The short answer
Most people with a common chronic condition get approved for fully underwritten coverage. Well-controlled type 2 diabetes, treated depression or anxiety, a mild BMI overage, a CPAP-compliant sleep apnea diagnosis and cancer histories more than a few years past treatment are all routinely insurable in 2026.
What changes is the rate class. Insurance Geek’s March 2026 carrier survey shows a 40-year-old paying $28.03 a month for $500,000 of 20-year term at Preferred Plus versus $54.08 at Standard, a 93% difference for the same policy. Table ratings below Standard add roughly 25% per table, so a Table 4 offer typically prices at about twice Standard.
One in ten Americans believes they would not qualify for life insurance at all, according to LIMRA and Life Happens in the 2025 Insurance Barometer Study. That belief is the most expensive misconception in the category, because it stops people from applying at the age when coverage is cheapest.
How rate classes actually work
Every carrier sorts applicants into a handful of classes. The names vary slightly, but the ladder is consistent.
| Rate class | Roughly means | Price vs. Preferred Plus |
|---|---|---|
| Preferred Plus / Super Preferred | Excellent labs, ideal build, no meaningful family history | Baseline |
| Preferred | Above-average health, one minor flag | About 20% to 25% more |
| Standard Plus | Average to above-average health | About 60% more |
| Standard | Average health, a controlled condition or a build overage | About 90% more |
| Table 1 to Table 4 (substandard) | Controlled but material risk: diabetes, recent cancer history, sleep apnea with complications | Standard plus roughly 25% per table |
| Table 5 to Table 8+ | Multiple conditions or poor control | Two to three times Standard |
Two mechanics matter. First, some carriers express substandard offers as a flat extra premium per $1,000 of coverage instead of a table, which is often cheaper for large face amounts. Second, many carriers will remove or reduce a table rating on request after two to three years of documented improvement, so a Table 3 offer today is not permanent.
Typical rate class by condition
Ranges below reflect common 2026 underwriting outcomes for a non-smoker applying for fully underwritten term coverage. Individual offers vary by carrier, state and the full picture in your file.
| Condition | Typical best case | Typical range | What drives the outcome |
|---|---|---|---|
| Type 2 diabetes, diagnosed after 40 | Standard | Standard to Table 4 | A1C, age at diagnosis, medications, no neuropathy or kidney involvement |
| Type 2 diabetes, diagnosed before 30 | Table 2 | Table 2 to Table 6 | Duration of disease is the dominant factor |
| Type 1 diabetes | Table 4 | Table 4 to decline | Control, insulin units per day, complications, continuous monitoring |
| Depression or anxiety, mild and treated | Preferred Plus | Preferred Plus to Standard | Stability, one medication vs. several, no hospitalization or suicide attempt |
| Depression, moderate to severe history | Standard | Standard to Table 4 | Hospitalizations, time since last episode, med changes in past 12 months |
| Breast or prostate cancer, treated, stage I | Standard | Standard to Table 4 plus temporary flat extra | Years since treatment completion, stage, grade, node status |
| Melanoma, in situ, treated | Preferred | Preferred to Table 2 | Depth, margins, years clear |
| High BMI 31 to 34 | Standard Plus | Standard Plus to Standard | Build charts vary widely; some carriers add an inch to height |
| High BMI 35 to 39 | Standard | Standard to Table 4 | Blood pressure, A1C and lipids alongside the build |
| Sleep apnea, CPAP compliant | Preferred | Preferred to Standard | Documented compliance data, AHI severity, no daytime somnolence |
| Sleep apnea, untreated or non-compliant | Table 2 | Table 2 to Table 6 | Untreated apnea is underwritten as an active cardiovascular risk |
Diabetes: what the numbers look like
Diabetes is the most common underwriting conversation in the country. The CDC’s National Center for Health Statistics reported in its November 2024 data brief that 15.8% of U.S. adults age 20 and over had diabetes during August 2021 to August 2023, including 4.5% undiagnosed, rising to 27.3% of adults age 60 and over.
Policygenius rate illustrations for a $500,000 20-year term policy on a non-smoker show what that means in dollars per month:
| Age and sex | Type 2 diabetes | Type 1 diabetes |
|---|---|---|
| Woman, 30 | $47.38 | $51.79 |
| Man, 30 | $51.06 | $61.91 |
| Woman, 40 | $59.98 | $82.41 |
| Man, 40 | $74.77 | $103.54 |
| Woman, 50 | $120.85 | $196.31 |
| Man, 50 | $170.62 | $278.11 |
Those type 2 figures reflect average substandard classifications of Table 4 at 30, Table 3 at 40 and Table 2 at 50, and the type 1 figures reflect Table 6. Note the counterintuitive pattern Policygenius flags: the younger you are at diagnosis, the higher the relative rating, because duration of disease drives complication risk.
