Life Insurance Options For People With Autism

Life insurance for people with autism can be challenging to obtain, but it is not impossible. The options available depend on the severity of the condition, age, and other factors such as overall health, occupation, and lifestyle. People with autism generally have a lower life expectancy, which makes it difficult to get insured, but there are still options available. These include fully underwritten life insurance, guaranteed-issue whole life insurance, and life insurance with a child rider. The application process will involve several questions about the condition and its impact on daily life, and it is important to be honest and provide as much information as possible. Working with an independent agent or broker who specializes in high-risk life insurance can make the process easier and increase the chances of finding suitable coverage.

Life insurance for children with autism

It is possible to get life insurance for children with autism, but it can be challenging. The options available depend on the child's age, the severity of their autism, and their overall health.

Underwriting

The first step in getting life insurance for a child with autism is to understand the underwriting process. Underwriting is when the insurance company assesses whether to approve an application and what rates to offer. It is important to do your research and understand how insurance companies view individuals with autism, as not all carriers will insure someone with autism. The severity of the autism will play a significant role in the underwriting process.

Insurance companies may decline applications for children with moderate to severe autism or place a table rating, which means higher premiums. The child's ability to perform activities of daily living (ADLs) independently and their level of functioning will also be considered. If the child requires a primary caregiver or has minimal social interaction, it may hinder their ability to obtain a policy.

Application Age

Most insurance carriers will decline applications for children diagnosed with autism until they are eight years old. Some carriers may even recommend waiting until the child is ten years old, as older children are easier to assess.

Available Insurance Options

If your child is high-functioning, communicates as a typical child, and has no other health conditions, you can expect to get life insurance at standard rates or with a table rating. Whole life insurance is usually a good option for children, but term life insurance is also available.

If your child has moderate to severe autism, guaranteed issue whole life insurance is an option. This type of policy has some drawbacks, such as higher costs and limited coverage.

Impact on Medicaid

If your child receives government assistance, such as Medicaid, purchasing a whole life insurance policy for them could negatively impact their eligibility for these programs. This is because the cash value of the policy is considered an asset, and there are limits on the assets an individual can have while still qualifying for Medicaid.

Life insurance for adults with autism

It is possible for adults with autism to obtain life insurance, although the options available will depend on the individual's specific circumstances. The severity of an autism diagnosis, their overall health, and their ability to perform activities of daily living (ADLs) will all be considered by insurance providers.

Underwriting

Underwriting is the process of reviewing an application and determining the insurable risk. For individuals with autism, the underwriting process will involve assessing the applicant's place on the autism spectrum, their ability to perform ADLs, their overall health, and any other pre-existing conditions.

Options for Adults with Autism

Guaranteed Issue Life Insurance

If an adult with autism is unable to obtain regular coverage, a guaranteed issue life insurance policy may be an option. This type of policy does not require a medical exam, making it suitable for individuals with health problems. However, it tends to be more expensive than traditional life insurance policies.

Simplified Issue Life Insurance

Simplified issue life insurance is another option for adults with autism. This type of policy involves answering health questions rather than undergoing a medical exam. It may be suitable for individuals with mild to moderate autism who have a high level of functioning and independence.

Traditional Life Insurance

Traditional life insurance policies, such as term life insurance and whole life insurance, may be available to adults with mild to moderate autism who are able to manage their condition well and demonstrate proof of being able to function normally, such as having a job or attending school.

Factors Affecting Insurance Rates

In addition to the specific circumstances of the individual with autism, other factors can influence insurance rates. These include age, occupation, family medical history, tobacco and alcohol use, and physical health.

Seeking Professional Help

Working with an independent agent or broker who specializes in high-risk life insurance can be beneficial when navigating the process of obtaining life insurance for an adult with autism. They can help determine the best options and provide guidance on the application process.

The underwriting process for people with autism

For children with autism:

Most insurance carriers will decline applications for children with autism until the age of 8, as this is when medical professionals have a better understanding of the child's prognosis. Some carriers may even recommend waiting until the child is 10 years old to get a more accurate assessment. The availability of coverage and the cost of premiums will depend on the severity of the child's condition and their overall health. If the child has mild autism and is high-functioning, they may be eligible for fully underwritten plans, including whole life, index universal, and term life insurance. For children with moderate to severe autism, a guaranteed-issue whole life insurance policy may be the only option available. This type of policy typically has a 2-year waiting period before the death benefit is paid out and comes with higher premiums.

For adults with autism:

Adults with autism may have more options available to them, depending on the severity of their condition and their overall health. If an adult with autism is high-functioning, with mild to moderate symptoms, and is able to live a relatively independent life, they may be eligible for traditional term life insurance or whole life insurance with standard rates. However, if an adult with autism requires assistance with daily activities and has severe symptoms, their options may be limited to a guaranteed issue life insurance policy, which tends to be more expensive and comes with a waiting period before the death benefit is paid out.

