Mason was 40 years old. He was married, very active in the community and father to two kids.
He was riding his bike when he experienced a chest pain like never before. He said it was like “a fire truck sitting on my ribcage.” ER doctors rushed him to the cath lab and found shocking results.
Mason, relatively young for heart disease, had an 80% blockage of one of the main arteries of the heart. A week later his cardiologist placed a stent into that left anterior descending artery and his life was forever changed.
Cleary any heart condition is enough to make a man consider death. When that heart stops beating, that’s it. That is the end of your natural life. For a family man like Mason, this new found reality check meant seriously exploring life insurance with a heart problem.
When I was laying on that table, all I could think about was Sherry and the kids,” he said. “At that moment, life insurance was no longer a luxury, but a priority. A necessity. I had to have it.
If you’re like Mason or one of the other 28.4 million Americans diagnosed with heart disease, maybe you are also looking for life insurance. Maybe you cannot put it off any longer either.
Can I get life insurance with heart conditions?
Yes you can, absolutely! Considering that heart disease is such a prevalent condition, life insurance companies have been dealing with these risks for over 150 years. They are very familiar with heart conditions in all of their forms and they have products designed to meet these needs.
A bit about high risk approvals
If you have a heart problem, you will usually be classified as “high risk” on a traditional life insurance application. High risk does not mean you could die at any second, it just means that your rates will be priced higher than a person who does not have a heart condition. Your rates are usually higher than “standard,” however they are still very affordable.
Certain heart conditions will not be classified as high risk and can still qualify for standard rates. Things like a heart murmur, minor high blood pressure under control, a heart rhythm disorder with no symptoms, or a minor valve issue with no backflow can still qualify for standard or better rates. It is also possible to qualify for a no exam policy if your heart condition is minor.
Likewise, certain heart conditions will almost always be classified as high risk. Heart problems such as cardiomyopathy, coronary artery disease, atrial fibrillation, congenital heart defects, mitral valve prolapse, heart attacks or valve replacements will cause the underwriter to review your file carefully. It is difficult to qualify for a “no-exam” type policy with these issues, and most life insurance plans will need to review your doctors’ records.
Though these cases usually come with higher rates, working with an independent agent will help you find you a plan you can afford.
Do you know your blood pressure? Thank your life insurance agent!
The life insurance industry was quick to make the connection between high blood pressure and heart disease even while the medical community was in doubt about the significance. That may seem shocking now, however in the early 1900’s most doctors didn’t even have the means to measure hypertension. The main tool – a sphygmomanometer – was only invented a decade before.
In 1911 actuaries from Northwestern Mutual required doctors to measure blood pressure for their life insurance applicants, and they found that those with higher levels of blood pressure had higher rates of early death. Those with a blood pressure higher than 170 were dying at an alarming rate for their age.
Underwriters talk, the word got around and soon all life insurance companies required blood pressure readings. This means that doctors purchased the needed the equipment, and by 1918 almost 90% of physicians were measuring blood pressure on every case.This effect radiated beyond just life insurance applicants to every patient in private practice. What effect do you think this had on overall health and life expectancy?
No exam? Not likely with most heart conditions.
“No Exam” policies are a big hit in the life insurance business. Think about it, just a simple application, no medical exam, no blood tests, no peeing in a cup and you’re qualified. Our clients love them for their speed and simplicity, and as advisors we love them because there are fewer surprises.
However, it’s unlikely that you will qualify if you have a heart condition for these policies. There is just too much risk and variation when it comes to heart problems, so the underwriters are going to need medical records and exams most of the time.
There are some exceptions to this rule. Whole life final expense at smaller face amounts usually come with no exam. Accidental death policies are always no exam. And if your condition is very very mild (like high blood pressure,) there are no-exam options available.
So what determines my rates when I have a heart condition?
All life insurance rates are made up of three factors: your age, your plan, and your health class. There really isn’t much you can do about your age, however you do have many options in regards to the plan you select and your benefit amount. Speak with your independent advisor at length until you are comfortable with your plan and how it fits within your budget.
What we are going to dive into headfirst is your health class. This will be determined by your application, your medical records and test results. The health class could be different among the different life insurance companies based on their specific risk tolerance. Therefore, it’s imperative to work with an independent advisor who has access to multiple life insurance companies.
Underwriters will take a comprehensive look at your health, not just your heart problems. They will check your driving record, your pharmacy report, your doctor’s records from the last few years, and as noted earlier, a paramedical exam.
In regards to the health class you receive, what every company wants to know is:
What is your specific heart condition?
Heart valve issues are going to be classified and priced differently than coronary artery disease, and cardiomyopathy is going to be priced differently than atrial fibrillation. To make this even more fun, each life insurance company has a specific risk stratification for each one of these conditions.
In general, the less serious the heart condition, the lower the rates.
How well are you managing your wellness?
Sometimes a bad cardiovascular diagnosis can be the catalyst for change. You start exercising more and eating right. You quit smoking and cut out the alcohol.
While an underwriter will not monitor your junk food and gym sessions, they can see your blood tests. An underwriter cannot tell you to take your medicine, however they can verify that you have refilled it recently on a pharmacy check. The attending physician’s report or APS is a wealth of knowledge about how often you visit your doctor and what you do with that advice.
The life insurance underwriter, your doctor and the ones you love all want you to live a long and healthy life. Longer lives mean lower premiums, so by following the doctor’s orders you can generally qualify for lower rates.
How long have you had a heart condition?
This requirement is condition specific, however being stable and symptom free for longer usually results in lower rates. In fact, if you have recently had heart or circulatory surgery of any kind most life insurance companies will postpone your case for a year. Usually after the first year, every five years of good history thereafter makes you a better risk in the eyes of an underwriter.
