Nobody Tells You What Changes When Your Medical Record Does

I was lying in a hospital bed with a blood clot in my leg when the math started running in the background. Not the medical math. Not the “will I be okay” math. The insurance math.

A deep vein thrombosis. That’s what the doctors called it. DVT. Blood thinners through an IV, then a prescription that would follow me home and stay on my medical record permanently. And somewhere between the diagnosis and the discharge paperwork, a thought cut through the fog: what would this moment look like if I didn’t already have a plan in place?

Because here’s what nobody in that hospital room explained, and what no insurance company will ever volunteer: the moment a serious diagnosis hits your medical record, the clock starts ticking in a direction most people don’t realize until it’s too late. Your health history doesn’t just follow you to your next doctor’s appointment. It follows you into every life insurance application you’ll ever fill out. It changes what companies will offer you, what you’ll pay, and in some cases, whether you’ll be approved at all.

That’s the part the industry doesn’t make easy to understand. Every article you’ll find online opens with some version of “yes, you can still get life insurance with a pre-existing condition.” And technically, that’s true. But it leaves out everything that actually matters: how underwriting classifications change your premium by thousands of dollars, why the same condition gets rated completely differently by different carriers, why applying at the wrong time can make your next application harder, and what your agent probably won’t explain about how the system actually evaluates you.

I’m not a broker. I’m not selling you a policy. I’m someone who has been in that hospital bed, watching a diagnosis reshape what the insurance industry thinks about my future. This guide exists because the information I needed in that moment didn’t exist in one place, written by someone who understood what it felt like to be on the patient’s side of the equation.

If you’re reading this with a pre-existing condition, whether it’s a recent diagnosis or something you’ve managed for years, here’s what you actually need to know.

How Life Insurance Companies Actually Evaluate Pre-Existing Conditions

Before you compare quotes, apply for coverage, or talk to an agent, you need to understand the system that determines what you’ll pay. Without this context, every number you’re quoted is meaningless.

Life insurance companies (aff) use a classification system to sort applicants by risk. The National Association of Insurance Commissioners (NAIC) oversees the regulatory framework that governs how insurers operate, but each carrier builds its own underwriting criteria within those guidelines. That’s why two companies can look at the same medical history and reach completely different conclusions about what to charge you.

The Standard Classifications

Most carriers use some version of the same tier structure, though the names vary slightly between companies. From best rates to worst, the standard classifications look like this: Preferred Plus (sometimes called Super Preferred or Preferred Elite), Preferred, Standard Plus, Standard, and Substandard. If you’re in good health with no significant medical history, you’ll likely land somewhere in the Preferred to Standard range. If you have a pre-existing condition, you’re either getting placed at the lower end of Standard or pushed into the Substandard category.

The Substandard category is where things get complicated, and where most articles stop explaining.

Table Ratings: The Part Nobody Translates Into Dollars

When an underwriter determines that your health risk exceeds what qualifies for Standard classification but doesn’t warrant a full decline, they assign a table rating. Depending on the carrier, this is expressed as a number (1 through 10, sometimes up to 16) or a letter (A through J or beyond). Each step on the table adds approximately 25% to your Standard rate.

Here’s what that looks like in real money. Take a 40-year-old applying for a $500,000, 20-year term policy with a Standard monthly premium of around $35. At Table 2 (50% above Standard), that same policy costs roughly $52 per month. At Table 4 (100% above Standard), you’re paying around $70 per month. At Table 8 (200% above Standard), the premium climbs to approximately $105 per month.

Over the full 20-year term, the difference between Standard and Table 4 adds up to more than $8,000 in additional premiums for the exact same coverage amount. Between Standard and Table 8, you’re looking at an extra $16,800. That’s not a rounding error. That’s a second car or a year of college tuition.

