Quick answer
On an ACA plan, your premium generally won’t change in the middle of the plan year. Your tobacco status is set when you enroll, and you’ll answer the tobacco question again when you update your coverage for the next year. Answer it honestly then. If you weren’t truthful when you applied, the insurer can charge the tobacco surcharge back to the start of the plan year, though it can’t cancel your coverage for that.
Key takeaways
- Your tobacco rating is set when you enroll in an ACA plan.
- For insurance, tobacco use means using tobacco four or more times a week on average within the past six months.
- If you misstate your tobacco use, the insurer can add the surcharge back to the start of the plan year, but it can’t cancel your coverage over it.
- In most states the surcharge can be up to 50% of your premium, and tax credits don’t cover it.
- Quit-smoking help is covered at no cost on ACA plans.
On this page
If you start smoking during the plan year
Insurers set your premium when you enroll, based in part on your answer to the tobacco question. Starting to smoke later in the year generally doesn’t change what you pay for the rest of that plan year. When you update your application for the next year, answer based on your tobacco use at that time. If you’ve been using tobacco four or more times a week on average over the past six months, you’re a tobacco user for insurance purposes.
The surcharge affects your premium only. Your deductible, copays and covered benefits stay the same; see how deductibles work.
If you weren’t honest when you applied
If you report false information about tobacco use, the insurer is allowed to charge the tobacco surcharge back to the beginning of the plan year. It isn’t allowed to cancel your coverage because of it. ACA plans ask about tobacco use rather than testing you, but life insurance applications and some employer wellness programs do use blood or urine tests. See nicotine tests and health insurance.
Job-based plans and family coverage
If your employer charges tobacco users more, you may be asked to confirm your tobacco status each year, often through a wellness program. Employers generally have to offer a way to avoid the charge, like a quit-smoking program.
On a Marketplace plan, the surcharge applies to each person on the plan who uses tobacco, not the whole family; see covering all family members under the same policy.
How much the surcharge can cost
In most states, ACA plans can charge tobacco users up to 50% more, and premium tax credits don’t cover the extra. Some states ban the surcharge or cap it lower. See does smoking affect your health insurance rates and how health insurance rates are determined.
Quitting
ACA plans cover quit-smoking counseling and FDA-approved medicines at no cost, and you can call 1-800-QUIT-NOW for free help. Once you haven’t used tobacco regularly for six months, you can answer “no” on your next application, which is one of the simplest ways to save on health insurance. Insurers set their own surcharges, so compare companies too; see the best health insurance companies.
Compare plans in your area: see quotes by ZIP code.
Frequently asked questions
Will my premium go up if I start smoking mid-year?
Generally not until your next plan year. Update your tobacco status honestly when you renew.
Can my insurer cancel my plan if I lied about smoking?
Not on an ACA plan. It can charge the surcharge back to the start of the plan year.
Do I have to tell my insurer if I quit?
You can answer “no” on your next application once you haven’t used tobacco regularly in the past six months.
Does the surcharge apply to my whole family?
No. On a Marketplace plan, it applies only to the people who use tobacco.
Sources
This article is general information, not legal advice. Last reviewed September 2026.