Understanding Life Insurance Health Ratings

How do they classify me?

What exactly do “Preferred” and “Standard” health ratings mean? 

In this article, we’ll break it down and give you some tips for getting the best rating you can.

Why Do Health Ratings Matter?

When you apply for life insurance, you will be assessed in terms of age, current health, and medical history. This evaluation is part of your application and the underwriter will rate you by putting you into a preset risk class that determines the premium you pay.

Insurance companies group people into categories of people who have similar characteristics to determine risk and price. The better your health class or rating, the lower your premium.

  • Better health = Less risk for the insurance company
  • Less risk = lower premiums (more $$ saved for you)

What Are Life Insurance Health Class Ratings?

An insurance company will use a variety of sources to obtain information about you and place you into a classification that determines your premium. This information may come from:

The job of the underwriter is to guess how long you will live based on your health, behavior, family history, driving history, location, finances, and more. If these factors suggest you will live a long time, you may get a more favorable rating. If you have health problems or you smoke, you will likely find yourself in a lower risk class with higher premiums.

Most life insurance companies have anywhere from 12 to 15 health class ratings. The first four classes are considered health ratings while the classes below those are table ratings.

Life Insurance Health Classifications

Every life insurance company has two sets of ratings: one for non-smokers and another for smokers or tobacco users.

If you have used cigarettes, chewing tobacco, snuff, nicotine gum, nicotine patches, or pipes within the last 12 months, you may fall into a Tobacco and Nicotine user health rating. While they go by different names and have slightly different requirements depending on the company, the standards for each classification are similar.

warningMarijuana users may also be classified as tobacco users depending on which company you apply with. We have compiled the most extensive resource available on obtaining affordable rates as a marijuana user.

Preferred Plus

Sometimes called Preferred Select, Preferred Elite, or Super Preferred, this is the best health category. If you fall into this category, you will get the lowest premiums the life insurance provider offers. Only 5% of people qualify for this classification.

To qualify for this health rating, you should be in excellent health, within recommended weight guidelines for your height, with no health risk factors like a family history of heart disease. Most people in this category take no medication and have no family history of disease.


To qualify for this health rating, you should be in excellent health. You may have a couple of minor health problems like a slightly high cholesterol level that is well controlled with medication. You may have a family history of disease or participate in limited high-risk hobbies or have a dangerous occupation.

Expect rates 20% to 30% higher than 1 level above – Preferred Plus

Standard Plus

Also called Select, this health class is associated with very good health yet some factors keep you from qualifying for the Preferred class. For example, you may be overweight or have high blood pressure, but you have no significant family history of disease.

Expect rates 25% to 45% higher than 1 level above – Preferred 


Most people who qualify for life insurance fall into the Standard health class. To qualify for this rating, you should be in average health with a typical life expectancy. You may have minor health problems like being overweight or a family history of premature death.

Expect rates 15% to 25% higher than 1 level above – Standard Plus

Preferred Tobacco

Someone who falls into the Preferred Smoker category is someone who would otherwise be in the higher Preferred category but smokes or uses tobacco. Even occasionally smoking can land you in this category.

Standard Tobacco

A smoker who is in normal health will likely fall into this category. Someone in the Standard Tobacco health class will pay higher premiums than someone in the Standard health class.

Expect rates 25% to 40% higher than 1 level above – Preferred Tobacco

Life Insurance Table Ratings

If your health is below average, you will likely not fall into one of the health class ratings above.

Below these health classifications are what are known as “table ratings”, all of which are considered substandard ratings. Most insurance companies have 8-10 table ratings that have a letter or number. For example, if you fall under the rating just below Standard, you will be considered “table rated” and you may have a Table A or Table 1 rating.

To be clear: Table A and Table 1 are the same. Just depends on which system a particular insurance company uses.

Table ratings allow insurance companies to provide coverage at a higher premium. You can still get coverage but have to pay extra for that increased risk.

Every table rating increase usually comes with a 25% premium increase over Standard. As an example, if you have a Table 1 rating, you will likely pay the Standard rate plus an extra 25%. If you have a Table 7 rating, you may pay the Standard rate plus 175%.

