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Life Insurance with Ventricular Septal Defect (VSD). Everything You Need to Know at a Glance!

🎯 Bottom Line Up Front

Can you get life insurance with Ventricular Septal Defect (VSD)? YES. Most people with successfully repaired VSDs can obtain standard or near-standard life insurance rates. Small, asymptomatic VSDs may qualify for preferred rates, while complex cases require specialized underwriting but remain insurable through our network of 50+ carriers.

Ventricular Septal Defect (VSD) is the most common congenital heart defect, affecting approximately 1 in every 500 births. A VSD occurs when there’s a hole in the wall (septum) separating the heart’s two lower chambers (ventricles), allowing oxygen-rich blood to mix with oxygen-poor blood.

Many people with VSD live completely normal lives, especially those with small defects that close naturally or have been successfully repaired. However, when applying for life insurance, even a history of VSD raises questions for insurance companies about long-term cardiovascular health.

This comprehensive guide explains exactly how VSD affects life insurance eligibility, what underwriters look for, and proven strategies to secure the best possible coverage and rates for your specific situation.

1 in 500
Births affected by VSD
85%
Small VSDs close naturally
95%+
Success rate for VSD repair
Normal
Life expectancy with repair

Understanding VSD and Insurance Impact

Key insight: Insurance companies primarily focus on current heart function, surgical history, and long-term prognosis rather than the original diagnosis alone.

VSDs are classified by size, location, and hemodynamic significance. From an insurance perspective, the most critical factors are whether the defect has been repaired, current symptoms, and any associated complications like pulmonary hypertension or heart failure.

Excellent Prognosis

Small VSDs that closed naturally or successful repair with normal heart function

  • Standard rates possible
  • May qualify for preferred rates
  • Minimal medical requirements

Good Prognosis

Moderate VSDs with successful repair, stable condition, regular monitoring

  • Standard to table 2 rates
  • Comprehensive medical review
  • Annual cardiology follow-ups

Complex Cases

Large VSDs, multiple defects, pulmonary hypertension, or heart failure

  • Table 4-8 ratings possible
  • Specialized carrier selection
  • Detailed medical underwriting

Professional Insight

“The insurance industry has become much more sophisticated in evaluating congenital heart defects. A well-documented repair with excellent long-term results can often qualify for standard rates, while even complex cases can find coverage through carriers who specialize in cardiac conditions.”

– InsuranceBrokers USA – Management Team

Key Underwriting Factors

Key insight: Underwriters use a comprehensive risk assessment model that weighs multiple factors rather than simply looking at the VSD diagnosis.

Insurance companies evaluate VSD cases using specific medical criteria that determine both eligibility and premium rates. Understanding these factors helps prepare a stronger application.

Factor Favorable Concerning Impact on Rates
VSD Size Small (<3mm), naturally closed Large (>10mm), residual shunting High – directly affects risk assessment
Surgical History Successful repair, no complications Multiple surgeries, recent procedures High – determines current status
Current Function Normal ejection fraction (>55%) Reduced function (<45%) Critical – primary risk factor
Associated Conditions No other heart defects Pulmonary hypertension, arrhythmias High – compounds risk assessment
Age at Repair Repaired in childhood Adult repair or delayed treatment Medium – affects long-term outlook
Activity Level No restrictions, normal exercise Activity limitations, shortness of breath Medium – indicates functional status

Medical Documentation Requirements

Comprehensive medical records are essential for VSD cases. Insurance companies typically require:

  • Detailed surgical reports from VSD repair
  • Recent echocardiogram results (within 2 years)
  • Cardiology consultation notes
  • Exercise stress test results (if performed)
  • Complete medication list and dosages
  • Documentation of any complications or restrictions

Coverage Options by VSD Severity

Key insight: Coverage availability and pricing varies dramatically based on VSD complexity, repair success, and current cardiac function.

