Under Section 1557, a health plan sold through a state exchange may, based on an individual's age, charge higher premiums.

Under Section 1557, a health plan sold through a state exchange may, based on an individual's age, charge higher premiums.

• A. No.
• B. Only for individuals over 65.
• C. Only if not insured previously.
• D. Yes.

Answer: (D)

Age can be used as a legitimate rating factor in health insurance pricing, even for plans sold on state exchanges. Section 1557 prohibits discrimination in access to health programs and activities on the basis of age, sex, disability, and other protected characteristics, but it does not ban charging different premiums by age. Under the ACA, insurers may set premiums higher for older individuals (within capped age-rating rules) because older people tend to incur higher medical costs. This is why a health plan may charge higher premiums based on age.

Age can be used as a legitimate rating factor in health insurance pricing, even for plans sold on state exchanges. Section 1557 prohibits discrimination in access to health programs and activities on the basis of age, sex, disability, and other protected characteristics, but it does not ban charging different premiums by age. Under the ACA, insurers may set premiums higher for older individuals (within capped age-rating rules) because older people tend to incur higher medical costs. This is why a health plan may charge higher premiums based on age.