What Xopenex (Levalbuterol) Is

Xopenex (levalbuterol) is a short-acting beta-2 agonist (SABA) inhaler used to provide rapid relief of acute bronchospasm (airway tightening) in patients with asthma and chronic obstructive pulmonary disease (COPD). Levalbuterol is the active left-handed isomer of albuterol, designed to provide effective bronchodilation with potentially fewer side effects than racemic albuterol. Xopenex is typically used as a rescue or quick-relief medication when respiratory symptoms occur. It can also be used as a maintenance therapy in some patients. Xopenex has a good safety profile and is well-tolerated by most patients.

What Is Asthma?

Asthma is a chronic inflammatory airway disease characterized by reversible airflow obstruction, bronchial hyperresponsiveness, and inflammation. Common symptoms include wheezing, coughing, shortness of breath, and chest tightness. Asthma severity ranges from mild intermittent (symptoms a few times per year) to severe persistent (daily symptoms). Asthma can be triggered by allergens, exercise, cold air, infections, or other factors. With appropriate management using controller medications and rescue inhalers, many people with asthma maintain good control and a normal quality of life.

What Is COPD?

Chronic obstructive pulmonary disease (COPD) is a progressive respiratory disease characterized by persistent airflow obstruction, usually caused by smoking or long-term exposure to irritants. COPD includes emphysema and chronic bronchitis. COPD is more serious than asthma and has a more limited prognosis, though management can slow progression and reduce symptom burden. COPD severity ranges from mild to very severe based on lung function (FEV1). Xopenex is used for acute symptom relief and maintenance therapy in COPD.

Why Insurers Evaluate Xopenex Users Carefully

Xopenex use indicates an underlying respiratory condition (asthma or COPD) that requires active management. Life insurers recognize that respiratory disease can impact mortality risk, particularly in more severe cases. The focus of underwriting for Xopenex users is on the underlying respiratory disease—its severity, control status, and functional impact—rather than on the medication itself. Well-controlled mild-to-moderate asthma is viewed favorably. COPD, which is progressive and more serious, receives closer evaluation. Poorly controlled respiratory disease or disease requiring frequent Xopenex use raises underwriting concerns.

Respiratory Diagnosis: Asthma vs. COPD

Underwriters first determine whether your respiratory condition is asthma or COPD. Asthma, which is reversible and generally has a better prognosis, receives more favorable underwriting than COPD. COPD, which is progressive and results in a progressive decline in lung function over time, is viewed more seriously. The diagnosis itself is a key factor in underwriting, and the underlying condition matters more than the Xopenex use.

Frequency of Xopenex Use

Underwriters assess how often you use Xopenex. Occasional use (a few times per month or less) suggests well-controlled asthma. Frequent use (multiple times per week or daily) suggests poorly controlled disease. Patients requiring frequent Xopenex use typically have inadequately controlled underlying respiratory disease and raise underwriting concerns. The frequency of rescue medication use is a key indicator of disease control and severity.

Lung Function (FEV1)

For patients with COPD or asthma with documented lung function testing, underwriters review FEV1 (forced expiratory volume in 1 second). FEV1 is the most important measure of lung function and COPD severity. Higher FEV1 values indicate better lung function and more favorable prognosis. Underwriters will request spirometry results if available. COPD severity is classified based on FEV1: mild (FEV1 ≥80% predicted), moderate (50-79%), severe (30-49%), and very severe (<30%). Disease severity based on FEV1 directly impacts underwriting.

Recent Exacerbations and Hospitalizations

Underwriters assess whether you have had recent respiratory exacerbations (acute worsening requiring increased medication, urgent care, or hospitalization). Frequent exacerbations or recent hospitalizations for respiratory disease indicate poorly controlled disease and raise underwriting concerns significantly. Stable respiratory disease without recent exacerbations or hospitalizations is viewed favorably.

