Could Medicare ever adopt a tiered premium system based on lifestyle factors?

Question

Larry Dalton · Accepted Answer

This question is a very vague question and difficult to answer without understanding the individual circumstances.

Medicare has tiers of cost in their Part B and part D premiums and are based on your income. This does not affect the average Medicare beneficiary unless you’re in those high-income brackets.  

Insurance companies operate on different levels, and their cost structure includes high and low deductibles, that can affect your cost.

Lt Col Tim Brown · Answer

That doesn’t appear to be in the horizon.  No one in my circles have mentioned anything to the effect either.

David Bell · Answer

Medicare supplement plans do surchage for tabacco use, build (height/weight) and health factors. Original Medicare and Medicare Advantage do not. It would take a major change to the Medicare system that probably won't happen.

Answered by David Bell on April 17, 2025

Agent Licensed in ID, AZ, CA & 8 other states

Answered by David Bell Medicare Insurance Agent

Steven Bleicher · Answer

I seriously doubt that since that would take a lot of time for the Senate and the House to come to an agreement. Don’t expect it anytime soon!

Chad Watkins · Answer

Anything is possible but Medicare adopting a tiered premium system based on non-health lifestyle factors is unlikely. Medicare supplement premiums already consider health lifestyle factors, for example, they charge a higher premium for people who smoke.

Answered by Chad Watkins on May 17, 2025

Agent Licensed in NJ, AK, AL & 48 other states

Answered by Chad Watkins Medicare Insurance Agent

Walt Smith · Answer

It is not likely because if they had a different tier system, it would require some level of health underwriting. That is not the basic under structure of Medicare.

Jill Belvin · Answer

That could potentially happen, however it would be a challenging and controversial process. Medicare is currently a single tiered system and provides coverage for elderly and low income as well.

Suzanne Lamperti · Answer

They have a tired premium already based on income. (SSA Retirement, Pension, and work income). Nit sure what other factors they would consider.

Robert Baez · Answer

That could potentially happen; however, it would be a challenging and controversial process. Medicare is currently a single tiered system and provides coverage for elderly and low income as well.

Steven Rodriguez Giudicelli · Answer

While Medicare premiums are currently based primarily on income, particularly for Parts B and D through the Income-Related Monthly Adjustment Amount (IRMAA), there isn't currently a system in place to adjust premiums based on lifestyle factors like smoking or BMI. Introducing such a system would involve significant legal, ethical, and practical considerations regarding fairness, privacy, and the role of health insurance in incentivizing behavior versus providing a safety net. It's a complex issue with ongoing discussions but no current indication of imminent adoption by Medicare.

Answered by Steven Rodriguez Giudicelli on June 3, 2025

Broker Licensed in FL & TX

Answered by Steven Rodriguez Giudicelli Medicare Insurance Agent

Nina Besant · Answer

I am not sure I understand this question. I feel like medicare has lots of options and can be based on budget, health factors, lifestyle and what that individual client wants. They have different premium's based off of if you're looking a Medicare Supplement (medigap) plan or a Medicare Advantage plan.

Answered by Nina Besant on May 26, 2025

Broker Licensed in CO, AZ, FL & 7 other states

Answered by Nina Besant Medicare Insurance Agent

Melanie Blackston · Answer

It is unlikely Medicare would implement a system based on lifestyle as many factors would have to be considered. In the current form due to potential inequities and practical challenges the current Medicare system largely bases premiums on income.

Answered by Melanie Blackston on May 28, 2025

Broker Licensed in SC, GA & NC

Answered by Melanie Blackston Medicare Insurance Agent

Veronique Kasbarian · Answer

Medicare is based on ones qualification as what a person  have paid into , like worked for ten years/or 40 quarters based on their Tax bracket..not on ones life style...

Could Medicare ever adopt a tiered premium system based on lifestyle factors?

Agents: Share Your Expertise

Seniors: Ask a Question of Your Own

Related Questions

Agent Locator

Medicare Agents Hub
A non-government resource website

Could Medicare ever adopt a tiered premium system based on lifestyle factors?

Agents: Share Your Expertise

Seniors: Ask a Question of Your Own

Related Questions

Agent Locator

Medicare Agents HubA non-government resource website

Medicare Agents Hub
A non-government resource website