And here’s the part that matters most: the same person, with the same medical history, can be rated Table 4 by one carrier and Standard by another. Underwriting guidelines are proprietary. Each company has its own risk appetite, its own specialty conditions, and its own thresholds for what qualifies as well-managed versus concerning. This is one of the core reasons we recommend comparing quotes from multiple carriers rather than accepting the first number you’re given. One company’s substandard is genuinely another company’s standard.

Why This Changes Everything About How You Shop

Most people approach life insurance the way they approach car insurance: get a couple of quotes, pick the cheapest one, and move on. With pre-existing conditions, that approach can cost you thousands of dollars or result in an unnecessary decline on your record.

The classification you receive isn’t just about your condition. It’s about how that specific carrier evaluates your specific condition at your specific age with your specific treatment history. A carrier that specializes in cardiovascular risk might offer Standard rates to someone with a well-managed history of hypertension, while a carrier that’s conservative on cardiac risk might push that same applicant to Table 2 or Table 4. Neither company is wrong. They just have different underwriting philosophies.

This is one of the most common life insurance mistakes families make: assuming a single quote represents what the market will offer. For healthy applicants, the difference between carriers might be a few dollars a month. For applicants with pre-existing conditions, the difference can be the gap between affordable coverage and no coverage at all.

The sections ahead break down how specific conditions are actually evaluated, what the different policy types cost in real terms, and the strategies that let you shop aggressively without leaving a trail of formal applications on your record. That last part, the Medical Information Bureau (MIB) and how it tracks your application history, is something most agents never bring up. We will.

What Underwriters Actually See When They Read Your Medical History

This is where most online guides fail you. They list common pre-existing conditions, say “it depends,” and move on. That’s useless when you’re the one sitting across from the underwriter’s evaluation. What follows is a realistic breakdown of how specific conditions are treated in the underwriting process, based on industry guidelines and carrier-specific patterns. None of this is a guarantee of what you’ll be offered, because every carrier evaluates differently, but it’s far more honest than “talk to your agent.”

Cardiovascular: DVT, Heart Disease, Hypertension, Post-Heart Attack

The CDC estimates that up to 900,000 Americans are affected by venous thromboembolism (blood clots including DVT and pulmonary embolism) every year, with an estimated 60,000 to 100,000 deaths annually. That’s a staggering number, and underwriters know it. But the way they evaluate cardiovascular conditions is far more nuanced than “do you have heart problems.”

A single DVT episode that resolved without ongoing medication can qualify for Standard rates with many carriers, and some will even consider Preferred if it’s been more than three years with no recurrence and no current blood thinners. If you’re on anticoagulants like Eliquis or Warfarin, mild substandard ratings (around Table 2) are typical. Multiple DVT episodes within a few years push that higher, but DVT alone rarely results in an outright decline. The critical factor is whether the clot was provoked (caused by surgery, immobility, or a one-time event) or unprovoked (no identifiable trigger), because unprovoked clots signal a higher recurrence risk.

Hypertension is one of the most common conditions underwriters encounter, and well-controlled blood pressure on one or two medications can still land you at Standard or even Standard Plus. Uncontrolled hypertension with multiple medications, or hypertension combined with other cardiovascular risk factors, shifts the picture significantly.

History of heart attack or stent placement carries a mandatory waiting period with most carriers, typically six months to a year minimum before they’ll consider an application. After that, the evaluation hinges on ejection fraction (how well your heart pumps), whether you’ve had additional cardiac events, and how closely you’ve followed your cardiologist’s treatment plan. Clean follow-ups and documented compliance can mean the difference between Table 4 and decline.

Metabolic: Type 1 Diabetes, Type 2 Diabetes, High Cholesterol

Diabetes is where the gap between Type 1 and Type 2 matters enormously in underwriting, and most guides treat them as the same conversation.

Type 2 diabetes diagnosed later in life, well-controlled with oral medication and an A1C below 7.0, can qualify for Standard or even Standard Plus rates with carriers that specialize in metabolic conditions. According to the CDC’s diabetes data, more than 38 million Americans have diabetes, making this one of the most commonly underwritten conditions. Carriers like Prudential, Banner Life, and Lincoln Financial have historically offered more competitive rates for well-managed Type 2 applicants.

