A medical condition changes the process, but it doesn’t end it. Here’s an honest look at how underwriting works, what carriers actually care about, and how to find coverage that fits.
- The Biggest Misconception
- What Carriers Actually Evaluate
- How Common Conditions Are Typically Viewed
- Why Comparing Carriers Matters Even More With a Condition
- Your Coverage Pathways
- How to Prepare for Your Application
- If You've Been Declined Before
- What to Expect on Cost
- The Bottom Line
- Find Out Where You Stand
If you’ve been diagnosed with a health condition, you might assume life insurance is off the table. It’s a common concern, and an understandable one. But for most people with medical conditions, coverage is not only possible, it’s more accessible than you’d expect. The process looks a little different, and the details of your condition matter more than the diagnosis itself. This guide explains how it works.
The Biggest Misconception
Many people hear «pre-existing condition» and assume it means automatic denial. That’s not how it works. Carriers don’t make a simple yes-or-no decision based on whether you have a condition. They look at the full picture.
What they’re evaluating is risk, not diagnosis. Two people with the same condition can receive very different outcomes depending on how well it’s managed, how long they’ve had it, what their current numbers look like, and what medications they’re taking.
A person with Type 2 diabetes who maintains good A1C levels, follows their treatment plan, and has no complications is a very different applicant than someone with uncontrolled diabetes and related complications. Carriers see and price that difference.
- The Key Principle
Carriers care more about how you manage your condition than the fact that you have one. Well-controlled conditions with consistent treatment, stable numbers, and regular follow-up care are viewed far more favorably than an unmanaged diagnosis.
What Carriers Actually Evaluate
When you apply for life insurance with a medical condition, the underwriting team looks at several specific factors. Understanding these helps you see the process through their eyes.
| Factor | Factor What They're Looking For |
|---|---|
| Diagnosis | What condition you have and when it was diagnosed |
| Severity | How advanced the condition is and whether there are complications |
| Control | Whether the condition is stable and well-managed through treatment |
| Medications | What you're taking, how long you've been on it, and whether dosages are stable |
| Lab Results | Current numbers like A1C, blood pressure, cholesterol, liver function, etc. |
| Treatment Compliance | Whether you follow up with your doctors regularly and follow prescribed treatment |
| Time Since Diagnosis | How long ago you were diagnosed, and how stable things have been since |
| Other Risk Factors | Age, weight, tobacco use, family history, and any other conditions |
Why This Should Encourage You
Most of the factors above are things within your influence. If you’re managing your condition well, following your treatment plan, and keeping up with your doctors, you’re already doing the things carriers want to see. That positions you better than you might think.
How Common Conditions Are Typically Viewed
- Often approved at standard or better rates
- Typically approved, possibly with a higher rate
- More complex; approval depends heavily on specifics
- High Blood Pressure (Hypertension)
- High Cholesterol
- Anxiety and Depression
Mental health conditions are much better understood by carriers than they were a decade ago. Mild to moderate anxiety or depression managed with medication or therapy is typically approved at Standard or Preferred rates. Carriers look at hospitalization history, medication stability, and whether there have been any complications like substance use.
- Type 2 Diabetes
- Sleep Apnea
- Asthma
Mild asthma controlled with an inhaler is generally a non-issue for most carriers. More severe asthma requiring frequent oral steroids, emergency room visits, or hospitalizations may result in a Standard or substandard rate class. Carriers look at frequency of episodes and what medications are required to manage them.
- Obesity
- Cancer History
Cancer underwriting depends heavily on the type of cancer, the stage at diagnosis, the treatment completed, and how long you’ve been in remission. Some early-stage cancers with five or more years of clean follow-up can be approved at Standard or near-Standard rates. More recent diagnoses, advanced stages, or aggressive types require more careful evaluation. Many people with cancer history do get approved, but the specifics matter more here than with almost any other condition.
- Heart Disease
History of a heart attack, bypass surgery, stent placement, or other cardiac events requires detailed underwriting. Carriers look at the event timeline, your current cardiac function, lifestyle changes since the event, and ongoing medication. Approval is possible, often at substandard rates, especially if the event was several years ago and recovery has been strong. This is a category where carrier selection can make a significant difference.
- Type 1 Diabetes
- A Condition Not Listed Here?
This list covers some of the most common conditions, but carriers evaluate hundreds of different diagnoses. If your condition isn’t listed, that doesn’t mean coverage isn’t available. The general principle applies across the board: how well you manage the condition matters more than the name of the diagnosis. Getting a quote is the best way to find out where you stand.
Why Comparing Carriers Matters Even More With a Condition
Carrier selection always matters. But when you have a health condition, it matters significantly more. Here’s why.
Each carrier has its own underwriting guidelines, its own risk appetite, and its own way of interpreting medical data. One carrier might consider controlled hypertension a non-issue and offer Preferred rates. Another might classify the same applicant as Standard Plus. A third might require additional follow-up documentation before making a decision.
