Last Updated: February 3rd, 2026
Life insurance companies assign health ratings to determine your premiums. Most applicants receive preferred, preferred plus, standard plus, or standard ratings based on their health and lifestyle. If you have significant health conditions, you may receive a table rating (A through H) that adds 25% to 200% to your standard premium. Your rating directly affects what you’ll pay, but it’s not permanent and can improve over time.
Getting life insurance when you have health issues can feel overwhelming. You fill out the application, take the medical exam, and then wait to hear what your “rating” will be. But what do these ratings actually mean for your coverage and costs?
Life insurance companies use health ratings to assess risk and set premiums. Think of it like a grading system that determines what you’ll pay. The better your health, the better your rating and the lower your premium. If you have health conditions or lifestyle factors that increase risk, you’ll receive a different classification that reflects those factors.
The good news is that even with health issues, you can still get coverage. Understanding how ratings work helps you know what to expect and how to find the best possible rates for your situation.
How Life Insurance Health Ratings Work
When you apply for life insurance, the insurer evaluates your application, medical exam results, prescription history, and sometimes your medical records through the life insurance underwriting process. They’re looking at factors like your overall health, family medical history, height and weight, blood pressure, cholesterol levels, and lifestyle choices such as smoking or risky hobbies.
Based on this information, they assign you a health rating. This rating determines your risk class, which directly affects your premium. Someone in excellent health pays significantly less than someone with health concerns, even for the same policy amount.
Most people fit into standard rating categories. But if you have more complex health issues, you might receive a table rating instead.
Standard Life Insurance Rating Classes
Life insurance companies typically use four main categories for healthy applicants. While the names vary slightly between insurers, the concepts remain consistent across the industry.
Preferred Plus (Super Preferred)
This is the best rating you can get. You’re in excellent health with no red flags in your medical history. Your height and weight are in the ideal range, you don’t smoke, your blood pressure and cholesterol are normal, and you don’t have any family history of serious illness before age 60.
People with preferred plus ratings get the lowest premiums available. Not everyone qualifies for this top tier, but it’s worth trying if you’re in exceptional health.
Preferred
You’re still in excellent health, but there might be minor factors that keep you out of the preferred plus category. Maybe your cholesterol is slightly elevated but controlled with medication. Or you have a parent who had heart disease at age 58 instead of 62.
Preferred rates are still very competitive. The difference between preferred plus and preferred is typically modest, maybe 10-15% higher premiums.
Standard Plus
You’re in good health overall, but there are some factors that prevent a preferred rating. This might include being moderately overweight, having well-controlled high blood pressure, or having elevated cholesterol levels that are being managed.
Standard plus rates are still reasonable. You’re paying more than preferred rates, but you’re not in the highest-risk categories.
Standard
This is considered average health with a normal life expectancy. You might have some minor health issues, be overweight, or have family history factors that affect your rating. This is where most Americans actually fall when they apply for life insurance.
Standard rates are the baseline. When insurers quote table ratings, they’re typically expressed as percentages above the standard rate.
Smoker Rating Classes
If you use tobacco products, you’ll be placed in smoker categories instead of the standard non-smoker classes. The impact is significant: smokers typically pay 2-3 times more than non-smokers for the same coverage.
Preferred Smoker
You smoke, but you’re otherwise in excellent health. Some companies will put occasional cigar smokers in this category if they only smoke a few times per year.
Standard Smoker
You’re a regular tobacco user in average health. This includes cigarettes, cigars, pipes, chewing tobacco, and vaping with nicotine. Most insurers define a smoker as anyone who has used tobacco products in the last 12 months.
The good news is that if you quit smoking, you can request a rating review after being tobacco-free for 12 months. Many people successfully move from smoker to non-smoker rates and save hundreds per year.
Understanding Table Ratings
When your health situation doesn’t fit into the standard categories, insurers use table ratings. These are sometimes called alphabetical ratings (Table A, B, C) or numerical ratings (Table 1, 2, 3), depending on the company.
