What Pre-Existing Medical Conditions May Disqualify You From Getting Life Insurance?

When you’re looking into life insurance, pre-existing conditions may be on your mind. The good news is your health doesn’t have to be in perfect shape to get a policy. Of course a medical diagnosis matters, but so does your treatment plan and how serious or mild your condition might be. 

If you’ve heard that medical issues like heart conditions or diabetes mean automatic insurance rejection, it’s time to break the myths. The truth is it’s always worth looking into your life insurance options, and you may have more choices than you think.

What Are Life Insurance Pre-Existing Conditions?

A pre-existing condition is a mental or physical health issue you had before applying for insurance that affects your overall health and mortality (i.e., how much more likely you are to pass away than if you didn’t have this condition). The more, or more severe, pre-existing conditions you have, the more that can impact your risk level and insurability.

A pre-existing condition is often a chronic, ongoing condition, but not always. For example, if you’ve had treatment for a mental health condition like depression or anxiety in the past few years, this may factor into life insurance risk calculations even if you’re not actively in treatment now. On the other hand, you might get seasonal allergies every year, but they probably won’t count as a “chronic” or pre-existing condition for insurance purposes because they don’t have a major impact on your overall health.

How Life Insurance Companies View Your Health

Life insurance policies care about your mortality risks, because they are insuring your life. When you apply for life insurance, the company generally requires you to go through a medical exam and share your full medical history and family health history. Even term life insurance policies with no medical exam will require detailed information about your health. A full picture of your health helps insurance companies assess your risk level more accurately and select rates that are the best fit for your profile.

That said, life insurance companies are primarily interested in learning about conditions that could impact your mortality. Conditions that affect your comfort but don’t increase your chances of passing away don’t matter nearly as much. 

For example, migraines could be considered a pre-existing condition for some health insurance policies or could count as a disability for accommodations at work. But while migraines can leave you feeling like you’re dying, they’re not generally considered to be a critical or mortality-affecting condition. An insurance company might want to check whether you have other underlying conditions that do impact mortality and could cause migraines, but a migraine itself likely wouldn’t have much effect on your life insurance.

Asthma, on the other hand, is more likely to be an issue. Anything impacting your breathing is likely to make insurance underwriters wary. There's a wide variety for asthma, so it’s not necessarily an insurance no-go, but it’s more likely to flag you as a riskier applicant.

One important note is that while a pre-existing condition could affect your life insurance application, your rates won’t be impacted if you develop a condition after you’re already covered. Once you have coverage, your rates are set and getting sick later in life won’t affect the terms of your policy.

What Conditions Will (and Won’t) Qualify for Life Insurance

What most people really want to know is, can you still get life insurance with a pre-existing condition? There isn’t one all-purpose answer, since many health conditions can exist on a spectrum from mild to severe and every application deserves its own consideration. That being said, this is generally what you can expect if you have some of the following conditions in your health history.

Asthma

Asthma can be very mild or severe enough to be life-threatening. Generally, insurance companies will want the details on your asthma — what medication you take, how frequent your asthma attacks are and how severe they are. 

If your asthma is mild, you may be able to find life insurance coverage at standard rates with some providers, but in many cases, you’re more likely to find “rated” life insurance. That means the company adds a certain percentage to the standard rate (e.g., you might pay 150 or 200 percent of the standard premium). As you move toward the more severe end of the asthma spectrum, you’re more likely to see insurance providers deny applications rather than offer rated policies.

Cancer

Cancer tends to be a major flag for insurance companies, but you’re not necessarily out of options to get coverage. 

If you’re currently undergoing treatment or have a later-stage cancer diagnosis, it may be difficult or impossible to qualify for traditional term or whole life insurance policies. You may be able to get some coverage from policies like simplified issue or guaranteed issue life insurance, which are more limited in coverage amounts but accept applicants with more serious health issues.

If your cancer was early stage and you’ve been in remission for several years, you may start to have more options again when it comes to term life insurance policies. Cancer survivors may have the best chances to qualify and get the best premium rates they can the further out they are from the cancer (e.g., 7 years or more).