Overall Asthma or COPD Control

Underwriters assess your overall disease control. Are you achieving daytime symptom control, normal nighttime sleep, normal activity levels, and minimal need for rescue medications? Or are you experiencing ongoing limitations in daily activities, frequent symptoms, or a need for frequent rescue medication use? Well-controlled disease with minimal symptoms and limitations is viewed favorably. Poorly controlled disease is a significant underwriting concern.

Smoking Status

For COPD or for any respiratory disease, smoking status is important. Underwriters will want to know if you currently smoke and your smoking history. Active smoking worsens respiratory disease control and raises underwriting concerns. If you have quit smoking, the length of time since quitting matters—longer cessation is more favorable. Smoking history is evaluated as part of both the respiratory condition and overall health profile.

Overall Health Profile

Xopenex use is evaluated within your overall health context. Your age, other medical conditions, and general health status matter. A younger person with well-controlled asthma and no other health issues is underwritten more favorably than an older person with COPD and multiple comorbidities (heart disease, diabetes, etc.). However, respiratory condition severity and control status are the dominant factors in underwriting for Xopenex users.

Xopenex and Other Respiratory Medications

Disclose Xopenex on your medication list with frequency of use. For example: “Xopenex inhaler as needed, typically 2-3 times per month” or “Xopenex inhaler daily.” If you use other respiratory medications (controller inhalers like fluticasone/salmeterol, ipratropium, or others), include those as well with dosing and frequency.

Respiratory Diagnosis

Always disclose your respiratory diagnosis (asthma, COPD, or both). Include when you were diagnosed, the severity level if known (mild, moderate, severe for asthma; mild, moderate, severe, very severe for COPD), and current control status. For example: “Mild persistent asthma diagnosed in 2015; well-controlled on fluticasone/salmeterol inhaler twice daily and Xopenex as needed; FEV1 91% of predicted.”

Lung Function and Recent Testing

If you have had spirometry or pulmonary function testing, include the results. Include your FEV1 percent of predicted and when the test was performed. For example: “Spirometry in 2023: FEV1 78% of predicted (moderate airflow obstruction); stable compared to 2022.” Recent lung function testing showing stable or improving function is favorable.

Symptom Control and Functional Status

Disclose your current symptom status and functional limitations. For example: “Asthma symptoms well-controlled; able to exercise and work without significant limitation; no nighttime awakenings from symptoms.” Or if applicable: “Experiencing shortness of breath with exertion; limited to light activity; using Xopenex 3-4 times daily.” An honest assessment of your functional status helps underwriters understand disease control.

Recent Exacerbations and Hospitalization

Disclose any recent respiratory exacerbations or hospitalizations. Include dates and reasons. For example: “Had respiratory exacerbation requiring urgent care in fall 2023; managed with oral corticosteroids and recovered completely; no hospitalizations in past 3 years.” Or: “Hospitalized in spring 2024 for COPD exacerbation; required 3 days inpatient care; currently stable.” Recent exacerbations raise underwriting concerns but should be disclosed honestly.

Smoking Status

Be clear about your smoking status. If you currently smoke, disclose that with the number of cigarettes per day. If you have quit, include the quit date. For example: “Former smoker; quit in 2015 (9 years ago); smoked 15 cigarettes daily for 20 years.” Smoking status directly impacts respiratory health and underwriting for respiratory conditions.

Pulmonary Function History

Include information about any pulmonary function testing history, asthma action plans, and management with a pulmonologist or primary care physician if relevant. For example: “Under care of pulmonologist; on comprehensive asthma management plan; regular follow-up every 6 months.” Active medical management of respiratory disease is viewed favorably as evidence of responsible disease management.

Scenario 1: Mild Intermittent Asthma, Well-Controlled

Situation: You have had mild intermittent asthma diagnosed several years ago. You use Xopenex as needed, typically only a few times per month or less. On control days, you have no symptoms and no activity limitations. FEV1 normal (>80% predicted).

Underwriting Outcome: Very favorable. Mild, well-controlled asthma with infrequent need for rescue medication is viewed similarly to the general population with respect to respiratory health. You will be approved at standard rates with minimal underwriting concerns.

Expected Result: Standard rates; approval likely within 2 weeks.

