Life insurance with epilepsy

People with epilepsy can get life insurance. Underwriters mainly want to know what type of seizures you have, how often they occur, how long you have gone without one, what caused the epilepsy and whether your medication works. Well-controlled epilepsy with a long seizure-free period is often viewed far more favorably than frequent or poorly controlled seizures, though how each insurer rates that varies.

What the CDC says about epilepsy

The Centers for Disease Control and Prevention describes epilepsy as a brain disorder that causes repeated seizures. It estimated that about 2.9 million U.S. adults had active epilepsy in 2021 and about 456,000 children had it in 2022 (page updated May 15, 2024). CDC notes that many people do well with treatment and live a typical life, though some have several seizure types or other health conditions that make management harder. Because seizure patterns differ so much from person to person, insurers rely on detail instead of the diagnosis alone.

What underwriters typically consider

Practice varies by company, but these factors come up repeatedly:

• Seizure type. Generalized tonic-clonic ("grand mal") seizures, focal seizures and absence seizures carry different implications, particularly for injury risk.
• Frequency and recency. The date of your last seizure and how many you had in recent years are among the most important facts. A longer period without seizures generally helps.
• Control on medication. Whether seizures are controlled on one drug, several drugs, or not at all. Frequent medication changes suggest less stable control.
• Cause. Epilepsy with no known cause, after a head injury, from a stroke, tumor or infection, or from a genetic syndrome has different outlooks. When a brain structure problem or other disease is behind it, that condition is also assessed.
• Age at onset and years since diagnosis. Childhood-onset epilepsy that has been controlled for years is often considered differently from newly diagnosed adult epilepsy.
• Adherence. Missed doses are a common trigger for breakthrough seizures, so underwriters look for consistent treatment.
• Injuries and emergencies. Falls, fractures, drowning scares, car accidents tied to seizures or status epilepticus (a prolonged seizure needing emergency care) are significant.
• Driving. Licensing rules differ by state, but whether you are legally driving can be a proxy for control.
• Alcohol and drug use, and mental health. These affect seizure risk and are underwritten separately.
• Other health conditions. Developmental disability, neurological disease or brain surgery adds complexity.

Seizure risks include sudden unexpected death in epilepsy (SUDEP); CDC's page has a section on it. This is a reason insurers treat frequent uncontrolled generalized seizures as higher risk. How an insurer converts these factors into a rate class or table rating depends on its own guidelines and its reinsurer's. See life insurance rate classes: preferred plus to substandard and table ratings and flat extras explained.

Typical range of outcomes

These are general patterns, not rules:

• Controlled, long seizure-free, one medication: may be considered for standard-type or modestly rated coverage by some insurers.
• Recent seizures or several drugs: more likely a table rating or a request to wait.
• Frequent uncontrolled seizures, seizures with injury, or epilepsy from a serious underlying disease: often postponed or declined for individually underwritten policies.

If you are turned down, see Declined for life insurance? What to do next for next steps.

What the insurer will see

The application asks about the diagnosis, the date of your last seizure, and medications. Insurers check prescription histories for anti-seizure drugs (see how insurers check your prescription history), and may request an attending physician statement or a neurologist's report. Note that some anti-seizure medicines are also prescribed for pain, migraine or mood conditions, so a prescription alone does not prove epilepsy, but you should still report the diagnosis you have. A misstatement can give the insurer grounds to contest a claim during the the two-year contestability period.

Steps before you apply

1. Get a neurologist's summary. It should state the seizure type, cause, date of the last seizure, the medicine and dose, and the response to treatment.
2. Know your dates. Date of diagnosis, last seizure, and any changes to medication in the past few years.
3. Be ready to explain injuries or emergency visits.
4. Apply when stable. If you are close to a meaningful seizure-free milestone, an agent can tell you whether waiting is likely to help the way the insurer reads the file; weigh that against going without coverage.
5. Compare insurers, ideally through an independent agent who knows which companies are open to your seizure history.
6. Look at group and workplace coverage. Employer plans typically offer a basic benefit without individual medical review.
7. Ask about a waiver of premium rider, which may keep a policy in force if you cannot work.

For parents of a child with epilepsy

Coverage for the child is not the main question for most families; the parent's coverage matters more. Some policies let you add a child term rider, and the underwriting of a child with a medical condition is handled at the insurer's discretion. If a child with epilepsy will depend on you as an adult, see life insurance for parents of a child with special needs.

A hypothetical example

Say a 36-year-old developed epilepsy at 12, has had no seizures for 6 years on one medicine, has a normal brain MRI and no injuries from seizures. Some insurers could see that file as low risk. Say a 36-year-old with seizures every few months despite two medicines and a recent emergency visit applies. That file would more likely be postponed or declined. These examples are illustrations only.

Key takeaways

• Epilepsy is underwritten on seizure type, frequency, time seizure-free, cause and medication response; the diagnosis alone does not decide it.
• Long seizure-free periods on stable treatment help; frequent or uncontrolled seizures, injuries and serious underlying disease raise risk.
• CDC estimated about 2.9 million U.S. adults had active epilepsy in 2021.
• Bring a neurologist's summary, answer precisely, compare insurers and review employer coverage.