Substandard Health Insurance

Updated: 05 December 2024

What Does Substandard Health Insurance Mean?

Substandard health insurance refers to health coverage provided to policyholders who have a serious illness, medical condition, adverse medical history, or unhealthy lifestyle. These individuals are rated below standard by insurers due to the higher risk they pose based on their mental and physical condition. As a result, they typically pay higher premiums than healthier policyholders and may encounter certain coverage restrictions.

Insuranceopedia Explains Substandard Health Insurance

Insurers assess applicants’ medical conditions and past medical histories to evaluate their overall health and classify their risk as standard, substandard, or otherwise. Applicants with higher or substandard risk levels increase the likelihood of the insurer incurring losses due to more frequent or larger claim amounts. To offset this elevated risk, substandard health insurance typically includes special provisions or higher premiums.

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