Life insurance with autoimmune conditions
Autoimmune conditions vary enormously in severity and impact. A mild case of lupus managed with hydroxychloroquine is a very different underwriting proposition to systemic scleroderma with lung involvement. Insurers assess each condition individually, and the key factors are consistent: organ involvement, medication level, disease activity, and how frequently you experience flares.
The short answer
Most autoimmune conditions are insurable for life cover, but the terms vary widely depending on the specific condition and its severity. Mild lupus on hydroxychloroquine can often be covered with a moderate loading. Systemic scleroderma with lung or kidney involvement is very difficult to insure. For all autoimmune conditions, the critical factors are organ involvement, medication level, disease activity, and flare frequency. A specialist broker who understands the differences between these conditions is essential.
What insurers ask about autoimmune conditions
Regardless of the specific autoimmune condition, insurers focus on a consistent set of factors. Understanding these helps you prepare your application and ensures the information works in your favour.
Which organs are affected?
This is the single most important factor. Skin and joint involvement is viewed far more favourably than lung, kidney, heart, or brain involvement. Organ involvement dramatically changes the underwriting outcome.
What medication are you taking?
Hydroxychloroquine, low-dose steroids, and other mild immunosuppressants suggest well-managed disease. Cyclophosphamide, rituximab, mycophenolate, or high-dose steroids indicate more severe or active disease and lead to higher loadings or decline.
How active is your disease?
Are you in remission, stable on treatment, or experiencing active flares? Remission or long-term stability is viewed most favourably. Recent flares requiring hospitalisation or escalation of treatment are viewed unfavourably.
How frequently do you have flares?
Rare, mild flares (perhaps once every few years) are very different from frequent flares requiring hospital admission or treatment changes. Flare frequency is a key indicator of disease control.
When were you diagnosed?
A long history of stable disease is viewed more favourably than a recent diagnosis where the disease trajectory is uncertain. Typically, at least 12 months of stable disease is needed for the best assessment.
Are there any associated conditions?
Autoimmune conditions can overlap. Having more than one autoimmune condition (e.g. lupus with secondary Sjogren's) complicates underwriting and may result in higher loadings.
Not sure how your condition will be assessed?
Tell us your specific diagnosis, medication, and whether any organs are affected. Our specialist brokers can give you an honest assessment of your options in minutes.
Get QuoteCondition-by-condition breakdown
Each autoimmune condition is assessed differently. Here is how insurers typically view the most common conditions our partner brokers help with.
Lupus (Systemic Lupus Erythematosus / SLE)
Lupus is the autoimmune condition we are asked about most frequently. The range of outcomes is wide because lupus itself varies enormously in severity.
Skin and joint lupus only
Managed with hydroxychloroquine, low-dose steroids, or NSAIDs. No organ involvement. This is the most insurable presentation. Life insurance is usually available with a moderate loading of 50-100%. Several mainstream insurers will consider applications.
Lupus with mild organ involvement
Mild pleuritis, pericarditis that has resolved, or stable blood count abnormalities. Cover is available but with higher loadings (100-200%). Insurer selection becomes more important.
Lupus nephritis (kidney involvement)
Significantly harder to insure. Active lupus nephritis or a history of renal impairment substantially narrows options. If kidney function has recovered and you have been stable for an extended period, some specialist insurers may consider an application, but terms will be heavily loaded. Current dialysis or transplant makes standard cover unavailable.
Lupus with CNS involvement
Central nervous system lupus (cerebral lupus) is the most difficult presentation to insure. Most insurers will decline. Specialist insurers may consider applications on a case-by-case basis if the condition has been stable for a prolonged period.
Scleroderma (Systemic Sclerosis)
Scleroderma is divided into limited and diffuse forms, and this distinction matters enormously for insurance.
Limited cutaneous scleroderma (CREST syndrome)
Skin thickening limited to the hands, face, and forearms. Raynaud's phenomenon. If there is no significant organ involvement (no pulmonary hypertension, no interstitial lung disease), life insurance is usually obtainable with a moderate to significant loading.
Diffuse cutaneous scleroderma
More widespread skin involvement with a higher risk of internal organ damage. Lung fibrosis, renal crisis, or cardiac involvement makes standard life insurance very difficult to obtain. Some specialist insurers may consider stable cases, but options are extremely limited.
Sjogren's Syndrome
Primary Sjogren's (occurring on its own) is generally one of the more insurable autoimmune conditions. The hallmark symptoms of dry eyes and dry mouth, while uncomfortable, do not typically carry significant mortality risk.
Life insurance is usually available with a minor to moderate loading. The main concerns for insurers are whether there is any associated lymphoma risk (a known association), organ involvement (lungs, kidneys), or overlap with other autoimmune conditions such as lupus or rheumatoid arthritis. Straightforward Sjogren's on symptomatic treatment is one of the better autoimmune outcomes for insurance.
Vasculitis
Vasculitis is a broad term covering many conditions. The insurance outcome depends entirely on which type of vasculitis and which organs are affected.
Cutaneous vasculitis (skin only)
Usually insurable with minor loading if resolved or stable. No significant impact on life expectancy.
ANCA-associated vasculitis (GPA / MPA)
Granulomatosis with polyangiitis (formerly Wegener's) and microscopic polyangiitis involve the kidneys, lungs, or both. Insurable in some cases if in sustained remission (typically 2+ years) with stable kidney function. Loadings will be significant. Active disease or recent relapse makes cover very difficult.
