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Does Smoking Increase My Medicare Premiums?


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If you are a smoker, you might worry that your Medicare premiums will be higher because of your tobacco use. While that may be true with some health insurance, in general your Medicare premiums won’t be higher if you smoke.

Cost of Medicare premiums for Part A and Part B 

The cost of Medicare premiums for Medicare Part A and Part B are the same nationwide. Some people pay more for Part A or Part B, but the difference isn’t based on health.

  • For Part A, it depends how long you or your spouse worked (if at all) while paying taxes. Most people do not pay a Medicare premium for Part A.
  • The standard premium for Part B is $144.60 per month in 2020, but can be higher for people with higher income levels.

Consistency in the Medicare premium rates means you will pay about the same for Original Medicare whether you smoke or not.

Medicare premiums: the cost of Medicare Advantage premiums

Medicare Advantage, also known as Medicare Part C, offers an alternative way to get your Original Medicare (Part A and Part B) benefits. Some Medicare Advantage plans provide additional benefits, like routine vision and dental care.

These plans are offered through private, Medicare-approved insurance companies, and the Medicare Advantage premiums may vary somewhat from company to company. However, these plans are required to provide the same coverage as Original Medicare to both smokers and non-smokers.

Medicare premiums: the cost of stand-alone Medicare Part D prescription drug plan premiums

Like Medicare Advantage plans, stand-alone Medicare Part D prescription drug plans are available from private, Medicare-approved insurance companies. Medicare Part D premiums may vary from plan to plan, but they are not higher if you smoke. Read more about Medicare Part D.

Cost of Medicare Supplement premiums

As the name suggests, Medicare Supplement plans are designed to be used in addition to Original Medicare to fill in coverage gaps such as coinsurance, copayments, and deductibles. These plans can require medical underwriting, which may increase Medicare premiums for smokers. Studies have found rates can be as much as ten percent higher if you smoke.

While you may pay more in Medicare Supplement premiums for these plans in some cases, there are situations where insurance companies cannot charge more if you smoke.

For example, if you buy a plan during your Medicare Supplement Open Enrollment Period (OEP), you are not subject to medical underwriting. This OEP begins the month when you are both aged 65 or over, and enrolled in Medicare Part B. The OEP goes for six months. There are other situation is when you might have guaranteed-issue rights to buy a plan, described below.

Smoking and Medicare Supplement eligibility: what are guaranteed-issue rights?

When you have guaranteed-issue rights to buy a Medicare Supplement insurance plan, that means an insurance company can’t deny your application or charge you a higher premium due to health conditions. Of course, you have to be enrolled in Medicare Part A and Part B to qualify.

For example, if you lose your insurance coverage due to circumstances beyond your control, you might have guaranteed-issue rights. If you qualify for guaranteed-issue rights, insurance companies cannot raise your Medicare premiums due to pre-existing conditions or the fact that you smoke. Under guaranteed-issue rights, insurance companies also cannot refuse you coverage based on those same pre-existing conditions.

Here are some other examples of when you might have a guaranteed-issue right to buy a Medicare Supplement insurance plan, even if you smoke:

  • Your Medicare Advantage plan leaves Medicare.
  • You move out of your service plan area or your plan stops offering coverage in your area.
  • Your employer group plan, including COBRA, is ending.
  • You are in a Medicare Advantage plan “trial period” and wish to switch back to Original Medicare and buy a Medicare Supplement insurance plan. Generally trial periods last no longer than a year, and only apply in certain situations.
  • You lose your Medicare Supplement insurance plan.

Some states might extend guaranteed-issue rights to other situations. You might want to check with your state’s department of insurance to learn more about smoking and Medicare Supplement eligibility.

If you wish to compare Medicare health plan premiums today, you can use our comparison tool. Simply enter your zip code, click the link, and follow the steps to compare plans in your area.

The product and service descriptions, if any, provided on these eHealth web pages are not intended to constitute offers to sell or solicitations in connection with any product or service. All products are not available in all areas and are subject to applicable laws, rules, and regulations.

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