Before a life insurance company quotes your final premium, it places you in a rate class, also called an underwriting class. Your class is the biggest single factor in what you pay: the gap between the best class and a table rating can be several times the premium for the same coverage.
This guide explains each class in plain language and then shows how insurers currently treat more than 85 common health conditions and lifestyle factors, across 126 specific situations, from high blood pressure and sleep apnea to cancer history, marijuana use and private flying. We built these tables from current insurer underwriting guides and our own recent approvals, and we update them as guidelines change.
Key takeaways
- Most people with common, well-controlled conditions qualify for a Standard class or better, and many still qualify for Preferred.
- Insurers disagree more than most people expect. The same health history can be Preferred at one insurer and a table rating at another.
- Underwriting has become more favorable since our 2019 guide for treated sleep apnea, mild anxiety and depression, removed skin cancers, mitral valve prolapse and many cancer survivors.
- Timing matters: wait for 12 months without nicotine, a year of stable weight after rapid loss, and finished follow-up testing before you apply.
- An informal review before you formally apply helps you find the best class without creating an unfavorable record.
The rate class ladder
Every insurer uses its own names and its own number of classes, but they all follow the same pattern. Most offer three or four non-tobacco classes, two tobacco classes, and a series of table ratings for higher risks. Each table adds about 25% of the Standard premium.
The rate class ladder, from lowest to highest premium
| Rate class | Who typically qualifies | Cost compared with Standard |
|---|---|---|
| Preferred Plus | Excellent health, a build within preferred limits, good lab results and no early family deaths. Treated blood pressure or cholesterol often still qualifies. | Lowest available |
| Preferred | Very good health with one or two minor, well-managed items, such as mild sleep apnea or a slightly higher weight or cholesterol ratio. | Low |
| Standard Plus | Good health that falls just outside preferred limits, for example a recent tobacco quit or a higher weight. | Below Standard |
| Standard | Average health, often with a controlled chronic condition or several minor ones. | The baseline (100%) |
| Table 1 to 4 | A condition with measurable added risk that is under reasonable control, such as type 1 diabetes or a recent heart condition. | Standard plus 25% to 100% |
| Table 5 to 8 | More significant or combined conditions. | Standard plus 125% to 200% |
| Table 9 to 16 | Serious health histories. Many insurers decline rather than offer this range. | Standard plus 225% to 400% |
| Postpone | A recent event, pending tests or treatment still under way. The insurer will reconsider after a waiting period. | No offer yet |
| Decline | Risk the insurer will not accept at this time. Another insurer may view it differently. | No offer |
Tobacco users are placed on a separate, much higher rate scale, usually with two classes: Preferred Tobacco for otherwise healthy applicants and Standard Tobacco. Some risks are handled with a flat extra instead of, or in addition to, a class change. A flat extra is a set charge per $1,000 of coverage, often for a limited number of years.
How insurers decide your class
Underwriters build a complete picture from several sources and then compare it with the insurer's guidelines:
- Your application and health interview, including medications, diagnoses, treatment and tobacco or marijuana use.
- Lab work and a paramedical exam (blood pressure, build, blood and urine), unless you qualify for an accelerated program that waives them.
- Medical records from your doctors, especially for any condition that is being treated or monitored.
- Prescription history, MIB and driving records, which insurers check electronically.
- Family history, hobbies, travel and occupation.
Most insurers use a debit and credit system. Each concern adds debits, and favorable results, such as excellent cholesterol or a normal stress test, can earn credits. That is why two modest issues can combine into a table rating, and why strong results elsewhere can offset a single concern.
How to read the condition tables
Each table below lists a condition or situation, the most common result across the insurers we reviewed, and the best result at some insurers, meaning the most favorable class at least one major insurer currently offers for that situation. The final column lists what underwriters weigh most.
Preferred Plus to Standard Table 1 to 8 Table 9 or higher, or decline Postpone or case by case Tobacco rates
Results assume the condition is your only significant health issue. Combined conditions, build, labs and family history all affect the final class. These tables are a guide to likely outcomes, not an offer of coverage.