Scenario 2: Moderate Persistent Asthma, Well-Controlled

Situation: You have moderate persistent asthma. You take a daily controller inhaler (e.g., fluticasone/salmeterol) and use Xopenex as needed, typically 1-2 times per week. Symptoms are well-controlled; you are able to exercise and work without significant limitation. FEV1 85% of predicted.

Underwriting Outcome: Moderately favorable. Moderate asthma that is well-controlled on appropriate therapy with infrequent need for rescue medication is manageable. You will be approved, likely at standard or possibly slightly elevated rates, depending on overall health.

Expected Result: Standard to slightly elevated rates; approval likely within 2-3 weeks.

Scenario 3: Asthma with Poor Control, Frequent Xopenex Use

Situation: You have asthma that is not well-controlled. You are using Xopenex multiple times per week or daily despite being on a controller inhaler. You have frequent daytime symptoms, limited activity tolerance, and occasional nighttime awakening from symptoms. You have had a respiratory exacerbation in the past year.

Underwriting Outcome: More challenging. Poorly controlled asthma with frequent need for rescue medication and recent exacerbations raises underwriting concerns. Underwriters may recommend optimizing therapy before applying or may approve at moderately elevated rates. Improvement in disease control would significantly improve your underwriting outcome.

Expected Result: Moderately to significantly elevated rates possible; approval not guaranteed; underwriting may take 3-4 weeks or recommend reapplication after disease optimization.

Scenario 4: Mild to Moderate COPD, Stable

Situation: You have COPD with FEV1 in the mild to moderate range (50-80% predicted). You use Xopenex as needed plus a maintenance therapy (LAMA, LABA, or combination). You have been stable for several years with no recent exacerbations or hospitalizations. You quit smoking 5+ years ago.

Underwriting Outcome: Moderately favorable, with more careful evaluation than asthma. Stable COPD with mild-to-moderate airflow obstruction, no recent exacerbations, and long smoking cessation is manageable. You will likely be approved at standard to moderately elevated rates.

Expected Result: Standard to moderately elevated rates; approval likely within 3 weeks.

Scenario 5: Severe COPD or Frequent Exacerbations

Situation: You have severe COPD with FEV1 <50% predicted or you have had multiple respiratory exacerbations requiring urgent care or hospitalization in the past 1-2 years. You are using Xopenex multiple times daily and require multiple maintenance medications.

Underwriting Outcome: Complex and uncertain. Severe COPD with frequent exacerbations indicates progressive disease with a higher mortality risk. Underwriters will carefully evaluate your overall status, functional limitations, prognosis, and life expectancy. Approval may be possible, but rates will likely be significantly elevated, or in some cases, denial may occur depending on overall health and prognosis.

Expected Result: Significantly elevated rates or conditional approval; approval not guaranteed; underwriting complex and may take 4+ weeks; specialized carriers may be needed.

Step 1: Optimize Your Respiratory Disease Control Before Applying

If your asthma or COPD is not optimally controlled, work with your physician to optimize therapy before applying for life insurance. Adjusting medications, adding a controller inhaler if needed, or other interventions may improve your control status. Better disease control at the time of application will result in faster approval and better rates. If you have been recently diagnosed or recently had an exacerbation, consider waiting until you are stable before applying.

Step 2: Obtain Recent Pulmonary Function Testing

If you have COPD or documented asthma with prior testing, obtain recent spirometry results showing your current lung function (FEV1). Recent testing demonstrating stable or improved lung function supports your application. If you don’t have recent testing, consider obtaining it before applying, as it provides underwriters with objective disease severity information.

Step 3: Be Specific About Xopenex Frequency

When completing your application, be precise about your Xopenex use frequency. Instead of “as needed,” specify something like “2-3 times monthly” or “once or twice weekly.” Specific frequency data demonstrates you have thought about your usage and indicates disease control status to underwriters.

Step 4: Provide Complete Pulmonary History

Include your complete respiratory history: diagnosis date, type of condition (asthma vs. COPD), severity level, all medications used, lung function results, and any exacerbations or hospitalizations. The more comprehensive your pulmonary information, the clearer picture underwriters have of your disease status and control.

