Life Insurance With Kidney Disease

Kidney disease affects millions of Americans and often raises concerns about qualifying for life insurance. However, obtaining coverage is possible if you understand how insurers evaluate your situation.

Let’s break down what high-risk life insurers look at and how your kidney health impacts your policy options.

Your stage of kidney disease significantly influences your insurance options and rates. Insurance companies evaluate kidney function using stages determined by your estimated Glomerular Filtration Rate (eGFR):

Stage	eGFR	Description	Rating
1	90+	Kidney damage with normal or slightly elevated eGFR	Standard rates or better
2	60 – 89	Kidney damage with mild decreased eGFR	60 = Table 2 – 4 89 = Standard rates
3	30 – 59	Moderate decrease of eGFR	30 = Decline 59 = Table 4 Range
4	15 – 29	Severe decrease of eGFR	Decline
5	< 15	End stage kidney failure	End-stage kidney failure

The estimated Glomerular Filtration Rate (eGFR) measures kidney function and is crucial in life insurance assessments.

Higher eGFR means healthier kidneys and better chances of securing affordable rates. Maintaining a stable or improving eGFR positively impacts your insurability.

PKD (aka hereditary polycystic kidney disease, HPKD) involves cysts growing in the kidneys. It can be a single cyst or multiple.

There are two types of PKD:

1. Autosomal dominant polycystic kidney disease (ADPKD) – Most Common 80-90% of cases
2. Autosomal recessive polycystic kidney disease (ARPKD) – Typically starts in childhood

• What type of polycystic kidney disease do you have?
• When were you diagnosed?
• How severe is your kidney disease?
• How controlled is your blood pressure?
• Have you had dialysis?
• Have you had a kidney transplant or has one been recommended?
• Is there a family history of kidney disease?
• What other health conditions do you have? Cardiac valve disease, aortic aneurysm, etc.

Life insurance table ratings are higher for younger insureds and more expensive for the dominant type of kidney disease compared to the recessive type.

Sample underwriting outcomes for PKD

Current Age	Dominant PKD	Recessive PKD
Under age 20	Decline	Decline
21 – 49	Table 8 – Decline	Table 4 – Decline
50 – 59	Table 4 – 6	Table 2 – 4
60 – 69	Table 2 – 4	Standard – Table 2
70+	Standard – Table 2	Standard – Table 2

If you have a family history of kidney disease but have not been diagnosed with it, life insurers will add a table rating to your policy, unless you’ve undergone testing to show that you do not have PKD.

All types of life insurance are available, including term, universal, and whole life.

If it is an infrequent occurrence and not repetitive, life insurance is not a problem and normal rates.

For people with repetitive kidney stones, the underwriting concern is that there may be an underlying health condition.

Underwriters review kidney function tests such as serum creatinine and Blood Urea Nitrogen (BUN) to determine insurance risks.

Creatinine is a waste product of muscle metabolism. Levels may be falsely elevated for dehydration or protein intake.

• Creatinine Levels: Levels between 1.6 and 2.0 mg/dL often lead to moderately increased rates; levels above 2.0 mg/dL generally result in declined applications.

Creatinine Clearance – Most companies calculate this value or use the blood creatinine level when lab tests are elevated.

Urea is a waste product of protein.

• Blood Urea Nitrogen (BUN): Normal levels are typically up to 25 mg/dL. Mild elevations (up to 50 mg/dL) with normal creatinine generally aren’t penalized. Higher elevations could impact approval and rates.

Protein in urine greater than 150 mg of total protein is usually an indication of renal disease.

On lab tests, you may see a urinalysis test called Casts, which may or may not indicate a kidney problem.

• red blood cell casts – glomerulonephritis
• white blood cell casts – glomerulonephritis, inflammatory conditions
• epithelial casts – nephritic syndrome
• Granular casts – glomerulonephritis
• fatty casts – nephrotic syndrome
• waxy casts – kidney failure

If you have developed end-stage renal disease (ESRD) and are on dialysis, term life insurance, universal life policies, and whole life policies are unavailable. However, you may qualify for guaranteed issue coverage.

Life insurance companies handle kidney transplants with special considerations:

• Kidney Transplant Recipients: Coverage is usually available one year after transplant. Insurers assess the health of the transplanted kidney, complications such as infections or rejection episodes, and donor type (living-related donors usually receive better ratings).

The best-case scenario after receiving a transplant is a Table 8 rating, and sometimes slightly better if the kidney came from a living relative. Some companies may also add a flat extra expense.

The expensive ratings are partly due to the increased risk of kidney cancer among recipients.

If you have other health conditions, such as heart disease or diabetes, guaranteed issue coverage is the only option available.

Individuals who’ve donated a kidney and fully recovered generally face no additional underwriting risk.

Kidney donors often qualify for preferred life insurance rates since the donation doesn’t significantly impact overall health or life expectancy.

Glomerulonephritis is a disease of the glomeruli, the part of the kidney that filters waste.

There are many causes of Glomerulonephritis, including:

• Cancer
• Diabetes
• Medications
• Hypertension
• Infections

Acute GN is a temporary infection that most people will fully recover from.

Life insurance rates for acute cases with full recovery will typically be in the standard table 2 range. Rates may improve as more time passes since the recovery.

Chronic cases of GN may lead to renal failure, requiring dialysis or a kidney transplant.

Underwriting looks at:

• The type of GN you have
• BUN Lab Results
• Creatinine Lab Results
• Blood Pressure
• Results of any biopsies

When available, life insurance offers tend to be in the Standard Table 4 – Standard Table 8 range.

Each table rating adds approximately 25% to a standard rate.

Having kidney disease doesn’t necessarily prevent you from getting affordable life insurance.

Please take a few minutes to submit your quote request today. We’ll then get to work finding your best life insurance options.