Understanding Berger’s Disease and Insurance

Key insight: IgA nephropathy insurability depends primarily on demonstrating stable kidney function over time rather than on the diagnosis itself.

IgA nephropathy, commonly called Berger’s disease after the physician who first described it in 1968, occurs when immunoglobulin A antibodies accumulate in the glomeruli—the tiny filtering units within the kidneys. This accumulation triggers inflammation that gradually damages the kidneys’ ability to filter waste from blood. The disease typically manifests with blood in the urine (hematuria), often appearing as dark or tea-colored urine following upper respiratory infections, along with varying degrees of protein in the urine (proteinuria).

For life insurance purposes, IgA nephropathy presents unique underwriting challenges because its natural history varies tremendously between individuals—some people maintain normal or near-normal kidney function indefinitely with minimal treatment, while others experience progressive decline leading to kidney failure despite aggressive intervention. Insurance companies recognize this variability and focus their evaluation on identifying which trajectory your specific case follows. Underwriters seek to answer critical questions: how well-preserved is your current kidney function, is your disease stable or progressing, how much protein are you losing in your urine, does your blood pressure remain controlled, and what does the trend of kidney function measurements over time reveal about your prognosis. The presence of IgA nephropathy automatically requires careful scrutiny because chronic kidney disease substantially increases mortality risk and the potential for progression to dialysis creates long-term uncertainty. However, well-documented cases demonstrating years of stability with preserved kidney function can achieve reasonable insurance outcomes, while recently diagnosed cases or those showing progressive decline face significant challenges until stability can be established.

The Spectrum of IgA Nephropathy Severity

Understanding where your IgA nephropathy falls on the disease severity spectrum provides insight into both prognosis and insurance prospects:

Mild IgA nephropathy involves microscopic hematuria with minimal or no proteinuria and normal kidney function. Many individuals with this form maintain stable kidney function indefinitely, requiring only monitoring without specific treatment. This represents the most favorable scenario for insurance purposes.

Moderate IgA nephropathy includes moderate proteinuria (500-2000 mg/day) with mild reduction in kidney function. These cases require treatment—typically ACE inhibitors or ARBs for blood pressure control and kidney protection, along with monitoring. Prognosis varies based on treatment response and whether kidney function stabilizes or continues declining.

Severe IgA nephropathy presents with heavy proteinuria (above 2000 mg/day), significantly impaired kidney function, and often rapid progression. These cases may require immunosuppressive medications including corticosteroids and other agents. The risk of progression to kidney failure is substantial, creating significant insurance challenges.

Rapidly progressive glomerulonephritis represents the most aggressive form, with acute kidney function decline over weeks to months. This medical emergency requires immediate intensive treatment and typically results in application postponement until disease control is established, if at all possible.

How Insurance Companies Evaluate IgA Nephropathy

Insurance underwriters employ a systematic, data-driven approach when assessing Berger’s disease cases, focusing on objective measurements that predict long-term kidney function preservation.

Primary Underwriting Considerations

Current kidney function measurement serves as the foundation of evaluation. The estimated glomerular filtration rate (eGFR) quantifies how efficiently your kidneys filter waste, with normal values above 90 mL/min/1.73m², mild reduction at 60-89, moderate reduction at 30-59, and severe impairment below 30. Serum creatinine levels provide additional information, with lower values indicating better function. Underwriters also review blood urea nitrogen (BUN), with normal ranges suggesting adequate kidney function while elevated levels indicate impairment.

Kidney function trajectory over time matters more than single measurements. Underwriters carefully track serial eGFR measurements spanning 12-24 months or longer to identify patterns. Stable readings demonstrate controlled disease, gradually improving values suggest treatment success, while progressive decline raises serious concerns about eventual kidney failure. The rate of decline particularly concerns underwriters—slow deterioration over many years is viewed differently than rapid decline over months.

Proteinuria levels and trends provide insight into ongoing kidney damage. Underwriters evaluate 24-hour urine protein collections or spot urine protein-to-creatinine ratios (UPCR). Minimal proteinuria (below 500 mg/day) suggests mild disease with good prognosis, moderate proteinuria (500-2000 mg/day) indicates more significant kidney inflammation, and heavy proteinuria (above 2000 mg/day) signals severe disease with higher progression risk. The trend matters critically—stable low-level proteinuria suggests controlled disease, while increasing protein loss despite treatment indicates progressive damage.

