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Life insurance with pre-existing conditions: What to know in 2021

If you have a pre-existing condition, chances are you know from firsthand experience just how complicated buying insurance can get. Here's what to people with pre-existing conditions need to know about life insurance.

Insurance companies can’t cover everybody. If there’s a better-than-average chance an applicant will pass away while a policy is active, insurers will likely deny coverage.

That’s why insurers who issue individual life insurance policies conduct a thorough underwriting process. They review your age, conduct a medical exam, ask health and lifestyle questions, and collect a blood sample to assess your overall health.

But what can affect your ability to buy life insurance most is having a pre-existing condition.

What is a pre-existing condition?

A pre-existing condition includes any health issue or condition that existed before you applied for insurance coverage. Examples of pre-existing conditions include:

  • Cancer
  • Heart disease
  • Diabetes
  • Mental illness
  • Sleep apnea
  • HIV/AIDS
  • Asthma
  • Epilepsy
  • Autism
  • Obesity

The Kaiser Family Foundation found that about 27 percent of adults under 65 have pre-existing health conditions that would likely have made them uninsurable for private health insurance before the Affordable Care Act.

What to know when shopping for coverage

A pre-existing condition does not necessarily prevent you from getting individual life insurance. It may, however, increase your cost compared to similar applicants with no-preexisting conditions.

Pre-existing conditions are not treated the same by underwriters. They will review the seriousness and duration of your condition, as well as how it’s being treated. For example, cancer that has been in remission for several years will be looked at more favorably than if a person had just completed chemotherapy.

In addition, your pre-existing condition won’t be the only factor that underwriters use to determine your insurability. Underwriters also consider your:

  • Age
  • Gender
  • Height and weight
  • Family history
  • Tobacco or alcohol use
  • Driving record
  • Employment
  • Hobbies

Based on these factors, plus your pre-existing condition, the insurance company will assign you a rating. The most common rating is standard, which means the applicant carries an average amount of risk.

If you are young, in optimal health, and/or carry few other risk factors, you may receive a select or preferred rating, which will result in paying less premium than if you qualified as a standard risk.

If you carry above-average risk factors, you may receive what is called a table rating. Table ratings allow an insurer to further assess an applicant in accordance with their risk level and to provide coverage at an increased rate.

Tables ratings are usually letter grades from A to whatever the lowest rating an insurer will consider. For example, an applicant that has a table rate of A will usually pay the standard rate plus an additional percentage.

If you’re a diabetic who regularly exercises and maintains your weight and glucose levels, insurers may look more favorably on you than if you’re an obese smoker with no pre-existing conditions.

Life insurance for pre-existing conditions

The best way to get affordable life insurance with a pre-existing condition is to shop around. Work with an independent insurance agent or broker who can help you find a carrier that covers applicants with pre-existing conditions.

Keep in mind that insurers have varying underwriting standards. One insurer may balk at insuring somebody who has had open-heart surgery, while another could approve coverage if the same applicant maintains an acceptable weight, cholesterol, and blood pressure.

You may also want to check out insurers that offer policies that specifically cater to applicants with preexisting conditions. Examples include:

Guardian Life offers term and whole life policies to people with HIV. To qualify, the applicant must:

  • Self-identify as an individual living with HIV
  • Be on highly active antiretroviral therapy for at least two years and demonstrate favorable lab results
  • Not have had an AIDS-defining illness
  • Be between ages 20 and 60
  • Be under the care of a doctor specializing in HIV

John Hancock has a special program called Aspire designed for people living with type 1 or type 2 diabetes. It combines life insurance with benefits and rewards to support healthy living — including the chance to save up to 25 percent off the cost of your insurance. It is available with any John Hancock term or permanent life insurance policy.

Other ways to get life insurance with a pre-existing condition

If your pre-existing condition is serious enough that you can’t find affordable life insurance, there are other ways to get covered.

One option is to find a guaranteed issue life insurance plan. With guaranteed issue life insurance, there is no underwriting. Anybody who applies for coverage will typically be issued a policy. While guaranteed issue policies don’t usually provide the same level of coverage as an individually underwritten policy, they can provide some financial support.

Examples of guaranteed issue life insurance include:

Group life insurance

Group life insurance covers the lives of several individuals, usually based on employment with the same employer or on membership with the same organization. It is typically cheaper because the life insurance company is collecting premiums and spreading its risk among multiple people. Also, group policies are sometimes provided at no cost to the insureds by the plan sponsor, be it an employer or association.

If your employee benefits package includes group life insurance, you will typically be able to sign up for the plan upon getting hired. If you decline coverage when you join the company, you may have another chance during your company’s annual benefit open enrollment period. The open enrollment period may also enable you to increase your life insurance coverage each year, though that option may be subject to a cap.

Keep in mind that group life insurance plans limit the amount of coverage you can apply for. Employers, for example, often limit your coverage to an amount based on your salary. Also, group life is typically contingent on your employment or group membership and is not portable.

Learn More: Group Life Insurance

Final expense insurance

This is a type of permanent life insurance designed to provide funeral expenses and any final medical bills. This is a permanent type of life insurance policy, so it does not expire as long as you pay the premium. Final expense insurance typically does not require full underwriting.

Learn More: Final Expense Life Insurance

AD&D insurance

Accidental Death & Dismemberment (AD&D) insurance is a subset of life insurance with some similarities to disability coverage. It provides benefits if an insured is the victim of an accident that causes death, dismemberment, or disability. An AD&D policy will not pay a death benefit if the insured dies from an illness. Since benefits are only paid due to accidents, there is no medical underwriting involved with AD&D insurance. In most cases, you are guaranteed AD&D coverage.

Learn More: AD&D Insurance


Joel Palmer is a freelance writer and personal finance expert who focuses on the mortgage, insurance, financial services, and technology industries. He spent the first 10 years of his career as a business and financial reporter.

The information and content provided herein is for educational purposes only, and should not be considered legal, tax, investment, or financial advice, recommendation, or endorsement. Breeze does not guarantee the accuracy, completeness, reliability or usefulness of any testimonials, opinions, advice, product or service offers, or other information provided here by third parties. Individuals are encouraged to seek advice from their own tax or legal counsel.