Simple VSD – Closed Naturally

Typical Rating: Standard to Preferred rates

Coverage Availability: All major carriers

Requirements: Basic medical questionnaire, possibly routine medical exam

Ideal Candidate Profile:

  • Small VSD that closed spontaneously in childhood
  • No symptoms or activity restrictions
  • Normal echocardiogram results
  • No other cardiac conditions

Successfully Repaired VSD

Typical Rating: Standard to Table 2 (25-50% increase)

Coverage Availability: Most carriers with cardiac expertise

Requirements: Detailed medical records, recent cardiology evaluation

Ideal Candidate Profile:

  • Successful surgical repair in childhood
  • Normal heart function post-repair
  • Regular cardiology follow-ups with stable results
  • No residual shunting or complications

Complex VSD with Stable Management

Typical Rating: Table 2-6 (50-250% increase)

Coverage Availability: Specialized cardiac underwriters

Requirements: Comprehensive medical review, multiple carrier evaluation

Candidate Profile:

  • Large VSD with successful repair
  • Mild complications (e.g., trace regurgitation)
  • Stable condition with medication management
  • Regular specialist monitoring

Severe VSD with Complications

Typical Rating: Table 6-10 (250-500% increase) or specialized products

Coverage Availability: Limited carriers, alternative products

Requirements: Extensive medical underwriting, possible postponement

Candidate Profile:

  • Complex repairs or multiple surgeries
  • Associated conditions (pulmonary hypertension, heart failure)
  • Activity restrictions or symptoms
  • Recent changes in condition

For comprehensive guidance on how various cardiac conditions affect coverage decisions, see our detailed resource on Life Insurance Approvals with Pre-Existing Medical Conditions.

Application Strategy & Documentation

Key insight: Proper preparation and complete medical documentation can significantly improve approval odds and premium rates.

Pre-Application Preparation Checklist

  • Gather Complete Medical Records: Request all VSD-related medical records from your cardiologist, including surgical reports, recent test results, and consultation notes
  • Update Cardiac Evaluation: Ensure your most recent echocardiogram is within the past 24 months, or schedule an update if needed
  • Document Current Status: Obtain a letter from your cardiologist summarizing your current condition, prognosis, and any activity restrictions
  • Medication List: Compile a complete list of all medications, dosages, and indications
  • Lifestyle Documentation: Prepare to discuss your activity level, exercise tolerance, and any symptoms

Timing Strategy

Optimal Application Window: 6-12 months after stable cardiology evaluation

Avoid applying immediately after surgery, during medication changes, or when symptoms are changing. Insurance companies prefer to see stable, well-documented conditions.

Common Application Mistakes to Avoid

  • Incomplete Medical History: Failing to disclose all VSD-related treatments and evaluations
  • Outdated Information: Using medical records older than 2-3 years
  • Wrong Carrier Selection: Applying to companies without cardiac underwriting expertise
  • Rushing the Process: Applying before gathering complete documentation
  • Multiple Simultaneous Applications: This can lead to automatic declines if not properly coordinated

Choosing the Right Insurance Carrier

Key insight: Different insurance companies have varying expertise and risk tolerance for congenital heart defects, making carrier selection critical.

Not all insurance carriers are created equal when it comes to underwriting VSD cases. Some excel at cardiac conditions while others may automatically decline or offer poor rates for any heart-related diagnosis.

Cardiac-Friendly Carriers

Best for: Successfully repaired VSDs

  • Specialized cardiac underwriters
  • Comprehensive medical review process
  • Competitive rates for stable conditions
  • Experience with congenital defects

Standard Market Carriers

Best for: Simple, naturally closed VSDs

  • Prefer straightforward cases
  • May offer preferred rates for minimal risk
  • Limited appetite for complex cases
  • Standard underwriting protocols

Alternative Market

Best for: Complex or high-risk cases

  • Specialized high-risk underwriting
  • Higher premiums but broader acceptance
  • Unique product offerings
  • Case-by-case evaluation

Carrier Evaluation Criteria

When selecting carriers for VSD cases, we evaluate:

  • Cardiac Underwriting Expertise: Does the carrier have specialized heart condition underwriters?
  • Historical Approvals: Track record with similar VSD cases
  • Medical Director Input: Availability of cardiologist consultation for complex cases
  • Rate Competitiveness: Premium structure for cardiac conditions
  • Policy Features: Conversion options, living benefits, and flexibility

Our Top 10 Best Life Insurance Companies in the U.S. (2025): Expert Broker Rankings can help identify carriers most likely to provide favorable consideration for complex cardiac cases.

