An Atypical Antipsychotic—Modern and Evidence-Based

Abilify (aripiprazole) is an atypical antipsychotic medication used to treat serious psychiatric conditions, including schizophrenia, bipolar disorder (both mania and depression), major depressive disorder (as an adjunct), and other conditions. Antipsychotics work by modulating dopamine and serotonin in the brain. Abilify is a newer-generation antipsychotic with a relatively favorable side effect profile compared to older antipsychotics. It hasa  lower risk of weight gain and metabolic effects than some alternatives. The fact that you take Abilify indicates you have a serious psychiatric diagnosis—one of the conditions listed above. Underwriters take antipsychotic use seriously because the conditions treated by antipsychotics (schizophrenia, bipolar disorder) are serious mental health conditions that can affect mortality risk through suicide, accidents, or poor medical self-care. However, modern underwriters recognize that people with these conditions who are stable on appropriate medication, compliant with treatment, and engaged with mental health care often live normal lifespans and can be insured.

Why Antipsychotic Use Requires Careful Underwriting

Antipsychotics are prescribed for serious conditions. Schizophrenia and bipolar disorder, especially when untreated or poorly managed, carry increased suicide risk and risk of dangerous behavior. These conditions can affect judgment, decision-making, and self-care. Underwriters must assess whether the person is stable, compliant with treatment, and at low current risk. Someone stable on Abilify for years with no recent crises has different underwriting than someone recently hospitalized or with multiple suicide attempts. The key distinction: active, serious psychiatric crisis versus stable, treated condition.

Schizophrenia

Schizophrenia is a serious mental illness characterized by hallucinations (hearing voices or seeing things not there), delusions (false beliefs), disorganized speech or behavior, and negative symptoms (reduced emotion or motivation). Abilify is often a first-line treatment. With appropriate antipsychotic medication and support, many people with schizophrenia achieve stability and function reasonably well. However, schizophrenia increases suicide risk, especially if untreated or poorly managed. Underwriting for schizophrenia requires evidence of stability on medication, compliance with treatment, no recent hospitalizations or crises, and engagement with mental health care.

Bipolar Disorder

Bipolar disorder involves cycling between elevated mood (mania or hypomania) and depression. During manic episodes, judgment is impaired and risky behavior increases. During depressive episodes, suicide risk increases. Abilify treats both manic and depressive symptoms. Early-onset bipolar disorder (diagnosis before age 25) may have different underwriting than later-onset. Bipolar disorder is highly treatable, and many people with bipolar disorder who are stable on medication live normal lives. Underwriting depends on the frequency and severity of episodes, stability on current medication, medication compliance, and psychiatric history.

Treatment-Resistant Depression

Abilify is also prescribed as adjunctive therapy for depression when SSRIs alone aren’t sufficient. This indicates more severe or treatment-resistant depression. Underwriting for treatment-resistant depression focuses on suicide risk history, current stability, and medication response.

Red Flags and Concerns

Underwriters are most concerned about: Recent psychiatric hospitalization (within the past 1-2 years). Multiple suicide attempts or recent suicidal ideation. Multiple medication changes or frequent psychiatric treatment adjustments. Poor medication compliance or history of medication non-compliance. Active or recent substance abuse. Untreated or unmanaged psychiatric condition. Current suicidal or homicidal ideation. These factors suggest active, unstable psychiatric illness with elevated mortality risk.

Positive Indicators

Underwriters look favorably on: Stability on current medication for 1+ years. Stable dose without recent changes. No psychiatric hospitalizations for 2+ years. No suicide attempts for 3+ years or ever. Good medication compliance has been demonstrated over time. Engaged in ongoing mental health care (therapy, psychiatry). Maintained employment or a stable living situation. Supportive family or social network. These factors suggest the psychiatric condition is well-controlled and the person is at low current risk.

1. Specific Psychiatric Diagnosis

What condition is Abilify treating? Schizophrenia? Bipolar disorder? Treatment-resistant depression? Each has different underwriting. Bipolar disorder with stable mood cycles may have more favorable underwriting than active schizophrenia. Be clear about your diagnosis.

2. Length of Stability on Current Medication

How long have you been stable on Abilify at the current dose? 6 months? 2 years? 5 years? Longer stability is better. Someone stable for 3+ years has more favorable underwriting than someone who started on Abilify 3 months ago.

3. Medication Compliance and Response

Are you taking Abilify as prescribed? No missed doses? Good response to medication? Poor compliance or inconsistent use raises concerns. Consistent medication adherence demonstrated over time is very positive for underwriting.

