Life Insurance With Pre-Existing Conditions: What to Expect

Yes, many people with pre-existing conditions can get life insurance, but the condition usually shapes which policy you qualify for and what it costs. The Texas Department of Insurance explains that insurers use underwriting to decide whether to sell you a policy, and a company can charge more, or refuse to sell, if it sees your health as a higher risk. The good news: insurers weigh conditions differently, and there are policy types built for people who don't fit standard underwriting.

This guide covers how insurers look at common conditions like diabetes, heart disease, COPD, and cancer history, what they check behind the scenes, and what to do if you're turned down.

Can you get life insurance with a pre-existing condition?

Often, yes, though no one can promise approval before an insurer reviews your application. Individual life insurance is medically underwritten, so your health can affect both approval and price.

Your realistic options usually fall into three groups:

There is also group life insurance through an employer, union, or association. The Texas Department of Insurance notes that group underwriting "isn't as strict" and you usually don't answer health questions for the basic amount, so you might qualify even if you can't buy a policy on your own.

For a side-by-side look at the middle and bottom rows, see guaranteed issue vs. simplified issue and our guide to no-medical-exam life insurance.

How do insurers find out about your health history?

They start with your answers, then check them against outside records you authorize. Two checks come up often in individual applications.

Your MIB consumer file

MIB runs a database of underwriting information shared by its member insurers. When you apply to a member company, it asks your permission to check MIB. According to MIB:

• The insurer cross-checks your application against any information in your MIB file and follows up with you if something doesn't match.
• Insurers are not supposed to make a decision based on your MIB file alone without further investigation.
• Information of underwriting significance found during your application is reported back to MIB, whether or not you buy the policy.
• You only have a file if you applied for individually underwritten coverage with a member insurer in the last seven years.

MIB is a specialty consumer reporting agency under the Fair Credit Reporting Act. You can request your own file free once a year, and get another free copy if an insurer tells you an MIB record influenced a rated or declined decision.

Your prescription history

Many insurers also review the prescriptions you have filled. The CFPB lists Milliman IntelliScript as a medical consumer reporting company that "collects prescription drug purchase history" of life insurance applicants and provides risk scores for underwriting. A prescription for insulin, a blood thinner, or an inhaler tells an underwriter a lot, even if you forget to mention the diagnosis.

The CFPB suggests you fact-check medical specialty reports before or when you apply, and you have the right to dispute errors. Its list of consumer reporting companies shows where to request them.

How do insurers view diabetes, heart disease, COPD, and cancer?

Each insurer sets its own guidelines, so the same history can be treated very differently from one company to the next. The points below describe what underwriters commonly ask about, not how any specific company will decide.

Diabetes

Underwriters generally want to know the type of diabetes, your age at diagnosis, how it is treated (diet, pills, or insulin), and how well it is controlled. Recent A1C results, and whether you have complications such as kidney, eye, nerve, or heart problems, usually carry a lot of weight. Well-controlled diabetes without complications is often viewed more favorably than poorly controlled diabetes with complications.

Heart disease

For a history of heart attack, stents, bypass surgery, or heart failure, insurers usually look at how long ago the event happened, how your heart functions today, test results your doctor has on file, and whether you have stayed stable on treatment. Many insurers also want time to pass after a recent event before they will review an application. Related risks, such as smoking, blood pressure, and cholesterol, factor in too.

COPD

For COPD, underwriters typically ask about its severity, breathing test results, whether you use oxygen, and how often you have been hospitalized for flare-ups. Current tobacco use is a major factor. Mild, stable COPD is generally viewed differently from severe COPD requiring home oxygen.

Cancer history

For cancer, insurers usually focus on the type and stage, the treatment you received, and how long you have been cancer-free since treatment ended. Many insurers will not consider a fully underwritten application until a certain period has passed after treatment, and that period varies by cancer type and company. Some cancers treated early, such as certain skin cancers, may have little effect.

How can you improve your chances of getting approved?

You can't control an insurer's guidelines, but you can present your health clearly and accurately. These steps help:

1. Gather your details first. Write down diagnoses, dates, medications and doses, doctors' names, and recent test results.
2. Check your records. Request your MIB file and prescription history report so nothing surprises you.
3. Answer every question honestly. Mismatches with your records slow things down and can put a future claim at risk.
4. Follow your treatment plan. Regular checkups and stable readings show an underwriter that a condition is managed.
5. Work with someone who knows multiple insurers. A licensed agent can often ask for an informal review before you formally apply, rather than sending you to company after company.
6. Keep existing coverage in force. Don't drop a current policy until a new one is issued. The NAIC warns that replacing coverage can be costly.

What if you're declined for life insurance?

A decline from one insurer is not a decline from all of them. Ask the insurer to explain the reason in writing, then consider these routes:

• Try another insurer's guidelines. Some companies are more comfortable with certain conditions than others.
• Look at simplified issue coverage. Shorter health questionnaires may leave out conditions that caused a decline elsewhere.
• Check group coverage. Enroll in life insurance at work during open enrollment, or through a union or association you belong to.
• Consider guaranteed issue. These small whole life policies don't ask health questions, but they usually limit the benefit if you die in the first years. Our guide to guaranteed issue life insurance explains graded benefits and waiting periods.
• Reapply later. If your health improves or more time passes after treatment, a new application may be reviewed differently.

If your main goal is covering a funeral, a smaller policy may be all you need. Our guide to what final expense insurance is explains how these policies work, and our funeral cost calculator can help you set a target. For more plain-English guides, visit the life insurance basics hub.