Americans experience heartburn weekly
Americans diagnosed with GERD
With controlled GERD, receive standard to Table A ratings
Face complications requiring closer underwriting
Understanding Heartburn, Reflux, and GERD: The Critical Distinctions
Key insight: Life insurance underwriting treats occasional heartburn as a non-issue, chronic acid reflux as manageable, and GERD with complications as a significant concern requiring careful evaluation. The distinction matters fundamentally for underwriting decisions.
Life insurance companies recognize these as different points on a spectrum of the same physiological process, but with dramatically different underwriting implications:
Occasional Heartburn (Symptom)
- Definition: Burning sensation in the chest/throat after certain foods, spicy meals, or large meals
- Frequency: Less than once per week; sporadic episodes
- Trigger: Identifiable cause (specific foods, alcohol, meals close to bedtime)
- Resolution: Resolves with antacid or time; doesn’t disrupt sleep or daily activities
- Underwriting impact: NONE—treated as normal experience most adults have occasionally
Chronic Acid Reflux (Condition)
- Definition: Regular stomach acid backing up into the esophagus; may cause heartburn or other symptoms
- Frequency: Multiple times per week; pattern established
- Trigger: Occurs even without obvious dietary triggers; lifestyle pattern
- Management: Requires regular antacids, H2 blockers, or PPI medication
- Underwriting impact: MINIMAL to MODERATE—understood as common; evaluated based on control
GERD with Complications (Disease)
- Definition: Diagnosed with gastroesophageal reflux disease with documented esophageal damage or complication
- Complications: Barrett’s esophagus, strictures, esophageal cancer, severe erosive disease
- Symptoms: Significant despite medication; sleep disruption; difficulty swallowing
- Management: High-dose or combination PPI therapy; possible endoscopic procedures; close monitoring
- Underwriting impact: MODERATE to HIGH—complication risk and potential for malignancy require careful evaluation
The Physiological Mechanism (Simplified)
Why This Matters for Underwriting
When you eat, food travels down the esophagus through the lower esophageal sphincter (LES)—a muscular valve—into the stomach. Normally, the LES closes after food passes, preventing stomach acid from backing up.
When the LES relaxes abnormally or weakens, stomach acid refluxes back into the esophagus. The esophagus lacks the protective lining the stomach has, so acid causes that burning sensation (heartburn).
- Occasional reflux: Everyone’s LES relaxes sometimes. One episode per month? Completely normal, not a health concern.
- Chronic reflux: LES dysfunction occurs regularly, requiring management. Common but worth monitoring.
- GERD with complications: Years of chronic acid exposure damage the esophageal lining, causing Barrett’s esophagus (pre-cancerous change) or other complications. This increases disease risk and mortality.
Underwriters focus on whether your reflux has caused tissue damage or carries increased cancer risk—that’s what affects mortality.
Favorable vs. Problematic Underwriting Profiles
Favorable Profile
- Occasional heartburn managed with lifestyle/OTC antacids
- Chronic GERD well-controlled on stable low-dose PPI
- Reflux symptoms resolving or stable; no progression
- No complications (Barrett’s, strictures, etc.)
- Normal endoscopy if performed
- Weight stable or declining (obesity worsens GERD)
Expected Rating: Standard
Moderate Complexity Profile
- GERD requiring high-dose or multiple medications
- Symptoms persist despite PPI therapy
- Recent medication changes or escalations
- Endoscopy showing mild erosive disease (healing)
- Comorbid condition (obesity, asthma) complicating reflux
Expected Rating: Standard to Table A
Higher-Risk Profile
- Barrett’s esophagus diagnosed
- History of esophageal strictures requiring dilation
- Severe erosive esophageal disease
- GERD is poorly controlled despite aggressive therapy
- Suspected esophageal malignancy or pre-malignancy
- Medication non-compliance or frequent changes
Expected Rating: Table B-D or specialist review
Severity Assessment and Underwriting Approach
Key insight: Underwriters evaluate GERD severity through frequency of symptoms, impact on daily function, medication requirements, and whether complications have developed. Severity determines whether reflux is treated as a non-issue or a significant concern.
