Genetic Testing: Life Insurance Rates And Your Health

Genetic testing can have a significant impact on your life insurance rates and coverage. While the Genetic Information Nondiscrimination Act (GINA) prohibits health insurance companies from using genetic information to make coverage or rate decisions, this protection does not extend to life insurance. This means that life insurance companies can request and use the results of genetic tests when evaluating applications and setting premium rates. As a result, individuals who undergo genetic testing and discover potential health risks may face higher life insurance rates or even be denied coverage. However, it's important to note that life insurance companies typically only consider genetic tests ordered by medical providers and not at-home consumer genetic tests. Additionally, some states have enacted laws to protect against genetic discrimination in life insurance, but the specific protections vary by state.

Genetic testing can be used by insurance underwriters to evaluate life insurance applications

In the United States, the Genetic Information Nondiscrimination Act (GINA) of 2008 prohibits health insurance companies from using genetic information to make coverage or rate decisions. However, GINA protections do not extend to life insurance, and insurance companies can use the results of genetic testing to evaluate life insurance applications and determine coverage and rates.

Life insurance companies are interested in genetic tests ordered by medical providers, which are usually included in a patient's medical records. While at-home genetic tests are not considered reliable, if they include a recommendation to contact a doctor, insurers may want the results confirmed through a doctor-ordered test.

Some US states have laws that offer additional consumer protections related to genetic testing and life insurance. For example, Florida has enacted a genetic privacy law that prohibits life insurance companies from using genetic information to set premium rates, cancel or deny coverage. In Illinois and South Dakota, direct-to-consumer commercial genetic testing companies cannot share genetic test information with insurers without written consent.

In other countries, such as Belgium, France, and Norway, laws have been adopted to prevent or limit insurers' access to genetic data for life insurance underwriting.

Genetic test results can be used to deny coverage or increase rates

In the United States, the Genetic Information Nondiscrimination Act (GINA) of 2008 prohibits health insurance companies from using genetic information to make coverage or rate decisions. However, GINA protections do not extend to life insurance, and there is currently no federal law that limits the use of genetic information by life insurance companies. This means that life insurance companies can use genetic test results to deny coverage or increase rates.

During the application process, life insurance companies assess how risky a person is to insure by looking at their current health, their family's health history, driving record, hobbies, and more. If a genetic screening turns up something the life insurance company considers risky, they may respond by raising the applicant's premiums or denying them coverage altogether.

While at-home DNA tests, such as those for ancestry, are not considered reliable by life insurance companies, they may still be interested in the results if they include a recommendation to contact a doctor. In this case, the insurer would want the result confirmed through a doctor-ordered genetic test.

Some US states have introduced legislation to address this issue. Florida, for example, has enacted a genetic privacy law that prohibits life insurance companies from canceling, limiting, or denying coverage and from setting different premium rates based on genetic information. In Illinois and South Dakota, direct-to-consumer commercial genetic testing companies cannot share genetic test information with life insurance companies without the individual's written consent.

The Genetic Information Nondiscrimination Act (GINA) prohibits health insurance companies from using genetic information to make coverage or rate decisions

In 2008, the Genetic Information Nondiscrimination Act (GINA) was signed into law in the United States. GINA is divided into two sections, or Titles. Title I of GINA prohibits discrimination based on genetic information in health coverage, while Title II prohibits discrimination based on genetic information in employment. This means that health insurance companies cannot use the results of a direct-to-consumer genetic test or any other genetic test to deny coverage or require higher premiums.

However, GINA does not apply to smaller employers with fewer than 15 employees, and it also does not apply to other forms of insurance, such as disability insurance, long-term care insurance, or life insurance. In these cases, insurance companies have the right to request medical information, including the results of any genetic testing, when making decisions about coverage and rates. This means that taking a genetic test could affect your ability to get certain types of insurance or the price you pay for coverage.