Table ratings allow insurers to offer coverage to people with health conditions while charging rates that reflect the increased risk. Without table ratings, many people with manageable health conditions couldn’t get coverage at all.
How Table Ratings Are Assigned
You’ll typically receive a table rating if you have conditions like diabetes (especially if not well-controlled), a history of heart attack or stroke, cancer treatment within the last few years, significant weight issues, sleep apnea with complications, or multiple health conditions that compound risk.
The key word is “manageable.” Insurers want to see that your condition is stable and being treated. If you had a heart attack last month, you won’t get coverage yet. But if it was five years ago, your condition is stable, and you’re following treatment plans, you might qualify for a table rating.
Table Rating Scale
Table ratings typically range from Table A (or Table 1) through Table H (or Table 8). Each level adds a percentage to the standard rate:
| Table Rating | Additional Premium | Total Cost vs. Standard |
|---|---|---|
| Table A (Table 1) | +25% | 125% of standard rate |
| Table B (Table 2) | +50% | 150% of standard rate |
| Table C (Table 3) | +75% | 175% of standard rate |
| Table D (Table 4) | +100% | 200% of standard rate |
| Table E (Table 5) | +125% | 225% of standard rate |
| Table F (Table 6) | +150% | 250% of standard rate |
| Table G (Table 7) | +175% | 275% of standard rate |
| Table H (Table 8) | +200% | 300% of standard rate |
What Table Ratings Mean in Real Dollars
Percentages can be hard to visualize, so here’s what table ratings actually cost. Let’s say a healthy 45-year-old man qualifies for standard rates on a $500,000, 20-year term policy at $75 per month.
| Rating Class | Monthly Premium | Annual Premium |
|---|---|---|
| Standard | $75 | $900 |
| Table A | $94 | $1,125 |
| Table B | $113 | $1,350 |
| Table C | $131 | $1,575 |
| Table D | $150 | $1,800 |
| Table E | $169 | $2,025 |
| Table F | $188 | $2,250 |
Yes, the premiums are higher. But remember the alternative: without table ratings, people with these health conditions couldn’t get coverage at any price. A Table C rating costs more, but it still provides hundreds of thousands of dollars in protection for your family.
Complete Rating Comparison Chart
Here’s how all the rating classes compare for that same 45-year-old with a $500,000, 20-year term policy:
| Rating Class | Health Profile | Est. Monthly Premium |
|---|---|---|
| Preferred Plus | Excellent health, no issues | $55 |
| Preferred | Excellent health, minor factors | $65 |
| Standard Plus | Good health, some factors | $70 |
| Standard | Average health | $75 |
| Preferred Smoker | Excellent health but smokes | $165 |
| Standard Smoker | Average health, smokes | $185 |
| Table A | Managed health condition | $94 |
| Table C | Significant health issues | $131 |
| Table E | Multiple or serious conditions | $169 |
These are estimates and vary significantly by age, gender, policy type, and insurance company. But they show the relative relationships between rating classes.
Factors That Determine Your Rating
Insurers evaluate dozens of factors when assigning ratings. Understanding what matters most helps you know what to expect.
Medical History and Current Health
Your current health conditions matter most. Well-controlled conditions are viewed more favorably than unstable ones. If you’re following treatment plans, taking prescribed medications, and having regular checkups, it shows insurers you’re managing your health responsibly.
Recent health events carry more weight than old ones. A heart attack five years ago is very different from one six months ago. Most companies want to see at least 2-5 years of stability after major health events before offering coverage.
Family Medical History
If your parents or siblings had heart disease, cancer, or diabetes before age 60, it can affect your rating. Insurers view this as indicating higher genetic risk. The impact varies by how young your relatives were and how many family members were affected.