See what your class costs
Once you have found the class that fits your situation, our Instant Term Life Quote tool shows current pricing for that class from leading insurers. An instant quote is only as accurate as the class it assumes, though. If your history includes any condition in these tables, a review by someone who knows how each insurer treats it is the most reliable way to confirm the class you will actually receive and which insurer is most likely to offer it.
Height and weight (build) chart
Build is the most common reason applicants miss the best class. The chart below shows the approximate maximum weight for each class at each height. It reflects the middle of the market: we calculated it from the build charts of 16 insurers, and individual insurers can be about 10 to 20 pounds stricter or more generous in either direction.
Approximate maximum weight (pounds) for each class, adults under about age 60
| Height | Preferred Plus | Preferred | Standard Plus | Standard | Table 2 | Table 4 |
|---|---|---|---|---|---|---|
| 5'0" | 146 | 157 | 169 | 192 | 199 | 217 |
| 5'1" | 151 | 162 | 175 | 198 | 206 | 224 |
| 5'2" | 156 | 167 | 180 | 205 | 213 | 232 |
| 5'3" | 161 | 173 | 186 | 211 | 220 | 239 |
| 5'4" | 166 | 178 | 192 | 218 | 227 | 247 |
| 5'5" | 172 | 184 | 198 | 225 | 234 | 255 |
| 5'6" | 177 | 190 | 204 | 232 | 241 | 263 |
| 5'7" | 182 | 195 | 211 | 239 | 248 | 271 |
| 5'8" | 188 | 201 | 217 | 246 | 256 | 279 |
| 5'9" | 193 | 207 | 223 | 253 | 263 | 287 |
| 5'10" | 199 | 213 | 230 | 261 | 271 | 296 |
| 5'11" | 205 | 219 | 237 | 268 | 279 | 304 |
| 6'0" | 211 | 226 | 243 | 276 | 287 | 313 |
| 6'1" | 216 | 232 | 250 | 284 | 295 | 321 |
| 6'2" | 222 | 238 | 257 | 291 | 303 | 330 |
| 6'3" | 228 | 245 | 264 | 299 | 311 | 339 |
| 6'4" | 235 | 251 | 271 | 307 | 320 | 348 |
Above the Table 4 limit, ratings typically continue to about Table 8 near a BMI of 46, and most insurers decline above a BMI of about 48 to 49. Many insurers allow more weight after about age 60, and a few use stricter charts for women. Very low weight, or unexplained recent weight loss, is also reviewed.
Weight-loss medications and surgery
Insurers do not give full credit for weight lost in the past 12 months. A common approach is to add back about half of the recent loss when measuring build. For example, someone who is 5'10" and went from 250 to 210 pounds this year may be assessed at about 230 pounds.
Weight-loss medications and surgery
| Condition or situation | Most common result | Best result at some insurers | What matters most |
|---|---|---|---|
| Taking a GLP-1 (Wegovy, Zepbound) for weight loss, started within the past year | Standard Plus | Preferred | About half of recent weight loss is typically added back when measuring build. |
| On a GLP-1 more than a year, weight stable | Preferred | Preferred Plus | Current weight is generally used once stable for 6 to 12 months. |
| GLP-1 (Ozempic, Mounjaro) prescribed for type 2 diabetes | Standard | Preferred | Rated as diabetes; age at diagnosis and A1c drive the class. |
| Weight-loss surgery more than 3 to 5 years ago, weight stable | Standard | Standard | Current build and no complications. |
Tobacco, nicotine, marijuana and alcohol
Tobacco status has the largest effect on price of any single factor. Nearly every insurer requires 12 months without any tobacco or nicotine for non-tobacco rates, and longer for its best class. Marijuana is treated far more favorably than it once was, especially when it is disclosed and not smoked or vaped.
