Life insurance health classes decide how much you pay for coverage. After you apply, an underwriter reviews your medical exam, prescription history, and lifestyle. They then place you in a rating class. Two people buying the same $500,000 term policy can pay very different premiums.
In most cases, the gap comes down to their assigned class. Understanding life insurance health classes helps you set realistic expectations before you apply. It also helps you spot errors and challenge a poor rating. For families counting on that policy, a one-class difference can add up to thousands of dollars over a 20- or 30-year term.
What Life Insurance Health Classes Mean for Your Premium
Most carriers use four core non-tobacco classes. These are Preferred Plus, Preferred, Standard Plus, and Standard. Names vary by company. For example, some carriers say “Super Preferred,” “Preferred Best,” or “Elite” instead of Preferred Plus. However, the structure is largely the same across the industry.
Preferred Plus is the best rate available. It is reserved for applicants in excellent health with clean family histories. Standard is the baseline that the insurer’s pricing is built on. Below Standard sit substandard, or “table-rated,” classes. These apply to people with significant health conditions. Tobacco users are rated separately, typically in Preferred Tobacco and Standard Tobacco classes.
Life insurance health classes are not one-size-fits-all. Each carrier writes its own underwriting guidelines. As a result, the same applicant might get Preferred from one company and Standard from another. The NAIC’s life insurance consumer guide encourages shoppers to compare several companies for this reason.
How Insurers Assign Each Rating Class
Underwriters look at measurable health markers and personal history. Typically, they review height and weight (BMI), blood pressure, cholesterol, and lab results. They also check prescription records and your file with the MIB (Medical Information Bureau). Driving records, hazardous hobbies, and family medical history also play a role. Carriers weigh these factors differently when setting life insurance health classes.
The table below shows how life insurance health classes typically compare. Exact cutoffs vary by carrier.
| Class | Typical Profile | Relative Cost |
|---|---|---|
| Preferred Plus | Healthy BMI, blood pressure near 130/80 or lower, no nicotine in 3–5 years, no parent or sibling death from heart disease or cancer before age 60 | Lowest |
| Preferred | Excellent health with one minor issue, such as slightly elevated cholesterol | Roughly 10%–25% more than Preferred Plus |
| Standard Plus | Good health with one or two borderline markers | Roughly 20%–40% more than Preferred Plus |
| Standard | Average health, or managed conditions like treated high blood pressure | Often 50%–100% more than Preferred Plus |
| Substandard (Table Ratings) | Serious or multiple conditions, such as heart disease or poorly controlled diabetes | Standard rate plus about 25% per table |
| Tobacco | Nicotine use within the past 12 months | Often two to three times non-tobacco rates |
In most cases, nicotine is the single biggest pricing factor. Most carriers require at least 12 months nicotine-free for non-tobacco rates. Many require three to five years for Preferred Plus. However, a few carriers treat occasional cigar use more leniently.
Substandard ratings use tables, labeled by number or letter. Each table typically adds about 25% to the Standard premium. For example, Table 2 (or Table B) costs roughly 50% more than Standard. Table 4 costs roughly double. Some carriers also add a “flat extra.” This is a fixed charge, often $2.50 to $10 per $1,000 of coverage per year. Flat extras commonly apply to private pilots, scuba divers, and recent cancer survivors. Some are temporary and drop off after a set number of years.
How to Qualify for Better Life Insurance Health Classes
Preparation matters before your medical exam. Typically, the exam includes blood and urine samples, blood pressure, and weight. Schedule it in the morning after fasting 8 to 12 hours. Avoid caffeine, alcohol, nicotine, and hard exercise for 24 hours beforehand. Drink plenty of water to make the blood draw easier. These small steps can keep a borderline reading from lowering your class.
Next, consider an independent agent or broker. They know which carriers treat certain conditions more favorably. For example, some carriers are lenient on well-controlled diabetes or high cholesterol. Others offer better life insurance health classes to people with a higher BMI. Online insurers like Ethos and Bestow use accelerated underwriting. That can mean no exam for healthy applicants. However, the very best rates sometimes still require a full exam.
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Always be honest on your application. Insurers can review misstatements during the two-year contestability period. As a result, hiding a condition can put your family’s future claim at risk. If you disagree with your rating, ask for the specific underwriting reason. You can then request reconsideration with updated medical records. Keep in mind that life insurance health classes are locked in at issue unless you request a review. Many carriers will reconsider after 12 to 24 months of improved health, such as weight loss or quitting tobacco.
Frequently Asked Questions
What is the most common life insurance health class?
Many applicants land in Standard Plus or Standard. Preferred Plus is typically reserved for a small group in excellent health. However, results vary by carrier. Because life insurance health classes weigh age-related conditions, top rates get harder to reach as you get older.
Can I change my health class after buying a policy?
Yes, in many cases. Most carriers allow reconsideration after 12 to 24 months of better health. For example, quitting tobacco or losing significant weight may qualify. Also, life insurance health classes cannot be downgraded after issue because of new illnesses.
Do no-exam policies use life insurance health classes?
Yes, most do. Accelerated underwriting uses prescription history, MIB records, and driving reports to assign a class. However, guaranteed issue policies skip health questions entirely. As a result, they cost more and carry low coverage limits, often $25,000 or less.
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Official Sources & Resources
For verified information on life insurance regulations and consumer protection:
- NAIC (National Association of Insurance Commissioners): naic.org
- Insurance Information Institute: iii.org
- ACLI (American Council of Life Insurers): acli.com
- LIMRA (Life Insurance Research): limra.com
- Social Security Administration (Survivor Benefits): ssa.gov/benefits/survivors
Content last reviewed September 2026. If you notice any outdated information, please contact us.
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