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Your Complete Guide to Life Insurance Classifications

Table of Contents

Life insurance policies are crafted around the people who buy them. So, when you purchase a life insurance policy, it will be unique to you and your circumstances. 

For example, you and your neighbor could purchase the same coverage amount from the same company. However, differences in your age, health, and other lifestyle factors would lead to you paying different premiums.

Think of it like buying car insurance. The car insurance company doesn’t determine your rate solely on the coverage amounts you select. They also base your rate on the type of car, your age, your driving history, your marital status, your credit, and even your location.

The company uses these things to determine your risk of making claims against your policy. That’s why you’ll receive a lower rate if your car has certain safety features, but you’ll receive a higher rate for a recent accident. 

Life insurance companies also need to determine the risk of having to pay a claim to your beneficiary due to unexpected death. Like the car insurance company, the life insurance company will assign you a rate based on that risk. 

Since a life insurance policy is paid out if you die, your risk of making a claim is tied to your health, lifestyle, and overall risk of early death.  Your risk level will put you into a life insurance rate classification. 

Life insurance companies use information you provide on your application, medical exam, and other underwriting methods to assign you a rate classification. Keep reading for a closer look at rate classifications.

Life Insurance Rate Classifications

Your life insurance policy will payout in the event of your death. If you die before you’ve made many payments, the life insurance company will take a loss. However, if you outlive your policy such as a term life insurance policy, and never use it, the company will make a profit.

For example, let’s say you took out a million-dollar policy over a 20-year term, and you outlived your policy. If you paid a 40 dollar premium each month, you’d end up paying $9,600 over the life of your policy.

However, if you had that same policy but died after six months, you’d have only paid $240, but the life insurance company would still need to make that million-dollar payout. 

That’s where rate classifications come in. Your rate classification is the risk the company is taking by extending a policy to you. You’ll pay much lower rates if the insurance company thinks it’s likely you’ll outlive your policy and much higher rates if there is a significant risk that you won’t. 

So what are the life insurance rate classifications? There are five primary classifications you might see:

Life Insurance Rate Classification Table
Preferred PlusFor people in excellent health
PreferredFor people in overall good health
Standard PlusFor people in above average health
StandardFor people in average health
SubstandardFor people in below average health

You might see slightly different names (risk classification, health classification, rate classification, etc.) depending on the company, but the classifications’ basic criteria will be the same.

Knowing what the standards for each classification are can help you make an educated guess where you might fall. You can check out the details for each classification below:

Preferred Plus

Preferred Plus Risk Classification - Example
Cholesterol with or without treament230
Chol / HDL5.0 (Ages 70 & Younger)
5.5 (Ages 71 & Older)
Blood pressure135/85 (Ages 70 & Younger)
145/85 (Ages 71 & Older)
Family History I: (Includes coronary artery disease and the following cancers: prostate, lung and melanoma)No family deaths before age 65 of either parent or sibling. Disregard if insured is age 65 or older.
Family History II: (Includes the following cancers: breast, ovarian and colon) Family history of occurrence or death from these cancers may require evidence of routine surveillance screening and may result in additional rating.
Personal Health HistoryNo heart or vascular disease, diabetes, or cancer (except some skin cancers).
Tobacco UsageNone in the past 5 years.

Preferred plus is the best insurance classification as it offers the lowest rates. This classification is for people who are in exceptional health. You’ll need to be a nonsmoker for at least five years and have excellent health readings on your blood pressure, cholesterol, and other tests.

You’ll also need a (Body Mass Index) BMI that’s within a healthy range and to be no more than 30 points from your ideal body weight. 

Family history matters, too. You’ll need to have no family history of a health-related death due to serious medical conditions before age 60 to qualify for this classification. As you can see, these are strict standards.

Only about five to ten percent of people qualify for preferred plus. Depending on the company, you might also see preferred plus referred to by other names like preferred elite, preferred select, extra preferred, or super preferred.