Tobacco, nicotine, marijuana and alcohol
| Condition or situation | Most common result | Best result at some insurers | What matters most |
|---|---|---|---|
| Cigarettes in the past 12 months | Preferred Tobacco | Preferred Tobacco | Tobacco rates apply. Meeting the other preferred criteria earns the better of the two tobacco classes. |
| Nicotine vaping, e-cigarettes or hookah in the past 12 months | Preferred Tobacco | Preferred Tobacco | Treated the same as cigarettes. |
| Nicotine pouches (such as Zyn), gum, patches or chewing tobacco | Preferred Tobacco | Standard Plus | Most insurers treat any nicotine as tobacco; a few offer non-tobacco rates if you do not smoke or vape. |
| Occasional cigar, about one a month or less | Preferred Plus | Preferred Plus | Disclose it, and the nicotine test on your lab work must be negative. |
| Quit all tobacco and nicotine 12 to 24 months ago | Standard Plus | Preferred | Twelve months nicotine-free is the near-universal line for non-tobacco rates. |
| Quit 2 to 3 years ago | Preferred | Preferred | Many insurers open Preferred at 2 or 3 years. |
| Quit 3 to 5 or more years ago | Preferred Plus | Preferred Plus | The best class usually requires 3 to 5 years free of all nicotine. |
| Marijuana, about once a month or less | Preferred | Preferred Plus | Disclose it. Edibles are treated most favorably; smoking or vaping can mean tobacco rates at some insurers. |
| Marijuana, about 2 to 8 days a month | Standard Plus | Preferred Plus | Usually non-tobacco rates; frequency and method decide the class. |
| Marijuana, about 3 to 4 days a week | Standard | Preferred | Results vary widely by insurer, so carrier selection matters. |
| Marijuana daily or nearly daily | Table 2 | Standard | Often rated or declined; a few insurers still offer coverage. |
| Medical marijuana or CBD products | Standard | Preferred Plus | Medical use is rated for the condition it treats. CBD without THC usually has no effect. |
| Alcohol treatment more than 10 years ago, sober since | Preferred | Preferred Plus | No relapse and a clean driving record. |
| Illegal drug use (other than marijuana) in the past 3 years | Decline | Decline | Time since last use is the deciding factor. |
Heart, blood pressure and cholesterol
Blood pressure and cholesterol medications rarely keep anyone out of a preferred class today. What matters is how well your numbers are controlled. For heart conditions, the age at diagnosis, recent test results and control of risk factors drive the outcome.
Heart, blood pressure and cholesterol
| Condition or situation | Most common result | Best result at some insurers | What matters most |
|---|---|---|---|
| High blood pressure on medication, readings about 135/85 or lower | Preferred Plus | Preferred Plus | Steady readings over the past 12 to 24 months. Limits loosen after about age 60. |
| High blood pressure on medication, readings averaging in the 140s | Standard Plus | Preferred | Bringing readings down and documenting them before you apply. |
| Blood pressure above normal, untreated or just starting treatment | Table 2 | Standard | Several months of controlled, documented readings. |
| High cholesterol on a statin, cholesterol/HDL ratio about 5.0 or lower | Preferred Plus | Preferred Plus | The ratio matters more than total cholesterol. |
| Cholesterol/HDL ratio about 5.6 to 6.5 | Standard Plus | Preferred | Treatment or a higher HDL can improve the ratio. |
| Occasional extra heartbeats (PVCs or PACs), normal heart tests | Preferred | Preferred Plus | A normal echocardiogram or stress test. |
| Mitral valve prolapse with a normal echocardiogram | Preferred | Preferred Plus | A recent echo showing little or no leakage. |
| Atrial fibrillation, occasional episodes, otherwise healthy heart | Standard | Preferred Plus | Infrequent episodes, a normal echo and no other heart disease. |
| Single blood clot (DVT) with a clear cause, fully recovered | Standard | Preferred Plus | A known cause such as surgery or travel, and finishing blood thinners. |
| Factor V Leiden or similar inherited clotting tendency | Standard | Standard | No clots, or a single clot with a clear cause. |
| Coronary artery disease or stent, diagnosed at 60 or older, stable | Table 2 | Standard | Normal heart function, a recent stress test and controlled risk factors. |
| Coronary artery disease diagnosed in your 40s or 50s | Table 4 | Table 2 | Number of arteries involved and heart pumping strength. |
| Single TIA (mini-stroke), normal workup, 6+ months ago | Table 2 | Standard | A complete workup and controlled blood pressure and cholesterol. |
| Single mild stroke after 50, good recovery, 12+ months ago | Table 3 | Standard | Full recovery and well-managed risk factors. |
| Pacemaker for a slow heart rhythm, otherwise healthy heart | Table 2 | Standard | Normal heart function. |
| Heart failure, or moderate to severe cardiomyopathy | Decline | Decline | Generally declined. |
Diabetes, thyroid, liver and blood
For type 2 diabetes, the age at diagnosis is the strongest factor: diabetes that begins after 50 and is well controlled is treated far better than diabetes that begins in your 30s. Thyroid conditions under good control usually have little effect.