Life insurance underwriting categorizes reflux severity to determine mortality risk and appropriate rating:
GERD Severity Classification
| Severity Level | Symptom Frequency | Impact on Daily Life | Typical Management | Underwriting Concern |
|---|---|---|---|---|
| Occasional (Mild) | Less than 1x per week | Minimal; easily managed with antacids | OTC antacids PRN (as-needed) | Very low—treated as normal experience |
| Mild-Moderate | 1-3x per week | Managed but noticeable; some lifestyle impact | Regular OTC antacids or occasional PPI | Low—very common; minimal underwriting impact |
| Moderate | 3-5x per week | Notable impact on daily activities; possible sleep disruption | Daily low-dose or PRN moderate-dose PPI/H2 blocker | Moderate—well-understood; manageable with treatment |
| Moderate-Severe | Daily or nearly daily | Significant lifestyle impact; regular sleep disruption | High-dose daily PPI, possibly combination therapy | Moderate-High—requires documented control; concern about complications |
| Severe | Constant or uncontrolled despite therapy | Major daily impairment; severe sleep disruption; difficulty swallowing | High-dose combination PPI; possible surgical intervention; frequent endoscopies | High—red flag for complications; requires detailed evaluation |
Questions Underwriters Ask
- How often do you experience reflux symptoms? Frequency determines whether this is occasional vs. chronic vs. disease-state requiring aggressive management.
- What triggers your symptoms? Identifiable triggers (spicy food, chocolate, late meals) vs. spontaneous episodes suggest different severity.
- How do you manage it? Over-the-counter antacids PRN (as-needed) vs. daily prescription medication vs. multiple medications suggest escalating severity.
- Has your medication changed or escalated? Dose increases or medication switching suggest inadequate control.
- Do symptoms disrupt your sleep? Sleep disruption indicates more severe disease and higher mortality risk (sleep disruption itself is a risk factor).
- Have you had an endoscopy? Results (normal vs. erosive disease vs. Barrett’s) fundamentally impact underwriting.
- Are there any complications? Barrett’s esophagus, strictures, or other damage changes the entire underwriting calculus.
Professional Insight
“GERD severity assessment in underwriting is straightforward: we’re looking for evidence of esophageal damage or complications that increase mortality risk. Someone taking a daily PPI but living their life normally with no complications? They get standard rates. Someone with moderate GERD that’s well-controlled despite requiring medication? Still standard rates—this is incredibly common. The person with severe, poorly controlled reflux despite aggressive therapy or with documented complications? That’s when we move to table ratings because we’re concerned about potential malignancy or significant disease progression.”
– InsuranceBrokers USA – Management Team
Medication Management: PPI and H2 Blocker Considerations
Key insight: Long-term proton pump inhibitor (PPI) use is safe and widely recognized by underwriters as appropriate treatment for GERD. PPI use itself doesn’t increase rates or disqualify you; medication compliance and symptom control matter more than medication choice.
Acid reflux medications fall into two main categories, each with different underwriting implications:
H2 Receptor Blockers (H2RAs)
- Examples: Famotidine (Pepcid), ranitidine (formerly Zantac), cimetidine (Tagamet)
- Mechanism: Reduce stomach acid production (less potent than PPIs)
- Typical use: OTC for occasional heartburn or mild chronic reflux
- Underwriting concern: Very low—OTC use signals conservative approach
- Rate impact: None
Proton Pump Inhibitors (PPIs)
- Examples: Omeprazole (Prilosec), esomeprazole (Nexium), lansoprazole (Prevacid)
- Mechanism: Blocks acid-producing cells; most potent acid suppressors available
- Typical use: Moderate to severe GERD requiring regular management
- Underwriting concern: Low—long-term PPI use is safe and well-studied
- Rate impact: Minimal to none if stable and effective
Long-Term PPI Use and Underwriting
Concerns You Might Have Heard
You may have read about studies linking long-term PPI use to vitamin B12 deficiency, osteoporosis, kidney disease, or other conditions. These are legitimate medical concerns that doctors monitor in patients on chronic PPI therapy.
