Health ratings

This is the machinery behind the price you're quoted, and it's where you have more leverage than most people realize.

Standard isn't the bottom

Most people assume there are two answers: healthy, or not. In fact there's a ladder, and "standard" sits in the middle of it, not at the bottom.

A typical company's ladder runs something like this, from the lowest premium to the highest:

There are usually tobacco versions of these too, priced separately. Someone who uses tobacco generally can't reach the preferred classes at all, and companies typically define a tobacco user as anyone who has used it in any form within the last year.

The practical point: if you're in genuinely good health, don't assume "standard" is the answer you should get. There may be two or three better rungs available to you.

What actually decides your class

The criteria are more specific than most people expect, and they're published in carriers' own underwriting guides. Common ones:

• Tobacco or nicotine use, and how long since you stopped. The window for the top class is often measured in years, not months.
• Blood pressure, usually looked at as an average over recent years rather than a single reading.
• Cholesterol, where the ratio typically matters more than the raw number. At least one major carrier accepts a wide range of total cholesterol at every class, treated or untreated, and differentiates on the ratio instead.
• Build — height and weight, assessed on the company's own chart.
• Family history, particularly cardiovascular death before a certain age. Stricter classes may look at siblings as well as parents.
• Driving record — moving violations over the past few years.
• Occupation and hobbies. Aviation and hazardous activities are often handled with a separate charge or an exclusion rather than by moving your whole class.

One encouraging note on how much this field has moved: one major carrier's current guide states outright that cancer is no longer a factor preventing consideration for its preferred classes. Underwriting has changed a great deal, and assumptions from a decade ago may simply be out of date.

The thing that matters most: the names mean nothing between companies

If you take one point from this page, take this one.

There is no industry standard for what these classes are called or what they require. The national model regulation on this subject explicitly declines to restrict how many rating classes an insurer uses or how it defines them. Each company sets its own.

Here's how big the difference gets in practice. Some carriers require three years nicotine-free for their top class. Others require five. The names differ too: one company's top class may be called Preferred Plus and another's Super Preferred. Same person, same health, same date, and the answer can be a top class at one company and a rung down at the other.

Carriers also describe family history differently, and even mark their substandard classes differently. Some use numbered tables, some use letters.

So when you're comparing offers, comparing the class names is close to meaningless. The name of the name of your rate class matters less than the amount of the rate. Compare the actual premium for the actual coverage.

If your health isn't perfect

People with a health condition often assume they're uninsurable. Usually they're not.

The substandard route, sometimes called a rated class, exists precisely so the insurer can price the extra risk instead of turning you away. Two mechanics do that work:

Table ratings. Your premium starts from a standard-based rate and is increased by a set percentage for each "table" you're rated. One carrier's published product specification states its premiums increase by 25% per table rating. That figure is that company's; the mechanic is common but the percentage isn't a universal constant.

Flat extras. A separate additional charge, sometimes temporary, layered on for a specific risk rather than expressed as a table.

At some companies, a rated risk drops to a standard-based class first, so the preferred classes aren't available with a table rating attached.

This connects to the idea running through the whole site. A health impairment can shorten how long you're likely to live, and how long you live is what the entire price is built on. The rating isn't a judgment. It's arithmetic about time.

If your health changes later

Once your policy is issued, your rate class is set. If your health gets worse, the insurer cannot move you to a worse class or raise your premium above what your contract guarantees. Read that last part carefully: what's protected is the guarantee written into your own policy. On a level term policy the premium is guaranteed for the level period. On a current-assumption universal life policy the charges can rise toward the guaranteed maximum in the contract, so the protection is real but it is the contract's guarantee, not a promise that nothing will ever change. On a level term policy the premium is guaranteed for the level period, and carriers' own agent materials instruct them to tell customers the premium will not exceed the guaranteed premium.

But if your health improves, you can ask them to reconsider. Carriers have a process for this. One major carrier's underwriting field guide describes requesting reconsideration of your original rate class, including a change to non-tobacco rates, starting with a call to customer service.

So the door swings one way. That's unusual, and it's worth acting on.

When to ask for a review

Situations where reconsideration is worth a phone call:

• You quit smoking and have stayed off tobacco.
• You lost significant weight and kept it off.
• Your blood pressure or cholesterol is now controlled.
• A condition you were rated for has resolved or is well managed.
• You gave up a hazardous hobby or changed occupations.

Ask the company what evidence they'd want. The worst outcome is that they say no and you keep the policy you already have.

Practical notes for applying

Be accurate on the application. This connects directly to the contestable period: for the first two years, a material misstatement can cost your family the claim. Understating tobacco use or omitting a condition is not a shortcut to a better class; it's a way to buy a policy that may not pay.

Shop if you're rated. Because companies underwrite conditions differently, the same condition can land you in different classes at different carriers. This is exactly where an independent agent earns their keep, since they can approach carriers known to treat your specific situation more favorably.

Consider timing. If you're mid-way through quitting tobacco or a weight-loss program, it may be worth asking how long a carrier requires before the better class opens up. But coverage bought now can be reconsidered later, which is worth weighing against waiting. You can request reconsideration later.

Common questions

Carrier underwriting guides are advisor-facing documents and their criteria change; treat specific company figures as examples, not industry rules. · Last updated: July 23, 2026