Diabetes, thyroid, liver and blood
| Condition or situation | Most common result | Best result at some insurers | What matters most |
|---|---|---|---|
| Prediabetes, A1c 5.7% to 5.9% | Preferred | Preferred Plus | Normal weight, blood pressure and cholesterol. |
| Prediabetes, A1c 6.0% to 6.4% | Standard Plus | Preferred Plus | Lower readings in your doctor's records can help. |
| Gestational diabetes in a past pregnancy, now resolved | Preferred | Preferred Plus | A normal A1c after delivery. Insurers vary noticeably here. |
| Type 2 diabetes diagnosed at 50 or older, pills or diet, A1c under 7% | Standard | Preferred | No kidney, eye or nerve complications; good blood pressure and cholesterol. |
| Type 2 diabetes diagnosed at ages 30 to 49, well controlled | Table 3 | Preferred | A1c control over time and no complications. |
| Type 2 diabetes on insulin, age 50 or older, well controlled | Table 2 | Standard | A1c history and no complications. |
| Type 1 diabetes, excellent control, no complications | Table 4 | Table 2 | A1c under about 7%, older age and use of a pump or glucose monitor. |
| Underactive thyroid (hypothyroidism) on stable medication | Preferred | Preferred Plus | Normal thyroid lab results. |
| Overactive thyroid or Graves' disease, treated and stable | Standard | Preferred Plus | One to two years of stable thyroid labs and no heart rhythm issues. |
| One liver test mildly elevated | Standard | Preferred Plus | No alcohol concerns and negative hepatitis tests. |
| Hepatitis C, treated and cured | Standard | Standard | Proof of cure and normal liver tests since treatment. |
| Gout, controlled | Preferred | Preferred Plus | Normal kidney function. |
| Mild iron-deficiency anemia with a known cause | Preferred | Preferred Plus | A treated, explained cause. |
| Elevated PSA, fully evaluated, no cancer found | Preferred | Preferred | Finish the urologist's recommended follow-up before applying. |
Sleep apnea, asthma and lungs
Sleep apnea is one of the most common conditions we see, and one of the most improved. The single most helpful document is a compliance report from your CPAP machine showing consistent nightly use.
Sleep apnea, asthma and lungs
| Condition or situation | Most common result | Best result at some insurers | What matters most |
|---|---|---|---|
| Mild sleep apnea, using CPAP or an oral appliance consistently | Preferred | Preferred Plus | A CPAP compliance report showing regular nightly use. |
| Moderate sleep apnea, using CPAP consistently | Standard | Preferred Plus | One to two years of documented compliance and no daytime sleepiness. |
| Severe sleep apnea, 1 to 2 years of documented CPAP use | Standard | Standard Plus | Compliance records, oxygen levels and no heart complications. |
| Moderate sleep apnea, untreated or inconsistent CPAP use | Table 2 | Standard | Restarting treatment and documenting use before you apply. |
| Mild asthma, occasional rescue inhaler | Preferred | Preferred Plus | No ER visits, hospital stays or oral steroids. |
| Asthma needing a daily controller inhaler, well controlled | Preferred | Preferred | Up to two medications, with no steroid bursts in the past year. |
| Moderate asthma with occasional steroid courses or ER visits | Table 2 | Standard | How often steroids or ER care are needed, and lung function tests. |
| Mild COPD or emphysema, no longer smoking | Table 2 | Standard | Lung function tests and a confirmed quit date. |
Mental health and ADHD
Insurers now distinguish carefully between mild, stable conditions and more serious ones. Stability, a consistent medication dose and no time off work or hospital stays carry the most weight.
