Gender can cost you in individual health insurance

When it comes to health insurance, Valencia resident Tova Hack's first problem is that she works part time and thus needs an individual policy for medical coverage because her employer doesn't offer one.

Her second problem is that she's a woman.

Hack, 22, a grad student at Cal State Northridge, is insured by Blue Shield of California. She just found out that the cost of her bare-bones, high-deductible insurance plan is going up 20%, to $119 a month from $99.

But the real surprise -- which Blue Shield neglected to point out in its recent letters to individual policyholders but which was apparent from a close reading of an accompanying chart -- is that men and women will now be charged different rates.

The change takes effect July 1.

"I don't think it's fair at all," said Hack. "I'm in perfectly fine health."

That may be. But as far as Blue Shield is concerned, Hack and all other women are somehow more accident-prone, or more likely to break a bone, or more susceptible to costly ailments.

Why? Because they're women.

"Our egghead actuaries crunched the numbers based on all the data we have about healthcare," explained Tom Epstein, a Blue Shield spokesman. "This is what they found."

That women get sicker than men?

"It's all about the statistics," Epstein said.

It's not about pregnancy, though. Hack's policy doesn't even cover pregnancy and maternity care.

No, this is purely a matter of Blue Shield deciding that women, as a general rule, are more expensive to insure than men.

Perhaps this is partly because women are more likely to seek preventive care, according to the Kaiser Family Foundation. But this should make them better insurance risks. After all, they're proactively working to stay healthy.

And isn't that exactly what insurers encourage people to do?

"It doesn't make any sense," said Alice Wolfson of United Policyholders, a San Francisco-based advocacy group. "The insurers aren't assessing risk. They're assessing how much healthcare is used, even when it's preventive treatment."

A spokesman for the California Department of Insurance said there were no regulations preventing gender-based pricing for individual policies.

Vehicle insurers also use gender in determining rates. In their case, though, men often pay more for coverage because they're viewed as the greater risk. Supposedly guys drive more recklessly and get into more accidents.

Yet men are nevertheless viewed as a lesser medical liability than women, who live longer on average because they tend to eat right, exercise more frequently and take better care of themselves.

Men and women start out as equals in Blue Shield's eyes. The pricing chart for the insurer's Balance Plan 1700 -- the plan Hack signed up for -- shows that 18-year-old men and women are both charged $98 a month.