However, for life insurance underwriting:
Underwriters don’t decline or significantly penalize PPI use itself. What they evaluate is whether you’re being appropriately monitored for PPI-related concerns:
- Are your B12 levels being checked periodically? (Simple to manage with supplementation)
- Is your bone health being monitored if you are on long-term PPI? (Calcium supplementation and monitoring standard)
- Are your kidney function tests normal? (Screen at baseline and periodically)
- Has your doctor documented the risk-benefit analysis showing PPI benefits outweigh potential risks for your case?
The person on a PPI with documented appropriate monitoring receives standard rates. The person on a PPI with no monitoring and resultant vitamin deficiency or worsening kidney function faces table ratings.
Red Flag Medication Patterns
Patterns That Trigger Concerns
- Dose escalation: Starting dose increased or doubled within 6-12 months suggests inadequate control
- Frequent medication changes: Multiple different medications tried in a short timeframe suggest GERD pis oorly responsive to standard therapy
- Multiple medications concurrently: High-dose PPI + H2 blocker + other agents suggest severe refractory GERD
- Medication gaps or non-compliance: Documentation showing the patient is not taking prescribed medication regularly
- Ongoing symptoms despite therapy: Medical records showing continued severe heartburn despite maximal medical management
Favorable Medication Patterns
- Stable dose: Same medication at the same dose for 12+ months
- Symptom control: Reflux well-controlled on current regimen
- Good tolerance: No significant side effects; documented good compliance
- Appropriate monitoring: Regular labs (B12, kidney function) if on long-term PPI
- Conservative approach: Lowest effective dose; attempts to reduce dose if reflux controlled
Complications from Chronic Reflux
Key insight: Barrett’s esophagus and esophageal strictures are the primary complications underwriters worry about because they indicate significant disease progression and increased malignancy risk. Complications change underwriting from standard to table ratings or specialist review.
While uncomplicated GERD is very manageable from an underwriting perspective, esophageal complications represent real mortality risk:
Barrett’s Esophagus
⚠️ Most Significant GERD Complication
What it is: Chronic acid damage changes the esophageal cell lining from normal squamous cells to specialized columnar cells that appear similar to stomach/intestinal cells (metaplasia). This is a pre-malignant change—not cancer yet, but abnormal cells that carry a risk of cancer.
Prevalence: Approximately 3-5% of people with GERD develop Barrett’s esophagus.
Cancer risk: Approximately 0.2-0.5% of Barrett’s cases progress to esophageal cancer annually—low risk per year but meaningful cumulative risk over decades.
Underwriting impact:
- Barrett’s without dysplasia (no abnormal cells): Table A-B rating; requires documentation of endoscopic surveillance plan
- Barrett’s with low-grade dysplasia: Table B-D rating; higher surveillance frequency required; possible endoscopic treatment recommended
- Barrett’s with high-grade dysplasia: Table D-F or specialist review; significantly elevated cancer risk; may require endoscopic ablation or esophagectomy
Esophageal Strictures
What They Are
- Narrowing of the esophageal opening due to scarring from chronic acid damage
- Causes progressive difficulty swallowing (dysphagia)
- Typically requires endoscopic dilation procedures
- May recur and require repeated dilations
Underwriting Impact
- Single occurrence, resolved: Table A-B; demonstrates significant GERD but is manageable
- Recurrent strictures: Table B-D; multiple dilations indicate severe disease
- Risk of perforation: Dilation procedures carry a small perforation risk; history of complications noted
Other Complications
| Complication | Description | Underwriting Concern | Rate Impact |
|---|---|---|---|
| Erosive Esophagitis (Grade III-IV) | Severe mucosal ulceration and erosion; significant tissue damage | Moderate-High; indicates severe GERD with tissue destruction | Table A-C depending on healing status |
| Esophageal Bleeding | Ulcer erosion into a blood vessel; can cause significant bleeding | High; serious acute event; requires assessment of current control | Table B-E depending on the underlying cause and current control |
| Esophageal Cancer | Malignancy of esophageal tissue; adenocarcinoma is often GERD-related | Very High; serious malignancy; mortality risk assessment required | Treated as a cancer case; likely decline or specialist review |
⚠️ Documentation Critical for Complicated GERD
If you have Barrett’s esophagus or a history of esophageal complications, provide:
- Copy of endoscopy report showing findings
- Pathology report if a biopsy was performed
- Documentation of surveillance plan (how often you’re monitored)
- Any treatment performed (ablation, dilation, etc.)
