Can You Get Coverage with a Pre-Existing Condition?
Learn how life and critical illness insurers assess medical history and what options may still be available
Having a health condition in your medical history does not automatically mean you are uninsurable. Whether you are applying for life insurance, critical illness insurance, or another type of coverage, insurers consider a range of factors — not just a diagnosis. Many people with pre-existing conditions still qualify for protection, although the process may involve more questions, extra documentation, or limitations on coverage.
Understanding how insurers view your health status and what adjustments they may make can help you find the right policy without unnecessary stress.
What Is Considered a Pre-Existing Condition?
A pre-existing condition is any medical diagnosis, symptom, or treatment you have had before applying for insurance. Common examples include:
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High blood pressure or elevated cholesterol
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Diabetes (type 1 or type 2)
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Depression or anxiety
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Asthma or other respiratory conditions
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Heart disease or a prior stroke
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Cancer history
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Autoimmune or neurological disorders
Insurers generally look at your full medical history, including hospital visits, medications, test results, and how well the condition is managed. Some companies only consider conditions from the last few years, while others look back further depending on the policy.
How Insurers Evaluate Pre-Existing Conditions
Underwriters assess risk based on the likelihood that your condition could lead to a claim. They may consider:
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The severity of the condition
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The stability of your health over time
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Current medications and whether symptoms are controlled
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Any history of hospitalization, surgery, or complications
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Whether the condition affects your daily activities or ability to work
Based on this review, you might:
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Be approved with standard rates
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Be approved with a higher premium (called a rating)
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Have the condition excluded from your policy
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Be declined, especially if the risk is high or the condition is unstable
Tip: Always answer health questions honestly and completely. Providing accurate information upfront avoids delays and preserves your eligibility for appeals or alternate coverage.
Types of Policies Available
| Policy Type | Pre-Existing Condition Handling |
|---|---|
| Fully underwritten | May offer standard or rated coverage based on detailed review |
| Simplified issue | Fewer health questions, but exclusions are more likely |
| Guaranteed issue | No medical questions asked, but higher premiums and lower coverage |
If traditional policies are unavailable, simplified or guaranteed issue coverage can provide limited protection, often for final expenses or temporary needs.
Caution: Even if you are approved, some policies include clauses that limit benefits for conditions diagnosed or treated within a set timeframe before the policy began. Review these carefully to understand when full protection begins.
How to Increase Your Chances of Approval
If you have a pre-existing condition, these steps can improve your outcome:
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Apply while your condition is stable
If your health has been consistent for 6 to 12 months, insurers may view you more favorably. -
Gather detailed medical records
Providing lab results, doctor’s notes, or a letter from your specialist can help clarify your situation. -
Work with a broker who understands impaired risk cases
Some advisors specialize in finding coverage for applicants with complex health histories. -
Consider layering policies
You might combine smaller policies from different insurers, or use simplified coverage while waiting to qualify for full protection.
Coverage Is Still Possible
Having a pre-existing condition means your application might take a little longer or require extra steps, but it does not mean coverage is out of reach. Many people with well-managed health conditions successfully get the protection they need.