Life insurance with rheumatoid arthritis
Rheumatoid arthritis (RA) is usually insurable. It is an autoimmune condition that affects the joints, and insurers assess it based on severity, treatment, and whether there are complications beyond the joints. Most people with mild to moderate RA can get life insurance at reasonable rates.
The short answer
Most people with rheumatoid arthritis can get life insurance. Mild RA managed with DMARDs like methotrexate typically attracts a minor loading. Moderate to severe RA on biologics (adalimumab, etanercept, rituximab) attracts a moderate loading. The key factors are the severity of your disease, how much joint damage you have, what medication you are on, your mobility, and whether RA has affected any organs beyond your joints. Even with severe RA, cover is available from multiple insurers.
What insurers ask about rheumatoid arthritis
Insurers assess RA based on how active your disease is, what damage it has caused, and how it is being managed. Having these details to hand ensures a smooth application.
When were you diagnosed?
A longer history with stable disease is generally viewed favourably. Recent diagnosis (under 12 months) may result in a short postponement while treatment is established and disease activity settles.
What medication are you currently taking?
NSAIDs and simple painkillers suggest mild disease. DMARDs (methotrexate, sulfasalazine, hydroxychloroquine, leflunomide) suggest moderate disease being actively managed. Biologics (adalimumab, etanercept, infliximab, rituximab, tocilizumab, abatacept) or JAK inhibitors (tofacitinib, baricitinib) indicate moderate to severe disease. Each step up in treatment increases the loading.
How active is your disease currently?
Are your joints well-controlled with minimal pain and swelling, or are you experiencing ongoing active inflammation? Current disease activity directly affects underwriting. Being in low disease activity or remission on your current treatment is the ideal scenario.
Do you have any joint damage or deformity?
X-ray evidence of erosive joint damage, joint deformity, or significant loss of function indicates more aggressive disease. Insurers assess the degree of damage and its impact on your daily functioning.
Have you had any joint replacements?
Joint replacement surgery (hip, knee, shoulder) indicates severe disease but also definitive treatment for the affected joint. Post-replacement with good function is not necessarily viewed unfavourably, but it does signal that the disease has been significant.
Are there any extra-articular (beyond the joints) complications?
RA can affect organs beyond the joints. Lung involvement (interstitial lung disease, rheumatoid nodules in the lungs), vasculitis, eye inflammation (scleritis), or cardiac complications all significantly increase the loading. Pure joint disease without extra-articular features is viewed more straightforwardly.
Know your medication and disease activity
Your current medication and whether your RA is well-controlled are the two things our specialist brokers need to give you an accurate picture.
Get QuoteHow RA severity affects your premiums
Insurers assess rheumatoid arthritis on a clear severity spectrum based on your treatment, disease activity, and complications.
Mild RA
Standard to minor loading
Managed with NSAIDs, hydroxychloroquine, or low-dose methotrexate. Minimal joint involvement, no erosions on X-ray, good functional ability. Many mainstream insurers will offer terms at standard rates or with a minor loading of up to 50%.
Moderate RA
Minor to moderate loading
On combination DMARDs (e.g. methotrexate plus sulfasalazine) or methotrexate at higher doses. Some joint damage but maintained function. Well-controlled on current treatment. Typically attracts a loading of 50-100%. Cover available from most mainstream insurers.
Severe RA
Moderate loading
On biologics (adalimumab, etanercept, rituximab, tocilizumab) or JAK inhibitors. Significant joint damage, possible joint replacements, reduced mobility. No extra-articular involvement. Typically attracts a loading of 75-150%. Cover available from multiple insurers, but insurer selection matters.
Severe RA with extra-articular disease
Significant loading
RA with lung involvement (interstitial lung disease), vasculitis, cardiac complications, or other systemic features. Significantly higher loadings (150-250%+). Some mainstream insurers may decline. Specialist insurers will usually still offer terms, and the extra-articular features are assessed individually based on their severity.
How your RA medication affects your premiums
Your treatment regimen tells insurers a lot about the severity of your RA. Here is how different medications are typically viewed.
| Medication | Insurer view |
|---|---|
| NSAIDs / painkillers only | Very mild disease. Minimal or no loading. |
| Hydroxychloroquine | Mild disease. Minimal loading. One of the mildest DMARDs. |
| Methotrexate (alone or with other DMARDs) | Standard first-line treatment. Minor to moderate loading. Very well understood by underwriters. |
| Biologics (adalimumab, etanercept, infliximab, rituximab) | Indicates more severe or DMARD-resistant disease. Moderate loading. Cover still available from multiple insurers. |
| JAK inhibitors (tofacitinib, baricitinib, upadacitinib) | Newer class. Most insurers treat similarly to biologics. Moderate loading. |
| Oral steroids (prednisolone - long-term) | Long-term steroid use adds an additional loading due to steroid-related risks (osteoporosis, diabetes, infection). |
On biologics for RA?
Our specialist brokers work with insurers who understand biologic therapy. Get in touch to find the most competitive terms for your specific treatment.
Get QuoteAssociated conditions that affect underwriting
RA is a systemic autoimmune disease, and insurers consider any extra-articular features alongside the joint disease itself. These associated conditions can significantly affect your terms.