Blood pressure control profoundly affects IgA nephropathy prognosis, as hypertension accelerates kidney damage while good control slows progression. Underwriters review blood pressure readings, evaluating whether you maintain optimal control (below 130/80 mmHg for kidney disease patients) and what medications are required. Well-controlled blood pressure on minimal medication suggests milder disease, while difficult-to-control hypertension requiring multiple drugs raises concerns about more advanced kidney damage.

Kidney biopsy findings provide pathological evidence of disease severity. The Oxford MEST-C scoring system quantifies mesangial hypercellularity (M), endocapillary hypercellularity (E), segmental glomerulosclerosis (S), tubular atrophy/interstitial fibrosis (T), and crescents (C). Higher scores predict worse prognosis. Biopsies showing minimal changes receive more favorable consideration than those demonstrating extensive scarring, crescents, or advanced pathology.

Hematuria pattern while less critical than proteinuria and kidney function, provides additional information. Persistent microscopic hematuria alone causes minimal concern, while episodes of gross hematuria (visible blood in urine) following infections, though characteristic of IgA nephropathy, signal more active disease when frequent.

Treatment requirements indicate disease severity. Maintenance on ACE inhibitors or ARBs alone suggests mild disease requiring standard kidney-protective therapy. Requirements for immunosuppressive medications including corticosteroids, cyclophosphamide, or mycophenolate indicate more severe disease necessitating immune-modulating treatment with associated risks and side effects.

Complications development substantially worsens outcomes. Cardiovascular disease, previous episodes of acute kidney injury, frequent kidney infections, or other complications from chronic kidney disease significantly impact insurability beyond the IgA nephropathy itself.

Coverage Outlook by Disease Severity

Life insurance prospects for IgA nephropathy vary dramatically based on kidney function preservation, proteinuria levels, disease stability, and progression risk. Understanding where your specific situation falls helps establish realistic expectations.

For more insights on how various medical conditions affect coverage decisions, see our comprehensive guide on Life Insurance Approvals with Pre-Existing Medical Conditions.

Key Underwriting Factors

Beyond basic kidney function measurements, specific factors critically influence both approval likelihood and premium rates for IgA nephropathy applicants.

Rate of Kidney Function Decline

Underwriters focus intensely on whether your eGFR shows stability, improvement, or progressive decline. The rate of change matters as much as absolute values. An eGFR declining from 85 to 75 to 65 over consecutive years suggests steady progression toward kidney failure that raises serious concerns, even though 65 remains in the “mild reduction” category. Conversely, eGFR stable at 65, 64, 67, 65 over two years demonstrates your kidney function has plateaued at that level and isn’t actively deteriorating.

Some IgA nephropathy patients experience initial kidney function decline during the disease’s active phase, then stabilize at a lower level after treatment. If your eGFR dropped from 95 to 60 during the first 2-3 years after diagnosis but has remained stable at 58-62 for the subsequent 3 years, this pattern suggests your disease has “burned out” and remaining function will likely be preserved long-term. Underwriters view this more favorably than continuing active decline.

The concept of “slope” matters—a steep negative slope (rapid decline) suggests aggressive disease, while a flat slope (stability) or even positive slope (improvement) demonstrates controlled disease with better prognosis.

Proteinuria Control and Trends

Protein loss in urine directly correlates with ongoing kidney damage and predicts progression risk. Underwriters carefully evaluate both current proteinuria levels and trends over time:

Low-level proteinuria (below 500 mg/day) suggests minimal ongoing damage and good prognosis, receiving favorable underwriting consideration when combined with preserved kidney function.

Moderate proteinuria (500-1500 mg/day) indicates more significant kidney inflammation requiring treatment but remains compatible with insurance approval when stable and accompanied by preserved kidney function.

Heavy proteinuria (1500-3500 mg/day) raises substantial concerns about disease severity and progression risk, typically resulting in higher ratings or postponement depending on kidney function status.

Nephrotic-range proteinuria (above 3500 mg/day) indicates severe kidney damage that significantly impacts insurability, usually resulting in decline or postponement for traditional coverage.

