TL;DR
As an FCA-authorised UK broker that has helped arrange over 900,000 policies, WeCovr provides expert guidance on private medical insurance. Your lifestyle choices, particularly smoking and BMI, are two of the most significant factors insurers use to calculate your premiums. This article explores exactly how much they can affect the price you pay.
Key takeaways
- Smoking status: The single biggest lifestyle factor affecting premiums.
- Body Mass Index (BMI): A key indicator of weight-related health risks.
- Alcohol consumption: The amount and frequency of drinking.
- Age: A non-negotiable factor, as health risks increase as we get older.
- Location: Private healthcare costs vary across the UK, with London being the most expensive.
As an FCA-authorised UK broker that has helped arrange over 900,000 policies, WeCovr provides expert guidance on private medical insurance. Your lifestyle choices, particularly smoking and BMI, are two of the most significant factors insurers use to calculate your premiums. This article explores exactly how much they can affect the price you pay.
How lifestyle factors like smoking and BMI affect PMI premiums
When you apply for private health insurance, providers don't just look at your age and location. They conduct a thorough risk assessment to predict how likely you are to make a claim. This is where your lifestyle comes in.
Insurers are in the business of managing risk. A person with habits linked to poor health outcomes, such as smoking or having a very high Body Mass Index (BMI), is statistically more likely to need medical treatment. This higher risk translates directly into higher monthly premiums.
Think of it like car insurance: a driver with a history of accidents pays more because they are seen as a higher risk. Similarly, in health insurance, lifestyle factors that increase your health risks will increase your costs. The key factors insurers analyse include:
- Smoking status: The single biggest lifestyle factor affecting premiums.
- Body Mass Index (BMI): A key indicator of weight-related health risks.
- Alcohol consumption: The amount and frequency of drinking.
- Age: A non-negotiable factor, as health risks increase as we get older.
- Location: Private healthcare costs vary across the UK, with London being the most expensive.
Understanding these factors is the first step to managing your private medical insurance costs and finding the right cover for your needs.
A Quick Refresher: What is Private Medical Insurance (PMI)?
Before we dive deeper, it's essential to be clear about what private medical insurance is and, crucially, what it isn't.
PMI is designed to cover the costs of private treatment for acute conditions that arise after you take out your policy.
An acute condition is a disease, illness, or injury that is likely to respond quickly to treatment and lead to a full recovery. Examples include joint replacements, cataract surgery, or treatment for a hernia.
What PMI Does Not Cover
This is a critical point: Standard UK private health insurance does not cover pre-existing or chronic conditions.
- Pre-existing conditions: Any illness, disease, or injury for which you have had symptoms, medication, advice, or treatment before your policy start date.
- Chronic conditions: Illnesses that cannot be cured and need long-term management, such as diabetes, asthma, arthritis, or high blood pressure. While PMI won't cover the long-term management of these, it might cover an acute flare-up in some cases, depending on your policy.
PMI is a complement to the NHS, not a replacement. It offers you faster access to eligible treatment, a choice of specialist, and the comfort of a private hospital room.
Smoking and PMI Premiums: The Stark Reality
Of all the lifestyle choices you make, your smoking status has the most dramatic impact on the cost of your private health insurance. Insurers view smoking as a major red flag, and the premium difference between a smoker and a non-smoker can be substantial.
Why Do Insurers Charge Smokers More?
The reasoning is purely statistical and based on overwhelming evidence from health organisations like the NHS. According to the NHS, smoking is the leading cause of preventable death and disease in the UK. It is directly linked to a vast array of serious health problems:
- Cancer: Smoking causes around 7 out of every 10 cases of lung cancer. It is also a major risk factor for at least 14 other types of cancer, including mouth, throat, bladder, and bowel cancer.
- Heart and Circulatory Diseases: Smoking damages your heart and blood vessels, significantly increasing your risk of heart attacks, strokes, and peripheral vascular disease.
- Respiratory Conditions: It is the primary cause of Chronic Obstructive Pulmonary Disease (COPD) and worsens conditions like asthma.
- Slower Recovery: Smokers often have slower recovery times after surgery and are more prone to post-operative complications.
For an insurer, each of these risks represents a potential future claim—and often a very expensive one. To offset this increased financial risk, they apply a significant "loading" to a smoker's premium.
How Much More Do Smokers Pay? A Cost Comparison
The "smoker loading" can increase your premium by anywhere from 30% to 50%, and sometimes even more. The exact amount depends on the insurer, your age, and other risk factors.