Mental health and ADHD
| Condition or situation | Most common result | Best result at some insurers | What matters most |
|---|---|---|---|
| Past anxiety or depression, resolved, no longer on medication | Preferred Plus | Preferred Plus | A single episode with full recovery. |
| Mild anxiety or depression, stable on one medication | Preferred | Preferred Plus | A stable dose with no recent changes and no time off work. |
| Anxiety or depression on two medications or seeing a psychiatrist, stable | Standard Plus | Preferred Plus | A track record of stability. Insurers vary widely here. |
| Adult ADHD, well controlled | Preferred | Preferred Plus | A clean driving record and no other mental health or substance issues. |
| Mild or resolved PTSD | Standard | Preferred Plus | Stability and no substance use. |
| Major or recurrent depression | Table 2 | Standard | Time since the last episode, and no hospital stays. |
| Bipolar disorder, stable 5 years or more | Table 2 | Standard Plus | Years of stability, consistent treatment and steady work. |
Brain and nervous system
Brain and nervous system
| Condition or situation | Most common result | Best result at some insurers | What matters most |
|---|---|---|---|
| Migraines, evaluated and stable | Preferred | Preferred Plus | A completed workup and a stable pattern. |
| Vertigo or inner-ear dizziness, evaluated and controlled | Preferred | Preferred Plus | A known cause. Unexplained dizziness may be postponed until evaluated. |
| Epilepsy, no seizures in 2 years or more | Standard | Preferred | Time since the last seizure is the key factor. |
| Epilepsy with occasional seizures | Table 3 | Standard | Seizure type, frequency and medication compliance. |
| Multiple sclerosis, mild and stable for several years | Table 2 | Standard | Few or no lasting symptoms and a stable MRI. |
| Parkinson's disease, mild, beginning after about age 60 | Table 3 | Standard | Independence in daily activities and slow progression. |
| Alzheimer's disease or dementia | Decline | Decline | Generally declined. |
Digestive, joint, autoimmune and kidney conditions
For inflammatory bowel disease and autoimmune conditions, years of stability and the type of medication matter most.
Digestive, joint, autoimmune and kidney conditions
| Condition or situation | Most common result | Best result at some insurers | What matters most |
|---|---|---|---|
| Acid reflux (GERD) or IBS, controlled | Preferred | Preferred Plus | No complications. |
| Benign colon polyps, removed | Preferred | Preferred Plus | The pathology report and routine follow-up colonoscopies. |
| Barrett's esophagus without dysplasia | Standard | Preferred Plus | Regular surveillance endoscopy. |
| Ulcerative colitis, mild and quiet for years | Standard | Preferred | Years since the last flare, non-steroid medication and a clear colonoscopy. |
| Crohn's disease, mild and stable for years | Standard | Preferred | Age, years since the last flare, and no recent steroids or surgery. |
| Crohn's disease with periodic flares or biologic treatment | Table 3 | Standard | Time since the last flare and medication intensity. |
| Osteoarthritis, mild to moderate | Preferred | Preferred Plus | Full function and no regular opioid use. |
| Osteoporosis or osteopenia, no fractures | Preferred | Preferred Plus | No fracture history. |
| Rheumatoid arthritis, mild and well controlled | Standard | Preferred Plus | No flares in 2 years and full function. |
| Rheumatoid arthritis with ongoing activity | Table 3 | Standard | Medications, function and organ involvement. |
| Psoriatic arthritis | Standard | Preferred | Time in remission and the type of treatment. |
| Lupus (systemic), mild and stable | Table 4 | Standard | No kidney or other organ involvement. |
| Kidney stones, occasional | Preferred | Preferred Plus | Normal kidney function and blood pressure. |
| Mildly reduced kidney function, stable | Standard | Preferred | Stable kidney filtration (eGFR), no diabetes and good blood pressure. |
| Endometriosis or PCOS | Preferred Plus | Preferred Plus | Usually no effect on its own. |
| Currently pregnant, no complications | Preferred Plus | Preferred Plus | Build is usually judged on pre-pregnancy weight. |
Cancer history
Cancer survivors are often more insurable than they expect. Most insurers want treatment to be finished, and for many internal cancers they wait one to five years before offering coverage. Early on, the offer is often Standard with a temporary flat extra (for example $5 per $1,000 for two years after early colon cancer, or $10 to $15 per $1,000 for three to four years after early breast cancer), which then drops off. Several lower-risk cancers can qualify for preferred classes, while some insurers cap any cancer history other than basal or squamous skin cancer at Standard Plus or Standard.
