Life Insurance Options For People With Kidney Failure

Kidney disease is a chronic and potentially life-threatening condition that affects millions of people worldwide. The progression of kidney disease can lead to kidney failure, requiring dialysis or a kidney transplant for survival. This distinction between kidney disease and kidney failure is crucial when it comes to life insurance options. While kidney disease presents challenges, individuals with kidney failure face even narrower choices due to the limited treatment options available to them.

The availability and cost of life insurance are influenced by several factors, including kidney function tests, underlying causes of kidney issues, family history, dialysis requirements, and transplant history. These variables collectively shape the eligibility and premium rates for individuals seeking life insurance in the face of kidney-related health concerns.

Kidney function test (KFT) results

Kidney function tests (KFT) are important for people with kidney disease, as they are one of the primary factors that insurance companies consider when underwriting a policy for someone with this condition. The results can indicate how well your kidneys are functioning and can influence your eligibility and premium rates.

KFTs can include blood tests, 24-hour urine samples, or both. Blood tests can measure:

• Blood Urea Nitrogen (BUN) - the nitrogen levels in your blood, which is derived from protein breakdown.
• Estimated Glomerular Filtration Rate (eGFR) - the filtration rates of your kidneys, calculated based on factors like protein levels, age, gender, size, and race.
• Serum Creatinine - the accumulation of creatinine, a byproduct of muscle tissue breakdown.

Urine tests can include:

• Microalbuminuria - which detects the presence of a specific protein called albumin.
• Urinalysis - which assesses your urine for indications of blood, proteins, and overall kidney function.

KFT results can be available on the same day, but typically take a few days. The results can include readings for:

• Glomerular Filtration Rate (GFR) - a GFR of less than 60 could indicate kidney disease.
• Urine Albumin-to-Creatinine Ratio (UACR) - a ratio of more than 30 milligrams per gram could be a warning sign of kidney disease.

If your KFT results show early kidney disease, your healthcare provider will follow up with treatment options, which may include medications to manage blood pressure or a referral to a nephrologist. Regular testing may also be necessary to monitor kidney damage over time.

Underlying causes of kidney failure

Kidney failure occurs when one or both kidneys lose their ability to function properly. It can be fatal if left untreated. The two most common causes of kidney failure are high blood pressure and diabetes. However, there are several other factors that can lead to kidney failure, including:

• Loss of blood flow to the kidneys due to scarring of the liver, severe infections, or medications.
• Urine elimination problems caused by cancers blocking the urine passageways or other conditions interfering with urination.
• Blood clots within the urinary tract.
• Heavy metal poisoning.
• Alcohol and drug use.
• Vasculitis, an inflammation of the blood vessels.
• Lupus, an autoimmune disease affecting multiple organs.
• Glomerulonephritis, inflammation of the small blood vessels in the kidneys.
• Hemolytic uremic syndrome, which involves the breakdown of red blood cells following a bacterial infection.
• Multiple myeloma, a cancer of the plasma cells in the bone marrow.
• Scleroderma, an autoimmune condition affecting the skin.
• Thrombotic thrombocytopenic purpura, a disorder causing blood clots in small vessels.
• Chemotherapy drugs.
• Dyes used in imaging tests.

The risk of kidney failure increases with age, family history, and the presence of conditions like diabetes and high blood pressure. It is important to manage these underlying conditions effectively to improve the chances of securing life insurance.

Dialysis and transplant options

Dialysis is a treatment for kidney failure, not a cure. There are two types of dialysis: peritoneal dialysis and haemodialysis. Peritoneal dialysis uses the lining of your belly to filter your blood inside your body, removing waste. Haemodialysis, on the other hand, uses a machine to move your blood through a filter outside your body, also removing waste. Both types of dialysis can be performed at home, which is less disruptive to your lifestyle and may have health benefits. However, it is important to note that dialysis does not cure kidney failure, but it can help you feel better and live longer.

When it comes to kidney transplants, it is important to remember that this is also a treatment for kidney failure and not a cure. A kidney transplant offers freedom from dialysis and dietary restrictions. The surgery involves placing a healthy donor kidney into your body, either from a living or deceased donor. The survival rate following a kidney transplant is high, with 97% of recipients from deceased donors alive at one year and 90% alive at five years. Living donor transplants have an even higher success rate, with 99% of recipients alive at one year and 96% at five years.