4. Suicide Attempt History and Current Ideation

This is critical. Have you ever attempted suicide? How many attempts? When was the last attempt? Are you currently having suicidal thoughts? Suicide attempt history significantly affects underwriting. Remote history (5+ years with no recent attempts) is more manageable than recent attempts. Current suicidal ideation is a major concern. Be completely honest here.

5. Psychiatric Hospitalization History

Have you been hospitalized for psychiatric reasons? How many times? How recently? Psychiatric hospitalization within the past 1-2 years requires more scrutiny. Hospitalizations 3+ years ago with stability since are more manageable. Frequent hospitalizations suggest active, difficult-to-treat illness.

6. Current Functioning and Employment Status

Are you employed or actively engaged in school or meaningful activity? Do you maintain relationships? Are you self-caring and independent? Current good functioning supports the narrative of stability. Poor functioning or isolation despite medication raises concerns about disease control.

7. Ongoing Mental Health Care and Provider Engagement

Are you currently seeing a psychiatrist regularly? Therapy? Ongoing engagement with mental health care is positive—it shows you’re managing your condition actively. Someone on Abilify with no ongoing psychiatric care has less favorable underwriting than someone regularly monitored by a psychiatrist.

Abilify Itself: Favorable Profile

Modern atypical antipsychotic with a good safety profile. Lower risk of movement disorders than older antipsychotics. More metabolically favorable than some alternatives. Abilify is viewed favorably. The medication creates minimal additional rate impact beyond the psychiatric condition itself.

Early-Stage, Stable Bipolar Disorder on Abilify

Example: Diagnosed 3-4 years ago, stable on Abilify for 2+ years, rare episodes, no suicide attempts, good medication compliance, maintained employment. Rate increase: 15-40% possible. Approval is very likely.

Stable Schizophrenia on Abilify

Example: Diagnosed 5+ years ago, stable on Abilify for 3+ years, no recent hospitalizations, good medication compliance, engaged in ongoing psychiatric care. Rate increase: 30-75% possible. Approval likely.

Complex History: Multiple Hospitalizations or Suicide Attempts

Example: Multiple psychiatric hospitalizations, prior suicide attempts, currently stable 1-2 years but complex history. Rate increase: 75-150%+ possible. Approval is possible with a significant rate adjustment or a possible decline, depending on current stability and the provider’s assessment of risk.

Comprehensive Letter from Your Psychiatrist

This is essential. The letter should describe: (1) Your diagnosis and when diagnosed, (2) Current psychiatric stability and symptom control, (3) Duration on Abilify and response to medication, (4) Any suicide attempts or psychiatric hospitalizations—when, circumstances, current risk assessment, (5) Current medications and compliance, (6) Frequency of psychiatric visits and engagement, (7) Psychiatrist’s assessment of your current safety and stability, (8) Prognosis. This letter is invaluable for underwriting.

Recent Psychiatric Treatment Records

Recent (past 6-12 months) psychiatric notes showing your visits, current mental status, medication effectiveness, compliance, and ongoing stability. These records demonstrate you’re actively engaged in treatment.

Primary Care Physician Confirmation

Your primary care doctor can confirm your psychiatric diagnosis, current medication list, and overall health status. A simple letter stating you’re stable and engaged in psychiatric care is helpful.

Employment or Functional Status Documentation

If employed, an employment letter confirming your job status and work performance can be helpful. Or a letter from someone in your life (family member, friend) confirming your current functioning and stability. This demonstrates your condition is well-managed enough for normal functioning.

Be Direct and Honest About Your Psychiatric Diagnosis

When applying, clearly state your psychiatric diagnosis and that you take Abilify. Include: when diagnosed, current symptom control, how long stable on Abilify, any suicide attempts or hospitalizations (be complete and honest), and current functioning. Direct disclosure: “I was diagnosed with bipolar disorder 4 years ago. I’ve been on Abilify for 2 years and it works well. My mood is stable. I’ve never attempted suicide. I’m employed and stable.”

Provide Comprehensive Psychiatric Documentation Upfront

Don’t wait for underwriters to request psychiatric records. Submit your psychiatrist’s letter and recent treatment records with your application. This demonstrates you’re being proactive, speeds underwriting, and shows your condition is well-documented and managed. Underwriters need psychiatric information to accurately assess risk—provide it early.

If You Have a Suicide Attempt History, Be Prepared

If you’ve attempted suicide, be honest and prepare a detailed explanation: when, method, circumstances, hospitalization/treatment, what’s changed since, current safety planning, protective factors. Underwriters must understand the severity and context. Have your psychiatrist address this directly in their letter, explaining why the current risk is low despite the history.

