Living With Ra: Getting Life Insurance Coverage

Rheumatoid arthritis (RA) is a chronic inflammatory disorder and the most common type of autoimmune arthritis. It affects around 1% of the population, with women being 2-3 times more likely to be diagnosed than men. While it is not a fatal condition, it can reduce life expectancy by 3-12 years. As a result, those with RA may wonder about their options for life insurance.

The good news is that people with RA can get life insurance. However, the availability of policies and the amount spent on premiums depend on the severity of the condition. Life insurance underwriters assess applications from those with RA by considering factors such as date of diagnosis, medication, symptoms, frequency of flare-ups, affected body parts, and other medical conditions. Based on these factors, applicants are given a health classification, which determines their premium rates. While standard rates are possible for those with mild RA, most people with the condition will receive a table rating, which increases their premiums. For those with severe RA, a traditional plan may not be available, and a no-medical policy may be the only option.

It is recommended that those with RA work with an independent agent who can help them find the best policy available to them.

Life insurance approval with RA

Life insurance approval with rheumatoid arthritis (RA) is possible, but the options and costs available to you will depend on the severity of your condition and your overall health.

How RA Affects Life Insurance Approval

When assessing life insurance applications from people with RA, underwriters will consider several factors, including:

• Date of diagnosis: A longer diagnosis date indicates a longer treatment time, which is associated with a higher mortality risk.
• Medication: Some medications are viewed more favourably by insurers than others due to their side effects.
• Disability: Being unable to work, needing motorized assistance, or being unable to live independently because of your RA will increase your premiums or result in your application being declined.
• Deformities: Deformities of the wrists, hands, feet, or toes will negatively impact your premium rates.
• Flare-ups: The more flare-ups you have, the higher the likelihood of joint damage and deformity or disability.
• Body parts affected: Carriers will want to know the extent of any joint damage and whether your heart, lungs, or other major organs have been affected.

Types of Life Insurance for People with RA

There are three main types of life insurance available for people with RA:

• Term life insurance and permanent life insurance: If you have mild RA, you may be eligible for term life insurance or permanent life insurance (such as whole life or universal life). Even in mild cases, however, you will likely receive a low table rating of 2 or 3.
• Simplified issue life insurance: This type of insurance has a simplified underwriting process, but carriers may limit the death benefit.
• Guaranteed issue life insurance: This is an option for people with severe RA who have been declined for traditional life insurance. Carriers do not underwrite these policies, so the death benefit is usually limited to $25,000.

Tips for Applying for Life Insurance with RA

• Apply now: The best time to apply for life insurance is now, as you will likely pay a higher premium if your condition worsens.
• Be transparent: Be open and honest with your insurer about your RA so they can find a coverage plan that works for you.
• Work with an independent agent or broker: An independent agent or broker is not tied to a particular carrier and can help you find the best policy for your situation.

Underwriting factors

• Date of Diagnosis: The date of diagnosis is important because RA is considered a chronic condition. Insurance companies want to know how long an individual has been treating RA, as longer treatment times can indicate a higher mortality risk. The longer the treatment, the higher the potential premium.
• Duration and Frequency of RA Flare-ups: More frequent and longer-lasting flare-ups increase the risk of joint and tissue damage, which can impact the insurance rating.
• Deformity: The presence and type of deformity, such as mild deformity of the wrists or fingers, or major deformity of the knees or hips, can affect the insurance rating.
• Disability: The inability to live independently and perform daily activities due to RA can negatively impact the insurance rating and increase premiums.
• Medication: The type and frequency of medication used to treat RA is considered. Some medications, such as steroids and immunosuppressive drugs, can have significant side effects, which may be factored into the underwriting process.
• Affected Body Parts: The extent of joint damage and bone erosion, as well as the involvement of other organs, such as the heart, lungs, or kidneys, can impact the insurance rating.
• Other Health Conditions: The presence of other health conditions or hazardous lifestyle choices, such as smoking, obesity, or diabetes, can impact the insurance rating and availability of options.