Type 1 diabetes is a different calculation entirely. Because it’s lifelong and insulin-dependent from diagnosis, carriers view it as a higher sustained risk. Standard rates are possible but less common. Substandard ratings (Table 2 through Table 6) are more typical, depending on your age at diagnosis, A1C history, and whether you’ve developed complications like neuropathy or retinopathy. Carriers that understand Type 1 (Corebridge Financial and John Hancock tend to be mentioned frequently by brokers) will look at the full picture rather than just the diagnosis.

High cholesterol on its own, managed with statins and supported by good bloodwork, is one of the least disruptive pre-existing conditions for underwriting. Many carriers treat it as a non-issue at the Preferred level if your other numbers are clean. The problem is when high cholesterol appears alongside obesity, hypertension, or family cardiac history, because the combination of risk factors shifts the evaluation dramatically.

Cancer History: Remission Timelines Change Everything

Cancer underwriting is almost entirely driven by two factors: the type of cancer and how long you’ve been in remission. The difference between one year and five years post-treatment can move someone from decline to Standard rates.

Fully recovered basal cell carcinoma (the most common skin cancer) often qualifies for Preferred rates, because the recurrence and mortality risk is minimal. Breast cancer, prostate cancer, and thyroid cancer survivors who are five or more years post-treatment with clean follow-ups are frequently eligible for Standard rates, and at ten years, some carriers will consider Preferred. According to the National Cancer Institute, the overall five-year relative survival rate for all cancers combined continues to improve, which has led some carriers to reevaluate their historical timelines.

More aggressive cancers (lung, pancreatic, advanced melanoma) carry longer exclusion windows and higher ratings even after remission. Ongoing treatment or surveillance within the first two years generally means either decline or guaranteed issue territory. The key insight most guides miss: if you’re in the one-to-five year window after treatment, the carrier you choose matters more than almost any other factor. Some specialize in cancer survivor underwriting. Others won’t touch it until the five-year mark.

Mental Health: The Category Nobody Talks About Honestly

Mental health is the most inconsistently handled category in life insurance underwriting, and it’s the one most people are afraid to ask about. The fear that disclosing depression or anxiety will automatically result in a decline keeps people from applying at all, which is often worse than the actual underwriting outcome.

Mild to moderate depression or anxiety, managed with a single medication and regular therapy, can qualify for Preferred or Standard rates with many carriers. The underwriter is looking at stability: how long you’ve been on your current treatment plan, whether you’ve had hospitalizations, and whether there’s a history of self-harm or suicidal ideation. A stable two-year history on the same medication with no emergency interventions is the profile most carriers view favorably.

Bipolar disorder and more complex diagnoses carry higher scrutiny. Multiple medication changes, recent hospitalizations, or gaps in treatment compliance can push ratings into substandard territory or result in postponement. But the assumption that bipolar disorder equals automatic decline is outdated. Carriers have become more sophisticated about evaluating mental health, and several now offer Standard or mild substandard rates for applicants with well-documented stable histories.

The most important thing to understand about mental health and underwriting: never omit it from your application. Carriers access prescription history databases, and undisclosed mental health treatment discovered during underwriting is treated far more harshly than an honest disclosure upfront. Transparency is both the ethical and the strategic choice.

Autoimmune and Chronic Conditions: MS, Lupus, Rheumatoid Arthritis, Crohn’s

Autoimmune conditions present a unique underwriting challenge because they’re chronic by nature. The question isn’t whether the condition exists; it’s how aggressively it’s progressing and how effectively it’s being managed.

Rheumatoid arthritis and Crohn’s disease, when well-controlled with medication and no recent flares requiring hospitalization, can often qualify for Standard or mild substandard rates. Carriers are looking for stable treatment histories without frequent regimen changes, which signal the condition is being managed rather than chased.