Cancer history
| Condition or situation | Most common result | Best result at some insurers | What matters most |
|---|---|---|---|
| Basal cell or squamous cell skin cancer, removed | Preferred | Preferred Plus | Clear margins and regular dermatology visits. |
| Melanoma in situ (stage 0), removed | Standard Plus | Preferred Plus | A single lesion, fully excised, with dermatology follow-up. |
| Thin melanoma (early stage I), removed within the past 3 years | Standard+ flat extra | Standard | Depth and stage. Often insurable right away. |
| Cervical dysplasia or cervical cancer in situ, treated | Preferred | Preferred Plus | Normal follow-up Pap tests. |
| Papillary thyroid cancer, early stage, under 5 years | Standard | Preferred Plus | Normal scans and labs after treatment. |
| Papillary thyroid cancer, early stage, 5 years or more | Standard Plus | Preferred Plus | Years with no recurrence. |
| Testicular cancer (stage I seminoma), treatment complete | Standard | Preferred Plus | Normal tumor markers and surveillance scans. |
| Prostate cancer on active surveillance | Table 2 | Standard | Age, PSA under 10 and a low Gleason score. |
| Prostate cancer, low risk, treated within the past 5 years | Standard+ flat extra | Standard Plus | An undetectable PSA after treatment. |
| Prostate cancer, low risk, 10 years or more, PSA undetectable | Standard Plus | Preferred | Years with no recurrence. |
| Breast cancer in situ (DCIS), treated | Standard | Standard Plus | Clear margins and normal follow-up mammograms. |
| Breast cancer stage I or II, within 2 years of chemotherapy or radiation | Postpone | Standard+ flat extra | Most insurers ask you to wait 1 to 3 years after treatment. |
| Breast cancer stage I or II, 2 to 5 years after treatment | Standard+ flat extra | Standard | Stage, lymph nodes and receptor status. |
| Breast cancer stage I or II, 5 years or more | Standard | Standard Plus | No recurrence and normal mammograms. |
| Colon cancer, early stage, 5 to 10 or more years after treatment | Standard | Preferred | Normal follow-up colonoscopies. |
| Any internal cancer with chemotherapy or radiation in the past 12 months | Decline | Postpone | Most insurers wait; a few low-risk types are exceptions. |
| Most other cancers, 2 to 5 years after treatment | Standard+ flat extra | Standard | Type, stage and time since treatment. |
| Most other cancers, 5 to 10 years after treatment | Standard | Preferred Plus | No recurrence; some insurers cap cancer history at Standard. |
| Most other cancers, 10 years or more after treatment | Standard Plus | Preferred Plus | No recurrence; lower-risk types do best. |
| Cancer that has spread (stage IV) | Decline | Decline | Generally declined for traditional coverage. |
Family history
Family history usually affects only the preferred classes, and many insurers have narrowed what counts. Most look only at deaths of parents or siblings from heart disease or certain cancers before age 60 (65 at some), and many stop considering family history once you reach about 60 to 70.
Family history
| Condition or situation | Most common result | Best result at some insurers | What matters most |
|---|---|---|---|
| No parent or sibling died of heart disease or cancer before 60 | Preferred Plus | Preferred Plus | No effect. |
| Parent or sibling diagnosed (but did not die early) | Preferred Plus | Preferred Plus | Most insurers count only early deaths. |
| One parent or sibling died of heart disease or cancer before 60 | Preferred | Preferred Plus | Several insurers ignore cancer deaths or count only certain types. |
| Two or more parents or siblings died of heart disease or cancer before 60 | Standard Plus | Preferred | Often ignored once you are past about 60 to 70. |
| Known hereditary syndrome in the family (for example BRCA) | Case by case | Standard | A negative genetic test can help a great deal. |
Driving record, aviation, hobbies and travel
Non-medical risks are often handled with a flat extra or an exclusion rather than a lower class. Recreational activities that once meant a table rating are now commonly accepted at preferred rates.