- Current symptom status and medication regimen
- Physician’s letter addressing cancer risk and management plan
Comorbid Conditions and Acid Reflux
Key insight: GERD frequently occurs alongside other conditions that impact underwriting. Underwriters evaluate whether comorbid conditions are being appropriately managed and whether they’re worsening reflux severity.
Acid reflux often coexists with conditions that affect both underwriting directly and GERD severity:
Conditions That Worsen GERD
Obesity
- Increased abdominal pressure worsens reflux
- Weight loss significantly improves GERD symptoms
- Underwriting concern: obesity itself + GERD interaction
- Solution: Weight management demonstrates GERD control improvement
Depression and Anxiety
- Stress exacerbates reflux; anxiety can trigger symptoms
- See our depression underwriting guide for mental health impacts
- Underwriting concern: untreated mental health + GERD control
- Solution: Treating anxiety/depression often improves reflux
Cardiovascular Disease
- Chest pain from reflux can mimic cardiac events
- Medications for cardiovascular disease may worsen reflux (certain beta-blockers, nitrates)
- Underwriting concern: differentiating reflux from true cardiac disease
- Solution: Documentation of EKG and cardiac workup if indicated
Asthma
- GERD can trigger asthma symptoms; reflux aspiration worsens airway reactivity
- Poor asthma control + GERD creates underwriting complexity
- Solution: Optimizing reflux control often improves asthma
Professional Insight
“GERD doesn’t exist in a vacuum—we almost always see it alongside other health conditions. What matters underwriting-wise is whether all the conditions are being appropriately managed. Someone with obesity, GERD, and anxiety who’s working on weight loss, taking PPI therapy, and treating anxiety? That person often gets better rates than someone with just mild reflux but multiple unmanaged comorbidities. It’s about comprehensive health management, not any single condition.”
– InsuranceBrokers USA – Management Team
Documentation Strategy: Strengthening Your Application
Key insight: Documentation proving GERD is well-controlled, complications have been ruled out, and you’re being appropriately monitored is the most powerful underwriting tool for reflux cases. Evidence of good symptom control matters far more than the reflux diagnosis itself.
Successful applications from people with GERD share common documentation elements: clear indication of reflux severity, evidence of appropriate management, normal or stable endoscopy results if performed, and absence of concerning patterns.
Essential Documentation Components
Comprehensive Application Documentation for GERD
- Reflux history timeline: When symptoms started, progression over time, current status (stable, improving, worsening)
- Current medication: Specific medication name, dose, frequency (e.g., “Omeprazole 20mg once daily”)
- Medication history: Previous medications tried and reason discontinued (efficacy, side effects, patient preference)
- Symptom frequency: How often do you experience reflux? What triggers symptoms?
- Symptom control: Are symptoms well-controlled on current medication? Any breakthrough symptoms?
- Sleep impact: Does reflux disrupt your sleep? If so, how often?
- Endoscopy results if performed: Date of most recent endoscopy, findings (normal, gastritis, Barrett’s, other)
- Pathology report if biopsy obtained: Diagnostic findings, any dysplasia
- Complications: Any history of strictures, bleeding, or other GERD complications?
- Surveillance plan: If Barrett’s or other complications present, what’s the monitoring schedule?
- Lifestyle modifications: Weight management, dietary changes, positional therapy (elevating head at night, etc.)