Critically, improving proteinuria demonstrates treatment response—reduction from 2500 mg/day at diagnosis to 800 mg/day currently shows your disease is responding to therapy, which supports more favorable outcomes than persistent heavy proteinuria despite treatment.

Blood Pressure Management

Blood pressure control profoundly affects IgA nephropathy prognosis, as hypertension accelerates kidney damage while optimal control preserves function. Underwriters evaluate both blood pressure levels achieved and medication requirements:

Optimal control (below 130/80 consistently) on a single medication (typically an ACE inhibitor or ARB) suggests well-managed disease compatible with favorable outcomes.

Good control (130-139/80-89) on 1-2 medications indicates more significant hypertension but remains manageable and receives reasonable consideration.

Suboptimal control (consistently above 140/90) despite multiple medications raises concerns about either medication non-compliance or treatment-resistant hypertension from advanced kidney damage, substantially worsening insurance prospects.

The specific medications matter—ACE inhibitors and ARBs provide kidney-protective effects beyond blood pressure reduction, so their use is viewed favorably. However, requirements for multiple additional antihypertensive agents suggest more significant hypertension and kidney disease.

Kidney Biopsy Pathology Findings

The kidney biopsy report provides microscopic evidence of disease severity that helps predict prognosis. The Oxford MEST-C classification quantifies specific pathological features:

M (Mesangial hypercellularity): Increased mesangial cells suggest more active disease. Lower scores receive more favorable consideration.

E (Endocapillary hypercellularity): Inflammatory cells within capillaries indicate active inflammation. Presence worsens prognosis.

S (Segmental glomerulosclerosis): Scarring in parts of glomeruli suggests ongoing damage. Higher percentages predict worse outcomes.

T (Tubular atrophy/interstitial fibrosis): Scar tissue in kidney structures indicates permanent damage. Extensive fibrosis substantially worsens prospects.

C (Crescents): Crescent formations indicate aggressive inflammation. Presence significantly worsens prognosis and insurance outcomes.

Biopsies showing minimal changes (M0 E0 S0 T0 C0) receive the most favorable consideration, while high scores indicating extensive pathology typically result in higher ratings or decline.

Time Since Diagnosis and Disease Duration

How long you’ve had IgA nephropathy influences underwriting in complex ways:

Recent diagnosis (within 12 months) typically results in postponed applications or decline because underwriters cannot yet assess whether your disease will remain stable or progress. They need time to observe your trajectory.

Intermediate duration (1-5 years) with documented stability provides compelling evidence that your disease responds well to treatment and isn’t rapidly progressive. This timeframe often produces optimal insurance outcomes when kidney function remains preserved.

Long duration (10+ years) cuts both ways—if kidney function remains normal or near-normal throughout, it demonstrates a benign disease course with excellent prognosis that supports favorable underwriting. However, if kidney function has declined significantly over those years despite treatment, it suggests inexorably progressive disease that concerns underwriters.

Age at Diagnosis

Younger age at IgA nephropathy diagnosis creates underwriting concerns because it suggests longer lifetime exposure to progressive kidney disease. A 25-year-old with IgA nephropathy potentially faces 50+ years of disease progression risk, while a 55-year-old has shorter time horizon for complications to develop. However, this factor matters less than absolute kidney function and stability—a 30-year-old with eGFR of 85 stable for 5 years fares better than a 55-year-old with eGFR declining from 70 to 55 over 2 years.

Optimal Timing for Applications

Strategic application timing can dramatically improve outcomes for IgA nephropathy cases, often meaning the difference between approval and postponement or between Table 2 and Table 6 ratings.

Before Applying

When to Avoid Applying

Certain circumstances virtually guarantee postponed or declined applications, making delay the strategic choice:

Within 12 months of diagnosis: Newly diagnosed IgA nephropathy requires time to assess disease trajectory, treatment response, and stability. Applying within the first year after diagnosis almost always results in postponement regardless of initial kidney function measurements.

While kidney function is actively declining: Progressive eGFR reduction—particularly rapid decline—raises serious concerns about progression to kidney failure. If your recent trend shows declining function, postpone application until function stabilizes, demonstrating that treatment has halted progression.

During proteinuria escalation: Increasing protein loss despite treatment suggests inadequately controlled disease. If your proteinuria is rising rather than stable or decreasing, wait until treatment adjustments bring it under control before applying.