Optimal Timing for Applications

Key insight: Strategic timing of your life insurance application can significantly impact both approval probability and premium rates.

Avoid: Immediate Post-Surgery Period

Timeframe: 0-6 months after VSD repair

Risk: High decline probability, postponement likely

Insurance companies prefer to see stable recovery and confirmed surgical success before considering coverage.

Caution: Early Recovery Phase

Timeframe: 6-12 months post-surgery

Risk: Possible postponement or high table ratings

Some carriers may consider applications, but rates are typically higher during this period.

Optimal: Stable Recovery Period

Timeframe: 12+ months post-surgery with stable condition

Advantage: Best rates and approval probability

Full recovery documented, stable cardiac function, normal activity level restored.

Special Consideration: Pediatric Cases

Timeframe: Young adults with childhood repair

Advantage: Excellent long-term data available

Adults with successful childhood repairs often qualify for the best rates due to proven long-term stability.

Timeline Best Practices

  • Plan Ahead: Start the application process 3-6 months before you need coverage
  • Coordinate with Medical Care: Schedule applications around routine cardiology appointments
  • Document Stability: Ensure at least 6-12 months of stable cardiac function
  • Avoid Active Changes: Don’t apply during medication adjustments or symptom changes
  • Consider Life Events: Apply before marriage, home purchase, or starting a family when possible

Alternative Coverage Options

Key insight: When traditional life insurance proves challenging, several alternative products can provide meaningful protection for VSD patients.

For individuals with complex VSD cases or those facing traditional coverage challenges, alternative insurance products offer valuable protection options.

No-Exam Life Insurance

Coverage: Up to $500,000

  • Simplified underwriting process
  • Health questionnaire only
  • Faster approval times
  • Good for stable VSD cases

Group Life Insurance

Coverage: Usually 1-5x annual salary

  • Available through employer
  • Limited or no medical underwriting
  • Guaranteed issue amounts
  • Portable options available

Graded Benefit Policies

Coverage: Full benefit after 2-3 years

  • Guaranteed acceptance
  • No medical questions
  • Limited initial death benefit
  • Good bridge coverage option

Alternative Product Considerations

  • Coverage Limits: Alternative products typically offer lower maximum coverage amounts
  • Higher Premiums: Simplified underwriting often results in higher rates
  • Waiting Periods: Some products have initial waiting periods for full benefits
  • Limited Features: May lack riders and benefits available with traditional policies

Our guide on Top 10 Best No-Exam Life Insurance Companies (2025 Update) provides valuable alternatives for those facing traditional coverage challenges.

Frequently Asked Questions


Can I get life insurance if my VSD was never repaired?

Yes, many people with small, asymptomatic VSDs that don’t require repair can qualify for standard life insurance rates. The key factors are the size of the defect, whether it causes symptoms, and your current cardiac function. Small VSDs (under 3mm) with no symptoms often qualify for preferred rates, while larger unrepaired VSDs require more detailed underwriting but remain insurable through specialized carriers.

How long after VSD surgery should I wait to apply for life insurance?

Most insurance companies prefer to see at least 6-12 months of stable recovery after VSD repair before considering applications. The optimal timing is 12+ months post-surgery when you have documented stable cardiac function and normal activity levels. Applying too early often results in postponement or higher premiums.

Will I need a medical exam for life insurance with VSD?

