Short answer: Yes — usually. But how affordable and what type of coverage you’ll get depends heavily on the condition, its severity, how well it’s controlled, your age, and the insurer’s underwriting rules. This long guide explains how life insurance companies evaluate pre-existing conditions, what policy types and underwriting outcomes to expect, ways to improve your chances, realistic pricing expectations, alternatives if you’re declined, and step-by-step advice to get the best deal.
Why insurers care about pre-existing conditions
Life insurers are in the business of managing risk. A pre-existing medical condition (diabetes, cancer history, heart disease, mental-health diagnosis, obesity, etc.) raises the statistical likelihood of an earlier death or serious health event. Underwriters use medical records, lab tests, prescriptions, and sometimes specialist notes to estimate that risk and price or accept the policy accordingly.
Important: Pre-existing does not mean “automatic denial.” It means the application will receive careful review and one of several possible outcomes: standard/preferred rate, rated policy (higher premium), modified coverage, temporary waiting period, or decline.
The main paths to get coverage with a pre-existing condition
1. Standard fully underwritten policies (preferred/standard/rated)
- Process: Medical exam (blood, urine, vitals), review of medical records, prescription and DMV checks, sometimes an APS (attending physician statement).
- Outcome: Best result: standard or preferred rates if the condition is mild or well controlled. More common: a rated policy (e.g., +50%, +100% premium) or a temporary exclusion/waiting period.
- When realistic: Controlled Type 2 diabetes with good A1c and no complications; treated hypertension with stable BP; early-stage, treated cancer with several years in remission (depends on cancer type and time since treatment).
2. Simplified-issue / no-exam policies
- Process: Short health questionnaire, no medical exam.
- Outcome: Faster approval (days), but higher cost per dollar of coverage and lower maximum face amounts. Good for modest needs or people who want speed.
- When realistic: Useful if the condition is serious enough to make full underwriting expensive or slow, but you still need basic protection.
3. Guaranteed-issue life insurance
- Process: No health questions, instant approval.
- Outcome: Guaranteed acceptance regardless of health. However, these policies usually:
- Have very high premiums relative to face amount.
- Cap coverage at low amounts ($5k–$50k typical).
- Often include a graded death benefit: if death occurs in first 2–3 years (except accidental), the company refunds premiums plus some interest instead of paying full face value.
- When realistic: When you cannot qualify for other options and need small final-expense coverage.
4. Group life insurance through employers
- Process: Often guaranteed issue up to a default amount (e.g., 1× salary) without medical underwriting.
- Outcome: Free or low-cost coverage is common; optional supplemental coverage may require evidence of insurability.
- When realistic: If your employer offers group term life, that is often the best immediate option even if it’s limited.
How different conditions are typically evaluated
A few examples to illustrate underwriting tendencies (generalized):
- Diabetes (Type 2): If A1c is well controlled and there are no complications (kidney, neuropathy, cardiovascular disease), many insurers will offer coverage at a rated class. Poor control or complications increase likelihood of higher ratings or declination.
- Cancer survivors: Underwriting depends on cancer type, stage, treatment, and years since remission. Early-stage skin cancers treated completely may be no problem. More aggressive cancers often require several years disease-free before standard rates are possible.
- Cardiovascular disease: History of MI, stents, or heart failure usually triggers rated offers; some severe cardiac conditions may lead to decline. Stability, ejection fraction, and time since event matter.
- Mental-health diagnoses / substance use: Controlled depression or anxiety with stable treatment often acceptable. Active substance abuse is a major red flag; insurers may require clean drug tests and time in recovery.
- Obesity: Evaluated via BMI plus comorbidities (hypertension, diabetes). Very high BMI with complications raises rates.
- HIV: Modern treatments make HIV insurable with many carriers at rated classes if viral load is undetectable and CD4 count is good; underwriting standards differ.
Remember: each insurer’s appetite differs. One company may offer a standard rate where another declines. That’s why shopping matters.
What “rated” policies mean — and how much more they cost
If you’re offered a “rated” policy, the insurer increases your premium to reflect higher risk. Ratings are often expressed as “Table A, B, C” or as percentage loadings (e.g., +50%, +100%, +200%). For example:
- A Table B offer (roughly +50%) increases annual premium by about half compared with standard.
- A +100% load roughly doubles the premium.
Small differences in rating can be expensive over decades—so comparing offers from multiple insurers (and considering term vs permanent) is crucial.
What underwriting documents and tests insurers use
- Paramedical exam: Blood work, urine, blood pressure, height/weight.
- APS (Attending Physician Statement): Your doctor’s notes and history.
