Exploring the Determinants of Medical Insurance Expenses: A Quantile Regression Approach

Abstract

Healthcare insurance costs are influenced by a combination of biological and socioeconomic factors. This study investigates how age, body mass index (BMI), gender, and discount eligibility affect medical insurance expenses in the United States, using data from 1,338 individuals. Due to the right-skewed distribution of expenses, quantile regression was applied at the 25th, 50th, and 75th percentiles, providing insights across low-, medium-, and high-cost groups. Results show that age and BMI consistently increase insurance expenses, with stronger effects among high-cost patients. Genderdifferences also emerged, with females incurring higher costs than males at certain expenditure levels. Discount eligibility significantly reduced expenses across all quantiles. In contrast, the number of children was not a significant predictor and was excluded from the final model. Compared to ordinary least squares regression, quantile regression provided a more accurate assessment of cost determinants in skewed data. These findings highlight the importance of adopting advanced modeling approachesin insurance pricing and suggest that targeted policies addressing individuals having high BMI and equitable discount programs could improve healthcare affordability and risk management.