Height and Weight
Your build (BMI and overall proportion) affects your rating more than you might think. Being significantly overweight increases your risk for many health conditions, which insurers factor into your classification. Even without other health issues, weight alone can move you from preferred to standard or standard plus ratings.
Lifestyle Factors
Smoking is the biggest lifestyle factor. It can double or triple your premiums. But other factors matter too, including dangerous hobbies like skydiving or rock climbing, risky occupations, history of DUIs or reckless driving, and drug or alcohol abuse history.
Blood Work and Vital Signs
Your medical exam results are crucial. Insurers look at blood pressure, cholesterol levels (total, HDL, LDL), blood glucose and hemoglobin A1C, liver and kidney function, and presence of protein in urine.
If your numbers are borderline, getting them under better control before applying can sometimes improve your rating by one or two classes.
Can Your Rating Improve Over Time?
Yes. Ratings aren’t permanent, and there are several ways your classification can improve.
Rating Reconsideration
If your health improves significantly, you can request a rating reconsideration. Most companies allow this after 2-3 years, though some require waiting the full term. You’ll need to provide updated medical records showing sustained improvement.
Common scenarios for successful reconsideration include completing cancer treatment and remaining cancer-free for several years, achieving significant weight loss that you’ve maintained, getting diabetes or blood pressure under excellent control, or recovering well from heart surgery or other major procedures.
Applying for a New Policy
Sometimes it makes more sense to apply for a completely new policy if your health has improved dramatically. You can then cancel your old, higher-rated policy. This works especially well if you’ve quit smoking, lost significant weight, or have several years since a major health event.
When to Consider Reapplying
Think about reapplying if you’ve been tobacco-free for 12 months or more, lost 50+ pounds and kept it off for at least a year, had well-controlled diabetes or blood pressure for several years, or it’s been 5+ years since a heart attack, stroke, or cancer diagnosis.
The key is demonstrating sustained improvement, not just temporary change. Insurers want to see that your healthier status is stable and maintained over time.
Different Companies, Different Standards
Not all insurance companies rate applicants the same way. This is crucial to understand if you have health issues.
Some insurers specialize in certain conditions. One company might rate diabetics more favorably, while another is better for people with heart conditions. A condition that gets you a Table D rating at one company might only be Table B at another.
While underwriting standards vary, all life insurance is regulated by state insurance departments to protect consumers. This is why working with an independent agent who knows multiple companies’ underwriting guidelines is so valuable. They can shop your application to companies most likely to give you the best rating for your specific situation.
What Happens If You’re Declined?
Sometimes an insurer decides your health risk is too high and declines your application. This doesn’t mean you can’t get coverage anywhere. It just means that particular company won’t offer you a policy.
If you’re declined, other options include applying with a different insurer that specializes in high-risk life insurance options, waiting 6-12 months if your health is improving, considering guaranteed issue policies (no medical exam, but higher rates and lower coverage), or looking into group life insurance through your employer.
Table ratings exist precisely to help people who don’t fit standard categories. The fact that you received a table rating instead of a decline means the insurer believes they can cover you, just at higher rates.
Tips for Getting Your Best Possible Rating
While you can’t change your medical history, you can take steps to present yourself in the best light.
Before You Apply
Time your application strategically. If you’re on the border of a weight category, losing 10 pounds before applying could improve your rating. If you recently quit smoking, wait until you’ve been tobacco-free for 12 months. Get any chronic conditions under the best possible control before applying.
Gather your medical records ahead of time. This speeds up the process and ensures the insurer has complete, accurate information. Sometimes delays or missing information can work against you.
During the Application Process
Be completely honest on your application. Lies or omissions can void your policy later. But do emphasize positive factors, like regular exercise, medication compliance, and preventive care. If you had a health scare but have since made major improvements, make sure that context is clear.
Shop Multiple Companies
Get quotes from at least 3-5 insurers if you have health issues. Underwriting standards vary significantly. One company’s Table D might be another company’s Table B, which could save you thousands over the life of your policy.
