Life insurance with asthma or COPD

Asthma and COPD are treated very differently in life insurance underwriting. Mild, well-controlled asthma is common among insured people and, depending on the insurer, can still qualify for competitive rates. COPD is a progressive lung disease, so underwriters usually look hard at lung function, smoking history and how often you are hospitalized, and coverage is typically rated higher or, in advanced cases, hard to obtain.

Two conditions, two risk profiles

The Centers for Disease Control and Prevention reports that in 2023 about 23.0 million U.S. adults (8.9%) had current asthma, according to CDC's national asthma data. The same data counted 3,624 asthma deaths in 2023, most of them among adults and rising with age. Asthma is a chronic airway condition that, for most people, is managed with inhaled medicines and flares up occasionally.

COPD (chronic obstructive pulmonary disease) is different. The National Heart, Lung, and Blood Institute describes COPD as airway and lung damage causing airflow obstruction, including emphysema and chronic bronchitis. It says COPD affects over 14 million U.S. adults, is the sixth leading cause of death in the United States, and is most often caused by cigarette smoking. It cannot be cured, though treatment can slow progression.

That is why an underwriter sees them so differently: asthma often fluctuates and responds to treatment, while COPD generally worsens over time.

How insurers typically assess asthma

Companies differ, but these factors usually drive the decision:

• Severity and control. Applicants are asked how often they have symptoms, how often they use a rescue inhaler, and whether they take daily controller medicine.
• Emergency visits and hospitalizations. Recent ER visits, hospital stays or intensive care are among the strongest negative signals.
• Oral steroids. Frequent courses of prednisone or similar drugs suggest less control.
• Lung function. Larger policies, or cases with questions, may need recent spirometry results or a physician statement.
• Age at diagnosis and course. Childhood asthma that is now mild or quiet is viewed differently than adult-onset disease that is worsening.
• Smoking or vaping. Using tobacco with asthma is treated as an additional risk and can move you to a tobacco rate class.
• Other conditions. Sleep apnea, allergies, reflux or a heart condition may be considered together.

Mild, infrequent symptoms with rescue-inhaler use and no hospital visits are frequently underwritten at or near standard or better, though specifics depend on the company. Moderate or severe asthma, or poor control, can lead to a table rating or a postponement. life insurance rate classes: preferred plus to substandard explains how those classes work.

How insurers typically assess COPD

• Lung function. Spirometry results, such as FEV1 (how much air you can force out in one second) and the stage of disease, carry heavy weight.
• Smoking history. Whether you still smoke is critical. Many insurers require a period of tobacco abstinence verified by a negative nicotine test before offering non-tobacco rates; see life insurance for smokers and how quitting smoking lowers life insurance rates.
• Exacerbations. Hospital stays and flare-ups requiring steroids or antibiotics indicate less stable disease.
• Oxygen use. Home oxygen is generally a sign of advanced disease.
• Age and other conditions. Heart disease, diabetes or lung cancer screening results influence the outcome.

Early, mild COPD in a former smoker who quit years ago may be insurable with a rating. Advanced COPD, oxygen dependence or frequent hospitalization often leads to a decline for individually underwritten term insurance. If you are declined, simplified or guaranteed issue life insurance: no health questions, with limits policies may remain available, usually with lower coverage limits, higher premiums and a graded death benefit.

What you will be asked

• When you were diagnosed and your current medicines (inhalers, steroids, biologics).
• Number of ER visits, hospital admissions or oral steroid courses in a set look-back period.
• Whether you use oxygen or have been told you have emphysema or chronic bronchitis.
• Your smoking and vaping history.
• Whether you have had spirometry or lung scans.

Insurers also check prescription histories and may request an attending physician statement. See how insurers check your prescription history for what shows up.

Steps to take before applying

1. Collect records. Get your diagnosis date, current medicines and your most recent spirometry or pulmonologist note.
2. Know your control. Count the past year's rescue-inhaler use, ER visits and steroid courses so your answers are precise.
3. Stop nicotine if you can. For people with lung disease, quitting is both a health step and an underwriting step.
4. Answer fully. Understating symptoms or omitting hospital visits can give the insurer grounds to contest a claim (see the two-year contestability period).
5. Shop across insurers. Carriers have different views of the same asthma file; an independent agent can show you several.
6. Check group coverage. Employer plans may offer a base amount without individual health questions.

A hypothetical example

Say a 38-year-old has had asthma since childhood, uses a controller inhaler daily, rarely needs a rescue inhaler, has had no ER visits in the past five years and does not smoke. Several insurers may consider that a low-risk file. Now say a 58-year-old former smoker with COPD has had two hospitalizations in the past year and uses oxygen at night. That file would likely face a significant rating or decline from standard underwriters. Both examples are illustrative only.

Key takeaways

• Controlled, mild asthma is often insurable at competitive rates; frequent ER visits, hospital stays and steroid use make it harder.
• COPD is underwritten on lung function, smoking status and exacerbations; advanced disease is often hard to insure through standard channels.
• According to CDC data, about 23.0 million U.S. adults had current asthma in 2023; NHLBI says over 14 million adults have COPD.
• Bring spirometry, medication and hospital history, answer precisely, and compare several insurers.