- Physician letter: Comprehensive assessment from GI specialist or primary care physician
The Physician Letter: Essential Elements
What Your Doctor Should Address
Request a comprehensive letter from your gastroenterologist or primary care physician covering:
- Diagnosis: Confirmed GERD diagnosis and severity assessment
- Symptom description: What symptoms do you experience? Frequency?
- Current treatment: Medication name, dose, duration, response/efficacy
- Previous treatments: What’s been tried? Why was each discontinued?
- Endoscopy status: Has endoscopy been performed? Results?
- Complications: Any Barrett’s, strictures, bleeding, or other complications?
- Monitoring plan: If complications present, what’s the surveillance frequency?
- Treatment response: Is the current treatment working? Symptoms controlled?
- Compliance: Is the patient taking medication as prescribed? Good compliance?
- Lifestyle modifications: What modifications has the patient implemented?
- Overall prognosis: What’s the expected disease trajectory?
- Physician’s assessment: How does this patient compare to typical GERD cases?
Strategic Application Timing
Apply Sooner If:
- GERD is well-controlled on current stable medication
- Endoscopy performed with normal results
- You’ve been on the same regimen for 6+ months
- No symptoms disrupting sleep or daily life
- No complications present
Consider Waiting If:
- You recently changed medications or dosage
- You haven’t had an endoscopy (though not always required)
- Symptoms are still poorly controlled despite current medication
- You’re in the process of weight management (wait for a more stable weight)
- Complications were recently diagnosed (get treatment plan established first)
⚠️ Documentation Mistakes to Avoid
- No medication list: Underwriters need to know current GERD treatment; omitting this looks like hiding information
- Vague physician letter: “Patient has reflux” isn’t sufficient; need assessment of control, complications, and prognosis
- Missing endoscopy results: If you’ve had an endoscopy, provide the report; absence suggests either you haven’t been evaluated or you’re hiding abnormal findings
- Escalating medication patterns: If doses have been increasing, document why; this suggests inadequate control without explanation
- No mention of complications: If you have Barrett’s or stricture history, not mentioning it creates bigger problems than disclosure would
- Ongoing severe symptoms: Documentation showing you’re still experiencing severe reflux despite medication raises concerns about whether treatment is working
Rate Classifications and Premium Examples
Key insight: Most people with uncomplicated GERD receive standard rates. Modest table ratings are reserved for severe, poorly controlled reflux or for those with complications. GERD-related premium increases are typically minimal compared to other health conditions.
Understanding realistic rate expectations helps you recognize fair offers and know when to negotiate or shop with other carriers.
Rating Distribution by GERD Profile
Standard Ratings (75% of GERD applicants)
Profile: Well-controlled GERD
- GERD symptoms controlled on stable medication
- No endoscopic complications
- Normal sleep; no daytime impairment
- No concerning symptoms suggesting complications
Rate impact: None—same as the general population
Table A Ratings (15% of GERD applicants)
Profile: Moderate GERD or minimal complications
- GERD requiring stable daily PPI medication
- Barrett’s esophagus without dysplasia (being monitored)
- History of esophageal stricture (resolved)
- Mild ongoing symptoms despite medication
Rate impact: +10% to +25% premium
Table B-C Ratings (8% of GERD applicants)
Profile: Severe or complicated GERD
- High-dose or combination PPI therapy
- Persistent symptoms despite aggressive treatment
- Barrett’s with low-grade dysplasia
- Multiple or recurrent esophageal strictures
Rate impact: +25% to +75% premium
Specialist Review or Postponement (2% of GERD applicants)
Profile: Very complex cases
- Barrett’s with high-grade dysplasia
- History of esophageal cancer or suspicious lesions
- Severe refractory GERD unresponsive to maximal therapy
- Recent esophageal bleeding or serious complications
Action: Specialist underwriting or postponement pending further evaluation
Premium Examples by Profile
Sample Rate Comparison: 50-Year-Old, $500,000 20-Year Term
| GERD Profile | Treatment | Rating Class | Annual Premium | Monthly Cost |
|---|---|---|---|---|
| Occasional heartburn managed with OTC antacids | Antacids PRN | Standard | $585 | $49 |
| Chronic GERD is well-controlled on PPI | Omeprazole 20mg daily | Standard | $615 | $51 |
| GERD requiring high-dose PPI with good control | Omeprazole 40mg daily | Table A | $725 | $60 |
| Barrett’s esophagus without dysplasia, on surveillance | Esomeprazole 40mg daily + monitoring | Table A | $755 | $63 |
| Severe GERD poorly controlled despite high-dose PPI | Multiple medications, frequent symptoms | Table B-C | $1,025 | $85 |
Rates are estimates for illustration only. Actual premiums vary by carrier, age, health factors, and individual circumstances.
