SNRI vs. SSRI Classification

SNRIs (like Pristiq) target both serotonin and norepinephrine, while SSRIs target only serotonin. This makes SNRIs appropriate for more complex cases where depression includes anxiety or pain components. Underwriters may request more information about why an SNRI was chosen over an SSRI.

Treatment Indication Matters

Whether Pristiq is being used for depression, anxiety, or both affects the underwriting assessment. Combined diagnosis may require additional documentation, but does not prevent approval. Clear communication about why your doctor prescribed Pristiq strengthens your application.

Approval Timeline

Pristiq applications typically take 3-6 weeks due to a more detailed underwriting review. Some carriers may request pharmacy records or additional medical documentation. Plan ahead if you need coverage by a specific date.

How Long on Pristiq?

Underwriters want to see a consistent treatment history. Six months to one year on Pristiq shows stability and response to treatment. Less than three months may require additional scrutiny or waiting. More than one year is ideal and supports approval at standard or near-standard rates.

Symptom Control

Can you describe your depression or anxiety as well-managed on current treatment? Do you have good days more often than bad? Can you function at work and in relationships? Underwriters assess current symptom severity directly from medical records. Documented improvement on Pristiq strengthens your case significantly.

Hospitalization History

Any psychiatric hospitalizations will be reviewed. Recent hospitalization (within 6-12 months) may result in denial or approval with higher premiums. Older hospitalization with documented stability since is less problematic. Suicidal ideation in your history requires 1-2 years of stability before approval.

Therapy or Counseling

Active participation in therapy alongside medication improves approval odds. Document your therapist’s name, frequency of sessions, and how long you’ve been in treatment. Combined pharmacological and psychological treatment demonstrates commitment and results in better rates than medication alone.

Dosage and Compliance

Pristiq dosing ranges from 50mg to 400mg daily. Your current dose and any history of dose adjustments will be reviewed. Consistent medication adherence signals stability. Frequent dose changes or medication non-compliance raises underwriting concerns about control.

Other Medications

Taking Pristiq alone (monotherapy) is viewed more favorably than adding additional psychiatric medications. If you’re on multiple antidepressants, mood stabilizers, or antipsychotics, underwriting becomes more complex. Your psychiatrist’s clinical notes explaining the rationale for combination treatment are essential.

Current Mental Health Status

Report your depression or anxiety as either “managed” or “well-controlled” if that’s accurate. If symptoms remain significant despite Pristiq, say so honestly—it doesn’t prevent approval, but affects rate calculation. Describe your current functioning: Can you work? Maintain relationships? Sleep reasonably well?

Treatment Timeline

Provide the exact date you started Pristiq. Include any previous antidepressants you tried before Pristiq and why you switched. If you’ve been on Pristiq for years, say so—this is beneficial. If recently started, explain why treatment began when it did.

Prior Mental Health Episodes

Disclose all hospitalizations, ER visits, or crisis counseling related to mental health. Include dates, duration, and reason (suicidal ideation, severe anxiety, depression crisis). Being upfront prevents insurers from discovering this later and denying your claim.

Therapy and Support Services

List your current therapist or counselor, frequency of visits (weekly, biweekly), and how long you’ve been seeing them. If you participate in support groups or other mental health services, include that. Combined treatment shows commitment.

Suicide or Self-Harm History

If you have any history of suicidal ideation, attempts, or self-harm, disclose it completely. Include when it occurred, whether you received treatment, and your current status. Active suicidal thoughts will delay approval; past ideation that’s resolved is manageable with proper documentation.

Current Dosage and Side Effects

State your current Pristiq dose and any side effects you experience. If side effects are minimal and you tolerate the medication well, mention that. If you’ve had dosage adjustments, explain when and why.

Best Case Scenario

You’ve been on Pristiq for 1+ years, symptoms are well-controlled, you’re in active therapy, no hospitalizations, and no suicidal history. In this case, expect approval at standard or near-standard rates, with underwriting completed in 3-4 weeks.

Moderate Case Scenario

You’ve been on Pristiq for 6 months, symptoms are improving but not fully controlled, or you have an older mental health history (5+ years ago). Expect approval with a moderate rating increase (10-25%), taking 4-6 weeks for review.

Complex Case Scenario

You’ve been on Pristiq for less than 3 months, have multiple medications, or have had a recent hospitalization (1-2 years ago). Expect to wait or potentially be denied initially. Reapplication after 6-12 months of documented stability increases approval likelihood significantly.

Preferred Carriers

Work with carriers that specialize in mental health and antidepressant use. Some mainstream insurers are less familiar with SNRIs; specialty carriers understand Pristiq and approve more readily. Licensed agents can match you with the right insurer for your situation.

Well-Controlled Condition (1+ Years)

Premium increase: 15-25% above standard rates. Example: Standard rate of $30/month might become $35-37/month. Underwriting is typically straightforward, approval is likely in 3-4 weeks with good documentation.

Moderate Control (6-12 Months)

Premium increase: 25-40% above standard rates. Example: Standard rate of $30/month might become $37-42/month. More detailed underwriting required; may take 4-6 weeks for approval decision.