Apply Sooner Rather Than Later if Recently Diagnosed

If recently diagnosed with a psychiatric condition, it’s reasonable to wait 6-12 months to establish stability on Abilify before applying. But don’t delay excessively. Someone stable for 2+ years on medication has very favorable underwriting. Apply once you have demonstrated stability.

Consider Coverage Amount Carefully

Request appropriate coverage reflecting your needs and income. Very high coverage amounts may face more scrutiny. Reasonable, justified coverage amounts are more likely to be approved smoothly.

Early-Stage Bipolar Disorder, Stable on Abilify, Age 45

A 45-year-old with bipolar disorder diagnosed 3 years ago, stable on Abilify for 2 years, no suicide attempts, employed, might pay $60-75/month for a $500,000 20-year term policy. This represents a 25-50% rate increase, reflecting the bipolar diagnosis but good stability.

Stable Schizophrenia on Abilify, Age 50

A 50-year-old with schizophrenia diagnosed 6+ years ago, stable on Abilify for 3+ years, no recent hospitalizations, compliant with treatment, might pay $85-120/month for the same coverage. This represents a 40-80% increase, reflecting a schizophrenia diagnosis but demonstrated long-term stability.

Complex History: Multiple Attempts, Multiple Hospitalizations, Age 48

A 48-year-old with bipolar disorder, two prior suicide attempts (5+ years ago), three psychiatric hospitalizations (last one 2 years ago), now stable 1+ year on Abilify, might pay $120-200/month for the same coverage. This represents a 100-300% increase reflecting a complex psychiatric history but current demonstrated stability.

What Affects Your Final Rate

Psychiatric diagnosis (bipolar disorder is more favorable than schizophrenia; schizophrenia is more favorable than with significant substance abuse or complex comorbidities). Length of stability on current medication. Suicide attempt history (or lack thereof). Psychiatric hospitalization history. Medication compliance. Current functioning and employment. Engagement with ongoing psychiatric care. Age. Other health conditions. All factors combined determine the final rate.

Will my psychiatric diagnosis prevent me from getting life insurance?

Direct answer: No. Modern insurers approve people on antipsychotics regularly.

Psychiatric conditions are serious, but many people with well-controlled schizophrenia or bipolar disorder live long, stable lives. If you’re stable on Abilify, compliant with treatment, and have no recent crises, approval is very likely.

Will I be declined because I take Abilify?

Direct answer: Decline from Abilify use alone is very unlikely.

Abilify is a standard antipsychotic with a good safety profile. The medication itself won’t result in a decline. Decline might occur only if psychiatric condition is severe, unstable, with multiple recent crises or suicide attempts—and even then, approval is often possible with rate adjustment.

How much will my rates increase?

Direct answer: Depends on diagnosis and stability. 15-150%+ increase possible.

Early-stage, stable bipolar: 15-50% increase. Stable schizophrenia: 30-75% increase. Complex history with suicide attempts: 75-150%+ increase. The rate reflects psychiatric condition severity and stability.

Do I have to disclose my psychiatric diagnosis?

Direct answer: Yes. Always disclose it.

Life insurance applications ask about diagnoses and medications. If you have a psychiatric condition or take Abilify, disclose it completely and honestly. Concealment is misrepresentation and can void your policy.

What if I have a history of suicide attempts?

Direct answer: Be honest. Approval is likely if you’re now stable.

Suicide attempt history requires full disclosure and more thorough underwriting. Provide complete details and have your psychiatrist address current risk and protective factors. If you’ve been stable for several years after an attempt with good treatment compliance, approval is likely with a rate adjustment.

What if I were recently hospitalized for psychiatric reasons?

Direct answer: Wait to apply until you’ve had a stable recovery time.

If recently hospitalized (within the past 6-12 months), it’s better to wait 6+ months after discharge to establish post-hospitalization stability before applying. Recent hospitalization creates underwriting difficulty. Once you’ve demonstrated 6+ months of stability post-discharge, apply. You’ll get better rates.

Can I apply if I’m currently in crisis or having suicidal thoughts?

Direct answer: No. Reach out for help first.

If you’re currently in a psychiatric crisis or experiencing suicidal thoughts, get help now. Contact your psychiatrist, go to ER, or call 988 (Suicide & Crisis Lifeline). Life insurance can wait. Your safety matters most. Once you’re stable again, you can apply.