Life Insurance With a Pacemaker: Can You Get Coverage (and at What Cost)?

This guide explains how pacemakers affect life insurance underwriting, identifies the best life insurance companies and policies, provides sample rating scenarios, and the steps you can take to improve your chances of approval.

A pacemaker is a small device implanted in your chest to regulate abnormal heart rhythms (arrhythmias). It sends electrical signals to keep your heart beating at a steady, consistent pace.

Pacemakers are most commonly prescribed for:

• Bradycardia – an abnormally slow heart rate
• Heart block – delayed or blocked signals between chambers
• Sick sinus syndrome – a malfunctioning sinus node (also called bradycardia-tachycardia syndrome)
• Atrial fibrillation (AFib) – an irregular, often rapid heart rhythm.

Some pacemakers also include an implantable cardioverter-defibrillator (ICD) to prevent sudden cardiac arrest. Others use one or two wire leads to maintain rhythm. The type of device you have matters in underwriting.

Pacemakers require high-risk life insurance expertise to get the best rates.

When you apply for life insurance with a pacemaker, underwriters focus less on the device and more on why you needed it.

Key Factors Life Insurance Companies Evaluate:

• Underlying Heart Condition: The underlying heart condition plays a big role. Was your pacemaker needed due to:
  • Atrial Fibrillation
  • Heart Block (complete, partial, or congenital)
  • Coronary Artery Disease
  • Heart Attack
  • Sick Sinus Syndrome (aka bradycardia-tachycardia syndrome)
• Pacemaker type:
  • Single chamber (1 wire lead)
  • Dual chamber (2-wire leads)
  • Biventricular (3-wire leads)
• Device Features: If your device includes a defibrillator (ICD), that usually signals a more serious heart condition.
• Complications: Underwriters will want to know if you’ve had any issues, such as infections, blood clots, device malfunctions, or perforations.
• Time since implant: If it’s been more than 5 years since the pacemaker was inserted—and your follow-up tests are normal—you may receive up to two table credits from some companies (like Prudential).
• Overall health: Other health concerns (diabetes, high blood pressure, GI conditions, cancer, etc.) also impact your rate.

If you’ve had a recent implant (within 6–12 months), many companies will postpone your application until stability is proven.

Most cases will include a table rating. Here’s what you might expect based on different scenarios:

Each case is unique. Companies care about stability, follow-up care, and test results as much as they do about the underlying diagnosis.

To help you qualify for the best rate, be ready to answer these questions:

1. When was your pacemaker implanted?
2. Why was the pacemaker needed? (e.g., AFib, heart block, sick sinus syndrome)
3. Was it due to a congenital (cardiomyopathy) or acquired heart condition?
4. Do you experience any symptoms now (like fatigue, chest pain, or dizziness)?
5. What type of pacemaker do you have?
   • Single chamber
   • Dual chamber
   • Biventricular
6. Does it also provide defibrillation (ICD)?
7. Have there been any complications such as:
   • Infection
   • Blood clots
   • Malfunction
   • Perforation
8. When was your last cardiac workup, and what tests were done? (EKG, echo, stress test, etc.)
9. How often do you see your cardiologist?
10. What medications and dosages are you currently taking? (blood pressure, cholesterol, etc.)
11. Have you applied for life insurance before? If yes, which companies and what was the result?
12. Why do you seek life insurance (family protection, final expenses, income replacement, etc.)?
13. Do you smoke?
14. So you have other medical conditions such as aortic aneurysm history, bypass history, diabetes, cancer, etc?

Don’t worry if you don’t have all the answers right now. We’ll work with what you do know to guide you.

Not all insurers treat pacemaker cases the same. These companies are more likely to make fair offers based on your complete medical history:

Offers up to two table credits for well-controlled cases with older implants and clean follow-ups.

Known for strong underwriting on cardiac cases, especially when supported with stable follow-up records.

Flexible for older applicants or cases with minor complications.

May be a fit if you have good cardiac follow-ups and limited comorbidities.

These companies understand that the presence of a pacemaker alone doesn’t always mean high risk; it’s the reason behind it and how well it’s managed that matters.

Having a pacemaker doesn’t mean you can’t get life insurance, but it does mean you need to be strategic about how you apply.

We specialize in helping people with heart conditions like yours. If you’ve been declined elsewhere or are unsure where to start, we’ll guide you step-by-step to the most favorable option based on your unique health history.

Let’s help you find the coverage you deserve.