Recent Hospitalization or Crisis

Premium increase: 40-50%+ or possible denial. If approval is granted, rates may increase significantly. Waiting 6-12 months for stability documentation can reduce rates substantially compared to applying immediately.

Factors That Lower Your Rate

Active therapy participation, long treatment history (3+ years), no hospitalizations, good employment history, and older mental health episodes (5+ years ago) all help reduce rates. Documenting these positives strengthens your application and improves pricing.

Step 1: Gather Medical Documentation

Collect records from your prescribing psychiatrist, primary care doctor, and therapist showing dates, diagnoses, treatment plan, and current status. Request a letter from your psychiatrist specifically addressing your depression/anxiety severity, Pristiq effectiveness, and prognosis. This narrative is more valuable than raw medical records.

Step 2: Work With a Specialist Agent

Don’t apply directly to mainstream carriers first. Licensed agents experienced with mental health cases know which insurers are most favorable to Pristiq applicants and can shop your application to multiple carriers simultaneously, improving your odds.

Step 3: Complete Applications Thoroughly

Don’t rush through the medical history section. Write clear, organized narratives explaining your condition, treatment response, and current status. Provide specific dates and details. Vague or incomplete answers flag applications for additional investigation or denial.

Step 4: Consider Timing

If you’ve recently started Pristiq (less than 3 months) or recently experienced a mental health crisis, waiting 6-12 months for documented stability can significantly improve approval odds and rates. If you’ve been stable for years, apply now.

Step 5: What NOT to Do

Don’t stop taking Pristiq before applying to improve your chances. Don’t omit or downplay mental health history. Don’t apply to multiple carriers independently in quick succession (this looks suspicious). Don’t provide inconsistent information across applications.

Will Pristiq automatically disqualify me?

Direct answer: No. Pristiq use alone does not disqualify applicants. Insurers evaluate your complete mental health picture and current functioning.

Most applicants on Pristiq get approved when working with appropriate insurers. Approval depends on condition severity, symptom control, treatment compliance, hospitalization history, and stability duration—not on taking an SNRI alone.

Why do SNRI applications take longer than SSRI applications?

Direct answer: SNRIs affect two neurotransmitters rather than one, signaling a more complex presentation. Underwriters typically conduct a more detailed review.

Expect 3-6 weeks for Pristiq underwriting versus 2-4 weeks for SSRIs. This is normal and doesn’t indicate approval is unlikely—it’s just more thorough assessment. Your psychiatrist’s clinical notes explaining why Pristiq was chosen help accelerate this process.

Should I stop taking Pristiq to get better rates?

Direct answer: No. Stopping medication to improve insurance odds often backfires and damages your health.

If you stop Pristiq before applying and your depression or anxiety worsens or returns, insurers will see that as a higher risk and deny coverage or charge much higher premiums. Stable treatment is what underwriters want to see. If your condition is controlled on Pristiq, that’s exactly what you should report.

What if I were recently hospitalized?

Direct answer: Approval becomes harder but not impossible. Most insurers want to see 6-12 months of stability after hospitalization before issuing a policy.

If hospitalization was recent, waiting 6-12 months significantly improves approval odds and rates. If you need coverage now, guaranteed issue or simplified issue policies are options, though expensive. Apply to specialty carriers experienced with mental health crises—many will approve after appropriate waiting periods.

How does therapy or counseling affect approval?

Direct answer: Positively. Active therapy participation improves approval odds and can lower premiums.

Underwriters view therapy as evidence of commitment to mental health management. Combined Pristiq and regular therapy often results in better rates than Pristiq alone. Document your therapy participation, frequency of sessions, and therapist name—include this in your application to show stability and active treatment.

What if I take Pristiq plus other antidepressants or medications?

Direct answer: Multiple psychiatric medications raise concerns. Approval becomes harder, and premiums may increase 25-50%.

Multiple medications signal to underwriters that your condition may not be adequately controlled on monotherapy. If your psychiatrist recommends combination treatment, that’s medically appropriate—disclose it fully and have your doctor explain why combination therapy is necessary. Some carriers are more flexible with well-documented combination treatment than others.

What if I have suicidal thoughts in my history?

Direct answer: Approval is more difficult but possible. Insurers typically want 1-2 years of stability before issuing a policy.

Active suicidal ideation will delay approval indefinitely. But documented past suicidal thoughts managed with current treatment often allow approval after waiting 1-2 years and showing consistent stability. All life insurance policies include a suicide clause (typically 2 years), so timing and documentation matter. Work with specialty carriers experienced with these situations.

Will my insurance rates change after I get the policy?

Direct answer: No. Once approved and the policy is in force, your premiums and coverage stay the same regardless of future mental health changes.

Any changes to your depression, anxiety, or Pristiq use after the policy issue won’t affect your rates or ability to claim benefits. This is a major benefit of locking in coverage while your condition is stable. However, if your mental health worsens before applying, it will affect your initial approval and rates.