Cholesterol issues

High cholesterol can indicate higher risk of heart disease, which worries insurance underwriters. Some people believe insurance companies flat-out deny anyone with concerning bloodwork, like high blood pressure or cholesterol, but fortunately this isn’t the case.

With conditions like high cholesterol, it may come down to how you manage your own risk. If you’re diligent about managing your cholesterol with healthy exercise, nutrition and certain medications, insurance companies are more likely to see you’re doing your part and approve you for a policy. Depending on how well managed your cholesterol is, you may even qualify for competitive rates. If there are signs that you’re having difficulty keeping cholesterol levels in check, you’ll likely face higher rates or rejection from some companies.

Diabetes

Diabetes is another condition that has a reputation for being a giant red flag for insurance companies, but the truth is more nuanced. Diabetes can range from no-go to not a big deal, depending on the type of diabetes and the insurance company on the other side of the desk (or computer screen).

In some cases, diabetes can be a temporary condition. People can develop gestational diabetes in pregnancy based on how the placenta draws nutrients from the body. This type of diabetes typically resolves on its own after the baby is born. If you have gestational diabetes, it might be worth waiting to apply until after you give birth, or asking underwriters what the process is like on their end to check if your gestational diabetes has resolved and update rates accordingly.

Type 2 diabetes develops later in life and is generally more responsive than Type 1 diabetes to diet, exercise and medication interventions. Insurance companies may have more options for people with Type 2 diabetes because there are more options to manage the condition and lower risk, whereas Type 1 diabetes requires lifelong management with insulin. People with Type 1 or poorly managed diabetes are more likely than other types to get denied coverage.

Heart disease

Heart disease sounds like a major red flag — and it can be — but it’s a common life insurance myth that heart troubles mean automatic rejection.

Heart issues can come in many different varieties. Some conditions, such as certain atypical heart rhythms, may not involve other disease symptoms or require treatment. The most common heart disease in the United States, coronary artery disease, can range from mild to severe and can sometimes be managed solely with lifestyle habits like a heart-healthy diet. Insurers look at your medications and lifestyle, history of clotting or blockages, interventions like a heart bypass and related conditions like cholesterol and blood pressure. Depending on multiple factors, you might get approved for standard rates, rated policies or be declined.

If you have congestive heart failure, a heart transplant, or you’ve had a heart attack in the last 5 years, most traditional insurance policies are not going to be an option for you. Alternative insurance types may be a better way to find coverage.

HIV 

HIV management has come a long way since the medical community began studying the disease. It’s still a difficult condition for many companies to insure. You may have the best chances at getting coverage by looking into simplified issue or guaranteed issue policies.

Mental health conditions 

Mental health is another area that has a wide range of conditions and severity. You may still be able to get traditional life insurance if you have mental health issues. Anxiety and depression are common issues that affect about 36-41 percent of U.S. adults. Again, treatment and how serious the condition is matters. 

If you see a therapist to help manage anxiety, you probably have a good chance at qualifying for a traditional policy. If you’ve had multiple recent hospitalizations to help you through a major mental health episode, you’ll have a tougher time getting approved. Insurance underwriters will consider medications, history of mental health episodes and overall health when assessing your application.

What to Do If You’re Denied Coverage

If your health is making it challenging to qualify for a traditional term life policy, there are other ways for you to get some life insurance coverage.

Simplified issue life insurance uses a short health questionnaire. Guaranteed issue life insurance typically does not ask health questions at all. Depending on what your diagnosis is and the severity of your health, one of these may be a viable option to get coverage.

Accidental death or AD&D insurance can also be an option to cover particular causes of death. Accidents are the fourth leading cause of death in the United States, so it may feel worthwhile to you to have a policy that covers common accidents even if it doesn’t cover your health risks.

In some cases, demonstrating that you’re managing a condition well is what insurance providers need to hear to set you up with a policy. In other cases, it’s possible for your health to be too risky for some insurance companies to take on. That said, there may still be other ways to get financial coverage, so the key is to explore your options.

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