Life Insurance After Heart Tests: What Insurers Look For and How to Qualify

Had a heart test? You’re not alone – and it doesn’t automatically mean life insurance is off the table. But underwriters will scrutinize your results.

This guide shows you how heart tests affect your life insurance options, what insurance companies look for, and how to find the best policy after a cardiac workup.

Life insurance underwriting for heart patients falls into the high-risk underwriting category. Companies rely on heart test results to evaluate your cardiovascular health.

Here’s what underwriters focus on for each major heart test:

An electrocardiogram (ECG) records the heart’s electrical activity, helping to detect arrhythmias, previous heart attacks, and cardiac abnormalities, such as heart blocks.

Key Underwriting Factors:

• Normal EKG – No impact on rates
• Minor Abnormalities – Minor T-wave changes range from no impact to Table 2 rating.
• Significant Arrhythmias – Major T-wave changes or ST depressions – Higher ratings to decline
• Recent Abnormal EKG – Postpone until your physician evaluates it.

If you had an abnormal EKG and were evaluated by a physician, we can use those results to offset the EKG results. For example, an abnormal result may lead to further testing, such as a stress test.

If a pacemaker is recommended, you will need to get it before life insurance becomes available.

A stress test evaluates how your heart responds to physical exertion and identifies potential blockages or irregular heartbeats.

The stress test may be performed alone or may include additional testing, such as nuclear or echocardiographic imaging.

Key Underwriting Factors:

• What did the results indicate?
• Did you complete the test or stop it due to fatigue, symptoms, chest pain, or other reasons?
• What were your blood pressure results during testing?

If your stress test results are normal, they can be used to offset an abnormal EKG. If the results are abnormal, underwriting is based on the identified condition.

Not everyone can complete a stress test due to existing health issues, an inability to walk for the required time, or other reasons.

The TEE test provides detailed ultrasound images of your heart using an endoscope procedure.

A TEE test is commonly used to evaluate:

• Atrial or ventricular heart defects
• Congenital heart conditions
• Heart valve disease

This test is used to diagnose cardiomyopathy and mitral valve conditions.

Nuclear testing, also known as myocardial perfusion scans, administers imaging isotopes intravenously that are then monitored and recorded to help identify artery blockages, assess ventricular function, detect signs of a heart attack, and more.

Types of tests include PET Scans, MUGA Scans, and SPECT Scans.

A cardiac cath (coronary angiogram) is one of the most definitive tests used to evaluate your heart and gives insight into:

• The extent of coronary artery disease.
• Ventricular pressure measurement
• Congenital defects
• Heart valve issues
• Ejection Fraction Measurement

For many people, the cardiac catheter results will indicate the types of heart problems present and the type of treatment needed to address the cardiac issue.

Coronary artery calcium scores hurt your underwriting chances or have no effect. It rarely helps you in underwriting.

Coronary artery calcium scores (CAC) measure the amount of calcium that has built up in your heart’s arteries. Electron Beam CT or Multislice CT scans measure the degree of calcification.

Here’s how coronary artery calcium scores affect life insurance based on age:

Age	CAC Score	Underwriting
< 35	1-10 > 10	Standard – Table 2 Decline
35-44	1-100 101-400 >400	Preferred Best – Table 2 Table 2 – 4 Table 4 – Decline
55-64	1-400 401-1000 >1000	Preferred Best – Table 2 Table 2 – 4 Table 4 or greater
>64	1-1000 >1000	Preferred Best – Table 2 Table 3 or greater

CAC scores compare your results to the general population of people of the same age, gender, and race as you.

If your calcium score is less than 90% of the expected score for your age and gender, your rate will be more favorable. Above 90% puts you into the high end of the above ranges.

The most important thing for us to know is why you had a coronary artery calcium score completed. Was it due to an existing heart condition, or was it part of a preventative screening?

With that information, we’ll help you find the best rates available.

Brain natriuretic peptide (BNP) is a hormone associated with the heart. BNP consists of an inactive hormone (NT-proBNP) and an active hormone (BNP).

BNP and NT-proBNP are blood tests used to diagnose and monitor heart failure.

According to the Cleveland Clinic, normal levels of NT-proBNP are:

• Age 0-74 = 125 pg/ml or less
• Age 75-99 = 450 pg/ml or less

It varies by company, but some general age guidelines are as follows:

• Age 0-59 – NT-proBNP levels under 300 do not affect underwriting
• 60-69 – NT-proBNP levels under 400 do not affect underwriting
• 70+ – NT-proBNP levels under 500 do not affect underwriting

Underwriters may add table ratings to your price if your level exceeds the above.

Increasingly, life insurance companies are using NT-proBNP in paramedical exam testing. BNP and NT-proBNP give underwriters a crystal ball when evaluating your health.

BNP levels evaluate:

• Left ventricular function
• Right ventricular function
• Pulmonary hypertension
• Atrial fibrillation
• Coronary artery disease

Slight elevations of BNP predict future heart problems and mortality.

The testing rules for NT-proBNP vary by company. We pulled the following information from each company’s underwriting guidelines.

• Corebridge Financial
  • Ages 20-39 – $5,000,001+
  • 40-44 – $1,000,001+
  • 45-49 – $1,000,001+
  • 50-55 – $250,001+
  • 56-59 – $100,000+
  • 60-66 – $100,000+
  • 67-70 – $50,000+
  • Ages 71+ – $50,000+
• Banner Life
  • Any insured over age 60, or if the insured has a medical history.
• Lincoln Financial
  • All ages – $10,000,000+
  • Ages 41-50 – $2,500,000+
  • Ages 51 or older – $250,000+
• Pacific Life
  • All ages – $10,000,000+
  • 18-40 – $5,000,000+
  • 41-50 – $1,000,000+
  • 51-60 – $500,000+
  • 61-70 – $250,000+
  • Ages 71 or older – All Face amounts
• Protective Life
  • Ages 51-60 – $500,000+
  • Ages 61 or older – All face amounts
• SBLI
  • Ages 50 or older AND $5,000,000+

We’ll continue to update this as we receive updates from other companies.

The liver produces C-reactive protein in response to inflammation, which plays a role in the buildup of plaque in arteries.

High-sensitivity CRP tests (hs-CRP) with levels above 2.0 mg/liter are linked to a higher risk of heart attack, stroke, and heart disease.

A cardiac MRI provides detailed images used to assess heart structure, function, scarring from heart attacks, aortic evaluations, and more, which give cardiologists detailed pictures of your heart.

A chest X-ray is a basic imaging test used to assess the size of your heart, lung conditions, and fluid accumulation.

Different life insurers evaluate heart test results differently. Some are more lenient with abnormal findings, while others are stricter.

• Which heart tests did you have?
• Why were these tests completed?
• What were the results?
• Have you undergone any procedures, such as stent placement, bypass surgery, or pacemaker implantation?
• Have any procedures been recommended that you have not completed yet?
• Do you have any other significant health history, such as:
  • Cancer History – prostate, breast, colon, skin, thyroid, etc.
  • Gastrointestinal Conditions – Crohn’s disease, ulcerative colitis, hepatitis

We’ll help you find the best options available, tailored to your unique health history.

A heart test can change your life insurance options — but it doesn’t have to close the door.

The key is understanding how underwriters view your specific test results — and knowing which companies are most lenient for your situation.

We specialize in helping individuals with cardiac histories obtain the coverage they need, without overpaying or being declined.

Request a free quote today — there’s no pressure, just real answers.