Burial insurance with HIV

Nothing here is medical advice and nothing here should change how anyone manages a health condition or a course of treatment. Underwriting rules differ from one insurance company to the next and change without notice. The outcome of any application is decided by the carrier on the individual case, not by a website.

The short answer

Many simplified issue burial insurance applications still ask about HIV directly, and where the question is asked as a knockout the answer closes the level benefit route with that company. A number of companies have narrowed or removed the question, so it is genuinely worth checking rather than assuming, and guaranteed issue cover is available to everyone in the age band whatever the outcome elsewhere.

The more useful point is this. Somebody with long standing, well managed HIV who is otherwise in reasonable health may do considerably better in the fully underwritten market than in the burial insurance market, because that is where the change has actually happened. A small whole life policy written on full underwriting can cost less per thousand than a simplified issue policy and pays in full from day one.

Two markets, moving at different speeds

It is worth being clear about the difference, because most people arrive here thinking there is only one kind of life insurance.

General market patterns rather than a promise about any company. Availability varies by company, by state and over time.

How the question is worded on a burial application

On simplified issue forms the question usually appears near the top, in the group of knockouts, and the older wording is still widely printed.

• Have you ever been diagnosed with or treated for AIDS, AIDS related complex, or human immunodeficiency virus.
• Have you tested positive for antibodies to the human immunodeficiency virus.
• A smaller number of forms ask a narrower question about an AIDS defining illness or about treatment in a recent window rather than about diagnosis at any time.

There is no time limit on the broad version, which is why waiting does not change the answer here the way it does after cancer treatment. What changes the answer is which company the application goes to, and that is a question about appointments and about current underwriting guides rather than about the applicant.

What a fully underwritten application looks at

If the fully underwritten route is being tried, the assessment is detailed rather than a single yes or no. In broad terms these are the things companies weigh, and they are the same things a treating clinician already tracks.

• How long ago the diagnosis was made, since a long stable history reads well.
• Whether antiretroviral therapy is taken consistently, and whether there have been gaps or changes of regimen.
• Viral load, and whether it has been sustained at an undetectable level.
• CD4 count and, just as importantly, the trend in it over several years.
• Whether there has ever been an AIDS defining illness, and when.
• Whether care is under a specialist and appointments are attended regularly.
• Whether hepatitis B or hepatitis C is present alongside, which is assessed in its own right.
• Tobacco use, substance use, and the ordinary things every application asks about.
• Age at application, and the amount and term of cover requested.

None of that is something to manage for the sake of an insurance form, and this page is not suggesting anyone should. It is simply what the file contains, and someone whose care has been steady for years generally has a strong file already.

Consent, confidentiality and your state department

HIV is one of the few areas of insurance underwriting with its own layer of state law, and it is worth knowing the shape of it.

In many states an insurer may not test for HIV without separate written informed consent, there are rules about who may receive a result and how it is communicated, and there are restrictions on how the information may be used and disclosed. States differ, and the detail is genuinely different from one to the next.

Your state department of insurance is the place to check, and it is also where a complaint goes if you believe an application was handled improperly. The National Association of Insurance Commissioners consumer pages list every state department. A refusal to offer a particular product is not by itself improper, since insurers are permitted to underwrite on sound actuarial grounds, but how information is gathered and handled is regulated.

Why leaving it off never works

The temptation is understandable and the outcome is bad. Life insurance is contestable for the first two years, and a company reviewing a claim inside that window compares the application against the medical and prescription record. Antiretroviral medication is visible on a routine prescription history search, which most simplified issue companies run as a matter of course.

The usual result of a mismatch is that the premiums are returned and the death benefit is not paid, at the exact moment the family needs the money. A guaranteed issue policy applied for honestly pays the full benefit after two years and pays for accidental death from day one. A level benefit policy obtained on an inaccurate answer may pay nothing at all.

The routes worth trying, in order

For someone in stable health with well managed HIV, the sequence that tends to make sense is as follows.

• Check any group life cover already in place. Employer group life usually asks no individual health questions up to a set amount, and it is the cheapest cover most people have access to. It generally ends when the job does, so it is a starting point rather than a plan.
• Ask about fully underwritten cover. This is where the market has actually changed, and a small whole life policy on full underwriting can be better value than simplified issue and pays in full from day one.
• Ask which simplified issue companies still ask the question. The answers differ and they change, which is exactly why an agent holding several appointments is worth more here than a single company advertisement.
• Take guaranteed issue if the others do not land. It is real cover with a two year waiting period on natural death, and it can be replaced later if a better offer becomes available. Never cancel an existing policy until the replacement is issued and in force.

How much cover to buy

Whichever route works, size it to the bill. A burial once the cemetery has billed commonly totals about $15,395. Funeral home charges alone for a service with viewing and a metal casket run about $8,300. A cremation with a service is nearer $6,280, and a direct cremation nearer $2,202. The calculator gives your own state figure.