Multiple sclerosis (MS) and systemic lupus carry more underwriting weight because of their unpredictable progression patterns. Mild relapsing-remitting MS with infrequent episodes and stable treatment may qualify for substandard rates (Table 2 through Table 4 is common). Primary progressive MS or lupus with organ involvement typically results in higher table ratings or decline, depending on the carrier.

For every autoimmune condition, the documentation you bring to the application matters as much as the diagnosis itself. Recent lab work, specialist treatment notes, and a clear timeline of disease activity give underwriters the data they need to evaluate you as an individual rather than a diagnostic code. This is where working with a broker who understands impaired-risk underwriting becomes essential, because the right broker knows which carriers are most receptive to specific autoimmune profiles. If you’re comparing carriers independently, tools like The Swiftest let you see how different companies evaluate your situation without committing to formal applications.

Fully Underwritten, Simplified Issue, and Guaranteed Issue: What Each Actually Costs

If you have a pre-existing condition and start searching for coverage, you’ll encounter three policy types almost immediately. Most guides list them side by side and move on. What they don’t do is show you what the difference actually looks like in your bank account over time. That gap is where expensive mistakes happen.

Fully Underwritten: The Best Rates, If You Qualify

A fully underwritten policy involves a medical exam, health questionnaire, review of your medical records, and sometimes an attending physician’s statement from your doctor. It’s the most thorough process, and it takes the longest, often several weeks. But it also produces the best rates, even for people with pre-existing conditions, because the carrier has enough data to evaluate your actual risk rather than guessing.

For a 50-year-old applying for $250,000 of 20-year term coverage at Standard rates, monthly premiums typically fall in the range of $40 to $60 depending on the carrier. Even with a Table 2 substandard rating (50% above Standard), that same policy might cost $60 to $90 per month. Over 20 years, you’re looking at somewhere between $9,600 and $21,600 total for a quarter million dollars of coverage. That’s the benchmark everything else should be measured against.

This should be the first path attempted for most people with pre-existing conditions. If your condition is managed, documented, and stable, a fully underwritten policy gives you the most coverage for the lowest cost. The process takes longer, but the savings over the life of the policy are substantial.

Simplified Issue: The Middle Ground

Simplified issue policies skip the medical exam but still ask health questions. Some also review your prescription drug history and MIB record. The approval process is faster (days instead of weeks), but premiums are higher than fully underwritten policies because the carrier has less data to work with.

For the same 50-year-old seeking coverage, simplified issue premiums can run 20% to 40% higher than a fully underwritten Standard rate for similar coverage amounts. The trade-off is speed and simplicity. This path makes the most sense in a few specific situations: you need coverage quickly while pursuing a fully underwritten policy in parallel, your condition is recent enough that you’re still within the waiting window for full underwriting, or your health history is complex enough that documenting it cleanly for full underwriting would be difficult.

Simplified issue can also serve as a strategic bridge. Some people secure a simplified issue policy to have coverage in place immediately, then apply for a fully underwritten policy once their health stabilizes further. If the underwritten policy comes through at better rates, they drop the simplified policy. If it doesn’t, they still have coverage. This is a legitimate strategy, and any good broker should be willing to walk you through it.

Guaranteed Issue: The Last Resort, Not the Easy Path

Guaranteed issue is the option with no health questions and no medical exam. You cannot be declined. That sounds like exactly what someone with a serious condition wants to hear, and it’s why insurance companies market it so aggressively. But the math tells a very different story.

Coverage amounts on guaranteed issue policies typically cap at $25,000, though a few carriers offer up to $50,000. Premiums are dramatically higher per dollar of coverage. A 50-year-old paying $40 per month for a guaranteed issue policy is getting roughly $10,000 of coverage. That same $40 per month on a fully underwritten Standard-rated policy buys closer to $250,000. The cost-per-dollar gap is not a little higher. It’s a different universe.