To illustrate the difference, let's look at some example monthly premiums.
| Age | Non-Smoker (Est. Monthly Premium) | Smoker (Est. Monthly Premium) | Potential Annual Difference |
|---|---|---|---|
| 30 | £45 | £65 | £240 |
| 40 | £60 | £90 | £360 |
| 50 | £85 | £130 | £540 |
| 60 | £130 | £200 | £840 |
Disclaimer: These figures are for illustrative purposes only and represent a mid-level comprehensive policy outside London. Actual quotes will vary based on individual circumstances, chosen cover level, and insurer. For an accurate quote, it's best to speak with a PMI broker.
As you can see, the financial penalty for smoking becomes more severe with age, as the underlying health risks are compounded.
Who Do Insurers Classify as a 'Smoker'?
This is a common point of confusion. An insurer's definition of a "smoker" is very broad and typically includes anyone who has used any tobacco or nicotine products within the last 12 months.
This includes:
- Cigarettes
- Cigars and pipes
- Vaping and e-cigarettes
- Nicotine replacement products (patches, gum, sprays)
- Heated tobacco products (like IQOS)
Even if you only smoke socially or use a nicotine patch, you must declare it. Insurers operate on a clear binary: you either have used nicotine in the last 12 months, or you have not.
The Impact of Quitting Smoking on Your Premiums
Here's the good news: this premium loading isn't permanent. If you quit smoking and remain nicotine-free for a continuous period (usually 12 months), you can be re-classified as a non-smoker.
How to get your non-smoker discount:
- Quit Completely: You must stop using all tobacco and nicotine products.
- Wait 12 Months: Stay completely nicotine-free for a full year.
- Contact Your Insurer: At your policy renewal, inform your insurer or broker that you have been nicotine-free for 12 months.
- Provide Confirmation: They may ask you to sign a declaration or, in some cases, take a cotinine test (a simple saliva or urine test) to verify your status.
- Enjoy Lower Premiums: Once confirmed, your premium will be recalculated at the lower non-smoker rate.
This can lead to immediate and significant savings, providing a powerful financial incentive to quit, alongside the obvious health benefits.
Beyond Smoking: How BMI Affects Your Health Insurance Costs
After smoking, your Body Mass Index (BMI) is the next most influential lifestyle factor for private health insurance premiums. While not as heavily penalised as smoking, a high BMI can still lead to a noticeable increase in your costs.
Understanding Body Mass Index (BMI)
BMI is a simple measure that uses your height and weight to work out if your weight is healthy. It's the most common tool used by doctors and insurers to assess weight-related health risk.
The formula is: BMI = weight (kg) / [height (m)]²
The NHS uses the following categories to interpret BMI for most adults:
- Below 18.5: Underweight
- 18.5 – 24.9: Healthy weight
- 25.0 – 29.9: Overweight
- 30.0 – 39.9: Obese
- 40.0 and above: Severely obese
While BMI doesn't account for muscle mass versus fat, it remains a reliable indicator of risk for the general population.
The Link Between High BMI and Health Risks
Similar to smoking, a high BMI is statistically linked to a range of serious health conditions that often require medical intervention. According to a 2023 report from the Office for National Statistics (ONS), obesity is a growing public health concern in the UK.
Health problems associated with a high BMI include:
- Type 2 diabetes
- High blood pressure (hypertension)
- Heart disease and stroke
- Certain types of cancer (including bowel, kidney, and gallbladder)
- Joint problems (e.g., osteoarthritis requiring knee or hip replacements)
- Sleep apnoea
- Liver and kidney disease
For an insurer, these conditions represent a higher likelihood of future claims for consultations, diagnostics, and expensive surgical procedures.
BMI and Premium Loading: What to Expect
Most insurers have a "standard" BMI range, typically up to around 30. If your BMI falls within this range, your weight is unlikely to affect your premium.
However, once your BMI goes above this threshold, insurers may start to apply a "loading" or percentage increase to your premium. The higher your BMI, the larger the loading.
| BMI Range | Insurer's Assessment | Estimated Premium Loading |
|---|---|---|
| 18.5 - 29.9 | Standard Risk | 0% |
| 30.0 - 34.9 | Moderate Risk | 10% - 25% |
| 35.0 - 39.9 | High Risk | 25% - 50% |
| 40.0+ | Very High Risk | 50%+ or potential decline |
Important Note: This table is a general guide. Each insurer has its own specific BMI thresholds and loading percentages. Some may be more lenient than others. This is where an expert broker like WeCovr can add huge value by matching you with the provider best suited to your health profile.
In very extreme cases (e.g., a BMI over 45), some insurers may decline to offer cover altogether until the applicant's BMI is reduced.
Other Lifestyle Factors Insurers Consider
While smoking and BMI are the heavy hitters, insurers also take a holistic view of your health and habits.
Alcohol Consumption
During the application, you'll be asked about your weekly alcohol consumption in units. Moderate drinking is unlikely to impact your premium. However, consistently high alcohol intake (well above the NHS recommendation of 14 units per week) can be a red flag. It's linked to liver disease, heart problems, and certain cancers, which may lead to a higher premium or special exclusions on your policy.