Following acute kidney injury episodes: If you’ve experienced acute kidney function deterioration requiring hospitalization, wait at least 6-12 months after full recovery to demonstrate that your baseline kidney function has been reestablished and remains stable.

With pending repeat kidney biopsy: If your nephrologist has ordered repeat biopsy to assess disease progression or treatment response, complete this evaluation and demonstrate stable findings before applying. Pending investigations raise red flags and typically result in postponement anyway.

When proteinuria remains heavy and uncontrolled: If your proteinuria persistently exceeds 2000-3000 mg/day despite treatment, work with your nephrologist to intensify therapy and achieve better control before applying. Heavy uncontrolled proteinuria typically results in decline or very high ratings.

Required Medical Documentation

IgA nephropathy cases require comprehensive documentation demonstrating kidney function stability and disease control to overcome underwriters’ concerns.

For IgA nephropathy, obtaining records before formal application is particularly valuable because it allows you to ensure you have adequate serial measurements demonstrating stability and identify any documentation gaps requiring additional follow-up before submission.

Critical Details Underwriters Scrutinize

Within your medical records, underwriters focus on specific data points that drive decisions:

eGFR trend line: They plot your serial eGFR measurements to visualize the trajectory. A flat or upward-trending line demonstrates stability or improvement, while a downward slope indicates progressive decline that substantially worsens prospects.

Proteinuria pattern: They examine whether protein loss is stable, decreasing (demonstrating treatment response), or increasing (suggesting progressive damage). Stable low-level proteinuria supports favorable outcomes, while escalating proteinuria raises serious concerns.

Treatment response evidence: Documentation showing that interventions successfully stabilized kidney function or reduced proteinuria demonstrates your disease responds to therapy, which significantly improves underwriting consideration.

Physician prognostic statements: Explicit nephrologist statements about expected long-term outcomes carry substantial weight. Notes stating “prognosis excellent with current stable disease” or “expect long-term kidney function preservation” support favorable decisions, while vague or concerning statements raise red flags.

Strategies to Improve Your Application

While you cannot change your IgA nephropathy diagnosis, strategic actions can substantially improve underwriting classifications and potentially save thousands in premiums.

Accumulate Maximum Stability Documentation Before Applying

The single most impactful strategy is extending your documented stability period before applying. If you have 12 months of stable kidney function data now, waiting an additional 6-12 months to accumulate 18-24 months of comprehensive data typically improves your classification by 2-4 table ratings. This patience translates to significant premium savings over your policy lifetime—potentially tens of thousands of dollars for large face amounts.

During this extended waiting period, maintain rigorous follow-up with your nephrologist, undergo regular kidney function testing every 3-4 months, ensure all results are documented in medical records, and maintain excellent medication compliance. Each additional quarter of stable measurements strengthens your eventual application.

Optimize Blood Pressure and Proteinuria Before Applying

Work closely with your nephrologist to achieve optimal blood pressure control (below 130/80) and minimize proteinuria before applying. This might involve medication adjustments, lifestyle modifications including sodium restriction and weight management if overweight, or adding medications that provide specific kidney-protective effects beyond blood pressure reduction.

Even modest improvements—reducing proteinuria from 1200 mg/day to 700 mg/day, or improving blood pressure from averaging 138/86 to 124/78—can shift underwriting classifications favorably. While you cannot manufacture kidney function improvement, ensuring you receive optimal nephroprotective treatment maximizes your kidney performance and demonstrates proactive disease management.

Request Comprehensive Nephrologist Documentation

Schedule a visit with your nephrologist specifically to discuss your life insurance plans and request comprehensive documentation of your current status. Ask them to include explicit statements about your disease stability over time, current prognosis, expected long-term kidney function preservation, and overall outlook. Explain that insurance underwriters need this prognostic information to make informed decisions about your case.

Many physicians write brief visit notes focused on immediate clinical management rather than providing the comprehensive assessments underwriters need. When they understand you’re applying for life insurance, most nephrologists willingly provide more detailed documentation addressing the specific questions insurance companies will ask about your prognosis.

Address All Cardiovascular Risk Factors

IgA nephropathy already creates underwriting challenges—allowing other cardiovascular risk factors to remain poorly controlled compounds these unnecessarily. Optimize cholesterol levels through diet, exercise, and medication if prescribed. If you smoke, quit immediately. If overweight, lose weight through sustainable lifestyle changes. If diabetic, maintain excellent blood sugar control with hemoglobin A1c below 7%.