When to Accept an Offer vs. Shop for Better Rates
Accept the Offer When:
- Rates match the examples above for your profile
- GERD is well-controlled on current medication
- You’ve received multiple quotes with similar results
- You need coverage now and don’t anticipate improvement soon
- Your endoscopy results (if performed) are normal or stable
Consider Shopping When:
- Rating seems worse than your profile justifies
- You just completed an endoscopy with normal results
- You recently optimized the medication regimen
- You’ve implemented weight loss/lifestyle changes, improving GERD
- You’ve only contacted one carrier
Coverage Options by Severity and Management Status
Key insight: Most people with GERD qualify for standard fully-underwritten insurance. Alternative options are relevant primarily for those with severe, poorly controlled reflux or significant complications.
Coverage pathways for acid reflux differ based on severity and management status:
Standard Underwritten Coverage (Typical Path)
Who It’s Best For
- Occasional heartburn managed with OTC antacids
- Chronic GERD is well-controlled on stable PPI medication
- No endoscopic complications or abnormalities
- Good symptom control with minimal daytime impairment
Process: Standard application, full medical underwriting, and possible endoscopy records request
Coverage available: Up to $1-5M+
Products: Term life insurance (10, 20, 30-year), whole life, universal life
Simplified Issue Insurance
When This Option Makes Sense
Simplified issue policies ask health questions but don’t require medical exams:
Best for:
- GERD is well-controlled, but you prefer avoiding extensive underwriting
- Quick coverage needs (24-72 hour approval typical)
- Moderate coverage amounts ($50K-$500K)
- Bridge coverage while full underwriting processes elsewhere
Coverage range: $50,000-$500,000
Rate implications: Slightly higher than standard, but often worth it for speed
Important consideration: Questions vary by carrier; some don’t specifically ask about GERD, making these products ideal options for reflux cases
No Medical Exam Insurance
How It Works
- Limited health questionnaire
- No medical exam required
- Fast approval (1-2 weeks typical)
- Focus on recent hospitalizations and serious health events
Coverage and Cost
- Coverage: $25,000-$500,000 typically
- Rates: Higher than exam-required but often reasonable
- Best for: Ages 45-70, manageable coverage needs, quick timeline
- See our no-exam insurance guide
Group Life Insurance Through Employers
Valuable Coverage Option
If your employer offers group life insurance:
- Guaranteed issue: Basic coverage (typically 1-3x salary) requires no health questions
- GERD irrelevant: No health underwriting for guaranteed amount
- Affordable: The Employer usually subsidizes most costs
- Supplemental options: Can layer individual policies on top for greater protection
- Limitation: Coverage terminates if employment ends
Layer employer coverage with an individual policy for comprehensive protection.
Guaranteed Issue Insurance
Last Resort Option
Guaranteed issue policies accept all applicants:
Best for:
- Severe GERD with multiple complications
- Declined by all other carriers
- Need coverage urgently
Coverage details:
- Amount: $5,000-$25,000 (modest)
- Graded death benefit: Full benefit after 2-3 years (accidental death immediate)
- Cost: Higher premiums but guaranteed acceptance
- See our final expense insurance guide
Frequently Asked Questions
Will acid reflux disqualify me from life insurance?
No. Acid reflux and GERD are very common—approximately 20% of Americans experience heartburn weekly—and underwriters recognize reflux as manageable. Most people with GERD receive standard rates. Occasional heartburn has zero impact on underwriting. Chronic GERD managed with medication receives standard rates in the vast majority of cases. Complications like Barrett’s esophagus increase scrutiny but don’t automatically disqualify you—they just require careful evaluation.
