Life insurance with kidney disease
Chronic kidney disease affects over 3 million people in the UK, and the impact on life insurance varies enormously depending on the stage. CKD Stage 1 with stable kidney function is a different proposition entirely from Stage 5 on dialysis. This guide walks through every stage, what insurers ask, and what you can realistically expect.
The short answer
CKD Stages 1-2 with stable eGFR are usually insurable at standard rates or with a minor loading. Stage 3a typically attracts a moderate loading. Stage 3b means a significant loading and fewer insurer options. Stage 4-5 is very limited, with specialist underwriting required. Dialysis means most insurers decline, leaving guaranteed acceptance as the main option. Post-transplant with stable function may be considered by some insurers from around 2 years after the procedure.
What insurers ask about kidney disease
Kidney disease underwriting is heavily data-driven. The more specific information you can provide, the more accurately an insurer can assess your application.
What is your current eGFR level?
Your estimated glomerular filtration rate is the single most important number for underwriting. eGFR above 60 ml/min (Stages 1-2) is viewed very differently from eGFR below 30 (Stages 4-5). Insurers will want your most recent reading and ideally the trend over the past 12-24 months.
What stage of CKD have you been diagnosed with?
CKD staging from 1 to 5 directly maps to underwriting outcomes. Stage 1-2 is the most straightforward. Stage 3 is subdivided into 3a and 3b, with materially different outcomes. Stages 4-5 require specialist consideration.
What is the underlying cause of your kidney disease?
Diabetes-related nephropathy, polycystic kidney disease, glomerulonephritis, hypertensive nephropathy, and other causes are all assessed differently. Some causes are viewed as more progressive than others. The cause also helps the underwriter assess your overall risk profile.
Do you have significant proteinuria?
Protein in the urine indicates kidney damage and is a marker for disease progression. High levels of proteinuria, even at earlier CKD stages, can result in less favourable terms. Albumin-to-creatinine ratio (ACR) results are useful to have available.
Are you on dialysis, or is dialysis anticipated?
Dialysis status is a critical dividing line. Active dialysis or an expectation of dialysis within the foreseeable future significantly limits options on the standard market. The type of dialysis (haemodialysis vs peritoneal) is also noted.
Have you had a kidney transplant?
Post-transplant applications are considered individually. Insurers want to know the date of transplant, current graft function (eGFR), rejection episodes, immunosuppressive medication, and overall stability. Most require at least 2 years post-transplant with stable function.
Have your kidney function results to hand
Your most recent eGFR, creatinine, and any proteinuria results make a significant difference to the accuracy of the guidance our specialist brokers can give you.
Get QuoteHow each CKD stage affects life insurance
CKD staging is the primary framework insurers use. Here is what to expect at each stage.
Stage 1-2 (eGFR above 60)
Standard rates or minor loading
Mild kidney impairment with stable function is usually insurable at standard rates or with a small loading, typically 25-50%. If the underlying cause is well-managed (for example, controlled blood pressure or diabetes), most mainstream insurers will offer terms. The key is demonstrating stability - a stable or improving eGFR trend over time is reassuring to underwriters.
Stage 3a (eGFR 45-59)
Moderate loading
Stage 3a represents a moderately reduced kidney function. Most insurers will still offer terms, but with a loading typically in the 50-100% range. Stable eGFR (not declining year on year) is important. Minimal proteinuria and a well-controlled underlying cause both help achieve better terms. Several mainstream insurers are comfortable at this stage.
Stage 3b (eGFR 30-44)
Significant loading, fewer options
Stage 3b is a meaningful step down in terms of insurer appetite. Fewer mainstream insurers will offer terms, and those that do will apply significant loadings, often 100-200% or more. Specialist insurers become more relevant at this stage. A stable eGFR is particularly important here - a declining trend may result in postponement until stability is demonstrated.
Stage 4 (eGFR 15-29)
Very limited options
Stage 4 CKD means severely reduced kidney function, and most mainstream insurers will decline. Specialist insurers may consider applications on an individual basis, but terms will be significantly loaded if available. For many people at this stage, guaranteed acceptance life insurance becomes the primary option alongside any group life cover through an employer.
Stage 5 / dialysis (eGFR below 15)
Most decline; guaranteed acceptance main option
End-stage renal disease with or without dialysis is very difficult to insure on the standard market. Most insurers will decline. Guaranteed acceptance life insurance, which requires no medical questions, is the main fallback. These policies typically have lower maximum sums assured, a waiting period before the full payout applies, and higher premiums per pound of cover. Group life through an employer is also worth checking.
Life insurance after kidney transplant
A successful kidney transplant can actually improve your insurability compared to remaining on dialysis. Some insurers will consider applications from around 2 years post-transplant, provided the graft is functioning well.