Preferred Risk Classification - Example
Cholesterol with or without treament260
Chol / HDL5.5 (Ages 70 & Younger)
6.0 (Ages 71 & Older)
Blood pressure145/85 (Ages 70 & Younger)
150/90 (Ages 71 & Older)
Family History I: (Includes coronary artery disease and the following cancers: prostate, lung and melanoma)No family deaths before age 60 of either parent. Disregard if insured is age 60 or older.
Family History II: (Includes the following cancers: breast, ovarian and colon) Family history of occurrence or death from these cancers may require evidence of routine surveillance screening and may result in additional rating.
Personal Health HistoryNo heart or vascular disease, diabetes, or cancer (except some skin cancers).
Tobacco UsageNone in the past 2 years.

Preferred is the second-highest rate classification. Rates are still very affordable and generally close to that of the preferred plus classification. To qualify, you’ll still need to be in relatively excellent health, but the standards are a bit less strict than in preferred plus.

For example, you might be assigned this classification if you have a health condition that is well managed with medication. 

There’s also a wider range of test values that are acceptable in this category, including cholesterol and blood pressure. You’ll generally still need to be at a healthy weight and be a nonsmoker for at least two years.

In general, if you’re in great health but don’t quite meet the guidelines for preferred plus, you’re likely to be assigned the preferred classification.

Standard Plus

Standard Plus Risk Classification - Example
Cholesterol with or without treament300
Chol / HDL6.2 (Ages 70 & Younger)
6.7 (Ages 71 & Older)
Blood pressure148/88 (Ages 70 & Younger)
152/88 (Ages 71 & Older)
Family History I: (Includes coronary artery disease and the following cancers: prostate, lung and melanoma)No family deaths before age 60 of either parent. Disregard if insured is age 60 or older.
Family History II: (Includes the following cancers: breast, ovarian and colon) Family history of occurrence or death from these cancers may require evidence of routine surveillance screening and may result in additional rating.
Personal Health HistoryNo heart or vascular disease, diabetes, or cancer (except some skin cancers).
Tobacco UsageNone in the past 2 years.

Standard plus is a classification for people in above-average health but have a few borderline high-risk health concerns. For example, if your BMI isn’t ideal or your blood pressure or cholesterol levels are a little high, you might be assigned this classification. You might also receive this classification if you have a well-controlled chronic condition, like type II diabetes or sleep apnea. 

However, it’s not just your current health that a company will look at. You could be in exceptional health and receive this classification if you have a family history of death related to medical issues before age 60.

NOTE: A select few life insurance companies will consider individuals who currently use smokeless tobacco, smoke a pipe or an occasional cigar at the standard plus risk classification avoiding tobacco rates altogether. 


Standard Risk Classification - Example
Cholesterol with or without treament300
Chol / HDL8.0
Blood pressure156/94
Family History I: (Includes coronary artery disease and the following cancers: prostate, lung and melanoma)N/A
Family History II: (Includes the following cancers: breast, ovarian and colon) N/A
Personal Health HistoryNo ratable inpairments.
Tobacco UsageNone in the past 2 years.

This is the most common, or the “standard” life insurance classification.  People who are in average health will fall into this classification?

What’s average health?

Generally, it means taking a few prescriptions to control a health condition, being outside a healthy BMI but not obese or severely underweight, or having elevated blood pressure.

You might also fall into this classification if you are an immediate family member who died young of a health condition. The rates in the standard classification are the base rates for policies. This means that they’ll be higher than what you’ll see in the preferred plus, preferred, or standard plus, but are much lower than any substandard rates.

Substandard or Table Rated Classifications

The substandard rate classification is actually a broad category. Unlike the other risk classifications, there are several levels and rates that apply within the substandard classification.

The levels are part of what’s called a table rating system. Life insurance rates are equivalent to the standard rate class cost but include an additional 25% increase in cost to each level of the table system. The general structure is as followed shown in the table below:

Substandard / Table Rating - Rate Increase Table
Table Level A or 1The standard rate plus 25 percent
Table Level B or 2The standard rate plus 50 percent
Table Level C or 3The standard rate plus 75 percent
Table Level D or 4The standard rate plus 100 percent
Table Level E or 5The standard rate plus 125 percent
Table Level F or 6The standard rate plus 150 percent
Table Level G or 7The standard rate plus 175 percent
Table Level H or 8The standard rate plus 200 percent
Table Level I or 9The standard rate plus 225 percent
Table Level J or 10The standard rate plus 250 percent

Who would qualify for a substandard rating?