Demonstrating excellent overall health management beyond just kidney disease helps offset some concerns about your IgA nephropathy and shows underwriters you’re committed to minimizing all mortality risk factors.

Work with a Specialized Renal Disease Broker

IgA nephropathy represents a challenging condition in insurance underwriting, with outcomes varying dramatically between carriers. Some companies decline all chronic kidney disease cases automatically regardless of severity or stability, while others with more sophisticated underwriting may offer reasonable coverage for well-documented stable cases.

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 kidney disease cases including IgA nephropathy.

We maintain relationships with underwriters at carriers experienced with kidney disease cases and can pre-screen your situation before formal application. This informal process identifies which carriers will consider your case and what approximate ratings to expect, without creating official application records that follow you if declined. For IgA nephropathy, this pre-screening is essential because applying to carriers likely to decline creates negative records, while identifying the 2-3 carriers with the most favorable policies for your specific kidney function and stability profile maximizes approval odds.

Alternative Coverage Options

When traditional fully underwritten life insurance proves unavailable or prohibitively expensive due to IgA nephropathy severity, alternative products can provide valuable financial protection.

Simplified Issue Life Insurance

Simplified issue policies use abbreviated health questionnaires without requiring medical exams or extensive record reviews. For very mild IgA nephropathy cases with normal or near-normal kidney function and minimal symptoms, these products might offer faster approval with reasonable rates compared to fully underwritten policies.

Applications typically ask yes/no questions about kidney disease, dialysis, recent hospitalizations, and current medications. If your IgA nephropathy is mild, stable for years, has never required hospitalization, and maintains eGFR above 80 with minimal proteinuria, you may qualify for simplified issue coverage by answering health questions favorably.

Trade-offs include premiums approximately 30-50% higher than comparable fully underwritten policies and coverage limits typically capped at $250,000-$500,000. However, faster approval and reduced medical scrutiny provide value for certain applicants.

For those seeking alternatives to traditional underwriting, our guide on Top 10 Best No-Exam Life Insurance Companies (2025 Update) provides comprehensive information worth exploring.

Guaranteed Issue Life Insurance

Guaranteed issue policies accept all applicants without medical questions or exams, making them valuable options for progressive or advanced IgA nephropathy that cannot qualify for traditional coverage. These policies eliminate health-based underwriting entirely and cannot decline you based on kidney disease.

The inherent limitations include significantly higher premiums relative to coverage amounts, limited face amounts (typically $5,000-$25,000), and graded death benefits during the first 2-3 years (most policies only return premiums plus interest if death occurs from illness during this period, though accidental deaths receive full immediate benefits).

Despite constraints, guaranteed issue coverage provides certainty of approval and immediate protection for final expenses and modest financial legacies when other options aren’t available. For someone with declining kidney function approaching dialysis facing certain traditional insurance decline, guaranteed issue coverage secured now provides immediate protection rather than leaving family without any coverage.

Group Life Insurance Through Employers

Employer-sponsored group life insurance offers guaranteed issue coverage up to certain amounts (commonly 1-2 times annual salary) without medical underwriting. If you have access to group coverage, maximize this benefit immediately regardless of your IgA nephropathy status, as it provides protection without health-based qualification.

Group coverage limitations include portability concerns (coverage typically ends when employment terminates unless converted, usually at very high rates), benefit amounts that often fall short of full financial needs, and potentially expensive voluntary supplemental coverage beyond guaranteed amounts. However, it provides immediate protection regardless of kidney function status or disease severity.

Future Application Strategy

If you currently have progressive IgA nephropathy precluding traditional coverage, consider securing guaranteed issue or group coverage for immediate protection while aggressively pursuing treatment and stabilization. If you successfully stabilize kidney function and maintain it for 18-24 months, you can reapply for traditional coverage at that time, potentially qualifying for table-rated traditional policies that provide larger coverage amounts at lower per-dollar costs than guaranteed issue.

This staged approach ensures continuous protection while you work toward improving your insurability, avoiding the risk of remaining completely uninsured while disease trajectory is uncertain.

Frequently Asked Questions

Can I get life insurance with IgA nephropathy (Berger’s disease)?