- MIB and prescription checks: Reveal prior applications and meds.
- Motor vehicle records and hazardous activity questions.
- Special tests: EKG, stress test, imaging if indicated.
You can prepare by obtaining copies of relevant medical records and a recent summary from your physician to speed review and correct errors.
Ways to improve your chances before applying
- Get medical records organized. A concise letter from your treating physician showing stability and control helps.
- Stabilize measurable risk factors: Optimize blood pressure, lower A1c, quit smoking, lose weight if feasible, treat sleep apnea.
- Wait if possible after major events: For example, after cancer remission or a cardiac event, waiting the typical 2–5 years (varies) improves offers.
- Address substance issues: Complete documented rehab and maintain clean drug/alcohol tests.
- Shop multiple carriers and use an experienced broker. Different insurers have different underwriting appetites for specific conditions.
- Consider smaller face amounts or split purchases: Getting a modest guaranteed-issue or simplified policy now for immediate needs and later applying for additional fully underwritten coverage once health improves can be useful.
Which policy types are cost-effective with pre-existing conditions?
- Term life: Still often the best value even with a rating, because term rates are lower than permanents. If you can get term (even rated), it frequently beats guaranteed whole life for coverage per premium dollar.
- Universal/whole life (permanent): Higher cost and poorer investment return relative to term. Buy permanent only for specific needs (estate taxes, lifelong dependents), not primarily to “lock in insurability” unless advised by an expert.
- Guaranteed-issue: Best for final expenses (funeral costs) when other coverage is unavailable.
Alternatives if you’re declined or rates are unaffordable
- Employer/group life: Many employers provide basic term coverage without medical underwriting.
- Accidental death & dismemberment policies: Very cheap but limited—they don’t replace all death causes.
- Mortgage/creditor insurance: Not ideal—more expensive and usually less flexible, but sometimes available.
- Wait and reapply: Improving health or time elapsed since diagnosis often improves offers.
- Buy smaller amounts gradually: A guaranteed-issue policy for funeral costs plus applying later for larger policies.
- Shop international or specialty carriers: Some insurers may be more willing depending on the condition.
Practical shopping strategy (step-by-step)
- Assess need: How much coverage do you really need (term coverage to protect mortgage, children, debts, etc.)?
- Gather medical info: Recent lab results, medication list, specialist contacts, hospital discharge summaries.
- Work with an independent agent or broker experienced in high-risk cases. They can match conditions to insurers with better guidelines.
- Start with fully underwritten term quotes from multiple carriers. Don’t assume immediate decline—some insurers are surprisingly flexible.
- If declined or rates are too high, try simplified issue or guaranteed-issue as fallback.
- After purchase, keep records and reapply later if health improves. Many people get better offers after a few years.
Realistic expectations on cost and coverage
- If your condition is mild and controlled, expect modestly higher rates (Table A–C).
- For moderate disease (complications, recent events), expect significant loadings or a need to take simplified/guaranteed options.
- For severe or progressive diseases, you may be declined or offered only low face amounts on guaranteed plans.
Keep in mind that age and smoking status compound the cost impact of health issues.
FAQs
Q: Will pre-existing conditions show up on my application?
A: If you answer truthfully and the insurer does medical checks, they will find prescriptions and prior diagnoses via databases if you omit them. Never lie—misstatements can void a claim later.
Q: Does a pre-existing condition affect group employer coverage?
A: Usually no for basic group term benefits—those are often guaranteed issue up to a default limit.
Q: How long do insurers look back at medical history?
A: They review your entire recorded medical history, but underwriting weight often focuses on recent years (1–10 years), depending on the condition.
Q: Can I get accelerated underwriting?
A: Some carriers offer accelerated decisioning for applicants with favorable medical data, but with conditions it’s unlikely.
Final checklist before applying
- Get recent lab work and vitals within 6 months if possible.
- Obtain a concise letter from your doctor summarizing stability/control.
- Quit smoking and avoid recreational drugs before application.
- Work with a broker experienced with your diagnosis.
- Get multiple quotes and compare total cost over the term.
- Consider combining guaranteed-issue now and fully underwritten later.
Bottom line
Pre-existing conditions make life insurance more complicated, but they do not usually make it impossible. Many people with chronic illnesses, prior cancer, or heart disease still obtain meaningful coverage. The key is preparation, honest disclosure, and smart shopping across insurers and product types. For most applicants, a well-structured approach—start by protecting immediate needs (group or simplified coverage), then pursue fully underwritten term coverage with the best possible health profile—gets the most affordable and practical outcome.