  • Table 1: Standard + 25%
  • Table 2:  Standard + 50%
  • Table 3:  Standard + 75%
  • Table 4:  Standard + 100%
  • Table 5:  Standard + 125%
  • Table 6:  Standard + 150%
  • Table 7:  Standard + 175%
  • Table 8:  Standard + 200%
  • Table 9:  Standard + 225%
  • Table 10:  Standard + 250%

Table ratings are usually given to people who have health conditions. These table ratings are assigned based on the perceived risk of a health condition or impairment. and some conditions are treated more favorably than others. Some insurance companies use table ratings to create a niche for applicants with cancer, diabetes, or chronic health conditions that would otherwise keep them from being approved.

Important: Each insurance company will have its own guidelines on certain risks. Just because you are Table C at one company does NOT mean you will automatically be Table C at other companies.

The secret to getting the lowest rates is to apply at the company that views your specific situation most favorably. Your trusted independent life insurance professional can steer you in the right direction. Contact our office if you need help or have any questions with this.

What Effects Life Insurance Health Class Ratings?

While other factors may be considered such as your driving record or a background check, these 3 factors affect your rating more than anything else:

  • Current health and health history
  • Family history of disease
  • Hazardous activities


In most cases, you will need to take a medical exam after applying for life insurance to measure your vital signs and check for high blood pressure, high cholesterol, and weight. Along with your current health, your medical history will be taken into consideration.

In general, your classification will not be affected by any health incidents that took place more than 10 years ago unless they were major, such as a stroke, heart attack, or cancer. Along with obesity, the top health conditions that can affect your life insurance health class rating are:

  • High blood pressure
  • High cholesterol
  • Depression
  • Asthma
  • Type 2 diabetes
  • Sleep apnea
  • Cancer (with the exception of skin cancer)
  • Heart disease
  • Coronary artery disease
  • Mitral valve prolapse – improper closure of the valve between the upper and lower left chambers of the heart

Smoking or tobacco use will also be taken into consideration. If your blood work turns up nicotine, you will automatically be ineligible for the best ratings and you will fall into a separate health class rating system for smokers and tobacco users.

Family History

You can also be downgraded for a family history of disease, in particular, cancer or heart disease. Even if you are in perfect health and do not take medication, you can be downgraded if a parent or sibling was diagnosed or died from cancer or heart disease before the age of 60.


Insurance companies consider non-health related hazards to classify you. You can be penalized for hazardous hobbies like skydiving, a high-risk occupation like being firefighter or construction worker, or potentially dangerous international travel.

How You Are Rated by Life Insurance Companies

Life insurance carriers have two broad approaches to ratings.

Knockout Approach – Strict and Objective

The first is a knockout approach in which failing to meet certain thresholds will automatically knock you down a health rating. For example, you may need blood pressure of 140/90 or better without medication to get a Preferred Plus rating. If your blood pressure is higher or you need medication, you will be knocked down to at least the Preferred rating even if your health and family history is otherwise perfect.

If the carrier uses this approach, common thresholds and guidelines are usually close to the following:

Preferred Plus

  • Blood pressure of 140/90 or better without medication
  • 230 cholesterol level without medication and an HDL ratio below 5.0
  • No parents or siblings diagnosed with cancer or heart disease before age 60
  • No tobacco use in the last 3-5 years
  • No more than 2 moving violations in the last 3 years and no DUI/Reckless Driving charges within the last 5 years


  • Blood pressure of 140/90 with medication or 150/90 without medication
  • 250 cholesterol level without medication and HDL ratio below 7.0
  • No parents or siblings deceased from cancer or heart disease before age 60
  • No more than 2 moving violations within the last 2 years and no DUI/Reckless Driving charges within the last 5 years
  • Health conditions usually accepted in the Preferred class include basal cell cancer, hepatitis A or B, osteoarthritis, and asthma that does not require steroid medication.


  • Blood pressure of 150/90 with medication or 155/95 with medication (age 41-60) or 160/95 (age 61+)
  • 300 cholesterol level with or without medication and an HDL ratio below 8.0
  • No more than 2 moving violations in the last year and no DUI/Reckless Driving charges in the last 2 years
  • Health conditions commonly accepted in the Standard class include depression, epilepsy, stroke, ulcerative colitis, and asthma controlled with steroid medication.

Debit/Credit – More Flexible and Subjective

A growing number of insurance companies are now moving away from this approach to a debit/credit system. With this approach, you will get a specific number of points for each health reading. Your total points will decide which health class you fall into. In this case, even if your cholesterol or blood pressure is a bit high, you can still get a Preferred Plus or Preferred rating if your other readings are very good.