A person who qualifies for a substandard rating would likely have either a high-risk medical history or a high-risk lifestyle to where the insurance company could not approve coverage at either the preferred or standard risk classes.

A substandard rating would not be the ideal risk classification for anyone because of the extra premium it requires to have coverage.

As we mentioned, insurance classifications are assigned based on the overall risk you are to the insurance company in having to pay out a sudden claim. The less of a risk you are the more affordable your coverage will cost. The higher the risk, the higher the cost.

Rather than declining coverage to someone that may be classified as a high risk, insurance companies can potentially offset the risk by approving some applicants with a substandard classification and charging a higher price for their coverage.

In return, the applicant is able to get the valuable life insurance coverage they need to protect their family.

What are some examples that would cause a substandard rating?

The answer to this question is going to depend on the insurance company greatly. Most of the time, substandard ratings tend to be due to medical reasons or participating in risky or dangerous hobbies.

Because every company uses its own set of underwriting guidelines, it’s hard to name for sure what does and does not fall within a substandard rating until an application has been fully underwritten.

We can provide a few examples of high-risk medical conditions that we often see approved as a substandard rating based on our experiences with applicants we have worked within the past.

  • COPD
  • Chronic Pain
  • Congestive Heart Failure
  • Coronary Artery Disease
  • Diabetes Type I
  • Diabetes Type II (possible to get standard classification)
  • Emphysema
  • Multiple Sclerosis

If you have one of the above mentioned medical conditions or even have another type of high-risk health condition not mentioned here, you should not be discouraged from applying for life insurance coverage.

The best thing you can do is work with an experienced agent or brokerage agency that can shop your medical condition with multiple insurance providers to see who will give you the best health classification. There a plenty of medical conditions that qualify for the preferred and standard health risk classifications.

Life Insurance Classifications for Smokers

Smokers applying for life insurance will have their own set of insurance classifications. For example, you might see classifications like “preferred smoker” or “standard smoker.” Other common terms include “preferred tobacco” or “standard tobacco.” 

A preferred smoker rate is for smokers in otherwise great health, while the standard smoker classification is for smokers in average health.  Regardless of your smoker classification, you’ll almost always pay more for your policy, no matter your health status.

Figuring Out Your Life Insurance Classification for rates

Your final risk classification will be determined by the insurance company you choose to apply with. You won’t know where you fall until the company has fully underwritten your application and has presented a decision for coverage. That doesn’t mean you can’t make a pretty good guess.

During the underwriting process, life insurance companies are looking for many of the same things your doctor does. So, for example, if you’ve been told you have high cholesterol in the past, and you haven’t taken the needs to correct it, you can safely bet you won’t receive the preferred plus classification.

A better choice would be preferred or possibly standard if it’s really elevated.

But how do you find out what potential rates could be at a specific risk classification without going through the entire application process?

Many companies, such as No Medical Exam Quotes, can offer their customers a no-obligation online quote tool to view potential rates. Online quote tools are connected to each insurance provider’s book of rates and updated anytime there is ever a change. They are extremely accurate.

The online quote tool allows you to instantly choose from the different insurance health classifications to view the potential rates you might get without completing the application process until you’re ready to apply.

Remember, a quote is just a quote until you have gone through underwriting and have officially been approved for coverage by the insurance company. However, an online quote tool can give you a good idea of what rates could be for a specific health classification you may qualify for.

Factors that make up your life insurance classification

How are Insurance Classifications Determined?

Each insurance company has standards they’ll use to evaluate your application and the results of your medical exam. This process is called underwriting. During underwriting, the company will look at your exam results to determine your: 

  • BMI
  • Blood Pressure
  • Cholesterol Levels
  • Lipid Levels
  • Blood Sugar Levels
  • Liver Function
  • Kidney Function

Additionally, your results can show the presence of or warning signs for various diseases. This includes: 

  • HIV 
  • Disorders of your immune system
  • Diabetes
  • Hepatitis
  • Prostate cancer 
  • Other cancers

Your results will then be used to assign you to one of the classifications. For example, if you show no signs of any disease, have a healthy liver and kidney function, and get exceptional reads on your BMI, blood pressure, cholesterol, lipids, blood sugar, you might receive the preferred plus classification.

