Arthritis And Life Insurance: What You Need To Know

Rheumatoid arthritis (RA) is a common condition that affects around 1-2% of the American population, with women being the most commonly diagnosed. RA is a factor that life insurance companies consider when assessing applications, as it can lead to complications that may increase the risk of premature death. When applying for life insurance, underwriters will ask about the date of diagnosis, the duration and frequency of flare-ups, any deformities or disabilities caused by RA, and any medications being taken. While having RA may result in higher premiums or a decline for traditional life insurance, there are alternative options available, such as graded benefit or guaranteed issue life insurance policies.

Date of diagnosis

The date of diagnosis is one of the most important factors in determining the impact of arthritis on life insurance premiums. The longer an individual has been diagnosed with and treated for arthritis, the higher the risk of joint and tissue damage, and the higher the premiums will be. Life insurance companies often categorise arthritis as mild, moderate, or severe based on the time since diagnosis. For example, an individual diagnosed with arthritis six months ago with only one flare-up and no prescription medication would likely be considered mild, whereas someone diagnosed 20 years ago who requires biologics and steroids to manage pain and inflammation and experiences inflammation in their joints and major organs would likely be considered severe.

The progression of arthritis symptoms over time is also a key consideration. Arthritis symptoms typically worsen over time, with an increased risk of joint and tissue damage, as well as potential damage to major organs. This can lead to higher premiums or even a decline of coverage. The frequency and duration of flare-ups are important factors, as more frequent and longer flare-ups indicate a higher risk of inflammation and joint damage.

The impact of arthritis on daily life and overall health is another critical aspect. Individuals with arthritis who are unable to work, perform daily tasks, or live an active lifestyle due to the condition may face higher premiums or a decline of coverage. The presence of deformities caused by arthritis can also negatively impact life insurance rates, as it indicates a more severe form of the condition.

The type and dosage of medication used to manage arthritis are also considered. Certain medications may be considered “red flags” by life insurance companies, as they may have potential negative side effects. However, it's important to note that rheumatologists prescribe these medications when the benefits outweigh the risks.

Frequency of flare-ups

The frequency of flare-ups is a crucial factor in determining the impact of arthritis on life insurance. Life insurance companies assess the risk associated with insuring individuals with rheumatoid arthritis (RA) by considering various factors, including the frequency and duration of flare-ups.

RA is characterised by periods of mild disease activity punctuated by flare-ups or times of heightened disease activity. The more frequent the flare-ups, the higher the risk of joint and body damage. This is a key consideration for insurance providers, as it increases the likelihood of long-term damage and impacts the insurability of individuals with RA.

When evaluating life insurance applications, underwriters will inquire about the frequency and duration of flare-ups to gauge the severity of the condition. The impact of flare-ups on daily life and overall health is also taken into account. Individuals with frequent and prolonged flare-ups may face higher premiums or even be declined coverage by certain insurance providers.

It is important for individuals with RA to document the frequency and duration of their flare-ups when applying for life insurance. This information, along with other factors such as medications, joint damage, and overall health, will help insurance providers assess the risk and determine the appropriate coverage and premiums.

While the frequency of flare-ups is a significant factor, it is just one aspect of the overall evaluation. Other considerations, such as the date of diagnosis, the presence of deformities, disabilities, and affected body parts, also play a role in determining the impact of arthritis on life insurance.

Deformities

The Arthritis Foundation describes the following as common RA joint deformities:

• Boutonniere deformity: The middle finger joint bends toward the palm while the outer finger joint may bend opposite the palm.
• Swan-neck deformity: The base of the finger and the outermost joint bend, while the middle joint straightens.
• Hitchhiker’s thumb: The thumb flexes at the metacarpophalangeal joint and hyperextends at the interphalangeal joint below the thumbnail. It is also called Z-shaped deformity of the thumb.
• Claw toe deformity: The toes are either bent upward from the joints at the ball of the foot, downward at the middle joints, or downward at the top toe joints and curl under the foot.

The presence of a deformity as a result of RA will typically cause insurance carriers to charge more for a policy. The more severe the deformity, the higher the premium will be. For example, a person with a mild deformity of one finger joint may qualify for a Rated traditional life insurance policy, which means they will have to pay a surcharge of 20-200% on their premiums. On the other hand, a person with toe joint deformities that prevent them from standing for extended periods of time and result in disability may receive a Decline for traditional life insurance.

In addition to the type and severity of the deformity, insurance companies will also take into account the person's overall health, age, and other factors when determining the cost of their life insurance policy.

Disability

Arthritis is a common condition that can lead to disability and long-term leave from work. It is a leading cause of disability, affecting more than 50 million people in the US, or about 24% of the population. The condition can be debilitating and limit the activities of nearly 10% of US adults. The Social Security Administration offers two long-term disability benefit programs: Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI).

Arthritis can be a disability, but whether or not an individual's condition qualifies for long-term disability benefits depends on several factors. The key consideration is how arthritis prevents the person from working and performing their job duties. The specific symptoms and their severity will determine eligibility for disability benefits. These symptoms may include:

• Joint pain and stiffness
• Limited range of motion
• Weakness in hand grip and lack of finger dexterity
• Pain while walking, squatting, bending, or standing
• Difficulty moving after periods of rest

To obtain long-term disability insurance benefits, individuals must file an application and provide evidence of their arthritis as a disability. This evidence includes medical records, treatment notes, clinical and lab tests, X-rays, and other scans. A narrative report from the treating doctor, detailing the individual's arthritis and its impact on their ability to function in the workplace, is also crucial.

The severity of arthritis symptoms can range from mild to severe and can affect isolated areas or the entire body. The frequency of flare-ups, the rate of progression, and the severity of pain are unique to each individual. Arthritis is generally considered a chronic condition, and if left untreated, it can lead to disability. Early detection and treatment are essential to managing the condition effectively.

When evaluating life insurance applications, insurance companies consider the type of arthritis, the degree of pain or limitation experienced, the duration of the condition, and any medications taken. In severe cases, where arthritis has led to disability, individuals may need to accept a guaranteed issue life insurance policy, which involves no exam or health questions.

Medication

Some medications are considered "red flags" by life insurance carriers due to their potential negative side effects. For example, disease-modifying antirheumatic drugs (DMARDs) such as methotrexate and biologics such as Humira are often prescribed to slow the progression of RA and reduce inflammation. However, these medications may be viewed as high-risk by insurance carriers.

On the other hand, over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and naproxen sodium are typically not considered high-risk. Occasional use of these medications for pain management is generally not a cause for concern for insurance carriers.

It's important to note that the benefits of RA medications usually outweigh the risks, and a rheumatologist would prescribe them with this knowledge. However, life insurance carriers are primarily concerned with risk assessment and may charge higher premiums or even decline coverage based on the medications you are taking.

The severity of RA also plays a role in the underwriting process. Mild RA may not require continuous treatment and can often be managed with physical therapy and occasional NSAIDs. Moderate RA typically involves more extensive joint involvement and slight deformities, requiring frequent or continuous drug therapy. Severe RA is characterised by chronic active disease, marked deformities, and serious restrictions on movement, often requiring multiple medications to manage symptoms.

The underwriting process for life insurance with RA can be complex, and the specific medications and dosages prescribed will impact the assessment. It's always best to consult with an independent agent who has authoritative knowledge of RA to find the most competitive policy that you qualify for.

Frequently asked questions