Does a Patent Foramen Ovale (PFO) Affect Your Life Insurance?

When purchasing life insurance, there are many things that you must consider – first off, can you get it? It’s no secret that your health conditions impact your rates.

People who suffer from a Patent Foramen Ovale (PFO) or any other Atrial Septal Defect (ASD) wonder if this will keep them from getting life insurance.


Yes you CAN get affordable life insurance, even with a Patent Foramen Ovale or Atrial Septal Aneurysm.

We’d like to help you understand the whole situation. So, read on to find out more about PFOs, how they’re treated and whether or not having one will impact your ability to purchase life insurance.

You may even qualify for a policy with no medical exam.

If you want to skip to the good stuff, just fill out our quote request form on the right and our underwriting experts will do the work for you!

Here is a handy guide to this article, feel free to head directly to the section you need.

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A PFO is a fairly common sort of heart defect – as many as 20-25 percent of Americans have this “hole” in their heart. Unlike many congenital heart defects, which are due to the heart not forming properly, a PFO is a leftover from time in the womb.

“Small valve” is probably a better description than “hole.” If all were to work properly, the PFO would close when a baby is born. Prior to birth, the foramen ovale is open to allow blood flow to bypass the fetus’ lungs since they aren’t yet functional. When this pathway doesn’t completely seal off, that’s what causes the PFO.

So, what’s the risk?

The biggest concern with a PFO is the risk of a blood clot getting to the brain and causing a stroke. This could happen because the blood that hasn’t filtered through the lungs could pass through the hole and reach the brain. This is called right to left shunting.

An Atrial Septal Aneurysm is often associated with a PFO and means that part of the atrial wall bulges outward in a strange way. An ASA in isolation is often incidental or insignificant, though it has been noted in some patients who suffer ischemic strokes.

Treatments for PFO

The majority of PFOs will require no treatment – remember, around 20-25 percent of Americans have one and go about their daily life normally. Patients and doctors discover and diagnose PFOs with an echocardiogram.

Since most PFOs are asymptomatic, you likely won’t know you have one unless you have some health incident (like a cryptogenic stroke) that makes your doctor suspect it.

Some PFOs are closed via a device threaded by a catheter to your heart or by open-heart surgery. But, in most cases, doctors will opt for treatment with blood thinners, like aspirin. This prevents the formation of clots – thereby preventing a stroke.


Having a Patent Foramen Ovale does raise your risk for a stroke by up to 25 percent, though many people will have a PFO and never have a stroke. If you’ve had a cryptogenic stroke, meaning one where the doctors couldn’t find risk factors, a PFO may be the cause.

How will this impact your ability to get life insurance? Ultimately, it comes down to this: What is your stroke risk?

Here are a few questions that will help clarify that issue:

Do you have high blood pressure or diabetes?

High blood pressure can increase the amount of non-oxygenated blood moving from the right atrium to the left, thereby increasing the risk of blood clots or stroke.

Are you Smoking?

Smoking is already a liability for most life insurance companies.  Due to the increases in blood pressure and toxins caused by smoking, it doubles the risk of stroke.  The link between smoking and higher mortality is clear, so life insurance companies will charge much higher rates because of it.

Certain companies may provide lower nonsmoker rates to certain tobacco classes, like smokeless tobacco and the occasional cigar.  However, even this usage needs to be disclosed on the application. Life insurance underwriters will detect tobacco usage through the blood test, physicians’ records and by reviewing previous insurance information.s

If you are using smokeless tobacco, e-cigarettes or the occasional cigar, contact our underwriting experts directly.

What are your recent cardiovascular test results?

Most important here is an echocardiogram. Recent tests are very helpful for your approval for two reasons.

First, they are a sure sign you are keeping up with your PFO and a sure sign you are seeing your doctor. We all want you to stay alive as long as possible, and seeing your doctor is a great way to do this.