The Role of your Family Health History

Your application will ask you questions about your family health history. You’ll need to let the insurance company know if anyone in your family has ever had:

  • Cancer
  • Diabetes
  • Kidney Disease
  • Heart Disease

You’ll also need to disclose the severity, age of your family member when they were diagnosed and whether or not the family member passed away from the medical condition. The information provided will play a big role in your health classification and the final rate. 

It is important to note that family health history only applies to your immediate family members (parents and siblings). For example, if you have an aunt who passed away from cancer before they were 60, it would not affect your health classification.

If you have had an immediate family member pass before the age of 60 due to specific cancers or heart-related issues, the risk classification will often be a standard risk class at best. 

It should also be noted that gender-specific cancers such as prostate or breast cancer will not have a negative effect on the health classification of an insured of the opposite gender who would be applying for coverage.

Looking Beyond Health

While your medical exam results, health history, and family medical history are key factors in determining your insurance classification, they’re not the only factors.

Remember, insurance companies are trying to assess how likely it is they’ll need to ever pay out a claim on your policy. So your health is a big part of the picture, but it’s not the full picture.

Companies will also look at factors like your driving record, your criminal history, your lifestyle, and more when assigning you a class.

Any Alcohol or Drug Use

Your application will ask how many drinks you have a week. If your drinking is within the recommended standards, you likely won’t see an increase in rates.

According to the Centers for Disease Control and Prevention (CDC), that means two or fewer drinks a day for men and one or fewer drinks a day for women. However, you will see an increase in rates if you drink heavily.

Companies will also look at your use of both legal and illegal drugs. How much it affects your rate depends on the company. For example, cannabis is now legal in many states, but some insurance companies might still increase your rates if you use marijuana on a regular basis.

This is true even if your cannabis is prescribed for medical reasons. Other companies will increase your rates if you smoke cannabis, but not if you take it in other forms.

Illegal drugs are considered high-risk behavior and will always raise your rates. You’ll be asked about your use of any illegal substances on your application. It’s important to answer honestly because you’ll also be drug tested during your medical exam.

Your Driving Record

Your driving record isn’t just important to car insurance companies. Life insurance companies will also look at your driving record.

A history of any reckless driving, including accidents and tickets, can raise your rates.

A history of driving under the influence of drugs or alcohol will also raise your rates, and recent driving under the influence (DUI) charges could result in a denial of your application.

Your Criminal Record

The life insurance company will also look at any criminal record you have.  Your rates and chances of being approved probably won’t be affected if you have had a misdemeanor or two in the past.

However, a felony or prison time can.  In fact, you might not be able to get coverage at all if you’ve had recent serious legal trouble. Most insurance companies will not qualify an applicant for life insurance coverage with a felony that has occurred within the past five years.

If you can secure coverage, you’ll like to receive standard or substandard rates, even if you’re in great health. The effects of a criminal charge will lessen with time. That means you’ll like to receive much better rates if it’s been several years since your felony charge and you are currently not on parole or serving probation.

Your Lifestyle

Your lifestyle includes your job and any hobbies you have. Some jobs and hobbies increase your risk of dying earlier. This makes you a higher risk to insure. High-risk hobbies include things like:

  • Sky diving
  • Scuba diving
  • Base jumping
  • Mountain climbing
  • Racing

High-risk jobs include things like:

  • Logging
  • Mining
  • Roofing
  • Construction work
  • Piloting aircraft or boats

Your job or hobby won’t affect your classification. Instead, you’ll pay what’s called a flat extra. A flat extra is a fee you pay on top of the rate you qualify for.

The amount of flat extra depends on the company and the job or hobby, but the increase often adds up to several thousand dollars in additional cost each year.

Your Age

Younger applicants tend to receive much lower rates than older applications.

As a rule, you can expect to pay more as you age, especially once you get close to or past retirement age. This is true even if you’re in great health.

That’s why it’s a good idea to apply for coverage while you’re young and it’s much easier to secure a low rate for a high benefit amount.