Then there’s the graded death benefit. Most guaranteed issue policies include a two-year waiting period before the full death benefit applies to natural causes. If you pass away from illness during those first two years, your beneficiaries receive your premiums back plus approximately 10% interest, not the face value of the policy. Accidental death is typically covered in full from day one, but death from a pre-existing condition during the graded period pays almost nothing beyond what you’ve already put in.

This is why guaranteed issue coverage like Gerber Life has a specific and narrow role. It’s appropriate for people ages 50 to 80 who have been declined everywhere else, whose conditions are severe enough that no underwriting will approve them, and who need something in place for final expenses while understanding the limitations. It is not a substitute for trying fully underwritten or simplified issue first. Anyone who tells you to start with guaranteed issue before exploring other options is either uninformed or selling you the product with the highest commission.

The right sequence for most people with pre-existing conditions is: attempt fully underwritten first (through informal inquiries, which we’ll cover next), consider simplified issue as a bridge or backup, and reserve guaranteed issue only if the other two options are exhausted. That order protects both your coverage and your budget.

How to Shop Without Leaving a Trail of Formal Declines on Your Record

This is the single most important tactical move available to anyone applying for life insurance with a pre-existing condition, and most people have never heard of it.

When you submit a formal life insurance application, you sign an authorization that allows the carrier to report information to the Medical Information Bureau (MIB). The MIB is a nonprofit data exchange used by approximately 430 member life insurance companies across the United States and Canada. It stores coded summaries of health conditions and application activity, and those records stay in the system for seven years. MIB doesn’t store your actual medical records or lab results, just coded alerts that flag potential underwriting concerns for future carriers.

Here’s why that matters: if you submit a formal application to Carrier A and get declined, that decline activity shows up as an inquiry in your MIB file. When you apply to Carrier B, their underwriter sees that you recently applied elsewhere. Multiple applications in a short window create a pattern that raises questions. Was the previous carrier’s underwriting too strict, or is this applicant shopping around hoping someone will miss something? That pattern alone can result in closer scrutiny, higher ratings, or postponement of your application. According to the Consumer Financial Protection Bureau, you have the right to request your MIB report once every 12 months at no cost to check for errors or outdated information.

The Informal Inquiry: Shopping Without the Paper Trail

An informal inquiry is a process where your broker collects your health information (medical history summary, prescription list, treatment timeline, relevant lab results) and submits it to multiple carriers for preliminary review without filing a formal application. Because you haven’t signed a formal application or an MIB authorization, none of this activity gets reported to the MIB database.

The carrier’s underwriter reviews your health profile and provides a tentative assessment: what risk class you’d likely receive, what the approximate premium would be, and whether they’d even consider your case. This gives you and your broker a realistic picture of what the market will offer before you commit to a single formal application.

Think of it like getting pre-qualified for a mortgage before making an offer on a house. You learn what you can afford and where you stand without the hard credit inquiry showing up on your report. The informal inquiry does the same thing for life insurance. It lets you test the market and find the carrier most likely to give you the best rating, then submit one targeted formal application with the highest probability of approval.

What to Tell Your Broker

Not every agent or broker offers informal inquiries. It’s extra work on their end, and agents who represent a single company (captive agents) may not have the carrier relationships to shop your case broadly. Independent brokers with access to multiple carriers are the ones best positioned to run informal inquiries on your behalf.

When you contact a broker, be direct. Tell them you have a pre-existing condition, you want to explore your options across multiple carriers, and you’d like them to submit informal inquiries before any formal application. A good broker will ask for your full medical history, current medications, treatment timeline, and any recent lab work. They’ll send an anonymized or de-identified summary to underwriters at several carriers and come back with a range of tentative offers.

If a broker pushes you to fill out a formal application immediately without discussing informal inquiries first, that’s a signal to find a different broker. The whole point is to avoid unnecessary formal applications that could complicate your record. Brokers who understand impaired-risk underwriting know this. Brokers who don’t will cost you options you didn’t know you had.

