By Juhi Walia
23 August 2022, 11:42 AM

Alcohol consumption is now more of a lifestyle than a decision, particularly in large cities. This does not negate the reality that alcohol is bad for us and that drinking too much of it can cause serious illnesses, including heart disease and liver cirrhosis. As a result, many people are curious as to whether or not alcohol users can purchase health insurance. A majority of them believe their insurance claims will be rejected. Even while they might not reject your application outright, there's a likelihood of the insurance company increasing the premium considering the high risk factor. But getting a clear picture of the sum insured and the premium will be vital. So, let’s not assume the price rise before knowing the exact impact of alcohol consumption on health insurance.

Is Health Insurance Cover Offered to Those Who Consume Alcohol?

While moderate alcohol use is acceptable, excessive drinking might be a severe worry for all insurance companies. This is because excessive drinking has been linked to harmful illnesses like high blood pressure, liver and renal problems, and cardiovascular issues. In addition to this, there are instances where excessive alcohol use might result in mental instability and persistent cravings.

What Effect Does Alcohol Consumption Have on Health Insurance Premiums?

It is not difficult for someone to qualify for and acquire a health insurance policy if they consume alcohol in moderation on rare occasions and that it has no negative effects on their health. However, there is a possibility that the insurance provider may deny your insurance application if you consume alcohol excessively and regularly. If you already have a policy, your premium will be far greater than what someone your age who doesn't drink would pay. So, alcohol consumption can significantly determine your health insurance premium

When someone starts drinking after purchasing a health insurance policy, the insurance provider may undertake a medical evaluation. The provider may raise the amount of the premium you are paying if the blood alcohol level is beyond the permitted limit. To avoid paying a larger premium, you must always keep a careful eye on your alcohol consumption. Even if the provider does not carry an evaluation, you should tell it the truth. Because if you hide this and face health issues due to the same, the insurer can reject your health insurance claim. Insurance providers ask for a medical investigation report where this alcohol consumption thing will pop up. God forbid, if that happens, you may have to pay for the treatment. Many hide this to prevent a skip in the premium hike. But the after-effect of claim rejection is far more crushing financially.

Alcohol drinking causes serious health problems, which raises the insurance company's responsibility and results in increased premiums for you. So, if you are a drinker, tick ‘alcoholic’ while generating health insurance quotes. Experiment by ticking non-alcoholic drinks and see the effect. That will show you the difference. Also, if you are planning a family floater health insurance plan, the premium will depend on you and your drinking habits, assuming you are the eldest member of your family.

What is the Standard Alcohol Acceptance Level for an Insurance Company?

The amount of alcohol a policyholder is permitted to consume frequently varies between health insurance companies. Even if drinking alcohol in any amount is detrimental to your health, if you have a habit of doing so, look to do so in moderation and at the level advised by your health insurance provider.

Alcohol consumption has a cap set by the Centers for Disease Control and Prevention (CDC), and exceeding that level is considered excessive drinking. In India, 0.03% of a person's blood must be within the legal limit before driving. Thus, the recommended alcohol intake is 30 milligrams of alcohol per 100 ml of blood. If you consume alcohol above this limit, your insurance provider will likely view you as posing an elevated risk and raise the cost of your health insurance premium.

The frequency of your drinking may not affect the acceptance rate of your health insurance application, but binge drinking may. You should speak with a healthcare professional if you believe you have excessive drinking syndrome so they can advise you on how to reduce or limit your alcohol use.

Are There Any Alcohol-specific Health Insurance Exclusions?

Even if you have alcohol moderately before being admitted to the hospital, health insurance providers cannot deny your claim. Any claim made for a condition or injuries resulting from alcohol use, however, will not be covered by your policy if you are an alcoholic or a heavy drinker. This is a typical alcohol exclusion in health insurance. 

It may also render claim settlements impossible. This is because all health insurance policies in India can exclude claims made for accidents or illnesses brought on by alcoholism or caused while under the influence of alcohol.

Read more - Do You Know What Your Health Plan did not Cover?

Conclusion

Alcohol consumption has negative implications on health insurance coverage. As a result, it is advised to steer clear of alcohol and maintain a healthy lifestyle. When applying for insurance, it's crucial to let the insurance company know whether you're an alcoholic. The insurance provider may decide to reject the claim or cancel the policy entirely if the fact is not reported and it is later discovered that the applicant had failed to disclose it.

Read more -

FAQs

1. What is the permissible alcohol level by an insurance provider standard?

The Centers for Disease Control and Prevention (CDC) have determined an upper limit for alcohol intake, and going above that limit is regarded as excessive drinking. A person cannot drive in India if their blood concentration is higher than the allowed limit of 0.03%. As a result, 30 mg of alcohol per 100 ml of blood is the advised intake.

2. What are the exclusions in terms of health insurance premium, if I am a moderate drinker?

Health insurance companies cannot reject your claim, even if you consumed alcohol in moderation before being brought to the hospital. However, if you are an alcoholic or a heavy drinker, any claim made for a condition or injuries brought on by alcohol usage would not be covered by your policy.

3. What are the basic features in a health insurance policy offered to those who drink alcohol?

The most basic features covered are in-patient hospitalisation, co-payment or deductibles, cashless facility and lifelong renewability.

4. What are the rules for heavy drinkers?

Any claim made for an illness or injuries resulting from alcohol usage will not be covered by your policy if you are an alcoholic or a heavy drinker.

5. Why are health insurance premiums so high for those who consume alcohol on a regular basis?

Alcohol drinking causes serious health problems, which raises the insurance company's responsibility and increases premiums for you.

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