For marketplace plans that can increase premiums 50 percent for tobacco users, “tobacco use” means a person has used a tobacco product an average of four or more times per week for the past six months. A state can increase the number of times per week or reduce the “look-back” period to less than six months. Check with your state marketplace to learn more about tobacco surcharges and how they work.
The surcharge on tobacco users can only be applied to an individual who can legally purchase a tobacco product in the state. Thus, the surcharge does not generally apply to a person under age 18. Outside the marketplace, not all plans are required to offer coverage to tobacco users or limit the premium increase to 50 percent. (45 C.F.R. § 147.102).