Yes, many individuals with IgA nephropathy can obtain life insurance, though approval depends heavily on kidney function preservation, proteinuria levels, disease stability, and progression rate. Mild IgA nephropathy with normal or near-normal kidney function (eGFR above 80), minimal proteinuria (below 500 mg/day), and documented stability for 18-24+ months may qualify for standard to table ratings ranging from Standard to Table 4 with carriers experienced in kidney disease underwriting. Moderate cases with mildly reduced kidney function (eGFR 60-80) and controlled moderate proteinuria (500-1500 mg/day) typically receive table ratings from Table 2 to Table 8 depending on specific stability and control quality. More severe cases with significantly reduced kidney function (eGFR below 60), heavy proteinuria (above 2000 mg/day), or progressive decline face substantial challenges, often requiring extended periods of documented stabilization before traditional coverage becomes possible, with many needing to rely on guaranteed issue or group coverage instead. The critical factors determining your prospects are your current eGFR measurements and trend over time, proteinuria levels and whether they’re stable or escalating, blood pressure control quality, kidney biopsy pathology findings, and whether your disease has remained stable or shown progression since diagnosis. Working with a broker experienced in kidney disease cases helps identify whether traditional coverage is realistic for your situation and which carriers offer the most favorable underwriting for your specific disease profile.

How long after IgA nephropathy diagnosis should I wait to apply for life insurance?

The optimal waiting period after IgA nephropathy diagnosis is typically 18-24 months before applying for traditional life insurance to achieve the best outcomes. This timeframe allows you to accumulate 6-8 serial kidney function measurements demonstrating clear stability trend rather than just initial snapshots, complete any intensive treatment phase if required, establish blood pressure control and medication regimen, demonstrate proteinuria control or reduction from treatment, and accumulate comprehensive nephrologist documentation confirming disease stability and favorable prognosis. Most insurance carriers automatically postpone applications from individuals diagnosed with IgA nephropathy within the past 12 months regardless of initial kidney function levels because early stability may prove temporary rather than sustained—many cases that appear stable initially subsequently show progression within the first year. Some very mild cases with completely normal kidney function, minimal proteinuria, and excellent control might achieve reasonable outcomes applying 12-18 months after diagnosis, though waiting until 24 months typically improves rate classifications even for favorable cases by demonstrating extended rather than short-term stability. Cases with any kidney function decline or moderate-to-heavy proteinuria benefit substantially from waiting 24-36 months or longer before applying, as carriers want extensive evidence that kidney function has stabilized at current levels and won’t continue deteriorating. The penalty for applying prematurely is receiving postponement decisions requiring you to wait anyway, or higher ratings that could have been lower with additional demonstrated stability. The premium savings from better ratings achieved by waiting often exceed tens of thousands of dollars over your policy’s lifetime, making patience financially valuable despite the difficulty of delaying coverage when you want protection immediately.

What kidney function level (eGFR) is required to qualify for life insurance with IgA nephropathy?

There’s no absolute eGFR cutoff that determines eligibility, but higher kidney function dramatically improves both approval likelihood and rate classifications. Generally, eGFR above 80 mL/min/1.73m² (normal or minimal kidney function reduction) provides the best prospects for favorable underwriting, often qualifying for standard to Table 2-4 ratings when combined with minimal proteinuria and documented stability. eGFR between 60-80 (mild kidney function reduction) remains compatible with traditional coverage approval, typically resulting in table ratings that increase as function declines within this range—eGFR of 75 might achieve Table 2-4, while eGFR of 62 typically faces Table 4-6. eGFR between 45-60 (moderate kidney function reduction) creates more substantial challenges, usually requiring exceptional stability documentation and excellent control of proteinuria and blood pressure to receive any traditional coverage consideration, with outcomes typically involving Table 6-8 ratings or decline depending on other factors and specific carrier guidelines. eGFR between 30-45 (moderate-to-severe reduction) faces severe underwriting challenges, with most carriers declining these cases for traditional coverage, though some specialty carriers might consider cases at the higher end of this range with extremely well-documented multi-year stability. eGFR below 30 (severe kidney function impairment) essentially precludes traditional life insurance, with guaranteed issue products representing the primary coverage option. However, the absolutely critical consideration isn’t just your current eGFR but the trajectory over time—stable eGFR at 55 for three years demonstrates controlled disease that won’t deteriorate further, which receives dramatically more favorable consideration than eGFR that declined from 85 to 65 over the past year even though 65 is numerically higher, because declining trend suggests ongoing progression. Underwriters plot your serial eGFR measurements to visualize the slope—flat or upward-trending lines demonstrate stability or improvement supporting approval, while downward-sloping lines indicate progressive decline that typically results in postponement until stabilization can be demonstrated.

