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Life Insurance Approvals with an Atrial Septal Defect (ADS). Everything You Need to Know at a Glance!


In this article, we wanted to take a moment and answer some of the most common questions we get from folks applying for life insurance after they have been diagnosed with an Atrial Septal Defect (ADS).

Questions that will be directly addressed will include:

  • Can I qualify for life insurance after I’ve been diagnosed with an atrial septal defect?
  • Why do life insurance companies care if I’ve been diagnosed with an atrial septal defect?
  • What kind of information will the insurance companies ask me or be interested in?
  • What rate (or price) can I qualify for?
  • How can I help ensure I get the “best life insurance” for me?

So, without further ado, let’s dive right in!

Can I qualify for life insurance after I’ve been diagnosed with an atrial septal defect?

Yes, individuals who have been diagnosed with an atrial septal defect can and often will be able to qualify for a traditional term or whole life insurance policy. In fact, they may even be eligible for a Preferred rating.   That said, however, one’s approval will depend upon various factors, including the type and severity of the ASD, one’s overall health, and other medical conditions.

In general, a small ASD that has been repaired and is not causing any symptoms or complications may not significantly impact one’s eligibility for life insurance. However, a larger ASD or one that is causing symptoms or complications may make it more challenging to qualify for coverage or may result in higher premiums.

Why do life insurance companies care if I’ve been diagnosed with an atrial septal defect?

Life insurance companies generally consider a variety of factors when evaluating an applicant for coverage, including their overall health and medical history.

An atrial septal defect (ASD) is a congenital heart defect involving a hole in the wall between the two upper chambers of the heart (the atria). It is typically diagnosed in infancy or childhood but can also be diagnosed in adulthood. The problem is that an ASD can potentially cause complications such as heart failure, stroke, and arrhythmias and may require ongoing medical management and monitoring.

Therefore, an insurance company may ask about an applicant’s diagnosis of ASD to better understand the potential risks and costs associated with insuring them. This information can help the company determine the appropriate premium for the policy and ensure it can meet its financial obligations if the policyholder passes away.

It’s important to note that the impact of an ASD on an individual’s ability to qualify for life insurance will depend on the case’s specific circumstances, including the type and severity of the ASD, the individual’s overall health, and any other medical conditions they may have.

Atrial Septal Defect defined:

An atrial septal defect (ASD) is a congenital heart defect involving a hole in the wall between the two upper chambers of the heart (the atria). It is typically diagnosed in infancy or childhood but can also be diagnosed in adulthood.

ASDs can range in size from small to large, and the severity of the defect can vary. Smaller ASDs may not cause any symptoms or complications and may not require treatment. However, larger ASDs or those that are causing symptoms or complications may require medical management and possibly surgery to repair the defect.

Types of Atrial Septal Defects:

There are several types of atrial septal defects (ASDs), which are classified based on the location and size of the hole in the wall between the two upper chambers of the heart (the atria). The main types of ASDs include:

  1. Ostium secundum ASD: This is the most common type of ASD, accounting for about 75% of cases. It involves a hole in the middle of the atrial septum, near the top of the heart.
  2. Ostium primum ASD: This type of ASD involves a hole near the bottom of the atrial septum, near the valve that separates the left atrium from the left ventricle. It is often associated with other abnormalities of the heart and blood vessels.
  3. Sinus venosus ASD: This type of ASD involves a hole in the upper part of the atrial septum, near the opening of the superior vena cava (a large vein that carries blood from the head and arms to the heart).
  4. Coronary sinus ASD: This is a rare type of ASD that involves a hole in the lower part of the atrial septum near the opening of the coronary sinus (a vein that carries blood from the heart muscle to the right atrium).

Symptoms of an ASD may include shortness of breath, especially with physical activity, fatigue, rapid breathing, and a heart murmur. In some cases, an ASD may be detected during a routine physical exam or medical screening. However, it may also be diagnosed after a person experiences symptoms or undergoes testing for another condition.

Treatment for ASD may include medications to manage symptoms and reduce the risk of complications and surgery to repair the defect. The specific treatment plan will depend on the patient’s needs and may involve a combination of approaches.

It is essential to work with a healthcare team, including a cardiologist, to develop a treatment plan that is appropriate for your specific needs.