Driving record, aviation, hobbies and travel
| Condition or situation | Most common result | Best result at some insurers | What matters most |
|---|---|---|---|
| Zero to two moving violations in the past 3 years | Preferred Plus | Preferred Plus | No reckless driving or suspensions. |
| Three or four moving violations in 3 years | Standard | Preferred Plus | Time since the most recent ticket. |
| One DUI more than 5 years ago | Preferred Plus | Preferred Plus | A few insurers look back 7 to 10 years for their best class. |
| One DUI 2 to 5 years ago | Standard | Standard Plus | No other violations and no alcohol treatment. |
| One DUI within the past 1 to 2 years | Standard+ flat extra | Standard+ flat extra | Many insurers decline within the first year. |
| Two or more DUIs within 5 years | Decline | Decline | Generally declined. |
| Experienced, instrument-rated private pilot | Preferred | Preferred Plus | Hours, instrument rating, or accepting an aviation exclusion. |
| Student or low-hour private pilot | Standard+ flat extra | Standard Plus+ flat extra | Flat extra of about $2 to $3.50 per $1,000 until experience builds. |
| Recreational scuba diving to 100 feet or less | Preferred Plus | Preferred Plus | Certification and depth. |
| Skydiving, hang gliding or paragliding | Standard+ flat extra | Preferred+ flat extra | Number of jumps or flights per year. |
| Technical or high-altitude mountain climbing | Standard+ flat extra | Preferred+ flat extra | Altitude, location and difficulty. |
| Travel to high-risk countries or long stays abroad | Case by case | Standard Plus+ flat extra | Destination, length of stay and purpose. |
Applying at older ages
Preferred classes remain available well into your 70s, and several rules relax with age. After about 80, the best classes are generally not offered.
Applying at older ages
| Condition or situation | Most common result | Best result at some insurers | What matters most |
|---|---|---|---|
| Healthy applicants ages 60 to 70 | Preferred Plus | Preferred Plus | Family history often stops counting, and weight limits loosen. |
| Healthy applicants ages 71 to 80 | Preferred | Preferred Plus | Expect cognitive and mobility checks and recent doctor visits. |
| Applicants 81 and older | Standard | Preferred | Overall health and recent medical care. |
What has changed since our 2019 guide
We first published our underwriting classes guide in 2019. Since then, insurers have updated their guidelines in ways that favor many applicants:
- Treated sleep apnea with good CPAP use is now commonly Preferred, rather than a Table 1 to 2 rating.
- Mild anxiety, depression and asthma are now often Preferred, rather than Standard.
- Removed basal or squamous cell skin cancer and mitral valve prolapse with a normal echo are now typically Preferred, rather than table rated.
- Weight limits are more generous. Standard now reaches a BMI of about 37 (about 261 pounds at 5'10"), so being 25 pounds over preferred limits usually means Standard, not a table rating.
- Hobbies such as scuba diving and private flying are usually accepted at preferred rates or with a flat extra, rather than a Table 3 to 4 rating.
- Cancer survivors treated 10 or more years ago commonly receive Standard Plus, and epilepsy with no seizures for two years is commonly Standard. Both were previously placed at Table 5 to 6.
- New factors include GLP-1 weight-loss medications, nicotine pouches and broader marijuana guidelines.
How to earn the best class you qualify for
- Finish any recommended follow-up first. Insurers postpone applications while tests or specialist visits are pending.
- Gather the documents that help. CPAP compliance reports, home blood pressure logs, recent A1c results and specialist notes can move a decision.
- Time the application. Wait for 12 months without nicotine, a year of stable weight after significant loss, and the end of any cancer waiting period, if you can do so safely while keeping existing coverage in force.
- Disclose fully. Admitted cigar or marijuana use is treated far better than use discovered later in lab work or records.