For those who prefer to start the comparison process on their own before engaging a broker, quote comparison tools can give you a preliminary sense of where the market stands for your age and coverage amount. That initial comparison isn’t a substitute for the informal inquiry process, but it can help you walk into a broker conversation with better questions and clearer expectations. If you’d rather have an expert handle the shopping from the start, matching services like Everyday Life connect you with brokers who specialize in finding the right carrier for your specific health profile.

Timing Your Application Can Save You Thousands

Applying too early after a diagnosis or health event is one of the most expensive mistakes people make with life insurance. Not because you’ll necessarily be declined, but because the rating you receive in the months immediately following a medical event will almost always be worse than the rating you’d receive a year or two later. That difference in timing can mean thousands of dollars in additional premiums over the life of a policy.

The general underwriting timeline works like this, though specific windows vary by carrier and condition.

The Key Windows

Six months post-event is the minimum waiting period most carriers require after an acute episode like a DVT, heart attack, surgery, or new diagnosis before they’ll consider a fully underwritten application. Applying before this window usually results in automatic postponement, not a formal decline, but it wastes time and may generate an inquiry on your MIB record depending on how far the application progressed.

One year is when many carriers begin offering Standard-adjacent rates for single-event conditions that have stabilized. If you had a single DVT episode, completed treatment, and show no recurrence at twelve months, several carriers will evaluate you more favorably than they would have at six months. The same applies to a first-time cardiac event with clean follow-up imaging and documented compliance with your treatment plan.

Two years is a significant threshold for several reasons. It’s the point where most guaranteed issue graded benefits expire and full death benefits kick in, which matters if you secured temporary coverage while waiting to apply for something better. It’s also when many carriers begin to consider cancer survivors who completed treatment, particularly for common cancers with strong post-treatment prognosis. For mental health conditions, a stable two-year history on the same medication regimen with no hospitalizations is the profile most underwriters want to see.

Five years is the milestone that changes the most for cancer survivors. Breast, prostate, thyroid, and early-stage colon cancer survivors with five or more years of clean surveillance often become eligible for Standard or even Preferred rates, depending on the carrier. This is also the window where multiple-event cardiovascular histories start to look more favorable, provided the most recent event is behind that five-year mark with no complications since.

The Re-Rating Option Most People Don’t Know About

If you already have a policy that was rated substandard because you applied shortly after a health event, you may not need to start over. Many carriers allow policyholders to request a re-evaluation of their risk classification after a period of health stability, typically one to two years after the original policy was issued.

If your condition has improved, your labs are cleaner, and you’ve maintained compliance with your treatment plan, the carrier may lower your table rating, which reduces your premium going forward. Not every policy includes this option, so ask about it upfront when purchasing a policy, especially if you know your health is likely to stabilize over time. This is also a strong reason to avoid locking into a guaranteed issue policy too early. If you take the time to pursue fully underwritten coverage at the right window, you get both better rates and the potential for re-rating as your health improves further.

The bottom line on timing: patience is a financial strategy, not just a medical one. If you can bridge the gap with temporary coverage or a simplified issue policy while waiting for the optimal application window, the long-term savings on your permanent coverage can be substantial. This is exactly the kind of planning a good broker can help you map out, especially when paired with the informal inquiry process covered in the previous section.

Why Comparing Carriers Is Non-Negotiable When You Have a Pre-Existing Condition

Everything in this guide points to the same conclusion: the carrier you choose matters more than almost any other variable when you have a pre-existing condition. More than the type of policy. More than when you apply. More than whether you work with a broker or shop on your own. The single biggest determinant of what you’ll pay, and whether you’ll be approved at all, is which company’s underwriting guidelines evaluate your specific condition most favorably.

This isn’t a soft recommendation. It’s the math. One carrier’s Table 4 is another carrier’s Standard. One company’s automatic decline for a condition within two years of treatment is another company’s Standard Plus at eighteen months. The proprietary underwriting guidelines that drive these decisions are not published, not standardized across the industry, and not something you can find by reading a carrier’s website. The only way to discover where you stand is to compare.

