Life Insurance with Pre-Existing Conditions: How to Get Covered

Can You Get Life Insurance with a Pre-Existing Condition?

Yes. A pre-existing condition does not automatically bar you from life insurance. Millions of Americans with diabetes, heart disease, cancer history, and other chronic conditions carry active policies. What changes is the type of policy available, the premiums you pay, and the coverage amount you can secure.

The outcome depends on three factors: the specific condition, its severity and how well it is controlled, and whether you are actively following treatment. Insurers are not looking for perfection — they want evidence that your condition is stable and managed responsibly. This guide covers how underwriting works, your policy options, and strategies for getting the best rate regardless of your health history.

How Insurers Evaluate Pre-Existing Conditions

When you apply, the insurer's underwriting department evaluates your health profile to classify your risk and price your policy. This involves a paramedical exam (blood pressure, blood work, urine sample), your attending physician statement with diagnoses and treatments, the Medical Information Bureau (MIB) database that stores coded information from previous insurance applications, and prescription drug databases that reveal your medication history and compliance.

Based on this data, the underwriter assigns you a risk classification that determines your premium. The hierarchy runs from Preferred Plus (best health, lowest rates) through Preferred, Standard, and Substandard or Table Rated (highest risk, highest rates). Table ratings add 25% per table to the standard rate — a Table 2 rating means 50% more than standard, Table 4 means 100% more.

Common Pre-Existing Conditions and Their Impact

Not all conditions are treated equally. Here is how insurers typically view the most common ones.

Diabetes

Well-controlled Type 2 diabetes can qualify for Standard or even Preferred rates. Key factors include A1C level (ideally below 7.0), length of diagnosis, presence of complications, and cardiovascular health. Type 1 diabetes is underwritten more conservatively but is still insurable, typically at Standard to Table 2 rates.

Heart Disease

Outcomes depend on the specific condition, when it occurred, and current cardiac function. A single heart attack five or more years ago with successful treatment and normal ejection fraction can qualify at Standard to Table 2 rates. Coronary artery disease managed with stents or medication is generally insurable at substandard rates. Congestive heart failure or multiple cardiac events may require specialized carriers.

Cancer (In Remission)

Cancer type, stage, treatment, and remission length all matter. Early-stage cancers like basal cell skin cancer or stage 1 breast cancer may qualify for Standard rates after one to two years in remission. More aggressive cancers typically require three to five years. Some carriers specialize in cancer survivors and offer coverage sooner.

High Blood Pressure

Hypertension affects nearly half of American adults and is among the most common conditions in underwriting. Mild to moderate hypertension controlled with one or two medications can qualify for Preferred or Standard rates. Uncontrolled readings above 160/100 or resistant hypertension requiring multiple medications results in substandard ratings.

Depression and Anxiety

Mild to moderate depression or anxiety managed with stable medication and therapy can qualify for Preferred or Standard rates. Insurers look for stability — no recent hospitalizations, consistent treatment, and ability to maintain daily activities. Severe cases involving psychiatric hospitalization or disability may result in substandard ratings.

Asthma

Asthma is one of the more favorably viewed conditions. Mild to moderate asthma controlled with an inhaler and without frequent ER visits can qualify for Preferred rates. Severe asthma requiring oral corticosteroids or frequent hospitalizations results in substandard ratings.

Obesity

Insurers use build charts that correlate height and weight to mortality risk. A BMI of 30 to 35 with no other issues can often qualify for Standard rates. Above 35 typically results in substandard ratings, and above 40 to 45 may make traditional coverage difficult. The impact compounds with co-occurring conditions like diabetes. Sustained weight loss of at least 12 months can improve your classification.

Sleep Apnea

Obstructive sleep apnea diagnosed and treated with a CPAP machine is generally insurable at Standard to Preferred rates. Insurers want to see regular CPAP compliance and no significant complications. Untreated sleep apnea is a red flag because it increases the risk of heart attack, stroke, and sudden death.

