Health insurance heavyweight Southern Cross Healthcare is set to penalise junk food eaters and smokers while rewarding those with gym memberships.
Health insurance companies are also investigating higher rates dependent on gender: women in their 30s and 40s are considered high-risk, as are older men.
But there are fears the new premiums could encourage patients to lie to their doctors about their smoking and eating habits.
Medical Association chairwoman Dr Tricia Briscoe said people needed to realise if they were caught lying they would not only have to pay higher premiums but would lose existing insurance cover.
Southern Cross is to announce details of its "wellness programme" in the next two or three months.
Group chief executive Dr Ian McPherson said members who met healthy lifestyle criteria were likely to be rewarded with discounts on their premiums.
Initiatives could include collaborating with gymnasium owners to provide discounts to members who buy gym subscriptions.
"We don't want to make it so draconian that people are reluctant to make claims but we do want to encourage a healthy lifestyle and reward people if they make an effort to stay healthy."
Tower Insurance has introduced exclusions for overweight people and Sovereign Insurance expects to bring in higher premiums for smokers within 12 months.
Encouragement for those with bad health habits to change would also be given, such as supporting smoking and weight-loss programmes or working with doctors to check members' fitness and health.
Overseas, insurance companies have arranged discount gym memberships in exchange for membership list updates but Mr McPherson would not reveal how gym use or fitness would be monitored.
He indicated it would involve working with doctors and employers.
Though doctors would be able to measure the health level of a patient, Mr McPherson said, care would need to be taken with assessments when the health status of a person changed - if, for example, they became ill.
He conceded the move would require a quantum change in attitude by members.
"People take out health insurance because they expect to make claims. It is a bit different to house or car insurance," he said.
Sovereign Insurance health general manager Trevor Lynds said his company was set to bring in different premiums for smokers and had begun discussions about rates conditional on gender and weight.
Reece Zondag, chief executive of the country's biggest gym chain, Les Mills, said gyms were bringing in a national registration system from September 1, a first step to working with the insurance companies.
"We've always believed that exercise is an important part of health."
- NZPA
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