These underwriting factors are used by life insurance companies to assess the risk associated with insuring an individual with RA. The severity of RA, along with these factors, will determine the premium rates, the availability of standard or rated policies, and the possibility of a decline for traditional life insurance.

Life insurance decisions with RA

If you have rheumatoid arthritis (RA), you can still get life insurance. The availability of life insurance options and the amount you will pay depend on the severity of your RA. Underwriting departments assess your mortality risk and determine your expected mortality and potential lifespan. This estimated mortality then influences:

• The premium you will pay
• The life insurance coverage available to you

If your lifespan is expected to be better than average, you will pay less and have more life insurance options. Conversely, if your mortality risk is higher, you can expect to pay higher premiums and have fewer life insurance options available (if any).

Underwriting Factors

Life insurance underwriters look at several factors when analysing a life insurance application from someone with RA. These include:

• Date of diagnosis – Underwriting departments prefer to see a recent diagnosis of RA as a longer diagnosis indicates longer treatment, which in turn indicates a higher mortality risk.
• Medication taken and treatment options – Some types of medication are viewed more favourably by underwriters than others. Mild medications like aspirin, ibuprofen, and other non-steroidal anti-inflammatory drugs (NSAIDs) likely won't affect your premium rates. However, treatment with steroids, methotrexate, prednisone, other immunosuppressive drugs, and anti-rheumatic drugs will likely result in higher premium rates due to their significant side effects.
• Disability – Being disabled by your RA indicates a severe situation and will increase your premiums or result in your application being declined.
• Deformity and symptoms – Deformities such as the inability to use your hands or move your wrists will negatively impact your premium rates. If your RA restricts your mobility, this will also impact your rates.
• Frequency of flare-ups – The more flare-ups you have, the higher the likelihood of joint damage, deformity or disability, all of which will impact your premium rates.
• Body parts affected – Carriers will want to know the extent of any joint damage and whether you experience bone erosion. RA can also affect your heart, lungs, and other major organs, as well as contributing to weight loss and low blood counts, so the more areas of your body that are affected, the higher your premium will be.
• Other medical conditions – Other health conditions or hazardous lifestyle choices will impact your ability to obtain life insurance.

Life Insurance Decisions

Based on the information you provide about your RA and other factors, the life insurance underwriting department will make an offer and assign a health classification. This health classification will determine the amount you pay (i.e. the premium) for your life insurance.

Life insurance carriers establish health classification ratings, also known as tables or table ratings. The tables start at preferred best (i.e. for very healthy people), which is the lowest premium you'll pay. The tables go up to Table J, which is the highest premium.

Standard rates are for typical health and lifestyle situations. The better your health and lifestyle, the better your classification and rate. Conversely, the worse your health and lifestyle, the worse your classification and premium rate. Classifications below the standard rate are known as table ratings. If the underwriting department is unable to classify you on the table, your application will be declined.

It's important to note that carriers won't offer a person with RA a preferred best or preferred rating. The best health classification available is the standard rate. While this is still very good, most, if not all, people with RA have a table rating, the level of which depends on the severity of the disease and other factors.

Life Insurance Options

There are three main life insurance options for people with RA:

• Term life insurance and permanent life insurance (whole life and universal life) – If you have mild RA, you can expect a standard rating to a table rating. If you take anti-rheumatic drugs like methotrexate and hydroxychloroquine, or immunosuppressant drugs or infusion drugs like Remicade, you can expect a table rating.
• Simplified issue life insurance – This is a "simplified" underwriting process that removes the medical exam. Carriers offering simplified issue whole life insurance typically limit the death benefit to $25,000 to $50,000. Simplified issue term carriers generally limit the death benefit to $150,000 to $250,000.
• Guaranteed issue life insurance – Guaranteed issue life insurance is reserved for severe cases where the applicant is disabled by their RA and cannot walk or work. Because these plans don't underwrite, they limit the death benefit to around $25,000.