For healthy applicants, carrier comparison is a nice-to-have that might save a few dollars a month. For applicants with pre-existing conditions, carrier comparison is the difference between affordable coverage and being told coverage isn’t available. That’s not an exaggeration. I’ve seen the same health profile quoted at Standard by one carrier and Table 6 by another. Over a 20-year term, that gap is tens of thousands of dollars for the exact same coverage amount.

This is where the strategies covered earlier in this article come together. Use the informal inquiry process to test multiple carriers without formal applications. Time your application to the window that gives you the best rating. Bring thorough documentation so underwriters evaluate you as an individual, not a diagnostic code. And start with a comparison tool to see the landscape before you commit to a single carrier. If your situation is complex enough that you’d benefit from someone managing the process for you, a matching service can connect you with a broker who specializes in pre-existing condition underwriting and has the carrier relationships to shop your case effectively.

The worst thing you can do is accept the first quote you receive. The second worst thing is give up after a single decline. Neither of those outcomes reflects what the actual market would offer if you approached it strategically. If nothing else stays with you from this guide, let it be this: your condition is not your classification. How you navigate the system determines what you pay far more than what’s on your medical record.

Frequently Asked Questions About Life Insurance with Pre-Existing Conditions

Can you get life insurance after a blood clot or DVT?

Yes. A single DVT episode that has resolved can qualify for Standard rates with many carriers, and Preferred rates are possible if it’s been more than three years with no recurrence and no current blood thinners. If you’re on anticoagulants like Eliquis or Warfarin, mild substandard ratings (around Table 2) are typical. The key factors underwriters evaluate are whether the clot was provoked or unprovoked, how many episodes you’ve had, and whether you’re currently on medication. According to CDC data, up to 900,000 Americans are affected by blood clots each year, making this one of the more commonly underwritten cardiovascular conditions.

Can you get life insurance with Type 2 diabetes?

Yes, and it’s often more affordable than people expect when the condition is well-managed. Type 2 diabetes controlled with oral medication and an A1C below 7.0 can qualify for Standard or Standard Plus rates with carriers that specialize in metabolic conditions. The underwriter will review your A1C history, whether you’re on insulin, your weight and blood pressure, and whether you’ve developed complications like neuropathy or kidney issues. Type 1 diabetes is underwritten differently because it’s lifelong and insulin-dependent from diagnosis, typically resulting in mild to moderate substandard ratings.

How long after cancer treatment can you get life insurance?

It depends on the type of cancer and how long you’ve been in remission. Fully recovered basal cell carcinoma often qualifies for Preferred rates almost immediately. For breast, prostate, and thyroid cancers, many carriers offer Standard rates at five or more years post-treatment with clean follow-ups. At ten years, some will consider Preferred. More aggressive cancers carry longer windows. The one-to-five year post-treatment period is where carrier selection matters most, because some companies specialize in cancer survivor underwriting while others won’t consider an application until the five-year mark.

Does a mental health diagnosis disqualify you from life insurance?

No. Mild to moderate depression or anxiety managed with a single medication and regular therapy can qualify for Preferred or Standard rates with many carriers. Underwriters evaluate stability: how long you’ve been on your current treatment plan, whether you’ve had hospitalizations, and whether there’s a history of self-harm or suicidal ideation. Bipolar disorder and more complex diagnoses carry higher scrutiny but are not automatic disqualifiers. The most important thing is to never omit mental health history from your application. Carriers access prescription databases, and undisclosed treatment discovered during underwriting is treated far more harshly than honest disclosure upfront.

What is a life insurance table rating?

A table rating is the classification assigned when your health risk exceeds Standard but doesn’t warrant a full decline. Expressed as a number (1 through 10 or higher) or a letter (A through J or beyond), each step adds approximately 25% to your Standard premium. Table 2 means 50% above Standard. Table 4 means 100% above Standard. Table 8 means 200% above Standard. For a $500,000, 20-year term policy with a Standard premium of $35 per month, a Table 4 rating would cost approximately $70 per month. Over 20 years, that’s more than $8,000 in additional premiums for the same coverage.