Second, these tests get rid of the unknown. A PFO noted on an echo with no other symptoms will not raise an eyebrow. Also, with good test results, we can make a case for a better health class or we may get credits that lower your rates.

Are you active? How active?

The benefits of exercise are far-reaching. Maintaining a healthy activity level after means your muscles use up oxygen more efficiently, thereby reducing the risk of stroke from shunting. This will help your chances of approval.

The underwriters are not looking for you to run a marathon, and in certain cases will discount the policy based on exercise.

Is there a prior history of stroke?

With a prior stroke, there is a higher chance of a recurrent or another stroke. About 1 out of 4 people who have one stroke will have another, and most of these happen within 5 years of the first stroke. Also, having a stroke at a younger age increases this risk.

The good news is almost 80% of these recurrent strokes are preventable through lifestyle change.

From a life insurance standpoint, after a stroke, the PFO is not the main concern of underwriting. We will write the case based on the stroke, CVA or TIA.


The top tier life insurance agencies operate using ratings for their clients. These ratings indicate the type of coverage people receive and the cost of their insurance.

Here are the details of the basic life insurance ratings:

Preferred Plus

People with excellent health receive this rating, and they are usually young. This means their weight, blood pressure, cholesterol, and family history are without blemish. Most normal people do not qualify for preferred rates.

For future clients with a PFO, if it is asymptomatic and discovered as the result of another test, you may still qualify for preferred rates.

Standard Plus

People with almost perfect health fall into this category for life insurance. For example, a person that has controlled high cholesterol but everything else is excellent would qualify for standard plus.

If you have a PFO, no symptoms and are taking one medication for high cholesterol, it’s possible to receive standard plus rates.


People with good health receive this rating, even if they have a few minor issues. For most clients taking medications daily with no major health conditions, standard rates are what we can expect.

With an asymptomatic patent foramen ovale and high blood pressure under control through medication, you can qualify for standard rates.

Substandard or Table Ratings

“Substandard” sounds worse than it is.  After standard, there are 12 substandard or table rated health classes. Clients with heart issues usually end up with substandard life insurance rates.  However, that’s OK!

Considering that most people over-estimate the cost of life insurance by 300%, term life insurance is still very affordable (even at substandard rates).

With an asymptomatic PFO, a combination of medications will usually rate as a mild substandard case. So if you take pills for high blood pressure, high cholesterol and diabetes you will be in this category.

If you are on oral blood thinners (like warfarin) for the rest of your life, your case will be substandard.

If you have other health complications, your case will be rated on the seriousness of that condition. A prior stroke and most heart conditions will qualify for moderate substandard rates.

Decline or Postpone

Sometimes we just don’t qualify for traditional life insurance coverage, however, this is rare. With multiple companies and literally thousands of options we will find life insurance for you.

What is more likely is a postponement of the application based on a recent event or a future test result. After a recent stroke, heart attack or hospitalization – you need 6 to 12 months’ worth of treatment to judge your progress. Also, if you have an echocardiogram or a stress test scheduled a month from now, life insurance underwriters will want to see those results too.

An asymptomatic PFO or a PFO combined with other minor health issues will not decline your application.

However, multiple strokes, significant heart damage or significant changes to your heart muscle could decline an application. A stroke at a young age could also deny an application.

If you are worried about your application being denied or postponed, give us a call first.


Unless you know something I don’t, you’re getting older every minute. That means life insurance will be more expensive for you tomorrow than it is today.

This is always the case, however, people still hesitate or ‘hem and haw’ before making a decision.

If you’re interested in finding out what kind of life insurance you can purchase with your Patent Foramen Ovale, we’re here to help. Fill out the quote form to the right of your screen and let’s get started.

Our rate quoter compares thousands of programs from the best life insurance companies in the US. It is accurate and up to date, there is no obligation and the quotes are FREE.

The key is moving forward and taking a step now, even if you just want more information. Peace of mind is important – and we are here to help you get it.

Fill out the quote form, take care of the people you love and get the peace of mind you deserve today.