Occupation and Hobbies
Your job and hobbies are generally less of a concern for standard PMI, as it doesn't typically cover accidents that would be handled by A&E or fall under a personal accident policy. However, if you have a particularly high-risk profession (e.g., professional diver, bomb disposal expert) or hazardous hobbies, it might be a point of discussion, though it rarely affects premiums for mainstream providers.
How Insurers Reward Healthy Lifestyles
The good news is that the insurance industry is moving towards a more proactive approach to health. Many leading UK providers now offer wellness programmes that reward you for living a healthy life.
The Rise of Wellness Programmes
Providers like Vitality and Aviva have pioneered this model. They offer discounts, cashback, and other perks for engaging in healthy activities. This can include:
- Tracking your daily steps
- Regular gym visits
- Completing online health assessments
- Healthy food purchases
- Mindfulness and sleep tracking
By linking your activity tracker or smartphone app, you can earn points that translate into real financial rewards, including a reduction in your renewal premium. This creates a win-win situation: you get healthier, and the insurer benefits from a lower claims risk.
WeCovr's Commitment to Your Health
At WeCovr, we believe in empowering our clients to live healthier lives. That's why, in addition to finding you the best private health cover, we offer added benefits to support your wellness journey.
- Complimentary CalorieHero Access: All clients who purchase private medical insurance or life insurance through WeCovr receive complimentary access to CalorieHero, our AI-powered calorie and nutrition tracking app. It's a powerful tool to help you manage your diet, understand your nutritional intake, and work towards your BMI goals.
- Multi-Policy Discounts: We value your loyalty. When you take out a PMI policy with us, you can also receive discounts on other types of cover you might need, such as life insurance or income protection, helping you save money while protecting everything that matters.
How to Reduce Your Private Health Insurance Costs
If you're facing high premiums due to lifestyle factors, or simply want to find the most affordable cover, there are several practical steps you can take.
- Quit Smoking: As shown, this is the single most effective way to slash your premiums, with potential savings of up to 50% after 12 months.
- Improve Your BMI: Losing even a small amount of weight to bring your BMI down a category can result in a lower premium at renewal.
- Increase Your Excess (illustrative): The excess is the amount you agree to pay towards a claim. Choosing a higher excess (e.g., £250 or £500) will significantly reduce your monthly premium.
- Choose a Different Hospital List: Insurers offer tiered hospital lists. Opting for a list that excludes the most expensive central London hospitals can lower your costs.
- Opt for a 'Guided' Option: Many insurers now offer "Expert Select" or "Guided" options. With these, the insurer chooses the specialist you see from an approved list, which makes the policy more affordable.
- Review Cover Annually: Don't just auto-renew. The market changes, and your needs might too. A yearly review can uncover better deals.
- Use an Expert PMI Broker: This is the most crucial step. A specialist broker like WeCovr does all the hard work for you. We compare policies from across the market, understand the different underwriting stances on smoking and BMI, and find the provider that offers the best value for your specific circumstances—all at no cost to you. Our high customer satisfaction ratings reflect our commitment to finding the right solution for every client.
The Application Process: Honesty is the Best Policy
When you apply for private medical insurance, you will be asked direct questions about your medical history and lifestyle, including smoking and your height/weight. It is absolutely vital that you answer these questions completely and honestly.
Intentionally hiding your smoking habit or providing a false weight is considered non-disclosure. If you later make a claim and the insurer discovers the truth (which they often do by checking your GP records), the consequences can be severe:
- Your claim will be denied.
- Your policy could be cancelled immediately.
- You may have to pay back any previous claims the insurer has paid.
- It will be much harder and more expensive to get insurance in the future.
The temporary saving from being dishonest is never worth the risk of having your cover invalidated when you need it most.
Do I have to tell my insurer if I start smoking after taking out a policy?
Does vaping count as smoking for private health insurance?
Will my premium go down immediately after I quit smoking?
Are pre-existing conditions related to smoking or BMI covered by PMI?
Your lifestyle choices have a direct and measurable impact on the cost of your private health cover. While factors like smoking and a high BMI will increase your premiums, the UK private medical insurance market is competitive, and there are always ways to find affordable, high-quality cover.
The key is to get expert, independent advice.
Ready to find the right private health cover for you? Let WeCovr do the heavy lifting. Get a free, no-obligation quote today and let our experts compare the UK's leading insurers to find a policy that fits your needs and your budget.
Sources
- Department for Transport (DfT): Road safety and transport statistics.
- DVLA / DVSA: UK vehicle and driving regulatory guidance.
- Association of British Insurers (ABI): Motor insurance market and claims publications.
- Financial Conduct Authority (FCA): Insurance conduct and consumer information guidance.