While having a kidney transplant does not automatically disqualify you from obtaining life insurance, it is important to note that some carriers may require a postponement period following the transplant before offering full cover. This period is usually around two years. During this time, you may be able to arrange interim cover that excludes pre-existing conditions. Additionally, undergoing dialysis is typically an automatic decline for most insurance companies, but some specialised options may still be available.

Family history of kidney issues

A family history of kidney issues can affect your life insurance policy as it indicates a genetic predisposition to kidney disease. While kidney disease may be inherited, it is more commonly caused by environmental and social factors, known as social determinants of health (SDoH). These factors can include a lack of access to healthy foods, open spaces, and reliable transportation to medical appointments. SDoH can make it difficult for people to lead healthy lifestyles and get the medical attention they need, increasing the risk of developing kidney disease.

If you have a family history of kidney disease, it is important to be proactive in protecting your kidney health. This may include regular testing to monitor kidney function and addressing any underlying conditions, such as diabetes or high blood pressure, which are the most common causes of kidney disease. By managing these conditions effectively, you can improve your chances of securing life insurance.

When applying for life insurance, you will typically be asked about your personal medical history and any family history of illnesses. It is important to be honest about your family's medical history, as insurers will verify your application against existing health records. While your personal health profile is a larger factor in determining the cost of your premiums, a family history of kidney disease may result in higher premiums.

It is worth noting that having a kidney transplant does not automatically disqualify you from obtaining life insurance. Some insurers may offer coverage if at least one kidney is functioning normally post-transplant, but you may encounter higher premiums due to the associated risks.

Insurance options

Federal Government Programs

The US Federal Government provides financial assistance for kidney failure treatment through Medicare, a federal health insurance program. Medicare covers 80% of the cost of dialysis treatment and 80% of the cost of immunosuppressant medications after a transplant.

Medicare is available for:

• People under 65 with certain disabilities who have received Social Security Disability Insurance (SSDI) for 2 years.
• People of any age with end-stage renal disease (ESRD), which is permanent kidney failure treated with a kidney transplant or dialysis.

Joint Federal-State Programs

Joint federal-state programs such as Medicaid and the Children's Health Insurance Program (CHIP) can also help with the cost of kidney failure treatment. Medicaid provides free or low-cost health coverage for low-income individuals, families, children, pregnant women, the elderly, and people with disabilities. CHIP offers free or low-cost Medicaid to children whose parents earn too much for standard Medicaid but not enough for private health insurance.

Other Federal Programs

The Social Security Administration provides financial assistance through the Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI) programs. SSDI pays a monthly amount to people who cannot work and have paid enough Social Security taxes. SSI pays a monthly amount to disabled children and adults with low earnings and few financial assets.

State Programs

State programs such as Medicare Savings Programs, State Health Insurance Assistance Programs (SHIPs), and State Pharmaceutical Assistance Programs (SPAPs) can also help with the cost of Medicare premiums, deductibles, and coinsurance.

Private Health Insurance

Group health insurance, purchased through an employer, union, or family member's employer or union, can cover the first 30 months from when an individual becomes eligible for Medicare for kidney failure. After this period, group insurance can work with Medicare to cover costs that aren't paid for by Medicare, such as copays, coinsurance, and deductibles.

Individual health insurance can be purchased directly by individuals and their families or through the Health Insurance Marketplace for those legally residing in the US with no other insurance options.

Medigap, or Medicare Supplemental Insurance, is extra health insurance purchased from a private company to cover some costs not covered by Original Medicare, such as copays, coinsurance, and deductibles.

Help for Special Populations

Special populations, such as US veterans, active-duty service members, military retirees, American Indians, and Alaska Natives, may be able to obtain financial assistance from organizations specific to their demographic groups.

Help from Private Organizations

Private organizations such as charities and foundations can also provide financial assistance for those with kidney disease and kidney failure. The National Kidney Foundation, for example, offers patient education, advocacy, and limited financial assistance in certain cases.

Frequently asked questions