Life insurance with COPD
Chronic obstructive pulmonary disease affects around 1.2 million people in the UK, with many more undiagnosed. The impact on life insurance depends heavily on the severity of your COPD, whether you still smoke, and how frequently you experience flare-ups. Mild COPD in an ex-smoker is a very different proposition from severe COPD with frequent hospital admissions.
The short answer
Mild COPD (GOLD Stage 1) in an ex-smoker with infrequent exacerbations is usually insurable with a moderate loading. Moderate COPD (Stage 2) attracts a significant loading and fewer insurer options. Severe and very severe COPD (Stages 3-4) is very difficult on the standard market. Smoking status is compounding - a current smoker with COPD faces the smoker loading on top of the COPD loading. Stopping smoking is the single most impactful thing you can do for both your health and your insurance terms.
What insurers ask about COPD
COPD underwriting is structured around severity, stability, and smoking status. These are the questions you should be prepared to answer.
What is your FEV1 percentage?
FEV1 (forced expiratory volume in one second) as a percentage of predicted is the single most important measure of COPD severity. FEV1 above 80% is classified as mild (GOLD 1). 50-79% is moderate (GOLD 2). 30-49% is severe (GOLD 3). Below 30% is very severe (GOLD 4). If you have had spirometry, this number is on your results. If you have not, ask your GP or respiratory nurse.
What GOLD stage are you classified as?
GOLD staging (1 to 4) is derived from your FEV1 and maps directly to underwriting outcomes. Not everyone knows their GOLD stage by name, but if you know your FEV1 percentage, the stage can be determined. Some newer classification systems also account for symptoms and exacerbation history.
How many exacerbations have you had in the past 12 months?
An exacerbation is a flare-up of symptoms requiring additional treatment (steroids, antibiotics, or both). The number of exacerbations per year is a key risk indicator. Zero or one mild exacerbation per year is the best scenario. Two or more exacerbations, or any requiring hospitalisation, significantly worsen the underwriting outlook.
Have you been hospitalised for your COPD?
Any hospital admission for COPD in the past 2-3 years is a serious concern for underwriters. It indicates a more severe or unstable condition. The number of admissions and how recently they occurred both matter. An admission for a COPD exacerbation is viewed more seriously than routine outpatient management.
Do you use supplemental oxygen?
Long-term oxygen therapy (LTOT) indicates very severe COPD and makes standard life insurance extremely difficult to obtain. Ambulatory oxygen for exertion is similarly challenging. If you are on home oxygen, the options are largely confined to guaranteed acceptance products.
Do you currently smoke?
Smoking status is critical. A current smoker with COPD faces two compounding factors: the smoker loading (typically +50% to +100% on its own) added to the COPD loading. Stopping smoking is the most significant thing you can do to improve both your health outlook and your insurance terms. Most insurers classify you as a non-smoker after 12 months without any tobacco or nicotine products.
Know your FEV1 before you call
Your FEV1 percentage is the starting point for everything. If you do not know it, ask your GP surgery - it will be in your spirometry results.
Get QuoteHow each GOLD stage affects life insurance
GOLD staging is the framework insurers use to assess COPD severity. Here is what to expect at each stage.
GOLD Stage 1 - Mild (FEV1 80%+)
Moderate loading
Mild COPD is the most insurable stage. If you are an ex-smoker (12+ months tobacco-free), have infrequent or no exacerbations, and no hospital admissions for COPD, most mainstream insurers will offer terms. Loadings typically range from +50% to +100%. If you are still smoking, the smoker loading compounds this, but cover is still usually available.
GOLD Stage 2 - Moderate (FEV1 50-79%)
Significant loading, fewer options
Moderate COPD narrows the field. Loadings typically range from +100% to +200% for an ex-smoker with stable disease. The exacerbation frequency becomes more important at this stage - stable Stage 2 with rare flare-ups is viewed differently from Stage 2 with frequent exacerbations. Current smokers at this stage face compounded loadings that make premiums expensive but not necessarily unobtainable. Specialist insurers are often needed.
GOLD Stage 3 - Severe (FEV1 30-49%)
Very limited options
Severe COPD is very difficult on the standard market. Most mainstream insurers will decline. Some specialist insurers may consider applications on an individual basis, but loadings are very high if terms are offered. For many people at this stage, guaranteed acceptance life insurance is the most realistic option, alongside any group life cover through an employer.
GOLD Stage 4 - Very severe (FEV1 below 30%)
Standard market extremely unlikely
Very severe COPD, particularly with supplemental oxygen use, frequent hospital admissions, or cor pulmonale (right heart failure), is not insurable on the standard market. Guaranteed acceptance life insurance is the primary option. These policies have lower maximum sums assured and a moratorium period, but they provide genuine cover without medical questions.
The smoking compound effect
Smoking and COPD together create a compounding effect on premiums that is worth understanding. Life insurance already charges smokers more. COPD adds a further loading. The two together can make premiums very high, particularly at GOLD Stage 2 and above.