There is one caveat though. Heart problems usually get worse with time, not better as our bodies age. A condition like atrial fibrillation can change the wall thickness of your left ventricle over the years, likewise leaky valves usually continue to leak.
So if you were younger when you started having heart trouble, this is usually a bad sign for underwriters. Having valves replaced and getting angioplasty in your 30’s makes it more difficult to approve the file. In these cases, it will be even more important that you are on top of your medication and your cardiologist’s other recommendations.
What are your other risk factors for heart disease?
Smoking can raise your life insurance rates by 200%, and in some cases smoking combined with heart conditions can lead to an outright decline. The biggest “bang for the buck” in life insurance is to quit smoking, and many companies will consider you tobacco free after 12 months.
There are special exceptions for an occasional cigar, pipe or chew. Sometimes these will be classified as non-tobacco based on a low frequency of use, so speak with your independent advisor if this is your case.
High cholesterol or triglycerides – are related to increased plaque in your arteries, restricting your blood flow and raising your blood pressure. Here’s more information.
Uncontrolled hypertension – or high blood pressure is a significant risk factor for advanced heart disease. The left side of your heart just pumps harder and harder as those pressures build, until eventually damage is done to the heart muscle itself.
Uncontrolled diabetes – high fasting glucose levels and A1C levels go hand in hand with heart disease due to the damage blood sugar dishes out to your arteries. These blood sugar spikes rub your arteries like sandpaper, increasing inflammation, increasing plaque and slowing down blood flow.
Physical Inactivity / Obesity – leads to higher blood sugar numbers, which leads to extra pounds and higher blood pressure. Over time, these three can be very damaging to your heart so an underwriter will be interested in your height/weight build or body mass index (BMI).
Cardiovascular Disease and Life Insurance – What rates can I expect?
Remember: your rates are going to be determined by your age, your plan, and your health class. In this final section we’ll explore some common heart problems and the health classes that come with them.
Coronary artery disease
CAD is very common and underwriters see it every day. Your rates will depend on how many arteries were affected, and which arteries were affected. 1 – 2 arteries is very common and easier to approve than 3 – 4 artery disease. Problems in the arteries branching off the right coronary artery are easier to approve than left side arteries like the left coronary or the left anterior descending.
If you had stents placed in these arteries, where are they? Stents further down the vein (distal) indicate less blood flow was affected, thereby getting better rates. Stents closer to the trunk (proximal) indicate a more concerning condition and higher rates. After stent surgery, mild to moderate substandard health classes are the norm for these cases.
Did you have a bypass? If so, how many arteries were affected? Much like stents, the lower the number, the better. Usually bypass patients can be approved after a certain amount of time, and without significant heart tissue damage they can expect moderate substandard health classes.
How about after a heart attack? For all CAD cases, underwriters want to determine the damage done to the muscle itself. They will measure this using your cardiac test results, most notably the echocardiogram or stress echo. On the left side of the heart, how strong the muscle is pumping is called the “ejection fraction.” Assuming this number is high enough, we can usually approve heart attack survivors with mild to moderate substandard health classes.
Cardiomyopathy cases usually have a high rate of decline due to low ejection fraction percentages of the left ventricle. However, if the client is older and the LVEF is high enough, cardiomyopathy can be approved with moderate substandard health classes.
Heart Valve Problems
Heart valve issues like mitral valve prolapse or aortic stenosis often do not have any symptoms. For years they go untreated or the cardiologists only observe, so these conditions seem minor.
For cases with mitral valve prolapse (or mitral regurgitation) the health classes are based on the amount of backflow over the valve and the age of the client. Women seem to receive better health classes than men with mitral valve problems, however the amount of backflow directly relates to risk for stroke. These health classes can go from standard plus all the way down to moderate substandard.
For aortic stenosis the health class will be determined by how narrow the aortic valve is and how old the patient is. The wider the opening and the older the client, the better. Best case scenario is mild substandard rates, though we also see moderate substandard approvals as well.
If the valve problems are significant enough to require surgery, then the rest of the heart needs to be in really good shape. One year after surgery, most clients can expect a moderate substandard rate when their case is approved.
Heart Rhythm Problems
There are multiple cardiac arrhythmia classes and there are multiple causes for them as well. Probably most common is atrial fibrillation, however we often see ventricular tachycardia, sick sinus syndrome and various flavors of electrical block as well.
The five main things a life insurance company will evaluate when it comes to heart rhythm problems are: your current symptoms, how long you’ve had the arrhythmia, your age at diagnosis, your risk for stroke, and if your heart muscle been affected or structurally changed.
As with other heart conditions, the older the client, the better for a health class. Rhythm problems that can be clinically explained, were short lived and under control can qualify for mild substandard rates. If the client was younger (30’s – 40’s), or there were some changes to the thickness of the heart walls, then moderate substandard rates are more likely.
Final thoughts on life insurance with heart conditions
Remember Mason and his family from the beginning of this article? Maybe you’re like him and you have decided that you need life insurance for the ones who depend on you. If you have heart disease, fear not; there are plans that will approve you.
Mason took advantage of these plans for his peace of mind and for his family’s protection. Why not you?
The key is working with an independent agent who has access to multiple companies. Preferably you need to partner up with an underwriting expert in heart conditions, for most of the companies who advertise heavily will decline cases with heart problems.
This wastes your time and it will cost you thousands of dollars if you choose the wrong policy. Use what you have learned in this post to avoid this hassle and expense. If you have heart trouble, seek out an expert independent agent to work on your behalf and sleep soundly knowing your family is protected.