HOW PRE-EXISTING CONDITIONS AFFECT YOUR LIFE INSURANCE OPTIONS

Key takeaways

• Life insurers typically give higher quotes or reject you for coverage if you have pre-existing medical conditions.
• Quotes for people with health conditions can vary a lot by insurer, so it’s important to shop around.
• There are strategies to help you qualify for a better life insurance rate.

Your health is one of the key factors that affect your life insurance quotes. If you have pre-existing medical conditions, insurers typically charge you much higher rates than applicants in excellent health. In some cases you could be declined for coverage. A few key strategies can help you get the best deal when shopping around for coverage if you have pre-existing medical conditions.

What counts as a pre‑existing condition?

Life insurance companies consider many health-related factors when deciding whether to insure you and how much to charge. They focus on health conditions that could affect your life expectancy, such as:

• A history of major medical conditions, such as heart disease, cancer, diabetes and cerebrovascular disease (which can lead to stroke or aneurysm)
• Cognitive impairment, such as Alzheimer’s disease and dementia
• High cholesterol
• High blood pressure
• Obesity, based on your body mass index (the ratio of your height to weight)
• Severe anxiety or depression
• Chronic organ failure

Insurance companies also consider nonmedical factors when doing their life insurance underwriting, such as:

• Whether you smoke or use tobacco products
• Your motor vehicle record
• Your family medical history (among your parents and siblings, especially conditions that caused death before age 70)
• Criminal history
• Risky hobbies
• History of bankruptcy

How pre‑existing conditions impact eligibility and cost

Insurers find out about pre-existing conditions by asking questions on the application, reviewing your medical and prescription drug records, and sometimes requiring a life insurance medical exam.

Some insurance companies might deny your application if you have severe medical conditions. But in most cases, insurers will offer coverage but charge higher rates than they do for applicants in better health. 

Life insurance companies typically have at least five rate classes. The lowest premiums are for the preferred plus class, followed by preferred, standard plus, standard and then table rates for more severe medical conditions, which typically add 25% to the standard premium for each table rating. 

For example, a life insurance company might offer someone with moderate rheumatoid arthritis a rate of table 2 to table 4, depending on the insurer. That would be 150% to 200% the insurer’s standard rate. Some insurers have 8 to 12 table ratings, says Byron Udell, an independent life insurance broker in Chicago.

“Each insurer evaluates risk differently, based on their own mortality data, underwriting philosophy and overall risk pool,” says Stacy Schurter, insurance adviser at SignatureFD a financial-planning firm based in Atlanta. 

Because the specifics can vary a lot by insurance company, it can be especially important to work with an experienced agent or broker who deals with several insurers and can find the ones likely to offer you the best quotes. 

How pre-existing conditions can affect your quotes

You usually have to pay more for life insurance if you have pre-existing conditions, with premiums more than double the preferred rates depending on the severity of your diagnosis. And the range of premiums can vary significantly by insurer for the same conditions. 

Term life insurance costs for a 40-year-old male

Term life insurance costs for a 40-year-old female

*BMI of 35.

**Type 2 diabetes diagnosed a year ago, oral meds, last A1C 6.5.

When a pre‑existing condition might limit your life insurance options

Some types of pre-existing medical conditions lead to automatic declines from most life insurance companies. For example, our analysis of life insurance underwriting guidelines found that many insurance companies will decline applicants with the following conditions: 

• AIDS or HIV positive status
• Alzheimer’s disease or dementia
• Amyothrophic lateral sclerosis (ALS)
• Aortic aneurysm if surgically corrected in the past six months
• Cirrhosis of the liver
• Congestive heart failure
• Current cancer treatment
• Currently on kidney dialysis
• Heart attack within the past six months
• Stroke within the past six months or year

However, it’s possible that some insurers might accept you with these conditions but decline you for other conditions. That’s why working with an experienced agent who is familiar with the marketplace is crucial. 

Life insurance options for applicants with health issues

Unless you have the conditions listed above, you can usually find an insurer that will offer you coverage—but expect to pay higher premiums. If you can’t find affordable coverage when buying an individual life insurance policy, consider these options:

Group life insurance. Take advantage of life insurance available through your employer. Some employers offer all employees basic group life insurance regardless of their health, usually one or two times your annual salary. 

Life insurance through affinity groups. You might be able to buy supplemental life insurance coverage from an affinity group—such as a trade association—without underwriting or with limited medical questions.

Guaranteed issue life insurance. Some insurance companies sell guaranteed issue policies without any medical underwriting, but these policies usually have small coverage limits (usually $20,000 or less). Insurers primarily market those policies to seniors as final expense policies to cover funeral expenses, says Udell. 

Guaranteed issue policies tend to be much more expensive than standard life insurance, and they typically include two-year waiting periods before your beneficiaries can receive the full death benefit. 

“Until then, if a death occurs, the beneficiary would only receive a return of the premiums paid plus interest,” Udell says.

Convert existing term life insurance. If you already have term life insurance but need coverage for longer than the level term period, find out about your policy’s conversion options. Life insurers generally let you convert a term life policy to permanent life insurance during most of the policy term. Your new premiums for the permanent coverage will be based on your older age and your health when you originally bought the term life insurance policy.

Strategies to improve your chances of getting coverage

Several strategies can help you find good life insurance at the best price if you have health issues.

Get help from an experienced agent

A good independent agent or broker who works with many companies should know from experience which ones are likely to offer the best rates for your situation. Ask the agent to anonymously shop your case around to the insurers most likely to give you a competitive quote. That way, you’re not submitting applications that might result in denials, which can make it harder to buy coverage.

Udell recently worked with a new client with significant medical issues who previously received a quote of $40,000 per year for a $1 million, 20-year term life policy. After talking with several insurers, Udell found another company willing to insure the applicant for $5,000 per year.

Add extra information to present a strong case

One reason why Udell was able to get his client a much better rate was because he included a cover letter with the application explaining how the client controlled his condition, that he exercises every day, has good bloodwork and other details about his health. 

“Presenting strong, detailed medical information, such as control with medication, good follow-up care, improved labs, can absolutely strengthen an applicant’s chances,” says Schurter. 

Consider a fully underwritten policy if there are nuances to add

This might seem counterintuitive, but sometimes you can get a better rate if your application goes through full underwriting—which typically includes a life insurance medical exam—rather than accelerated underwriting with no exam. 

“Some of the automated term [life insurance] processes are so streamlined that the application may never be reviewed by an actual person,” says Schurter. The insurer might ask a series of yes/no questions and cross-check those answers against medical records, prescription drug reports and other databases. “There isn’t an opportunity for the insured to provide additional context,” she says.

Avoid genetic testing

If you’re in the market for life insurance, avoid genetic testing until you’ve locked in a policy. Positive markers for certain conditions you don’t even have yet could affect your life insurance quotes. 

Can I get a better rate if my health improves?

If you bought life insurance and paid a higher rate due to a medical issue that has now improved, you can ask your insurer to reconsider your rate, especially if several years have passed since treatment.

You might also benefit from being re-rated if the insurer’s criteria has changed, which can happen based on medical advancements and improvements in longevity. 

“For example, well-controlled diabetes, certain cancers in remission and improved cardiac outcomes are often handled more favorably today than a decade ago,” says Schurter. “On the other hand, carriers now may take a stricter stance on issues like obesity, substance use or mental health concerns.”

Or you might get a better rate by shopping around again. “Most of the time we get them a new policy,” says Udell. Plus, with a new policy, you can lock in the better rate for a longer period.

Shopping for quality products made easy.

Sign up for our Buy Side Newsletter

2025-12-08T22:21:45Z