It’s rare to be declined for life insurance solely based on your prescription history, but it can happen in certain scenarios. Working with a licensed life insurance professional can help you learn why you were declined and what next steps to take.
Life insurance terms you should know
Beneficiaries: The people you name on your life insurance policy to receive the lump sum of money — also known as the death benefit — when you die.
Cash value: The portion of a permanent life insurance policy’s monetary value that grows tax-deferred over the life of the policy.
Death benefit: The amount of money the life insurance company will pay your beneficiaries when you die.
Face amount: The dollar amount, or death benefit, your beneficiaries receive if you die while your life insurance policy is active.
Insured: The person who is covered by the insurance policy.
Policy: The legal document that includes the terms and conditions of your life insurance contract.
Policyholder: The person who owns an insurance policy. Usually, this is the same person as the insured.
Permanent life insurance: A type of life insurance that lasts for the rest of your life and usually includes a cash value account.
Premium: The amount you pay your insurance company to keep your coverage active. Premiums are typically paid monthly or annually.
Riders: Add-ons to a life insurance policy that provide more robust coverage, sometimes for an extra cost.
Term life insurance: A life insurance policy that lasts for a set number of years before it expires. If you die before the term is up, your beneficiaries receive a death benefit.
Underwriting: The process where an insurance company evaluates the risk of insuring you and determines your final rate.
Why does your prescription history affect your life insurance options?
Prescription history is just one of the many factors life insurance companies take into consideration when assessing your insurance risk and setting your premiums.
Life insurance companies use factors such as your age, gender, lifestyle, and medical history to assess how risky you are to insure.
In turn, this helps the insurer determine how much you’ll pay for your coverage.
Prescription history can help ensure there isn’t important medical information getting left out of your application.
It can also provide information about the scope of certain underlying health conditions based on the specific drugs prescribed, the dosages, and the specialty of the medical professional writing the prescription.
“Prescription history is a direct link to a medical condition or diagnosis,” says Warren Robbins, senior sales associate and licensed life insurance agent at Policygenius. It “can be a true indicator of what is going on [...] sometimes a client will even disclose medication they’re taking before a medical diagnosis.”
How do life insurance companies know what prescriptions you’ve taken?
If you want to apply for term life or whole life insurance, you’ll need to authorize the insurance company to access information pertaining to your medical history.
Insurers use databases such as the Medical Information Bureau (MIB) and Milliman Intelliscript to verify the information on your life insurance application and protect against fraud.
These organizations gather information from health insurance companies and pharmacies, and then securely share the data with the insurance company in question.
The insurance company then uses this data to gain insight into your medical history.
Learn more about underwriting and the MIB
Do all life insurance companies check prescription records?
Yes, life insurance companies check prescription records as part of their review of your application — a process called underwriting.
However, insurers can’t view prescription records without your consent — your health information is protected by the Health Insurance Portability and Accountability Act (HIPAA). When you sign your application, you’ll sign a HIPPA form that authorizes the insurance company to access your health information in order to review your application for coverage.
If you apply for a no-medical-exam life insurance policy, you may give a verbal authorization over the phone instead, but it accomplishes the same goal.
How is prescription data regulated?
Although you need to share prescription history with your insurer in order to buy a policy, this kind of personal data is regulated by law.
The Fair Credit Reporting Act (FCRA) regulates any agency that collects consumer information and reports. [1]
Under the FCRA, you have the right to request information in your report, as well as the right to dispute it.
The FCRA also mandates that an insurance company let you know if prescription history is a reason for an application decline, or a reason for a change in the terms of the coverage offered.
If you’re denied life insurance because of your prescription history, you’ll receive written notice from your insurer.
What medications can affect the cost of your life insurance policy?
Though all medications related to a specific diagnosis could affect your life insurance application, medications that are linked to more serious health conditions tend to have a higher impact on your premiums — and, in some cases, your policy options.
Below are a few examples of types of medications that may affect your life insurance rates more drastically.
Immunosuppressants. Doctors often prescribe immunosuppressants to treat autoimmune disorders — like rheumatoid arthritis, ulcerative colitis, or lupus. This type of medication often impacts your premiums because it can increase your risk of infection. [2]
Blood thinners. Blood thinners can be used to prevent heart attack, stroke, or pulmonary embolism, which can occur if your blood clots. [3] If you take a blood thinner regularly, your insurer will want to gather more details about your health condition. You’ll pay more in premiums if your blood thinner was prescribed for a condition listed above, since heart attacks and strokes are high-risk medical incidents.
Antipsychotics. Antipsychotics are a class of medication that can be used to treat mental health conditions such as schizophrenia, major depressive disorder, acute mania, and borderline personality disorder. [4] Just because you’re prescribed an antipsychotic drug doesn’t necessarily mean you have a condition related to psychosis, so the insurer may request an attending physician statement (APS) to gather more information from your doctor before assigning your rates.
Narcotic dependence. If you’re on a drug like Suboxone (buprenorphine) or methadone, your life insurance options will be limited. Because these medications are used to treat narcotic dependence, insurers view them as a significant risk factor. [5] [6] You may not qualify for traditional life insurance until it’s been two years from your last refill.
Regardless of your prescription history, working with an independent broker can help you apply with the best insurer for your circumstances. Each insurer has slightly different guidelines when it comes to assessing risk for health conditions and medications.
Should you disclose your prescription history when you apply?
You should disclose all pre-existing conditions and medications you take on your initial application — intentionally withholding information is considered life insurance fraud.
This includes routine medications, as well as any temporary medications you can recall.
For instance, if you were prescribed a painkiller following a minor surgical procedure, you should let your life insurance agent know, because it’ll still come up on a prescription check.
On the other hand, you don’t have to disclose any over-the-counter medication, like vitamins or supplements.
If you simply forget to name a medication, this isn’t a problem. The insurer will catch any prescriptions of note while reviewing your records. Plus, any minor prescriptions like a temporary antibiotic won’t have any impact on your rates.
How to apply for life insurance if you have a sensitive prescription history
If you have a sensitive prescription history, you’ll still apply for life insurance much like anyone else would.
What are your options if you’re denied coverage?
There are few instances where you’ll be denied life insurance coverage solely because of your prescription history. If this happens to you, the insurer will contact you with a notice — this is required by law. Once your insurer has contacted you, there are a few steps you can take.
If you had originally applied for a no-medical-exam or instant life insurance policy, it’s possible you still qualify for traditional coverage with a medical exam. Some no-exam policies have stricter parameters for health conditions and medications. Working with an independent broker can help you apply for a different policy in this case.
If you were declined from a traditional policy with a medical exam, you can request a copy of your Millman report. It’s possible there’s a mistake on your report, so it’s best to check before trying to apply with another insurer.
If you request your report and learn that there are no errors or you’re on a prescription that disqualifies you for traditional life insurance, you can consider the following options.
Group life insurance. Some employers offer group life insurance at a subsidized rate — or no cost at all — as part of a benefits package. Group life policies usually offer up to one or two times your annual salary. They also don’t have any medical requirements, so your prescription history won’t keep you from being approved.
Guaranteed issue life insurance. Guaranteed issue policies offer small amounts of permanent coverage with no health qualifications for approval. Although you’ll pay more for less coverage, this is one way to get a policy in place. Guaranteed issue policies are typically available for people age 45 and up.
Other health concerns that can affect your life insurance
Certain pre-existing conditions and other health-related concerns can affect your life insurance options or costs. A Policygenius expert can help you find the right policy for your needs.
Mental health issues such as depression or anxiety