For traditional life insurance, most carriers will require a medical exam for VSD cases, especially for coverage amounts over $250,000. The exam typically includes basic measurements, blood work, EKG, and sometimes an echocardiogram. However, no-exam life insurance options are available for smaller coverage amounts with simplified underwriting.

What if I have other heart conditions along with VSD?

Additional cardiac conditions like pulmonary hypertension, arrhythmias, or heart failure will increase complexity and likely result in higher premiums. However, coverage remains possible through carriers specializing in complex cardiac cases. Each condition is evaluated individually, and stable, well-managed conditions receive more favorable consideration.

Can my children get life insurance if they have VSD?

Yes, children with VSD can often obtain life insurance through child life insurance riders on parents’ policies or standalone juvenile policies. The underwriting requirements are typically less stringent for children, especially for small coverage amounts. Successfully repaired VSDs in children often qualify for standard rates.

How much more expensive is life insurance with VSD?

Premium increases vary significantly based on VSD complexity. Simple, naturally closed VSDs may qualify for standard rates with no increase. Successfully repaired VSDs typically see 0-50% premium increases (standard to table 2 ratings). Complex cases may face 50-250% increases but remain insurable through our specialized carrier network.

Should I disclose VSD if it was repaired in childhood and I have no symptoms?

Absolutely yes. All medical history must be disclosed honestly on insurance applications, regardless of how minor it seems. Failure to disclose VSD history could void your policy if discovered later. However, childhood repairs with excellent long-term results often qualify for favorable rates, so disclosure rarely prevents coverage.

What medical records will the insurance company need?

Insurance companies typically request complete VSD-related medical records including: original diagnosis reports, surgical records if repaired, recent cardiology consultation notes (within 2 years), recent echocardiogram results, exercise stress test results if performed, current medication list, and documentation of any activity restrictions or symptoms.

Ready to Explore Your Life Insurance Options?

Don’t let VSD history prevent you from securing the life insurance protection your family deserves. Our cardiac specialists work with 50+ carriers to find the best coverage and rates for your specific situation.

📞 Call Now: 888-211-6171

Free confidential consultation – All consultations are HIPAA compliant

About Our Cardiac Insurance Specialists

45+
Carrier relationships specializing in cardiac conditions

Our team includes insurance professionals who specialize exclusively in cardiac conditions, including congenital heart defects like VSD. We understand the complex medical and insurance considerations involved and work directly with underwriters who have specific expertise in evaluating cardiac risks. This specialized focus allows us to secure coverage for cases that other brokers might consider impossible.

Our specialized services include:

  • Pre-application medical record review and strategy development
  • Carrier selection based on specific VSD characteristics and history
  • Coordination with cardiac specialists to optimize documentation
  • Application preparation and underwriter communication
  • Multiple carrier evaluation to ensure best rates and terms

Disclaimer: This information is for educational purposes only and does not constitute medical or insurance advice. Individual coverage availability and pricing depend on personal health factors, VSD type and severity, surgical history, current cardiac function, and insurance company guidelines. Consult with licensed insurance professionals for guidance specific to your situation.

This article provides general information about life insurance for individuals with Ventricular Septal Defect (VSD), offered for educational purposes. Individual circumstances vary significantly, and outcomes depend on numerous factors including VSD type, size, repair status, current cardiac function, and overall health. All consultations are confidential and comply with HIPAA privacy requirements.
2 comments… add one
  • Jacob G October 24, 2020, 5:29 am

    Will this information change if the ACA is reverted?

    • IBUSA October 24, 2020, 12:41 pm

      Jacob,

      If you are asking if an appeal of the Affordable Care Act (ACA) or “Obamacare” will affect the life insurance industry, the answer to that question is no. This is because the ACA only applies to health care and health insurance.

      The fundamental tenant of the ACA is that health insurance is a basic human right and shouldn’t be denied to any citizen. This argument has not been made concerning life insurance.

      This is why the life insurance industry remains able to discriminate against those with pre-existing medical conditions among a wide variety of other factors as well.

      Thanks,

      InsuranceBrokersUSA.

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