Rheumatoid lung disease
Interstitial lung disease (ILD) associated with RA is one of the most significant extra-articular complications for insurance. Even mild ILD on CT scan results in a substantial additional loading. Progressive or severe ILD significantly narrows options. Pulmonary nodules related to RA are viewed less seriously if stable and confirmed as rheumatoid in origin.
Vasculitis
Rheumatoid vasculitis (inflammation of blood vessels) is a serious complication that substantially impacts underwriting. It indicates aggressive systemic disease and results in significant loadings. The severity, affected organs, and current disease activity all matter.
Eye involvement
Scleritis or episcleritis associated with RA is assessed based on severity and frequency. Mild occasional episcleritis has relatively little impact. Recurrent scleritis requiring systemic immunosuppression is viewed more seriously as it indicates more active systemic disease.
Cardiovascular risk
RA is associated with increased cardiovascular risk due to chronic inflammation. Insurers factor this into their assessment. If you also have high blood pressure, high cholesterol, or other cardiovascular risk factors, the combined impact is assessed together. Well-managed cardiovascular risk factors alongside RA minimises this additional loading.
The honest answer
Rheumatoid arthritis is one of the more straightforwardly insurable chronic conditions. If you have mild to moderate RA managed with standard DMARDs, you should expect to get life insurance without great difficulty, though the premiums will be higher than someone without RA. Even severe RA on biologics is insurable - the loading is higher but cover is available from multiple insurers. The main complications arise when RA has affected organs beyond the joints, particularly the lungs. In those cases, the extra-articular features dominate the underwriting. As with many conditions, the biggest mistake is applying to the wrong insurer. Some are significantly more competitive for RA than others.
Critical illness cover with rheumatoid arthritis
Critical illness cover is generally available with RA, though some insurers may apply a loading or add specific exclusions. Since RA is not itself a listed condition on most critical illness policies, the underwriting focuses on the increased risk of associated conditions (particularly cardiovascular disease).
Mild RA on DMARDs can usually obtain critical illness cover alongside life insurance from the same insurer. Severe RA on biologics may face a higher loading on the critical illness element, and some insurers may decline the critical illness component while accepting the life insurance.
Income protection with rheumatoid arthritis
Income protection is available with RA but commonly comes with an RA-related exclusion - meaning the policy would not pay out if you are unable to work specifically due to your rheumatoid arthritis or its complications. The policy would still cover you for all other conditions.
For mild, well-controlled RA with no time off work, some insurers may offer income protection without an RA exclusion, though typically with a loading. The key factors are your current functional ability, time off work in the last few years, and the severity of your disease. A longer deferred period (e.g. 6 months or 12 months) may make cover without an exclusion more achievable.
Need income protection with RA?
Our specialist brokers know which insurers are most likely to offer income protection with or without an RA exclusion for your specific situation.
Get QuotePut your policy in trust
Once you have secured your life insurance, writing the policy in trust ensures the payout goes directly to your beneficiaries outside your estate. This avoids inheritance tax and probate delays. It is free, takes 2 minutes, and our partner brokers set it up on every policy they arrange.
Read our full guide to trusts and estate planning
Frequently asked questions
Is rheumatoid arthritis the same as osteoarthritis for insurance?
No. Rheumatoid arthritis is an autoimmune disease that causes the immune system to attack the joints and potentially other organs. Osteoarthritis is wear-and-tear joint degeneration. Insurers view them very differently. Osteoarthritis typically has less impact on life insurance premiums. RA attracts higher loadings because of its systemic nature and associated complications.
I am on methotrexate. Will this be a problem?
Not at all. Methotrexate is the standard first-line treatment for RA and is very well understood by underwriters. Being on methotrexate with well-controlled disease typically results in a minor loading of 25-75% above standard rates. Most mainstream insurers are comfortable with methotrexate-managed RA.
Does having RA increase my risk of being declined?
RA alone rarely results in a decline. Even severe RA on biologics is insurable, albeit with higher premiums. The scenarios where decline becomes more likely are severe extra-articular disease (particularly significant lung involvement) or RA combined with other serious conditions. For the vast majority of RA patients, the question is not whether you can get cover but how much it will cost.
I was diagnosed young. Does my age at diagnosis matter?
Age at diagnosis can matter. Young-onset RA (under 30) may indicate more aggressive disease, and the longer disease duration means more time for complications to develop. However, young-onset RA that has been well-controlled for many years with minimal damage is actually viewed favourably - it shows the disease has a manageable course. Current disease status matters more than age at diagnosis.
I also have another autoimmune condition (thyroid disease, Sjogren's). How does this affect things?
Multiple autoimmune conditions are assessed individually and together. Hypothyroidism managed with levothyroxine has minimal additional impact. Sjogren's syndrome alongside RA is common and may add a small additional loading. More serious co-existing autoimmune conditions (lupus, vasculitis) have a greater impact. Each combination is assessed on its own merits.
Will my premiums decrease if my RA goes into remission?
Once your policy is in force with guaranteed premiums, the premiums are fixed regardless of whether your health improves or worsens. This is a strong argument for securing cover while your disease is well-controlled. If your RA flares in the future, your existing cover remains unaffected at the original premium.
Get a life insurance quote with rheumatoid arthritis
Tell us your medication, disease activity, and whether you have any extra-articular features. Our specialist brokers will find the right insurer and get you the best available terms.
Get QuoteFree. No obligation. Takes 2 minutes.