- Under 2 years post-transplant - Most insurers will postpone until a clear track record of graft stability is established
- 2-5 years post-transplant - Some specialist insurers will offer terms if eGFR is stable and above 40, no rejection episodes, and stable immunosuppression. Significant loadings are typical
- 5+ years post-transplant - More options open up. Loadings remain but may reduce to moderate levels. Long-term graft survival and stable function are reassuring to underwriters
Key factors for post-transplant underwriting include current eGFR from the transplanted kidney, number and severity of any rejection episodes, current immunosuppressive medication, and the original cause of kidney failure.
Post-transplant and looking for cover?
Your transplant date, current graft function, and medication details allow our specialist brokers to identify which insurers are most likely to offer terms.
Get QuoteWhat kidney disease does to premiums
Premium loadings for kidney disease are directly tied to your CKD stage and stability. A “loading” is a percentage added to the standard premium. Here is a realistic guide:
- CKD Stage 1-2, stable - Standard rates to +50%. Many people at this stage are pleasantly surprised by their premiums
- CKD Stage 3a, stable - +50% to +100%. Still competitive across several insurers
- CKD Stage 3b, stable - +100% to +200%. Fewer insurer options, but still obtainable
- CKD Stage 4 - +200% or more if terms are offered. Individual underwriting essential
- Post-transplant (stable, 2+ years) - +100% to +250% typically. Specialist market
These are indicative ranges. Your actual premium depends on the full picture: age, sum assured, policy term, underlying cause of CKD, and any co-existing conditions such as diabetes or hypertension.
The honest answer
Kidney disease insurance is genuinely stage-dependent. If you have CKD Stage 1-2 with stable function, you should not assume the worst - many people get very reasonable terms. If you are at Stage 4-5 or on dialysis, our partner brokers will not pretend the standard market is likely to help. They will tell you that straight, explain the guaranteed acceptance options that do exist, and help you make the most of any group life cover you may already have. The worst thing you can do is apply blind to mainstream insurers and collect declines on your record. A specialist broker ensures your application goes to the right insurer first time.
Critical illness cover with kidney disease
Critical illness cover is harder to obtain with CKD than life insurance. Most insurers will either decline or apply a kidney-related exclusion, meaning the policy would not pay out for kidney failure but would still cover cancer, heart attack, stroke, and other specified conditions.
At CKD Stage 1-2, some insurers may offer critical illness with a renal exclusion. At Stage 3 and above, critical illness becomes increasingly difficult to obtain even with exclusions.
Income protection with kidney disease
Income protection is available for early-stage CKD, typically with a kidney-related exclusion. The policy would cover you if you could not work due to other conditions but would not pay out if your kidney disease prevented you from working. At Stage 3b and above, income protection on the individual market becomes very limited.
Put your policy in trust
If you have gone through the effort of securing life insurance with kidney disease, it makes sense to ensure the payout is handled properly. Writing your policy in trust means the money goes directly to your beneficiaries, outside your estate, without probate delays or inheritance tax. It is free and takes minutes to arrange.
Read our full guide to trusts and estate planning
Frequently asked questions
Can I get life insurance with Stage 3 CKD?
Yes. Stage 3a CKD with stable eGFR is insurable with a moderate loading from several mainstream and specialist insurers. Stage 3b is harder but still possible. The key factors are your eGFR trend (stable is better than declining), the underlying cause of your CKD, and whether you have significant proteinuria.
My eGFR has been stable for years. Does that help?
Significantly. A stable eGFR is one of the most positive things an underwriter can see. It indicates your kidney disease is not progressing rapidly, which directly improves your risk profile. If you have 2-3 years of consistent readings, make sure these are available when you apply.
I am on dialysis. Are there any options at all?
Standard life insurance is very unlikely while on dialysis, but guaranteed acceptance life insurance requires no medical questions and cannot decline you. These policies have lower maximum sums assured (typically up to 20,000-25,000 pounds) and a moratorium period, but they provide genuine cover. Group life through an employer is also worth checking, as it often has limited or no medical underwriting.
Does the cause of my kidney disease matter?
Yes. Some causes are viewed as more stable or manageable than others. CKD due to well-controlled hypertension, for example, may be viewed more favourably than CKD due to polycystic kidney disease, where progression is more predictable. CKD secondary to diabetes is assessed alongside the diabetes itself, creating a combined risk profile.
I had a kidney transplant two years ago. Can I apply now?
Yes. Some specialist insurers will consider applications from around 2 years post-transplant if your graft function is stable, you have not had rejection episodes, and your immunosuppressive medication is well-tolerated. Terms will include a significant loading, but cover is available. The longer since your transplant with stable function, the better the terms become.
Will having a kidney removed (nephrectomy) affect my insurance?
A nephrectomy for a benign reason (such as donation or a non-cancerous condition) with remaining kidney function in the normal range is typically insurable at standard or near-standard rates. A nephrectomy for cancer is assessed under cancer survivor underwriting, where the cancer type and staging matter more than the kidney removal itself.
Get honest advice about insurance with kidney disease
Tell us your CKD stage, eGFR, and any treatment details. Our specialist brokers will tell you which insurers are most likely to offer terms and what to expect.
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