Now, in cases…

Where this “hole” is small, it’s possible that it can seal itself or only allow small amounts of blood to pass through, making the effects of such a hole very minor or noticeable. Where it can become an issue rather quickly is when the whole is large enough that a surgical procedure may be needed to repair it or when so much blood is allowed to mix that irreversible damage can occur to the heart muscle over time. Damage such as:

  • Right heart enlargement can ultimately lead to heart failure.
  • Abnormal heart rhythms, including atrial fibrillation and atrial flutter.
  • As well as an increased risk of suffering from either a heart attack or stroke.

This is why it should make sense that a life insurance company would want to know more about your situation before making any definitive decisions about your life insurance application.

The good news is…

Most atrial septal defects significant enough to require treatment can usually be repaired surgically, and once remedied, they typically eliminate the need for further treatment. This is why most life insurance companies tend to accept applicants diagnosed with this condition early on and have it repaired early in life.

 What kind of information will the insurance companies ask me or be interested in?

When you apply for life insurance, the insurance company will ask you a number of questions about your health, including any pre-existing medical conditions you have or have had in the past.

If you have a congenital heart defect such as an atrial septal defect (ASD), the insurance company will likely ask about the specific type of ASD you have, any symptoms you experience, and any treatment you have received or are currently receiving.

Specific questions may include:

  • When were you first diagnosed with an atrial septal defect?
  • Who diagnosed your atrial septal defect? A general practitioner or a specialist?
  • How old were you when your atrial septal defect was diagnosed?
  • What symptoms (if any) led to your diagnosis?
  • What treatments (if any) have you required?
  • Have any treatments been recommended for the future?
  • Do you currently suffer from any symptoms now?
    • An arrhythmia (irregular heartbeat)?
    • Heart murmur?
    • Palpitations?
    • Shortness of breath,
    • Pulmonary hypertension?
    • Fatigue?
    • Swelling of the lower body and/or abdomen?
  • Have you been diagnosed with any other cardiovascular conditions?
  • Have you ever suffered from a heart attack or stroke?
  • In the past 12 months, have you used any tobacco or nicotine products?
  • What is your current height and weight?
  • Are you currently working now?
  • In the past 12 months, have you applied for or received any form of disability benefits?

They may also ask about your family medical history and other relevant medical information.

The insurance company will use this information, along with other factors such as your age, gender, and lifestyle, to determine your risk level and calculate your insurance premiums.

What rate (or price) can I qualify for?

As you can see from the questions above, there are many factors regarding what “kind” of rate an individual might qualify for after being diagnosed with a cardiac septal defect. This is why it’s pretty much impossible to know what kind of “rate” you might be able to qualify for without first speaking with you for a few minutes.

That said, however…

What we can say for sure is that if your atrial septal defect is minor or has been surgically repaired. You’re not really suffering from any symptoms of your congenital disability; there is a reasonable chance that you should still be considered “eligible” for a Preferred rate provided that you would otherwise be regarded as eligible for such a rate.

Or, in other words, if your atrial septal defect really isn’t causing you any significant issues, and it doesn’t appear to be affecting your overall “cardiac” health, having been diagnosed with an atrial septal defect really shouldn’t affect the outcome of your life insurance application.

Where we run…

Into trouble is when an individual hasn’t corrected their problem, and they are beginning to exhibit some severe consequences of this disorder, such as:

  • A heart murmur,
  • Pulmonary hypertension,
  • Shortness of breath,
  • Swelling of the lower extremities,
  • Fatigue,
  • , etc.…

In cases like these, it may still be possible for them to qualify for a traditional term or whole life insurance policy; now, their chances of qualifying for a Standard or better rate will undoubtedly be challenging and, in some cases, impossible! In some situations, we may even find that an individual may not qualify for “traditional” coverage. We may need to look at some “alternative” options, such as a guaranteed issue life insurance policy or an accidental death policy.

The good news is…

Should you decide to call us here at IBUSA, you won’t need to try to figure out all of this on your own. We’ll be here to answer any questions you may have. This brings us to the last topic that we wanted to take a moment to discuss, which is…

How can I help ensure I get the “best life insurance” for me?

In our experience here at IBUSA, we have found that usually, the folks who seem to find the “best” life insurance policy for them are those that:

  • Take their time reviewing their options.
  • Ask a lot of questions.

And seek out… 

Those life insurance agents not only have experience working with individuals who have been diagnosed with a wide variety of pre-existing medical conditions but also have access to dozens of different life insurance companies so that when it comes time to help a more “challenging” case, they don’t have to rely on a…

“One size fits all approach!”

The good news is that this is precisely what you’ll find here at IBUSA!

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