A practical example
A 50-year-old non-smoker without COPD might pay 30 pounds per month for 150,000 pounds of cover over 20 years. A 50-year-old smoker without COPD might pay 55-65 pounds. A 50-year-old ex-smoker with mild COPD might pay 50-60 pounds. A 50-year-old current smoker with moderate COPD could pay 120-180 pounds or more for the same cover. The numbers vary by insurer, but the principle is consistent: stopping smoking dramatically reduces the combined loading.
If you are still smoking and have been diagnosed with COPD, stopping smoking for 12 months before applying (or as part of an ongoing cessation) can make a material difference to your premiums. It is also the single most important thing you can do to slow the progression of COPD itself.
What COPD does to premiums
Here are indicative loading ranges for COPD, assuming an ex-smoker with stable disease and no recent hospital admissions:
- GOLD 1 (mild), ex-smoker, stable - +50% to +100%
- GOLD 1, current smoker - +100% to +175% (smoker loading compounded)
- GOLD 2, ex-smoker, stable - +100% to +200%
- GOLD 2, current smoker - +200% to +300% or individual assessment
- GOLD 3-4 - Individual assessment if terms are available; very high loadings or decline
These are indicative ranges. Actual premiums depend on age, sum assured, term, exacerbation frequency, and any co-existing conditions. Current smoker loadings are on top of the COPD loading.
Ex-smoker with COPD?
The combination of stopping smoking and mild, stable COPD is one of the more insurable respiratory conditions. Get in touch with your FEV1 and smoking history for guidance from our specialist brokers.
Get QuoteThe honest answer
COPD insurance is heavily severity-dependent. If you have mild COPD and have stopped smoking, you are likely to find affordable cover. If you have moderate COPD, cover is available but more expensive, and the right insurer makes a significant difference. If you have severe or very severe COPD, our partner brokers will be straight with you: the standard market is very unlikely to help, and guaranteed acceptance is probably your best route. They will not waste your time or money having you apply to insurers who will decline. They will tell you honestly where you stand and what your options are.
Critical illness cover with COPD
Critical illness cover with COPD is more limited than life insurance. Most insurers will apply a respiratory exclusion, meaning the policy would not pay out for conditions related to your lungs but would still cover cancer, heart attack, stroke, and other specified conditions. At GOLD Stage 2 and above, critical illness becomes increasingly difficult to obtain even with exclusions.
Income protection with COPD
Income protection is particularly difficult with COPD because the condition directly affects your ability to work, especially in physically demanding roles. Most insurers will either decline income protection for COPD or apply a respiratory exclusion. Even at GOLD Stage 1, income protection is significantly harder to obtain than life insurance. Group income protection through an employer may be the most accessible route.
Put your policy in trust
If you have secured life insurance with COPD, take the final step to protect the payout. Writing your policy in trust ensures the money goes directly to your beneficiaries, outside your estate, without probate delays or inheritance tax. It costs nothing and our partner brokers arrange it on every policy.
Read our full guide to trusts and estate planning
Frequently asked questions
Can I get life insurance with COPD?
Yes, in most cases. Mild COPD (GOLD Stage 1) is insurable with a moderate loading from most mainstream insurers. Moderate COPD (Stage 2) is insurable from specialist insurers with a significant loading. Severe and very severe COPD (Stages 3-4) is very difficult on the standard market but guaranteed acceptance products are available.
Does it matter if I still smoke?
Enormously. Smoking with COPD creates a compounding premium effect. It also signals to the underwriter that the condition is more likely to progress. Stopping smoking for 12 months reclassifies you as a non-smoker for insurance purposes and can significantly reduce your premiums. Even if you continue to use nicotine replacement therapy, some insurers will classify you more favourably than an active tobacco smoker.
I have emphysema. Is that treated the same as COPD?
Emphysema is one of the conditions under the COPD umbrella (the other being chronic bronchitis). For insurance purposes, it is assessed using the same framework: FEV1 percentage, GOLD staging, exacerbation frequency, and smoking status. The term your doctor uses matters less than the spirometry results.
I use inhalers. Does that affect my insurance?
Using inhalers is expected with a COPD diagnosis and does not in itself cause concern. What matters is the type and number of inhalers (a short-acting reliever only is better than multiple maintenance inhalers), and whether you also use oral medications such as regular steroids or nebulisers, which indicate more severe disease.
Will my premiums go up if my COPD gets worse?
No. Once your policy is in force with guaranteed premiums, the insurer cannot change them regardless of how your health changes. This is a key reason to secure cover while your COPD is at its mildest. Waiting risks needing to apply at a more advanced stage with higher loadings or fewer options.
I was hospitalised for a chest infection related to COPD. How does this affect my application?
Hospital admissions for COPD exacerbations are taken seriously by underwriters. A recent admission (within the past 12 months) may result in a postponement or higher loading. An admission 2-3 years ago with stability since then is viewed more favourably. Multiple admissions indicate unstable disease and significantly limit options.
Get honest advice about insurance with COPD
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