Risk Classifications Explained

Your risk classification is the single biggest factor in what you pay. Preferred Plus — the best class — accepts roughly 10% to 15% of applicants with no significant medical history. Preferred captures those with minor, well-controlled issues. Standard is where most applicants with manageable pre-existing conditions land. Substandard or table-rated classes apply when conditions increase mortality risk beyond average.

To illustrate: a 45-year-old woman buying a $500,000 20-year term might pay $30 per month at Preferred Plus, $38 at Preferred, $52 at Standard, $78 at Table 2, and $104 at Table 4. Over 20 years, the difference between Preferred Plus and Table 4 exceeds $17,000 in total premiums. Each insurer has its own guidelines, so one carrier may rate your condition as Standard while another rates it Table 2 — shopping multiple carriers matters.

Fully Underwritten Policies

Fully underwritten policies involve the most thorough evaluation — medical exam, blood work, health records, prescription checks — but offer the best rates for manageable conditions. The process takes four to eight weeks from application to approval. A paramedical technician visits your home or office for a 20- to 30-minute exam.

To get the best classification, take medications as prescribed before your exam, schedule it in the morning when blood pressure is lowest, avoid alcohol for 24 hours and caffeine on exam day, and be completely honest about your health history. If you have been making lifestyle changes, give them at least six to twelve months to show in lab results before applying.

Simplified Issue Policies

Simplified issue replaces the medical exam with a health questionnaire and pulls data from prescription databases and the MIB. It is a strong option for moderate pre-existing conditions that might trigger substandard ratings on a fully underwritten policy, since the insurer does not have lab results to scrutinize. Premiums run 15% to 30% higher, and coverage caps at $250,000 to $500,000.

Disqualifying answers typically include cancer treatment within two to five years, recent heart attack or stroke, organ transplant, oxygen use, or HIV/AIDS. If your condition is not on the knockout list, simplified issue provides faster coverage — approval in minutes to a few days — at reasonable though not rock-bottom rates.

Guaranteed Issue Policies

Guaranteed issue is the last resort — no health questions, no exam, no underwriting. If you meet the age requirements (typically 50 to 85) and can pay, you are approved regardless of health. The trade-offs are steep: coverage caps at $5,000 to $25,000, premiums are the highest per dollar of any life insurance, and a graded death benefit means your beneficiaries receive only a return of premiums plus interest if you die of natural causes within the first two to three years. Accidental death is covered in full from day one.

Despite these limitations, guaranteed issue serves people with serious conditions like advanced COPD or recent cancer treatment who cannot qualify elsewhere. It is always available as a safety net when other options are exhausted.

Group Life Insurance

Employer-sponsored group life insurance is often the easiest path to coverage with a pre-existing condition. Most plans offer basic coverage of one to two times your salary at no cost, with no health questions during initial enrollment. Supplemental coverage up to $50,000 to $150,000 is often available on a guaranteed issue basis when you first enroll.

The downsides are limited amounts, lack of portability (you lose coverage when you leave your job), and rising costs at older ages since rates are based on age bands. Group life is a valuable foundation but typically should not be your only coverage.

Tips for Getting the Best Rate

• Work with an independent agent. They represent dozens of carriers and can informally shop your case before formal application, identifying which companies are most favorable for your condition and avoiding unnecessary denials on your record.
• Shop multiple carriers. One insurer might rate controlled diabetes at Standard while another rates it Table 2. Get at least three to five quotes to find the most favorable rating.
• Get healthy before applying. Lose weight, improve your A1C, control your blood pressure, and quit smoking — then maintain those improvements for at least six to twelve months so they show in medical records and lab results.
• Time your application. Applying too soon after a diagnosis or treatment almost always results in higher rates. Wait until your condition has been stable for the recommended period.
• Gather your medical records. Review them for accuracy before applying. Errors in medical records — a misrecorded diagnosis or incorrect medication — can trigger an unfavorable rating.

