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Last updated: March 14, 2016 at 22:47 pm

Life Insurance When You Have Health Risks

Only about half of people with serious health conditions have a life insurance policy. Reasons that this is the case include the higher costs of high health risk life insurance, the more limited number of companies willing to insure people with such conditions, and the false (but popularly held) belief that you simply cannot get life insurance if you suffer from major health issues.

In reality, there are almost always life insurance options even for those who are high health risks. Better understanding how these risks will affect your policy, what to expect during the application process, and where to go to find the best-fitting policy at the best price will help make wise, informed choices as you search for high health risk insurance.

Health risks and life insurance

How Having Health Risks Affects Your Life Insurance Policy

Preexisting health conditions increase the likelihood that an insured individual will die at an early age or relatively soon after taking out the policy. These conditions also increase the odds of there being large medical debts and other expenses left behind that the insurer will have to cover. These factors tend to increase premiums as well as affect the types of policies practically available.

First, let us mention some of the main health conditions that insurers consider “high risk.” Some of the most common high-risk health categories include: cancer patients, Type 1 or Type 2 diabetes, organ transplant recipients, people with hypertension, those extremely overweight, those who have had a heart attack in the past, those suffering from anxiety or depression, asthmatics, Alzheimer’s patients, those with high cholesterol levels, those with severe sleep apnea, and more.

It used to be that people with such health conditions as those listed above had little chance of obtaining good life insurance, but today, there are many insurance companies specializing in this kind of cover. This change is due, in large part, to medical advancements in both detection and treatment, which have led to patients living longer than ever before.

Insurers specializing in high health risk insurance will delve deeper than just noting the existence of a serious health condition. They will base their rates on such factors as:

  • The specific condition involved
  • The severity/progression of the condition
  • How long it has been since the initial diagnosis
  • How stable the patient’s health is at present
  • The regularity and reliability of treatment

Besides looking for a specifically high-risk insurer, you can also try to get on a group plan, which will likely have lower rates. This is not always possible, but when it is, the price is reduced due to risk pooling. Everyone in the group is basically treated equal regardless of health condition. Group plans are often available through an employer, labor union, credit union, trade association, or other organizations like AARP.

How Insurance Companies Assess Your Risk Based on Your Health

Every insurer operates on the basis of “risk categories” that help them set rates based on a risk-based formula. These “risk management schemes,” called” underwriting guidelines,” are the reason why insurance rates vary from person to person, even when buying the same policy.

Most insurers use four main risk classes: Preferred Plus, Preferred, Standard, and Substandard. For smokers, there are usually only two: Standard Smoker and Preferred Smoker. Some insurers are more precise with their risk categories than others, and they also vary a little on which class you would go into for certain conditions. That’s why it pays to shop around.

For example, someone with hypertension, but who is on medication and otherwise in good health, might be counted as Preferred with one insurer but only Standard with another. Standard (or nearly Standard) rates might apply if a preexisting condition is “under control,” but this varies from insurer to insurer.

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The Application Process and What to Expect in the Health Exam

You can easily go online and get a quick quote after filling out a short questionnaire, but it will usually take a little more information to actually apply.

Besides the type and amount of coverage desired, you will be asked to provide such information as:

  • full legal name,
  • state of residence,
  • income level,
  • date of birth,
  • height and weight,
  • lifestyle habits,
  • type of employment, and
  • medical conditions.

Your medical history will be viewed by the prospective insurer via the MIB (Medical Information Bureau), so there is no way it can be hidden.

Besides asking some health questions, the insurer will send a paramedical to conduct a full health examination. Blood and urine tests will be used to check for alcohol, tobacco, marijuana, cocaine, opiates, prescription medications, and all manner of drugs. Far more drugs are tested for than in employment drug screenings.

Should you test positive for any non-prescription drug, a confirmation test will be conducted. Should you test positive for a prescription drug, you will be asked to produce the doctor’s prescription. Tests will also be made for caffeine, since too-high of caffeine levels increases the chances of cardiovascular issues.

The exam will also likely involve taking your blood pressure, listening to your heartbeat, checking your weight and height, asking about your medical history, and asking about any disease that run in your family. You will also be asked about your specific health condition, and depending on your age, you may need to take a chest X-ray, a treadmill test, or other extra tests.

If you clear the drug tests and the medical exam, you will then need to wait while your application is pending approval. This can take only a few days or several weeks, depending on the insurance company and on the speed of the labwork and paperwork.

What About No Medical Exam Insurance Policies?

It is possible to get a high health risk insurance policy without taking a medical exam, but your options are fewer and generally a bit more expensive. Usually, these policies are only term life rather than permanent. The most basic one is called “Simplified Issue” and can have a term of 5 to 20 years, with a coverage amount of $25,000 to $350,000.

Another no-exam option is called “Accidental Death & Dismemberment,” which only applies to accidental deaths. However, you cannot be terminally ill, be already hospitalized, or live in a nursing/hospice center to get this coverage.

Finally, you can seek a no-exam, no-health questions policy called “Guaranteed Issue” if you are 40/50 or older. The good side of guaranteed issue is the near-automatic approval, which can be very rapid since no exam must first be conducted. The downside is the limited benefit amount (usually capped at $25,000) and the higher premiums.

What Are Impaired Risks Specialists?

An “impaired risk specialist” is an independent insurance broker who can take your health and other information and match it to the best policy. He/she will have access to dozens of insurers and be familiar with their offerings.

For high health risk applicants, using an impaired risk specialist is normally the fastest way to locate the best available insurance policy.


Getting good insurance when you have a preexisting, high-risk health condition can be difficult, but it is not impossible. You may have to adjust policy type and/or coverage and use an impaired risk specialist, but insurance that meets your needs probably exists.

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