More than half of insurance carriers also allow underwriters to use stretch criteria to push you into a better class if your numbers are very close. Some carriers will even give you a one-time exception to a rule in some situations.

Some insurance companies will treat risk factors outside of your health differently than others. Rather than putting you in a different health class rating or table rating, you may be required to pay a flat extra fee.

moneyThis fee is an extra premium amount per $1,000 of coverage.

For example: let’s say you get a 20-year term life insurance policy with $500,000 in coverage with a $600 annual premium.

If you engage in a high-risk hobby or have a dangerous occupation, you may need to pay a $2 flat-extra per $1,000 in coverage which adds another $1,000 to your premium. Your total premium would then become $1,600 per year.

Improving Your Life Insurance Health Rating

The best way to improve your risk class is to address red-flag problems like your body mass index, cholesterol levels, and blood pressure. Bringing these numbers within a healthy range through exercise, diet, and/or medication may bump you into a higher risk class.

If you were rated as a smoker, you can quit smoking, wait 12 months, and reapply as a non-smoker to potentially get a better rate on life insurance.

If you are overweight, losing weight before applying for life insurance can get you into a better health class rating.

Keep in mind insurance companies realize that many people attempt to lose weight quickly before applying. This means you will usually only be given credit for 50% of the weight you have lost within the last 12 months. That means that if you have lost 40 pounds in the last year and now weigh 190 pounds, you will be rated as if you weigh 210.

Bottom Line:

Do what you can to improve your health before the exam but don’t delay getting the coverage to protect your loved ones. If your health significantly improves after getting a policy, you can request reconsideration for a better health class and therefore a lower premium. If they turn you down, you can shop yourself to a different company that will recognize the newer, healthier you.

Getting Approved for Life Insurance

It’s important to understand that every insurance carrier assesses risk differently. While one company may turn you down if you have had a heart attack in the past, another may accept you with a table rating. Some life insurance providers are more aggressive in determining risk while others will put you in a better health class.

There are some conditions that make most of the top insurance carriers very concerned. This means that you will have trouble getting life insurance even with a table rating. These conditions include:

  • Treatment for alcohol within the last 2 years
  • Alzheimer’s disease or dementia
  • Present cancer treated with radiation or chemotherapy
  • Illegal drug use within the last 3 years
  • Cirrhosis
  • Heart attack within the last 6 months
  • Heart bypass surgery within the last 3 months
  • Several DUI/DWI charges within the last 5 years
  • HIV positive
  • Present lung disease
  • Current kidney failure or kidney disease
  • Mental disorder that required hospitalization within the last year
  • Stroke within the last year
  • Suicide attempt within the last year
  • Current pregnancy with complications

If you have any of the above, don’t give up hope yet. Contact our office and we’ll give you honest advice about options based on the most current underwriting guidelines in the industry.

Understanding life insurance health class ratings and the factors that affect your rate can help you shop for life insurance.

We are one of the rare independent brokers that ONLY sells life insurance so we’ve gotten pretty darn good at it. If you are ready to get started, please fill out a quote request or always feel free to contact us with any questions.

We are here to help and will never pressure you in any way (and our service is totally free).

Check also more articles:
  1. 10 Best Movies about Life Insurance
  2. 10 Facts and Statistics about Life Insurance
  3. 10 Life Insurance Myths Explained and Debunked


  • Ty Stewart

    Ty Stewart is a founder and contributor of SimpleLifeInsure.com. He started researching and studying about life insurance when he got his first policy for his own family. He has been featured as a life insurance expert speaker at agent conventions and in top publications. As an independent licensed life insurance agent he has helped clients nationwide to secure affordable coverage while making the process simple.

  • Bennett Bier

    I’m Bennett Bier, owner, author and fact checker of Simple Life Insure. I believe working with a small independent broker offers consumers more personal attention and superior customer service. As an independent agent licensed in all 50 states and the District of Columbia I have access to many of the top A+ rated life insurance carriers. This lets me locate a plan that you will qualify for while saving you money at the same time. Over the years I have mastered the art of underwriting, getting approvals even for my highest risk clients. I’m also likely the person that will answer the phone when you call.