These differences are even more pronounced for conditions that require judgment calls, things like cancer history, diabetes management, or mental health treatment. The gap between the most favorable carrier and the least favorable carrier can be the difference between Preferred rates and a decline.
An Illustrative Example
| Carrier | Rate Class | Outcome |
|---|---|---|
| Carrier A | Standard | Approved, moderate premium |
| Carrier B | Standard Plus | Approved, lower premium |
| Carrier C | Substandard (Table 2) | Approved, higher premium |
| Carrier D | Postponed | Wants 12 more months of records before deciding |
This is an illustrative example. Actual outcomes depend on the full application, medical records, and each carrier’s current guidelines.
What This Means for You
If this applicant only applied with Carrier C or D, they’d either overpay or face a delay. By comparing across carriers, they find Carrier B’s more favorable interpretation of the same data. This is exactly the kind of situation where comparing matters most, and it’s what Ozzo is built to do.
Your Coverage Pathways
Depending on your condition and its severity, there are several routes to getting covered. Not every pathway will be available to everyone, but understanding the options helps you find the best fit.
Fully Underwritten Policy
The standard process: full application, medical exam, blood work, and medical records review. This gives you access to the best possible rates for your health profile. Best for people with well-managed conditions who can demonstrate strong control.
No-Exam Policy
Some carriers offer policies that don’t require a medical exam. They use health questions, prescription databases, and other data to underwrite. Coverage amounts may be lower, and premiums may be higher, but the process is faster and avoids the exam.
Simplified Issue
A streamlined application with a limited set of health questions and no exam. Approval is faster, but coverage limits are typically lower. This can be a good option if your condition makes full underwriting difficult or if you need coverage quickly.
Guaranteed Issue
- Start with the Best Option Available
How to Prepare for Your Application
Get current with your doctor. Carriers will request your medical records. Make sure your records reflect your current, well-managed status. If you’ve been putting off a check-up or lab work, schedule it before you apply. Recent records showing good numbers are one of the best things you can have in your file.
Know your numbers. Be ready to share your current blood pressure, cholesterol, A1C, weight, and any other relevant metrics. Knowing these off the top of your head signals to the underwriter that you’re engaged in managing your health.
Have your medication list ready. Names, dosages, and how long you’ve been on each medication. Stability in your medication regimen is a positive signal. Frequent changes can suggest the condition isn’t well-controlled yet.
Be completely honest. Carriers verify your medical history through prescription databases (like MIB and Milliman IntelliScript), your medical records, and the exam. Omitting or downplaying a condition doesn’t help. If they find a discrepancy, it can result in a decline, a policy void, or a refused claim. Full honesty gives the underwriter the clearest picture and leads to the best long-term outcome.
Follow your treatment plan consistently. If there’s time before you plan to apply, make sure the months leading up to your application show consistent treatment compliance. Regular doctor visits, filled prescriptions, and stable lab results all work in your favor.
If You've Been Declined Before
Reasons a New Application Might Go Differently
Your health may have improved. If your condition is better managed now than it was when you were declined, your results may be different. Stable medication, improved lab values, or more time since a diagnosis all change the picture.
A different carrier may view your condition differently. Each carrier has its own guidelines. A condition that one carrier declines might be something another carrier will insure at Standard rates. This is especially true for conditions that require nuanced evaluation, like cancer history or diabetes.
New products may be available. The insurance market evolves. Carriers regularly update their underwriting guidelines, and new no-exam and simplified issue products become available. Options that didn’t exist when you were declined may exist now.
One Important Note
If you’ve been declined, that information is recorded in the MIB (Medical Information Bureau) database, which other carriers can access. This doesn’t prevent you from getting coverage, but it does mean the next carrier will be aware of the prior decline. Being upfront about it on your new application is important. Transparency always works in your favor.
What to Expect on Cost
| Carrier | Rate Class | Outcome |
|---|---|---|
| Carrier A | Standard | Approved, moderate premium |
| Carrier B | Standard Plus | Approved, lower premium |
| Carrier C | Substandard (Table 2) | Approved, higher premium |
| Carrier D | Postponed | Wants 12 more months of records before deciding |
- On Waiting to "Get Healthier" Before Applying
Some people delay applying because they want to improve their health first. That can make sense if you’re a few months away from a meaningful improvement, like 12 months nicotine-free or a better A1C result. But waiting indefinitely is risky. Age increases your rate every year, and a new condition could develop. If your current numbers are reasonable, it’s often better to apply now and lock in what’s available today.
The Bottom Line
A medical condition changes the path to coverage, but it rarely closes it entirely. Most people with health conditions qualify for life insurance. Many qualify at rates that surprise them. The key variables are how well you manage your condition, how honestly you present your health, and which carrier you apply with.
That last variable, carrier selection, is where the process can either frustrate you or work in your favor. Each carrier sees your condition through a different lens. The one that views your particular situation most favorably is the one you want to apply with. That’s exactly what comparing is for.
- Why This Is What Ozzo Was Built For
Find Out Where You Stand
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