Step 5: Address Smoking Status

If you smoke, seriously consider quitting before applying for life insurance. Smoking significantly worsens respiratory disease control and impacts overall health and underwriting. Quitting smoking will improve your respiratory health and your underwriting outcome. If you have quit, note the time since cessation—longer abstinence is more favorable.

Step 6: Work with an Experienced Agent

An experienced insurance agent familiar with respiratory conditions can guide your application effectively. Different carriers have different underwriting guidelines for asthma and COPD. An experienced agent will know which carriers are most favorable for respiratory conditions at your severity level and can help present your case optimally. This guidance significantly improves approval odds and rates.

Will my asthma or COPD keep me from getting life insurance?

Direct answer: No, but approval depends on severity and control.

Asthma and COPD are common conditions for which life insurance is available. Well-controlled mild-to-moderate asthma receives favorable approval. COPD receives more careful evaluation due to its progressive nature. Approval rates for Xopenex users range from 65-85% depending on disease severity and control status. Your respiratory condition alone will not prevent you from obtaining life insurance, but disease severity and control will impact your rates and approval timeline.

Will my life insurance rates be higher if I use Xopenex?

Direct answer: Depends on disease severity and frequency of use.

Occasional Xopenex use for well-controlled mild asthma may result in standard rates. Moderate asthma or COPD typically results in slightly to moderately elevated rates depending on control. Poorly controlled disease with frequent Xopenex use will result in moderately to significantly elevated rates. The frequency of rescue medication use is a key indicator of disease control—infrequent use is favorable; frequent use is concerning.

Do I have to disclose my Xopenex use?

Direct answer: Yes, always disclose all respiratory medications and diagnoses.

Xopenex use and underlying respiratory diagnosis must be disclosed on your life insurance application. This is a material fact required by law. Include Xopenex on your medication list with frequency of use and include your asthma or COPD diagnosis. Full transparency is legally required and will not negatively impact your application compared to non-disclosure.

How long does underwriting take for Xopenex users?

Direct answer: 2-4 weeks typically; longer for complex cases.

Respiratory conditions typically require more detailed underwriting than some other conditions. Most cases are underwritten within 2-4 weeks. Straightforward, well-controlled asthma may be approved in 2 weeks. Complex COPD cases or those with recent exacerbations may take 4+ weeks or require specialized underwriting.

Will I need lung function testing or an exam?

Direct answer: Not usually; underwriters rely on existing medical records.

Life insurance medical exams include standard health screening, but not pulmonary function testing. Underwriters rely on your physician’s records for FEV1 and lung function information. If you have recent spirometry results, provide them. If underwriters need additional information, they may request documentation from your physician or, rarely, recommend pulmonary function testing.

What if I have frequent asthma exacerbations?

Direct answer: Optimization before applying is recommended.

Frequent exacerbations indicate poorly controlled asthma and raise underwriting concerns. Before applying, work with your physician to optimize your asthma management. This may involve adjusting medications, improving medication adherence, or other interventions. Once your disease is stabilized with fewer exacerbations, reapply. Optimized disease control will result in faster approval and better rates.

What if I have COPD with low lung function (FEV1)?

Direct answer: Approval possible, but rates will likely be elevated.

COPD with low FEV1 (<50% predicted) is severe and raises underwriting concerns. Underwriters will assess your functional status, recent exacerbations, symptoms, and overall health. Approval is possible, but rates will likely be moderately to significantly elevate,d reflecting disease severity. In rare cases of very severe disease with poor functional status, denial may occur.

What if I’m declined or offered poor rates?

Direct answer: Try other carriers; optimize disease control; consider reapplying later.

Different carriers have different underwriting guidelines for respiratory conditions. An experienced agent can shop your case with multiple carriers. Additionally, if you can improve your disease control over the next few months (fewer exacerbations, better lung function, reduced need for Xopenex), reapplying may result in better outcomes. Many people who receive poor initial offers are approved at better terms after disease optimization or with different carriers.