Large vessel vasculitis (Giant Cell Arteritis / Takayasu's)
Depends on extent and complications. Giant cell arteritis that has resolved after steroid treatment is often insurable with moderate loading. Takayasu's arteritis with significant vessel involvement is harder.
Addison's Disease
Addison's disease (primary adrenal insufficiency) is one of the more straightforward autoimmune conditions from an insurance perspective. With proper hormone replacement therapy (hydrocortisone and fludrocortisone), life expectancy is near normal.
Life insurance is usually available with a minor loading, provided you are stable on replacement therapy, compliant with medication, carry emergency injection supplies, and have had no adrenal crises requiring hospitalisation. A history of adrenal crisis increases the loading but does not necessarily prevent cover.
Realistic pricing examples
Premiums vary enormously across autoimmune conditions. These illustrative examples give a sense of the range.
| Profile | Cover | Indicative monthly premium |
|---|---|---|
| 38-year-old, lupus (skin/joints only), on hydroxychloroquine, stable 3+ years | 200,000 level term, 25 years | 20-35/month |
| 45-year-old, Addison's disease, stable on replacement therapy, no crises | 200,000 level term, 20 years | 18-30/month |
| 42-year-old, GPA vasculitis, remission 3 years, stable kidney function | 150,000 level term, 20 years | 40-80/month |
| 50-year-old, limited scleroderma (CREST), no pulmonary hypertension, stable | 150,000 level term, 15 years | 35-65/month |
These are indicative figures based on typical market rates. They are not quotes. Actual premiums depend on your full circumstances and the insurer selected.
The honest answer
Autoimmune conditions exist on a wide spectrum, and so do insurance outcomes. If your condition is well-managed with no major organ involvement, you will very likely find life cover at reasonable rates. If you have significant organ involvement - particularly kidneys, lungs, or heart - your options narrow considerably, but they do not disappear entirely. The biggest mistake people with autoimmune conditions make is going directly to a mainstream insurer without broker guidance. Different insurers have very different approaches to autoimmune risk, and the difference between the best and worst insurer for your specific condition can be the difference between a decline and an affordable policy.
Critical illness cover with autoimmune conditions
Critical illness cover is generally harder to obtain than life insurance for autoimmune conditions. Some insurers will offer critical illness with exclusions for the autoimmune condition itself and related complications. Others will decline entirely.
For milder presentations (Sjogren's, Addison's, skin-only lupus), critical illness may be available with an exclusion or moderate loading. For more complex conditions (lupus nephritis, diffuse scleroderma, systemic vasculitis), critical illness is typically unavailable.
Income protection with autoimmune conditions
Income protection is the product most affected by autoimmune conditions, because these conditions can cause unpredictable flares that prevent work. The typical outcome is an exclusion for claims related to the autoimmune condition - meaning the policy covers you for everything else but not for your autoimmune condition keeping you off work.
For some milder, well-controlled conditions, full cover without exclusions may be available, but this requires careful insurer selection. For conditions with frequent flares or significant functional impact, income protection is very difficult to obtain without exclusions.
Have a specific autoimmune condition?
The difference between conditions and severity levels means generic advice is rarely useful. Get in touch with your specific diagnosis and our specialist brokers will tell you exactly what to expect.
Get QuotePut your policy in trust
Whatever your autoimmune condition, every life insurance policy should be written in trust. Without a trust, the payout enters your estate and may face 40% inheritance tax and months of probate delays. Writing your policy in trust is free and takes 2 minutes. Our partner brokers set it up on every policy.
Read our full guide to trusts and estate planning
Frequently asked questions
I have lupus - will I definitely be able to get life insurance?
In most cases, yes. Lupus affecting only the skin and joints, managed with hydroxychloroquine or low-dose immunosuppressants, is insurable with a moderate loading from several insurers. Lupus with kidney involvement (lupus nephritis) or CNS involvement is substantially harder. The specific organs affected and your disease activity are the determining factors.
Does being on immunosuppressant medication affect my insurance?
Yes. The type and dose of immunosuppressant tells insurers about the severity of your disease. Hydroxychloroquine and low-dose methotrexate are viewed more favourably than cyclophosphamide, rituximab, or high-dose steroids. However, being on immunosuppressants does not prevent you from getting cover - it is one of several factors assessed together.
I have more than one autoimmune condition - how does that affect things?
Overlap is common in autoimmune conditions and does make underwriting more complex. Having two or more conditions typically results in higher loadings than either condition alone, because the combined risk is greater. However, it does not automatically lead to a decline. The key is the overall severity and organ involvement across all conditions.
My condition is in remission - does that help?
Significantly. Sustained remission (typically 12+ months) is one of the strongest positive indicators for insurers. It demonstrates that the disease is controlled and the risk of complications is reduced. The longer the remission, the better the terms are likely to be.
Should I wait until my condition is more stable before applying?
If you have been recently diagnosed and your treatment is still being adjusted, waiting 6-12 months for stability is usually advisable. Insurers view a period of demonstrated stability favourably. However, if your condition is already stable, there is no reason to wait further. Applying while stable and healthy gives you the best possible terms.
Do I need to disclose an autoimmune condition even if it is mild?
Yes, always. Non-disclosure of any known medical condition can void your policy. Even if your condition is mild and well-managed, it must be declared. With proper broker guidance, a mild autoimmune condition often results in very manageable loadings - non-disclosure is never worth the risk.
Get specialist advice for your autoimmune condition
Every autoimmune condition is different. Tell us your specific diagnosis, treatment, and disease activity, and our specialist brokers will find the insurer best suited to your situation.
Get QuoteFree. No obligation. Takes 2 minutes.