Factors considered during the underwriting process:

During the underwriting process, insurance companies will consider various factors to assess the risk of insuring an individual with autism. These factors include the person's age, age of diagnosis, severity of the diagnosis, ability to perform daily activities independently, current health status, medical history, prescription history, and any other serious medical conditions. The insurance company may also require a medical exam and request an Attending Physician Statement (APS) to gather more information about the individual's health and condition.

The impact of life insurance on Medicaid

Life insurance policies can impact eligibility for Medicaid, as applicants must meet specific financial requirements, including an asset limit, to qualify for the program. Depending on the type and value of the life insurance policy, it can be counted towards the asset limit, which varies depending on the type of Medicaid Long Term Care, the applicant's state of residence, and their marital status.

For individuals, the asset limit for Medicaid is generally $2,000, but this can differ by state. For example, New York has an asset limit of $31,175, Illinois allows up to $17,500, New Hampshire has a limit of $2,500, and Connecticut sets the limit at $1,600. California is the only state without an asset limit as of January 1, 2024.

Whole life insurance policies can impact Medicaid eligibility because they accrue a cash value that policyholders can borrow against or cash out. This means that policyholders can take cash from their existing policy, and since it can be counted as an asset, it may affect eligibility for needs-based programs like Medicaid. On the other hand, term life insurance policies do not accumulate cash value, so they are usually exempt from the Medicaid asset limit.

In most states, whole life insurance policies with a face value of $1,500 or less are exempt from Medicaid's asset limit. However, some states have higher exemption amounts, such as Florida ($2,500), Rhode Island ($4,000), and North Carolina ($10,000). If the face value of a policy exceeds the exemption amount, the cash value will be counted towards the asset limit.

If a person has a life insurance policy that may disqualify them from Medicaid, they can implement planning strategies to meet the asset limit without letting the policy lapse. They can cancel the policy, collect the cash surrender value, and spend down the cash on long-term care, home modifications, or debt repayment. Alternatively, they can take out a loan against the policy, which will lower its cash and face value. Transferring the policy to a non-applicant spouse or a funeral home for a non-cancellable burial plan is also an option. Seeking advice from a Certified Medicaid Planner or an Elder Law Attorney is recommended when navigating these complex strategies.

How to get life insurance approved for autism

Understanding the Underwriting Process

Before applying for life insurance, it is important to understand how insurance companies assess individuals with autism. This process, known as underwriting, involves evaluating the applicant's health, lifestyle, and risk factors to determine their eligibility and premium rates.

Factors Affecting Underwriting for Autism

• Age and Age of Diagnosis: The likelihood of approval increases if the applicant is older and if more time has passed since the initial diagnosis.
• Severity of Autism: Mild to moderate autism that is well-managed and does not significantly impact daily activities is viewed more favorably. Severe autism may result in limited options or a declined application.
• Ability to Perform Activities of Daily Living (ADLs): The ability to perform basic tasks such as eating, dressing, and using the bathroom independently is an important factor. Difficulty with ADLs may reduce life insurance options.
• Employment and Social Interaction: Insurance carriers prefer to see individuals who are employed, as it demonstrates independence and the ability to interact socially.
• Overall Health and Comorbidities: Carriers will consider other health conditions, medications, and factors like BMI, as these can impact life expectancy and insurance rates.

Life Insurance Options for Children with Autism

Most insurance carriers will decline applications for children with autism until they reach the age of 8, as this is when underwriters have a better understanding of the child's condition and future prognosis. For children with autism, the following factors are considered:

• Placement in a mainstream classroom
• Ability to perform ADLs without assistance
• Need for assistive devices like an iPad
• Ability to speak, communicate, and interact socially
• Documented IQ of greater than 70

If the child is high-functioning and meets most of these criteria, they may qualify for standard rates or a table rating. For children with moderate to severe autism, guaranteed issue whole life insurance policies are available.

Life Insurance Options for Adults with Autism

The life insurance options for adults with autism depend on their level of functioning and overall health. If an adult requires assistance with daily activities, a guaranteed issue life insurance policy may be the only option. However, if the adult is high-functioning, employed, and has a typical life, a wider range of options are available, including term life insurance and whole life insurance.

Working with Specialists and Comparing Options

When seeking life insurance for individuals with autism, it is recommended to work with independent agents or brokers who specialize in high-risk life insurance and understand the unique considerations for this situation. Shopping around and comparing options from different carriers is crucial, as not all insurance companies will insure individuals with autism, and rates and policies can vary significantly.

Frequently asked questions