What happens in a life insurance medical exam?

A medical exam is a standard part of the underwriting process for most life insurance policies. Companies use the medical exam to verify the information you put on your application and get a complete picture of your health

The medical exam will be paid for by the life insurance company. You’ll be able to schedule the exam at a time that’s convenient for you. Most companies will even send someone to your home or office to complete the exam.

Life insurance medical examinations are performed by trained professionals like nurses or medical assistants. 

The exam will take about half an hour. The first thing you’ll do is show your ID and sign paperwork that allows the medical exam company to release your results to the insurance company. Then, you’ll answer questions about your health and medical history.

After your paperwork and medical history are complete, the examiner will complete the rest of the exam. Generally, this includes:

  • Measuring your height
  • Taking your weight
  • Measuring your blood pressure and pulse
  • Collecting a saliva sample
  • Drawing blood work
  • Collecting a urine sample

You might be asked to take further tests in some cases, like an echocardiogram or cognition test. Companies might request these tests if you’re applying for a high benefit amount, you’re more than 60 years old, or both. The company will let you know in advance if you need to take these additional tests.

Preparing for a Life Insurance Exam

You can’t change your medical history or your health conditions before a life insurance exam. However, you can take steps to make your exam results better. 

Quit smoking – It can make a big difference in your rates. A smoker can easily pay 6-8x more than the cost of non-smokers insurance rates. While you will need to be at least one-year tobacco-free to qualify for non-smoker rates, quitting now can improve your blood pressure and overall health, leading to a better tobacco classification. After one year of being tobacco-free, most companies will allow for a classification adjustment on your policy to no-tobacco health classification to include adjusted rates.

Quit drinking alcoholAvoiding alcohol before your exam can also make a positive impact. Alcohol can dehydrate you and impact your reads. Plus, any alcohol you’ve had in the past few days will show up in your system, which can make you look like a high-risk drinker to underwriters

Reduce caffeineYour daily cup of coffee can dehydrate you and raise your pulse and blood pressure. So if you’re able to go a day or two without caffeine, you might get better results.

Eat a healthy balanced diet – The foods you eat in the days before your exam can impact your blood sugar and blood pressure life. It’s a good idea to focus on whole grains, greens, and healthy fats, like nuts or avocados.   

You should also be aware of anything that could cause a false positive for drug use. Many people have heard that poppy seeds are a common culprit, but they’re not the only one. Other things that can cause false positives include:

  • Cold and flu medicine
  • Ibuprofen and other nonsteroidal anti-inflammatory drugs
  • Tonic water
  • Antibiotics
  • Some HIV medications

You can avoid some of these things on your own. However, you should never stop taking anything that’s prescribed to you, like an antibiotic, without talking to your doctor.

Instead, you can let your medical examiner know that you’re taking any antibiotics or HIV medications. They can let the lab know and make a note of it for the insurance company. 

It’s also a good idea to take things easy in the days before your medical exam. Get plenty of rest, drink lots of water, and try to reduce your stress level. Another tip? Avoid the gym on exam day. That might seem counterintuitive, but a workout can raise your pulse, blood pressure, and even cholesterol.

Your rate will be HIGHER if:Your rate will be LOWER if:
You have one of more health concernsYou're in great health
You take one or more medicationsYou don't take an medications
You have a family history of health concernsYou don't have a family history any medical concerns
You're above or below a healthy BMIYou're at a healthy BMI
Your medical exam results indicate health concernsYour medical exam results are within the healthy range
You're a smokerYou don't smoke

Can a Medical Exam Change my Final Price?

Yes. When you first apply for life insurance, you’ll get a quoted price. That price is dependent on the results of your medical exam. The initial quote could go up, go down, or stay the same price.

If you had a general idea of your overall health before applying and were truthful on your application, any difference should be minimal.

However, if you stretched the truth on your application or the exam discovered something you weren’t aware of, your rate classification could change dramatically. 

If your price goes up, it’s up to you whether you want to accept the higher rate or not. You can choose not to take the policy and apply with a different company or postpone coverage and try again at a later time.

