Health insurance for Preferred-risk Applicants

TA | January 1, 2010


Some very healthy people who meet specific medical guidelines may qualify significant discounts on health insurance rates in the same way that those individuals with clear driving records qualify for discounts on auto insurance.  Overall, only about 1 in 20 Americans qualifies for this preferred rating and not all health insurance companies utilize this type of tiered risk pricing system.

To qualify for preferred risk rates, an applicant must generally have a build that falls within the normal range as determined by AMA gender-specific height/weight guidelines. No prescription drugs may be taken at the time of application and the applicant should be generally free of significant medical treatment for the past five years. A normal healthy physical exam with favorable BP, cholesterol measurement and blood test with normal results should have been completed within the past twelve months.

Note that heavily muscled athletes will not qualify for the discount despite a perfect health history because the AMA height/weight guidelines do not distinguish between various types of body mass, and so many elite athletes are medically classified as "overweight".

This class of preferred risk applicants often favor high deductible low cost health insurance plans including insurance that qualifies for Health Savings Accounts. The amount of the premium discount ranges from about $200 for an average single to about $600 for a typical family.

Two excellent sources of nationwide coverage available online for long term renewable coverage are Celtic Insurance and Golden Rule Insurance (now known as UnitedHealthcare). Both of these companies are known for innovative ways to reduce costs for healthy applicants and offer individual and family plans that quality for Health Savings Accounts (HSA). Online rate quotes and application is available in most states except New Jersey, New York, Massachusetts, Rhode Island and Vermont. Group policies and managed care plans like Blue Cross generally do not currently offer preferred risk pricing since this is viewed as a form of prohibited discrimination.

Because of the strict scrutiny of applications for preferred risk plans, it is best to continue other health insurance until the preferred risk plan is approved. Keep in mind that the majority of applicants making insurance applications will not be issued at preferred risk prices although it is always possible to apply for an improved rate class at a later date.

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