Does taking a PPI (proton pump inhibitor) affect my life insurance rates?
No. Long-term PPI use doesn’t increase life insurance rates or disqualify you from coverage. PPIs are an appropriate treatment for GERD and have been safely used for decades. What underwriters evaluate is whether you’re being appropriately monitored for potential long-term effects (B12 levels, kidney function, bone density), not the PPI use itself. Someone on a stable PPI with good monitoring receives standard rates.
What if I only get heartburn occasionally?
Occasional heartburn (less than once per week, managed with OTC antacids, resolves quickly) has zero underwriting impact. This is considered a normal experience most people have. It’s not a health condition requiring insurance consideration. Only when reflux becomes chronic and frequent (multiple times weekly, requiring regular medication, causing daytime or sleep disruption) does it enter underwriting consideration—and even then, well-controlled reflux receives standard rates.
Do I need an endoscopy before applying for life insurance?
Endoscopy isn’t always required for life insurance with reflux. However, if you have symptoms concerning complications (severe symptoms, difficulty swallowing, signs of bleeding, family history of esophageal cancer), underwriters may request endoscopy results or require the procedure before approving. If you haven’t had an endoscopy but have risk factors, getting one done before applying can strengthen your application—a normal result is very powerful underwriting documentation.
How does Barrett’s esophagus affect life insurance underwriting?
Barrett’s esophagus (pre-malignant changes in esophageal lining) increases underwriting scrutiny because it carries an increased esophageal cancer risk. However, it doesn’t automatically disqualify you or result in extreme ratings. With Barrett’s esophagus without dysplasia and a clear surveillance plan, Table A ratings are typical. Higher grades of dysplasia require specialist review and more significant table ratings. The key is demonstrating you’re being appropriately monitored and managed.
What if my reflux is still bothering me despite being on PPI medication?
Persistent reflux symptoms despite standard PPI therapy suggest either inadequate medication management or that treatment-resistant GERD exists. Underwriters view this as a concern because it suggests your reflux isn’t well-controlled. The solution is to work with your gastroenterologist to optimize therapy (higher dose, different PPI, addition of H2 blocker, etc.). Once symptoms improve on othe ptimized regimen, you’ll be in a much better position for insurance approval.
Can I get coverage with the best life insurance companies if I have GERD?
Yes. GERD is common enough that most major insurers have experience underwriting it. You’re not limited to specialty carriers—standard insurers routinely provide coverage to people with well-controlled reflux at standard rates. Carrier selection matters for complicated cases (severe reflux, Barrett’s esophagus, complications), but for straightforward GERD, major carriers are typically fine with standard rates.
Will I need to disclose my heartburn history on my insurance application?
Yes. Insurance applications ask about reflux and heartburn because this is relevant medical information. Honesty is essential. However, disclosing occasional heartburn or well-controlled GERD with documentation showing good control results in standard rates. Attempting to hide reflux history creates a misrepresentation risk. Full disclosure with supporting documentation is far superior to hoping it’s not discovered.
What should I know about the difference between heartburn and acid reflux for insurance purposes?
For insurance, the distinction is straightforward: heartburn is the symptom (burning sensation); acid reflux is the condition (acid backing up causing that sensation); GERD is the chronic disease requiring management. What underwriters evaluate is: How frequently is this happening? How severe is it? Is it causing damage? How well is it being treated? A single episode of heartburn is normal and not a health condition—it’s only when reflux becomes chronic and requires ongoing management that it enters underwriting consideration.
Ready to Secure Coverage With Acid Reflux?
Acid reflux and GERD don’t disqualify you from life insurance—most people with reflux receive standard or near-standard rates when their condition is well-controlled. Our team specializes in placing GERD cases with carriers who understand the distinction between occasional heartburn and chronic reflux, and who recognize that well-managed reflux carries minimal mortality impact. We handle the documentation strategy so you get approved at fair rates.
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