Applying again at a later time can be a good idea if your rate went up due to an exam read, you can improve. The company will provide you with your exam results and show you what range you fall in.

You can use this information to make changes. For example, if your blood pressure was slightly elevated, you can take steps to lower it and reapply in a few months. Similarly, if your BMI was outside the acceptable range for a higher rate classification, you could apply again after losing weight.

You can’t predict everything a medical exam will find. However, you can try to be as accurate on your application as possible. The closer the information you provide is to your exam results, the closer your exam will be to your final price.

NOTE: If your application for coverage is not approved as applied, consider accepting coverage. After having the policy for one year, most companies will allow you to re-test if you believe your health has improved. This option allows you to have the life insurance coverage you need rather than going without, and it locks in your age rather than waiting a whole year to re-apply.

Life insurance without a medical exam

You don’t always need a medical exam to get coverage. Several companies now offer policies without an exam. A no exam policy can be a great option if it’s been a while since your last checkup and you are unsure what the lab result may turn up. It is also helpful if you’re just not comfortable taking a medical exam.

There are a few options for coverage without an exam:

Guaranteed coverage policies Guaranteed coverage policies are exactly what the name implies. Anyone between the ages of 50-80 can get coverage with these policies, no matter their health history. These policies are generally much more expensive but can be a good option for people who might not otherwise qualify. Coverage is limited to a maximum of $25,000 with a two-year wait before it will payout.

Accelerated underwriting policies An accelerated underwriting policy will give you a decision in minutes. These policies might limit the amount of coverage typically to $1,000,000 and only offered to customers in a set age range. If you meet the underwriting guidelines, you will not be required to take an exam. However, if you don’t meet the underwriting guidelines for accelerated approval, you could be asked to take a medical exam to proceed with coverage.

Simplified issueA simplified issue policy is offered with absolutely no chance of taking a medical exam. However, the underwriters will still review the background checks and health information you answer on your application to determine approval. But, no exam will be required. Preferred rates are a possibility but often because there is no chance for an exam, many plans are limited to the standard health class.

What Happens if You Get Declined?

Sometimes life insurance companies are unable to offer you a policy. You can be denied coverage if your exam results or medical history don’t meet the underwriting standards.

When this happens, you have a few choices. Your first step should be to discuss with your agent the reason for the decline. In almost all cases, the insurance company will notify the insured directly of the reason for the decline.

Second, you are entitled to receive a copy of your medical exam results so be sure you request a copy. You can look over your results and take them to your doctor if you feel they don’t reflect your actual health. If your doctor agrees, they might help you get the insurance company to reconsider especially if they can write a letter on your behalf. 

If your medical exam results are accurate, going to your doctor is still a good first step. They can help you with any concerns conditions the exam found. They might be able to recommend lifestyle changes or prescribe medications that can improve your health. You can apply for a policy again once your health has improved. 

If you’re still having trouble getting coverage, you still have options. You can look into guaranteed coverage policies or policies from companies that specialize in offering policies to high-risk applicants. An insurance agent or broker can help you find and secure a plan if you’re having trouble.

Final Word

Life insurance companies assess the risk of insuring you when you apply for coverage. Your life insurance rate classification is a measure of that risk and will determine how much you’ll pay for coverage.

The lower risk you are, the less you’ll pay for coverage. However, that doesn’t mean you can’t get coverage if you have health concerns. It just means your rate will be a little higher. 

If you’re ready to get a quote, we can help.

No Medical Exam Quotes can help you get the policy you need, with or without a medical exam. We will help determine your health risk classification so that your quote is accurate the first time and that you are applying with the correct company to offer you the best rates for your life insurance coverage.

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Picture of Jeffrey Manola - Life Insurance Expert
Jeffrey Manola - Life Insurance Expert

Jeffrey Manola is the founder of No Medical Exam Quotes, an online insurance agency that strongly focuses on helping people shop for the perfect life insurance policy. He is a licensed life insurance expert and content creator for the website.

Before becoming a life insurance agent, he served in the United States Marine Corps, transitioning from serving his country to helping families find affordable life insurance coverage beginning in 2009. Since starting a career as a licensed life insurance agent, Jeffrey has helped thousands of families with their life insurance needs.

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