What to Do If You Are Denied

A denial is a setback, not the end. You have several options.

• Appeal. Request the specific reason for denial, then submit additional documentation — updated labs, a physician letter, or corrected medical records — and ask for reconsideration.
• Try a different carrier. A condition that results in denial at one company may be accepted at standard rates by another. An independent agent specializing in impaired risk cases is invaluable here.
• Wait and reapply. Use six to twelve months to optimize your health metrics, build a track record of stability, and gather documentation of improvement.
• Use simplified or guaranteed issue as backup. Simplified issue may accept you without detailed medical records. Guaranteed issue is always available as a safety net with no health questions.
• Explore group coverage. Your employer's group plan may provide guaranteed issue coverage during enrollment periods, serving as a bridge while you pursue individual coverage.

How Long After Diagnosis Can You Get Coverage?

Timing matters. Each condition has typical waiting periods before competitive rates are available.

• High blood pressure. Apply once blood pressure is controlled with three to six months of stable readings.
• Type 2 diabetes. Most carriers want six to twelve months of controlled A1C levels and stable medication.
• Heart attack or stroke. At least six months to one year after the event, with many insurers preferring two to five years of stability.
• Cancer. Early-stage cancers may require one to two years in remission. More serious cancers need three to five years. Some aggressive types may require ten years or result in permanent decline.
• Depression or anxiety. Stable medication with no recent hospitalizations allows immediate application. Recent hospitalization may require six to twelve months of stability.
• Sleep apnea. Apply within three to six months of starting CPAP treatment with demonstrated compliance.

The general principle is that insurers want stabilization — a diagnosed condition, a treatment plan in place, compliance with that plan, and stable health metrics over a meaningful period.

The Bottom Line

A pre-existing condition is a hurdle, not a wall. The life insurance industry offers multiple pathways — fully underwritten policies at competitive rates for well-managed conditions, simplified issue for moderate challenges, guaranteed issue as a safety net, and group coverage through employers. The key is understanding which pathway fits your situation.

Start with an independent agent who specializes in impaired risk cases. Get your health optimized, gather your records, and time your application strategically. If denied, appeal, try another carrier, or use alternative products as a bridge. The worst outcome is not paying higher premiums — it is having no coverage at all. Nearly 40% of American adults lack life insurance, and for people with health conditions, the need to protect their families is often even more urgent.

Frequently Asked Questions

Do I have to disclose my pre-existing conditions on a life insurance application? Yes. Failing to disclose a known condition is misrepresentation and can result in a denied claim within the first two years. Insurers verify information through medical records, prescription databases, and the MIB. Honesty protects your beneficiaries.

Will my premiums decrease if my health improves? Some insurers allow reconsideration after one to two years if your health has significantly improved, potentially upgrading your rate class. Alternatively, you can apply for a new policy at a better rate, though this restarts the contestability period.

Can I be denied for taking prescription medications? Medications alone typically do not cause denial — underwriters evaluate the underlying condition. Being on medication and compliant is viewed more favorably than having an untreated condition. However, medications associated with high-risk conditions like chemotherapy drugs may signal issues that affect your rating.

Does family history affect my life insurance rates? Family history is a factor but not typically a reason for denial on its own. An immediate family member diagnosed with heart disease or cancer before age 60 may prevent Preferred Plus rates. Good personal health metrics can offset family history concerns.

What is the contestability period? The first two years of a policy during which the insurer can investigate and contest a claim based on application misrepresentation. If you fail to disclose a condition and die within this period, the claim may be denied. After the period ends, claims generally cannot be denied for omissions except in cases of outright fraud.

Should I apply to multiple carriers at the same time? You can, but each application generates an MIB inquiry visible to other insurers, and too many simultaneous applications can raise red flags. A better approach is having your independent agent conduct informal inquiries first, then submit formal applications to the one or two carriers most likely to offer favorable terms.