- Get an informal review before you apply. An independent broker can present your history anonymously to several insurers and compare their likely offers. This protects your record and points you to the insurer that views your history most favorably.
- Choose the insurer, not just the price. The lowest advertised rate is meaningless if that insurer will not offer you its best class. Carrier selection is often worth more than any other step.
If you are comparing online quotes, keep in mind that they assume a rate class you may not receive. Our article on the real cost of buying life insurance online explains why.
Quick answers to common questions
What is the best life insurance rate class?
The best class is usually called Preferred Plus, although insurers also use names such as Preferred Best, Super Preferred, Elite or Select Preferred. It goes to applicants in excellent health whose build, blood pressure, cholesterol, family history and driving record all fall within the insurer's strictest limits. Taking medication for blood pressure or cholesterol does not rule it out at most insurers if your readings are well controlled.
Can I get life insurance with a pre-existing condition?
Yes. Most common conditions, including high blood pressure, diabetes, sleep apnea, anxiety, asthma and many cancer histories, are insurable. The condition affects the rate class, not whether you can be covered, unless it is severe, recent or still being evaluated.
Does taking blood pressure or cholesterol medication hurt my rate class?
Usually not. Most insurers look at how well the condition is controlled rather than whether you take medication. Treated blood pressure averaging about 135/85 or lower, and a cholesterol-to-HDL ratio of about 5.0 or lower, often still qualify for Preferred Plus. A few insurers do limit their best class to people who need no medication.
Will marijuana use put me in a smoker rate class?
Usually not. Most insurers offer non-tobacco rates for occasional marijuana use, and many offer Preferred or better at about once a month or less if you disclose it. Edibles are treated most favorably. Smoking or vaping marijuana several times a month can lead to tobacco rates at some insurers, and daily use is often rated or declined.
What is a flat extra?
A flat extra is an added charge per $1,000 of coverage, such as $5 per $1,000 for three years, placed on top of your rate class. Insurers use it for risks that are temporary or not tied to overall health, such as recent cancer treatment, a DUI, or hobbies like skydiving and private flying. Many flat extras end after a set number of years.
Can my rate class be improved after the policy is issued?
Often, yes. Many insurers will reconsider your class if your health improves, but they generally want to see sustained results, often 12 to 24 months of stable readings, before they will. Because premiums are based partly on age, the increase from being older can offset some of the savings, so we review the numbers before recommending a change.
Should I apply to several insurers at once to see who offers the best class?
Generally no. Formal applications report coded health information to the Medical Information Bureau (MIB), a database insurers check, and many applications ask whether you have ever been declined or rated. A better approach is an anonymous, informal review: an independent broker summarizes your history and asks several insurers how they would likely rate it before you formally apply.
Talk through your health history before you apply
Advisor Insurance Resource is an independent brokerage. We are not tied to any one insurer, we compare more than 60 life insurance companies, and we specialize in applicants with health histories that need careful placement. Before you apply, we review your health history, ask insurers for informal opinions when helpful, and recommend the insurer most likely to offer your best class. We work alongside fee-only and fiduciary financial planners, and with physicians and individuals in 48 states.
For a quick starting point, the Instant Term Life Quote tool lets you price coverage at the class you expect from this guide. Before you rely on that number, let us confirm the class with you, since one overlooked detail in a health history can move the result by one or more classes.
We are compensated by the insurance company when a policy is placed. There is no fee to you, and your premium is the same as through any other licensed agent.
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How we built these tables
We reviewed current field underwriting and impairment guides from more than 20 life insurers, using 2023 to 2026 editions where available, together with reinsurer publications and the outcomes of our own recent applications. For each condition we recorded how each insurer rates it at different levels of severity, then summarized the most common result and the best result available. Guidelines change, and every insurer makes its final decision only after a full review of your application and records.
This article is provided for general information and is not medical, legal, tax or financial advice. Rate classes shown are typical outcomes based on published insurer guidelines and our experience; they are not an offer or guarantee of coverage or of any rate class. Actual underwriting decisions are made by each insurance company and depend on your complete application, medical records, age, the amount of coverage and state rules.