Frequently Asked Questions
What’s the difference between a table rating and a flat extra premium?
Table ratings are percentage increases based on your health classification. Flat extras are fixed dollar amounts added to your premium, typically used for temporary risks like recent surgery or short-term health concerns. Flat extras usually drop off after a specified period, while table ratings remain unless you request reconsideration.
Will every insurance company give me the same rating?
No. Different insurers have different underwriting guidelines and risk tolerances. One company might specialize in diabetics and give you a better rating, while another focuses on heart conditions. This is why it’s important to shop around if you have health issues.
How long does a table rating last?
Table ratings typically remain for the life of your policy. However, you can request reconsideration after 2-5 years if your health has significantly improved. Some people also choose to apply for a new policy if their health improves, then cancel the older, higher-rated policy.
Can I get life insurance with no medical exam if I have health issues?
Yes, no-exam policies exist, but they typically have lower coverage amounts (often $25,000 to $500,000 maximum) and higher premiums than medically underwritten policies. Some people with health conditions actually get better rates by taking the exam and receiving a table rating than by choosing a no-exam option.
What health conditions typically result in table ratings?
Common conditions include diabetes (especially Type 2 with complications), heart attack or stroke history, cancer diagnosed within the last 5-10 years, significant obesity (BMI over 40), sleep apnea with complications or non-compliance, and multiple health issues that compound risk. The severity, how well-controlled the condition is, and how recent the diagnosis all factor into which table rating you receive.
Is a table rating permanent, or can it improve?
Table ratings can improve. You can request rating reconsideration after showing sustained health improvement over several years. Many people successfully move from table ratings to standard classes, or from higher table ratings to lower ones, after demonstrating long-term health improvements.
Do all insurance companies use the same table rating system?
The concept is the same, but terminology varies. Some companies use letters (Table A through H), others use numbers (Table 1 through 8). The percentage increases are generally standardized across the industry, but the exact criteria for assigning each rating can differ between insurers.
How much more will I pay with a table rating?
It depends on which table rating you receive. Table A adds about 25% to standard rates, while Table H can add 200% or more. For a policy that costs $100 per month at standard rates, you’d pay $125 with Table A, $150 with Table B, or $200 with Table D. The dollar impact varies based on your age, coverage amount, and policy type.
Should I wait to apply for life insurance if my health might improve?
This is a personal decision. Waiting can sometimes result in a better rating if you’re on the verge of significant improvement (like reaching 12 months tobacco-free). However, waiting also means being uninsured during that time. And if your health declines unexpectedly, you might end up with a worse rating or be unable to get coverage at all. For most people, getting coverage now, even with a table rating, is better than risking going without.
Can I have both a table rating and a smoker rating?
Yes, unfortunately. If you smoke and have health conditions, you can receive both a smoker classification and a table rating. This results in very high premiums. The best strategy is often to quit smoking first, wait 12 months, then apply for coverage to avoid the double penalty.
Key Takeaways
- Life insurance companies assign health ratings to determine your premiums, with preferred plus being the best and standard being average for most Americans.
- Table ratings (A through H) allow people with health conditions to get coverage at higher rates, typically adding 25% to 200% to standard premiums.
- Your rating depends on current health, medical history, family history, height and weight, lifestyle factors, and medical exam results.
- Ratings aren’t permanent and can improve after 2-5 years if you demonstrate sustained health improvements.
- Different insurance companies rate health conditions differently, making it essential to shop with multiple insurers if you have health issues.
- Even with a table rating, you can still get substantial coverage to protect your family, and it’s better than going without insurance altogether.
Ready to see what rates you qualify for? Even with health conditions, you have options. Our team specializes in finding the best possible coverage for people with all types of health ratings. We shop multiple insurers to find which companies will give you the most favorable rating for your specific situation. Use our quote tool to compare rates from top-rated companies.