Some states have enacted laws to provide additional consumer protections related to genetic testing and insurance. For example, the state of Vermont prohibits genetic testing as a condition of applying for any type of insurance and using the results of genetic tests of family members. Additionally, some countries outside the United States, such as Canada and those in the European Union, have adopted laws or agreements that prohibit the use of genetic test results by life insurers.

It is important to weigh the possible benefits and risks of direct-to-consumer genetic testing before undergoing any testing, as it could have implications for insurance eligibility and coverage.

GINA does not apply to life insurance, long-term care insurance, or disability insurance

The Genetic Information Nondiscrimination Act (GINA) was passed in 2008 to make it illegal for health insurance providers to use genetic information when making decisions about a person's health insurance eligibility or coverage. However, GINA does not apply to life insurance, long-term care insurance, or disability insurance. This means that companies offering these types of insurance can request and use genetic test results when evaluating applications and setting rates. This exclusion of certain types of insurance from GINA has raised questions about the distinction between health insurance and other forms of insurance, such as long-term care and disability insurance.

One argument for the special status of health insurance is that access to healthcare is considered a right, and since healthcare access in the US is mediated through insurance, healthcare insurance can also be seen as a right. Long-term care and disability insurance, on the other hand, are not seen as 'rights' and are therefore not included in GINA. However, it is argued that long-term care and disability insurance are often needed as a direct consequence of medical care and are essential for well-being. They ensure access to medical care and are thus more similar to health insurance than life insurance, which benefits the policyholder's dependents.

Another argument for the distinction is financial feasibility. Insuring high-risk individuals at average-risk rates could be unsustainable for insurance companies. However, this argument is weakened by the lack of evidence that genetic information is a significant factor in determining financial risk. In fact, non-genetic information such as age, current health status, and family health history are often sufficient for risk assessment. Additionally, the use of genetic information in insurance underwriting can have negative consequences, such as deterring individuals from undergoing genetic testing and seeking early medical intervention.

While GINA does not apply to life insurance, long-term care insurance, or disability insurance, some states have passed their own laws regarding genetic discrimination in these areas. For example, California's GINA of 2011 (CalGINA) includes life and disability insurance in its list of protected areas, and Oregon's law covers long-term care, disability, and life insurance. These state-level laws demonstrate a recognition of the importance of protecting individuals from genetic discrimination in these areas, even if it is not currently covered by federal law.

Some states have laws that protect consumers from genetic discrimination in life insurance

In the United States, the use of genetic test results in life insurance underwriting is currently legal. However, some states have laws that protect consumers from genetic discrimination in life insurance. Florida, for instance, has banned life insurance companies from using genetic information in underwriting unless accompanied by a diagnosis of a medical condition. This means that carriers of autosomal recessive or X-linked disorders are protected.

In addition to Florida, several other states have laws that offer some level of protection against genetic discrimination in life insurance. These laws vary in scope and applicability, but they aim to address the concerns of individuals who may be treated differently by insurance companies due to their genetic makeup.

At the federal level, the Genetic Information Nondiscrimination Act (GINA) was enacted in 2008 to protect Americans from genetic discrimination in health insurance and employment. However, GINA does not cover life insurance, long-term care insurance, or disability insurance. This means that insurance companies offering these types of policies can request medical information, including genetic test results, when making decisions about coverage and rates.

The lack of comprehensive protection against genetic discrimination in life insurance has led to concerns among individuals considering genetic testing. Some choose to defer or avoid testing altogether, while others may be reluctant to share their results with their physicians due to the potential impact on their medical records.

To address these concerns, some have called for self-regulation within the insurance industry or collaboration between insurers, stakeholders, and the government to adopt policies that balance economic and social arguments. Others have suggested that genetic counselors, who are well-versed in rapidly evolving genetic information, should play a role in shaping policies and advocating for patients' interests.

While the current legal landscape offers some protections against genetic discrimination in life insurance, there is a need for further action to ensure that individuals are not deterred from undergoing genetic testing due to fears of discrimination.

Frequently asked questions