Will life insurance companies require my kidney biopsy report?

Yes, insurance companies almost always request complete kidney biopsy reports for IgA nephropathy cases because biopsy findings provide critical pathological evidence about disease severity and prognosis that fundamentally drives underwriting decisions. The biopsy report documents confirmation of IgA nephropathy diagnosis through immunofluorescence staining showing IgA deposits in mesangium, pathological severity using the Oxford MEST-C classification system (when available), percentage of glomeruli affected by disease, presence of crescents indicating aggressive inflammation, extent of interstitial fibrosis and tubular atrophy indicating permanent damage, and overall disease severity assessment—all factors that directly predict progression risk and long-term kidney function preservation. Without biopsy documentation, underwriters must assume worst-case scenarios and typically postpone applications pending receipt of complete pathology information or assign very high preliminary ratings reflecting maximum uncertainty. The biopsy pathology significantly influences decisions—biopsies showing minimal changes (low Oxford scores) with little scarring or crescents receive substantially more favorable consideration than biopsies demonstrating extensive glomerulosclerosis, significant interstitial fibrosis, or crescents in multiple glomeruli, which indicate more aggressive disease with higher progression risk. You should obtain your complete kidney biopsy pathology report from your nephrologist before applying, reviewing it to understand the specific findings and severity indicators documented. Some applicants discover they don’t actually know their biopsy details despite having been diagnosed with IgA nephropathy—obtaining this information from medical records provides essential knowledge both for understanding your prognosis and for navigating insurance applications effectively. The biopsy report becomes a central piece of evidence that underwriters analyze carefully, so ensuring you have a complete copy and understand its implications before application helps you prepare for questions and discussions about your case and realistic coverage prospects.

Can I get life insurance if my IgA nephropathy requires immunosuppressive medications?

Yes, requirement for immunosuppressive medications doesn’t automatically disqualify you from life insurance, though the specific medications, treatment intensity, and why they’re required significantly impact underwriting decisions. Many IgA nephropathy patients who eventually secure insurance coverage take immunosuppressive therapy because their disease severity necessitates immune-modulating treatment beyond standard ACE inhibitors or ARBs alone. Treatment with corticosteroids (prednisone) at moderate doses or mycophenolate mofetil for severe disease with heavy proteinuria or declining kidney function indicates more aggressive disease requiring powerful medications, typically resulting in higher table ratings reflecting both disease severity and medication-related risks including infection susceptibility. However, applicants who successfully complete intensive immunosuppressive induction therapy, achieve disease control with kidney function stabilization and proteinuria reduction, then taper to maintenance therapy or discontinue immunosuppression entirely while maintaining stability present much stronger cases for insurance approval. The trajectory matters critically—documentation showing you required immunosuppression initially but successfully tapered off while kidney function remained stable demonstrates treatment response and disease control, supporting more favorable underwriting than persistent requirements for intensive immunosuppression despite treatment. Recent initiation of immunosuppressive therapy typically results in postponement until sufficient time has elapsed to assess treatment effectiveness and whether kidney function stabilizes or continues declining despite intervention. Underwriters also consider immunosuppression-related complications including serious infections, opportunistic diseases, bone density loss, or other medication side effects, which compound concerns beyond the IgA nephropathy itself. When applying for insurance while on or after completing immunosuppressive therapy, comprehensive documentation of your treatment course, reasons for specific drug choices, treatment response including kidney function and proteinuria improvements, and current stability status helps underwriters understand that therapy effectively controlled your disease rather than representing unsuccessful attempts to halt inexorable progression toward kidney failure.

What happens if my kidney function gets worse after I get life insurance?

