Can you qualify for life insurance with dilated cardiomyopathy? What kind of rates can you expect?
Yes. You can get life insurance approved after cardiomyopathy.
You will pay higher rates than a 30 year old with no health issues, however there are still policies available for you.
This is crucial when shopping for life insurance with cardiomyopathy
You need to start here first. DO NOT apply with just anyone – make sure they understand and are experts in underwriting heart conditions.
It is very important that you avoid a denial of your life insurance application. After you are declined at one life insurance company, it makes it more difficult to qualify at other companies.
What are your Life Insurance Choices after Dilated Cardiomyopathy?
What are your Life Insurance Choices after Dilated Cardiomyopathy?
When it comes to life insurance and heart disease, most people assume that having a heart problem will be cause for denial of coverage.
However, each insurance company is different, as is your condition, so it’s always best to take a comprehensive look at your situations and circumstances before worrying about whether or not you’ll be able to get covered.
Today we’re going to look at dilated cardiomyopathy specifically and see what kinds of things insurers take into consideration with this condition so that you can get a better idea of what to expect.
Understanding Dilated Cardiomyopathy
As more research is done to figure out how dilated cardiomyopathy develops in the system, it becomes easier to pinpoint an underlying cause for the condition. Typically speaking, it can be either a result of coronary artery disease, or it can be viral, alcoholic, or postpartum.
If your doctor does not know the source, then it is considered idiopathic cardiomyopathy. What’s also important to remember is that sometimes the disease is called congestive cardiomyopathy, so we may use these terms interchangeably.
The cause of the disease will play a crucial role in determining your eligibility for coverage. While several years ago all patients with this condition were denied, it has recently become clear:
- Cardiomyopathy more common than once thought, and
- Long-term prognosis and mortality can range greatly depending on the patient.
As such, it’s imperative that you and your doctor work to uncover what’s really going on in your body.
This is good for your outcome and it helps us paint a great picture for the underwriters too. Once we can figure out the level of risk, we can price the life insurance approval even with dilated cardiomyopathy.
Life Insurance Underwriting for Dilated Cardiomyopathy
There are always guaranteed issue life insurance policies available for clients with cardiomyopathy.
For traditional life insurance-like term policies, whole life and universal life-cardiomyopathy is approved on a case by case basis. You can’t be sure until you talk to both your doctor and the underwriting experts here at Heart Life Insurance.
There are several things that insurers will look at with dilated cardiomyopathy that will help them determine your health class.
Here are the most common variables that will need to be addressed.
Date of Diagnosis
As with all long-term illnesses, insurance companies will consider you to be less of a risk the longer that you have lived with it without any serious complications. With congestive cardiomyopathy life insurance, most underwriters will deny coverage if the diagnosis was less than a year ago. The reason for this is that the disease has a relatively high mortality rate, and the first year can be the most dangerous, particularly if you are not taking any preventative steps.
The other part to this is your age. Generally speaking, if you were diagnosed when you were younger, then you will be much more of a risk because it can get worse as you age. Similarly, if you are over 50 and have been recently diagnosed, then it can significantly impact your rates as well as your ability to get covered at all. Each insurance company will have its own rating system based on age.
Your Left Ventricle Ejection Fraction
One of the best ways to determine the seriousness of your heart disease is to get tested for an ejection fraction percentage. Using an echocardiogram, your doctor will measure the amount of blood that pumps out of your ventricles during each contraction.
According to the fine folks at the American Heart Association, a normal heart will eject between 50-70% of blood that it brings in. So if your EF rating is below 50%, then it can greatly affect your coverage potential.
Although each insurer is different, most will consider you to be eligible if your EF number is between 40-55%. They may have several ranks in between, such as 50-55%, 45-49%, and so on. These grades will determine what kind of coverage you can get, with a lower EF number increasing your overall rates.
Typically speaking, if you test below 40%, then you will be declined traditional life insurance. There are still guaranteed policies available,
Fortunately, if you work with your doctor and start taking medication that can improve these results, then you might qualify as soon as the number reaches a more acceptable level. Thus, even if you are currently below 40%, you shouldn’t assume that that’s the end of it.
The other thing to remember about tests like this is that most companies will require that it be completed within the last year so that it’s considered “up to date.”
Symptoms of Dilated Cardiomyopathy
Most commonly, those suffering from congestive cardiomyopathy will have shortness of breath, dizziness, chest pain, leg swelling, fatigue, and possible fainting. Most insurers will want to know how many you’ve experienced, as well as which symptoms are the most common.
Overall, those who show these signs more frequently will be considered more of a risk, as it indicates that the disease is having a more profound effect on the body. As with everything else, the longer you go without any problems, the better your chances of getting covered.
These symptoms will also be noted in your attending physicians report (or APS), as well as your full cardiologist workup. Both of these are required for a fully underwritten life insurance approval after cardiomyopathy.
Do you Use Alcohol or Tobacco?
As we mentioned, sometimes dilated cardiomyopathy can be caused by excessive alcohol consumption, meaning that the best way to treat it will be to abstain from drinking as soon as possible. Smoking can also exacerbate the disease as it puts more pressure on your heart than if you were a non-smoker.
Simply put, if you currently partake in either or both habits, then it will most likely result in denial of coverage because it can accelerate the disease and lead to complications. Most insurers will consider smoking to be a major red flag anyway, so if you are doing it with congestive cardiomyopathy, then it will only make things worse.
The important thing to remember as well is that becoming sober matters more the longer you’ve done it. So, if you quit drinking and/or smoking in the last six months, most insurers will still consider you a risk. However, if it’s been several years since your last drink or cigarette, then you will qualify for a better rate.