What moves you up the ladder: an A1C under 7.0% with a consistent history, no tobacco, normal kidney function on your urine test, controlled blood pressure and lipids, and a BMI under 30. Policygenius notes type 2 applicants who follow their treatment plan with blood sugar under 7.5 may reach average rates, and type 1 applicants taking fewer than 50 units of insulin with levels under 8 may still get an offer.
Depression, cancer history, BMI and sleep apnea
Depression and anxiety. Treated, stable mild-to-moderate depression is one of the most forgiving conditions in life underwriting. Many carriers will still write Preferred Plus on a single SSRI with no hospitalizations and no medication changes in the past year. The flags that cost you: a suicide attempt, an inpatient stay, a recent medication switch, or a diagnosis paired with alcohol or substance use. Never omit a mental health history; it appears in your prescription record anyway.
Cancer history. Underwriting turns on time since treatment ended, stage and grade. A stage I breast cancer treated five years ago frequently prices at Standard with no rating. The same case two years out typically gets Standard plus a temporary flat extra of roughly $2.50 to $7.50 per $1,000 of coverage that expires after a set number of years. Most carriers postpone rather than decline during active treatment or the first one to two years after it.
High BMI. Build is judged against each carrier’s own height and weight chart, and the spread between charts is large. Some accelerated-underwriting programs even add an inch to your height, which quietly improves a borderline case. If your BMI is near a threshold, weigh in the morning, and if you have lost weight, get the last 12 months of documented weights into the file.
Sleep apnea. Diagnosed and CPAP-compliant is close to a non-event at many carriers; Preferred is achievable. Untreated or non-compliant apnea gets rated as a cardiovascular risk. Bring your machine’s compliance report. It is the single most useful document you can hand an underwriter.
Guaranteed issue vs. simplified issue
If fully underwritten coverage is declined or priced past what you can carry, two fallbacks exist. They are not interchangeable.
- Simplified issue. Health questions, prescription check, MIB and motor vehicle records, but no exam and no labs. Approval in days. Coverage commonly $25,000 to $1 million depending on the carrier and your age. Expect roughly 15% to 40% more than a comparable fully underwritten policy. Serious conditions can still be declined, because the health questions are knockout questions.
- Guaranteed issue. No health questions at all beyond age and residency. Everyone in the age band is accepted, typically ages 45 to 85. Face amounts are small, usually $2,000 to $40,000, and nearly all policies carry a graded death benefit: die of natural causes in the first two years and beneficiaries get premiums back plus roughly 10%, not the face amount. Accidental death is usually covered in full from day one.
Guaranteed issue is expensive per dollar of coverage. A $15,000 policy on a 65-year-old often runs $85 to $130 a month, which means you can pay in more than the death benefit if you live long enough. It is the right tool for a funeral you want funded regardless, and the wrong tool for income replacement.
Sequence matters: try fully underwritten first, then simplified issue, then guaranteed issue. Going in the wrong order leaves money on the table, and a decline on file makes the next application harder.
How to get a better offer
Underwriting rewards documentation more than it rewards optimism.
- Get your labs before you apply. A recent A1C, lipid panel and metabolic panel from your own doctor tell you where you will land, at no underwriting cost.
- Ask your broker to informally pre-screen with three or four underwriters using an anonymous summary. No application, no MIB entry, no decline on file.
- Assemble the paper trail: compliance reports, pathology and oncology summaries, medication history, weight log, cardiologist clearance letters.
- Fix the cheap things. Tobacco cessation for 12 months typically moves you off tobacco rates, which Insurance Geek notes commonly double or triple premiums.
- Apply for a term length you can revisit. Ask about a rating reconsideration after two to three years of stable control.
- Compare a rated fully underwritten policy against simplified issue on price, not just on convenience. Rated is often still cheaper.
When you are ready, start a life quote and tell us the condition up front. Pre-screening with the right carriers is the whole game. Availability and underwriting standards vary by state.
Sources & further reading
- CDC / NCHS — Prevalence of Total, Diagnosed, and Undiagnosed Diabetes in Adults, Data Brief 516
- Policygenius — Life insurance for diabetics, type 1 and type 2 rate illustrations
- Insurance Geek — Average cost of life insurance and rate class comparison, 2026
- LIMRA and Life Happens — 2025 Facts About Life Insurance
- MIB — Facts about MIB and the Consumer File
- Texas Department of Insurance — Life insurance guide, contestability and claims