Life insurance options approved for RA

If you have rheumatoid arthritis (RA), your best chance of getting affordable life insurance is to apply through a broker, as they are not tied to one life insurance company and can shop the market.

Traditional Life Insurance

Your best option is usually a traditional, fully-underwritten life insurance policy (the kind that requires a medical exam). This works best for mild (or moderate, at most) rheumatoid arthritis. It offers large benefit amounts but has stricter underwriting.

Graded Benefit Life Insurance (GBLI)

If you are declined for traditional life insurance, GBLI is your next best option. This works best for moderate to severe rheumatoid arthritis. The benefit amount is typically capped at $50,000, and there is a more lenient underwriting process with some health questions asked. There is a waiting period of 2-3 years for the full benefit, and premiums cost more than traditional life insurance.

Guaranteed Issue Life Insurance (GI)

This is your last resort if you are unable to secure Traditional or Graded Benefit Life Insurance. It works best for severe rheumatoid arthritis, with benefit amounts typically capped at $25,000. There is a lenient underwriting process, with no health questions asked, and the same waiting period as GBLI. Premiums are more expensive than the other two options.

Standard Approval

To get approved at standard rates, your RA will need to be well-controlled with mild medications, like non-steroidal anti-inflammatory drugs (NSAIDs). This means minimal flare-ups of joint pain and swelling, no evidence of organs affected by RA, no disability, and documented regular check-ups with your rheumatologist.

Rated Approval

Rated approval is for mild/moderate RA. Insurance carriers will be looking for long-term treatment with medications such as steroids and disease-modifying antirheumatic drugs (DMARDS), a mild deformity, and/or mild disability. A rated approval means you still qualify for life insurance but will have a premium surcharge of somewhere between 20-200%.

Table Rating

It is possible for those with mild rheumatoid arthritis to not be table rated. A table rating is given when a life insurance underwriter deems an applicant too high of a risk to insure at a standard rate. The table rating means the applicant will have to pay a price increase on top of the standard premium price to offset the risk the company is taking.

Independent Agent

An independent life insurance agent is not held captive to a particular carrier and has access to the top-rated life insurance companies. They will have your best interest at heart and can offer you the best policy you qualify for at the most competitive price.

Application process for life insurance with RA

The application process for life insurance with rheumatoid arthritis (RA) can vary depending on the insurance company and the type of policy you choose. Here is a step-by-step guide to help you navigate the process:

• Select a Policy Option: The first step is to choose the right life insurance policy that meets your needs and circumstances. Consider the length of the policy term, the death benefit, and seek advice from an experienced insurance professional.
• The Application Process: Review life insurance quotes and decide on the policy you want to apply for. Submit an application request, and a licensed representative will help you complete the application over the phone or schedule a convenient time to do so. The application typically includes questions about your health, lifestyle, and family history. Be prepared to provide detailed information about your RA diagnosis, treatment, and any medications you are taking.
• Medical Exam: Some insurance companies may require a medical exam as part of the application process. This exam can be conducted by a paramedical examiner at your home, office, or a designated clinic. The exam may include recording your medical history, blood pressure measurement, and other tests such as an electrocardiogram or treadmill stress test.
• Underwriting: Once your application and medical exam (if required) are completed, the information will be reviewed by an underwriter who will assess the risk and determine the premium amount. This process can take a few weeks, depending on how quickly the information is supplied and the availability of medical records.
• Approval or Denial: After the underwriting process, the insurance company will either approve or deny your application. If approved, you will receive the policy, which you should review carefully before accepting. If denied, you may still have alternative options, such as applying with a different insurer or considering graded benefit or guaranteed issue policies.
• Payment and Coverage: If you agree to the terms of the approved policy, you will need to make the premium payment to finalise the process. Once the payment is processed, your life insurance coverage will be in force.

It is important to be honest and provide accurate information throughout the application process. Misrepresenting or omitting information could lead to legal trouble and may affect your eligibility for coverage or the benefits payable to your beneficiaries.

Frequently asked questions