Once your life insurance policy is issued and inforce, changes to your health status—including IgA nephropathy progression, declining kidney function, worsening proteinuria, or even development of kidney failure requiring dialysis or transplantation—cannot affect your coverage, premiums, or death benefits, provided you answered all application questions truthfully when applying. Life insurance premiums remain fixed at issue (for term insurance) or follow the policy schedule (for permanent insurance) regardless of subsequent health deterioration, and your policy cannot be cancelled or repriced due to worsening disease. This protection represents one of life insurance’s most valuable features—locking in coverage and rates based on your health status at application, providing financial security even if your kidney disease progresses significantly later. The only exception involves the contestability period (typically first two years) during which carriers can investigate whether you made material misrepresentations on your application and potentially rescind coverage if substantial fraud is discovered, though this applies only to information you knew but concealed at application time, not to honest statements about your health status that subsequently changed. After the contestability period expires, your coverage is essentially guaranteed regardless of health changes, disability, or disease progression. This reality makes securing coverage while your IgA nephropathy is relatively stable particularly valuable—even if your kidney function eventually declines to eGFR of 20 requiring dialysis despite current stability at eGFR of 70, your insurance remains fully inforce providing your beneficiaries with the full death benefit at the premiums locked in when you applied. This underscores the importance of applying when your disease is optimally controlled and stable rather than waiting indefinitely hoping for even better kidney function, because once you have coverage, future disease progression cannot take it away or increase your premiums, but waiting too long risks your disease deteriorating before you apply, making coverage impossible to obtain or dramatically more expensive if obtainable at all.

Should I disclose my IgA nephropathy if it’s mild with normal kidney function?

Absolutely yes—you must disclose IgA nephropathy regardless of current kidney function levels or disease severity, as failing to reveal known kidney disease constitutes material misrepresentation and fraud that can void your entire policy. Life insurance applications specifically ask about kidney disease, kidney conditions, abnormal kidney function tests, and related diagnoses. Attempting to conceal IgA nephropathy—even when mild with normal kidney function—creates enormous risks with virtually no benefits. Insurance companies verify application information through multiple comprehensive channels: they request complete medical records from all your physicians which document IgA nephropathy diagnosis including kidney biopsy reports, they review prescription medication databases revealing ACE inhibitors, ARBs, or other kidney-protective medications you’ve been prescribed, they conduct urinalysis during paramedical exams that may detect hematuria or proteinuria suggesting kidney disease, they perform blood tests measuring creatinine and eGFR that reveal any kidney function abnormalities, and they check the Medical Information Bureau (MIB) database containing information from previous insurance applications. Undiscovered IgA nephropathy found during this extensive verification process results in automatic application decline and creates official decline records in the MIB database that follow you to other carriers, making future coverage more difficult and expensive with any company. More seriously, if misrepresentation isn’t discovered until after policy issue—perhaps when your beneficiaries file a death claim—the insurer can investigate your application during the contestability period (first two years), discover the concealed kidney disease, and rescind coverage entirely, leaving your family without benefits despite years of premium payments. The risk-benefit calculation overwhelmingly favors complete honesty—attempting to hide even mild IgA nephropathy gains nothing (many applicants with well-controlled mild disease obtain coverage at reasonable rates anyway when disclosed) while creating catastrophic risk (policy rescission leaving your family with nothing). Moreover, mild IgA nephropathy with documented stability and normal kidney function, while definitely affecting your rates, often qualifies for coverage at standard to modest table ratings that still provide meaningful family protection at reasonable cost. Insurance underwriting functions only when built on accurate information—complete disclosure combined with comprehensive documentation of excellent disease control and stability consistently produces far better outcomes than concealment attempts for IgA nephropathy cases.

Can I qualify for preferred rates with IgA nephropathy?

Qualifying for preferred rates with IgA nephropathy is extremely rare but not impossible. Preferred classifications typically require absence of significant chronic diseases, which kidney conditions generally preclude. However, some carriers might consider preferred rates for exceptionally mild cases meeting strict criteria: completely normal kidney function (eGFR above 90) maintained for 10+ years, no proteinuria (below 150 mg/day), only microscopic hematuria, no medications beyond ACE inhibitor for kidney protection, excellent blood pressure control, and kidney biopsy showing minimal changes. Most IgA nephropathy cases realistically target standard to table ratings as best-case scenarios, with preferred rates representing rare exceptions rather than realistic expectations for the vast majority of applicants.