Current Medications and Treatment
As a general rule, insurers want to make sure that their clients are taking all of the necessary steps to be as healthy as possible. So, if you are taking any medication as prescribed by your doctor, then it shows that you are working on maintaining the disease and keeping it under control.
With that in mind, the types of medicine that you’re taking, the frequency, as well as any other treatments you’re doing will be considered comprehensively to get a better understanding of how it is affecting the disease.
Overall, if you can show demonstrable progress based upon your treatment schedule, then it will signify that you are much less of a risk. For example, if your EKG or EF numbers were abnormal before but now they are starting to level off, it will be a significant factor when determining if you can get coverage and how much.
Surgery as Treatment
One possible treatment option for this condition is surgery, but that can also complicate things on the insurance side. Most companies will still consider you to be a high risk if your surgery was within the last year, so you may have to wait a couple of years to get coverage or improve your rates. Again, the point is to see the long-term effects of such treatment, and since there can always be complications from surgery, it’s imperative that you wait long enough to prove that there is no added risk involved.
Pacemakers for Dilated Cardiomyopathy
Like surgery, this may be a recommended treatment option for your condition, and it can affect your policy rates. For the most part, having a pacemaker is a net positive, but it’s still essential to see how it affects your body over time.
Thus, insurers will want to know when it was put in place and whether or not there have been complications due to its presence.
Implantable cardioverter defibrillators (ICD) as cardiomyopathy treatment
These are suggested for people at higher risk for life-threatening arrhythmias, atrial fibrillation, heart attacks or sudden cardiac death.
As such, this line of treatment will result in higher substandard rates if traditional life insurance is approved. Guaranteed Issue life insurance policies will be available though.
Do you have a family history of cardiovascular disease?
Underwriters will also want to know if your family has a history of heart disease, as well as any premature deaths that resulted from such conditions. What’s important to remember here is that this information is taken in conjunction with everything else, meaning that you shouldn’t be overly worried if a close relative died from heart disease at a young age.
While it can increase your risk of death, what’s most important are the steps you are taking to prevent that from happening.
What rates can you expect for life insurance with congestive cardiomyopathy?
Life insurance rates are going to be determined by your age and health class. That’s it! Since you know your age already, the only thing we need to focus on is getting you the absolute best life insurance health class that you qualify for.
What is a Life Insurance Health Class?
The health classes start out at preferred plus for those with fantastic health. These are the people who you see on the Today show living to be 101. They are fit and trim.
After that, standard plus for better than average health, and then standard for those with normal health. A standard health class might have a little extra weight, and they may have some negative family history of cardiovascular disease or cancer. Otherwise they are in pretty good health.
Once we move past a standard health class, there are 8 – 12 different substandard health classifications for high risk life insurance. Life insurance underwriters will name each table with a number (Table 1, Table 2, etc.) or a letter (Table A, Table B, Table C, etc.).
Each life insurance company is different, however each table represents an 18% – 27% increase over their standard rates. Every life insurance company will also gauge a health class uniquely based on their life insurance underwriting guidelines and historical performance.
It’s safe to say that some companies have a better handle on cardiovascular conditions than others, while at the same time different companies deal great with diabetes. Every one has their niche.
With all of this, it is very important you get an underwriting expert to look at your case before you submit it. You could be leaving thousands of dollars on the table going at this alone.
Common Health Class outcomes with Dilated Cardiomyopathy
We approve life insurance cases all the time with cardiomyopathy. This is what we usually see:
Preferred Plus / Preferred / Standard / Standard Plus
For traditional life insurance, the best health classes are reserved for clients without any significant heart condition. Cardiomyopathy is serious and will qualify as high risk, not as preferred.
It is possible to qualify for standard rates if the underlying cause of the cardiomyopathy was viral, or postpartum. After a full cardiological workup, EF higher than 60%, no other complications, and a clear demonstration of improvement standard rates are possible.
This is not likely and we rarely see congestive cardiomyopathy cases approved standard.
Mild Substandard Rates
If you were diagnosed with mild cardiomyopathy at a later age and have a high ejection fraction, mild to mid substandard rates are possible. Underwriters will look for recent echocardiograms, an EF greater than 50%, proper maintenance through medication, and no other complications.
If the cardiomyopathy was related to alcohol, you need complete abstinence, documented improvement in EF and no alcohol on the blood / urine exams.
Moderate Substandard Rates
This is a likely outcome due to the severity of the disease. We frankly approve many candidates in this category just because of the higher variances among ejection fractions. With an EF less than 50%, however greater than 40%, higher weight, or diagnosis at a younger age you can end up in this category.
Decline / Postpone
If there are additional complications to stack on top of cardiomyopathy such as diabetes, alcoholism, coronary artery disease or atrial fibrillation, the application may be postponed. The application will also be postponed within 6 months of your diagnosis.
Even with a postponed application, we have programs that can get you approved today. Also, we will know in advance if an application would be declined because we work with the underwriters before submission.
We are not going to “throw your application against the wall to see if it sticks.”
This saves you time and frustration, and it keeps very valuable life insurance doors open to you in the future.
Life Insurance with Dilated Cardiomyopathy: The Bottom Line
Overall, if you are working to stay healthy despite your condition, then you should request a life insurance quote from us ASAP.
In the end, don’t assume that because you have congestive cardiomyopathy that you cannot get coverage. It all depends on your circumstances. Life insurance is such a crucial thing to protect your family though, you need it, regardless of the situation.
Right now, sitting where you sit, you have options you don’t even know you have.
95% of life insurance agents don’t even know about some of these programs available to people with serious cardiovascular diseases. So let’s do this!
Get our underwriting experts to work for you today, so you may rest easier tomorrow.