What is the MIB and how does it affect my life insurance application?

The Medical Information Bureau (MIB) is a nonprofit data exchange used by approximately 430 member life insurance companies. When you submit a formal application, the carrier reports coded health information to the MIB, and those records stay in the system for seven years. The MIB doesn’t store your actual medical records, just coded alerts that flag potential concerns for future carriers. Formal application activity, including declines, creates a pattern that other carriers can see. This is why informal inquiries (where your broker shops your case without filing formal applications) are so valuable for people with pre-existing conditions.

What is an informal inquiry in life insurance?

An informal inquiry is a process where your broker submits your health information to multiple carriers for preliminary review without filing a formal application. Because no formal application is signed, the activity is not reported to the MIB. The carrier’s underwriter reviews your profile and provides a tentative assessment of what risk class and approximate premium you’d receive. This lets you test the market and identify the most favorable carrier before committing to a single formal application. Not every broker offers this service, so ask specifically. Independent brokers with access to multiple carriers are best positioned to run informal inquiries.

What is the difference between guaranteed issue and simplified issue life insurance?

Simplified issue policies skip the medical exam but still ask health questions and may review your prescription history and MIB record. Premiums are higher than fully underwritten policies but significantly lower than guaranteed issue. Guaranteed issue policies have no health questions and no exam, meaning you cannot be declined, but coverage typically caps at $25,000, premiums are dramatically higher per dollar of coverage, and most policies include a two-year graded death benefit (if you pass away from natural causes in the first two years, beneficiaries receive premiums paid plus approximately 10% interest rather than the full death benefit). Guaranteed issue should be a last resort after fully underwritten and simplified issue options have been explored.

Can I get life insurance after a heart attack?

Yes, though timing matters significantly. Most carriers require a minimum of six months to one year after a cardiac event before they’ll consider a fully underwritten application. The evaluation hinges on your ejection fraction (how well your heart pumps), whether you’ve had additional cardiac events, your compliance with your cardiologist’s treatment plan, and your overall cardiovascular risk profile. Clean follow-ups and documented compliance can mean the difference between a Table 4 rating and a decline. At five or more years post-event with no complications, many carriers will offer significantly more favorable ratings.

Can I get a better rate if my health improves after I buy a policy?

Potentially, yes. Many carriers allow policyholders to request a re-evaluation of their risk classification after a period of health stability, typically one to two years after the original policy was issued. If your condition has improved, your labs are cleaner, and you’ve maintained compliance with your treatment plan, the carrier may lower your table rating and reduce your premium going forward. Not every policy includes this option, so ask about re-rating eligibility upfront when purchasing coverage. This is especially relevant if you’re applying shortly after a health event and expect your condition to stabilize over time.

Your Medical Record Doesn’t Get the Final Word

A diagnosis changes your medical history. It doesn’t have to change whether your family is protected. The system is more flexible than most people realize, and far more flexible than most articles about it are willing to explain. The difference between uninsurable and well-covered often comes down to which carrier you ask, when you ask, and how you present your case. Those are things you can control. If you take one thing from this guide, let it be that the process rewards people who show up prepared and refuse to accept the first answer they’re given.

• 7 Life Insurance Mistakes That Could Leave Your Family With Nothing (What Agents Don’t Mention)
• Estate Planning for Families with Special Needs: The Complete Protection Guide
• Terms and Conditions
• Top 5 Burial Insurance Providers to Consider 2025 and 2026
• Privacy Policy

Author: Gabriel Killian

Founder, Memorial Merits U.S. Navy Service Member Gabriel created Memorial Merits after experiencing funeral industry complexities & exploitation firsthand when his father passed away unexpectedly in 2019. His mission: protect families from predatory practices and provide clear guidance during impossible times. [Read Full Story →] EXPERTISE: • Personal experience with loss • Funeral planning (multiple times) • AI grief support development • Published author (legacy planning)