Life insurance with a heart condition or high blood pressure

Yes, it's possible, though it can be harder. Insurers may charge a higher premium or not sell you a policy, depending on you and your condition. They assume a heart or circulatory condition makes you more likely to claim.

Each insurer decides case by case against its own requirements, so one insurer's answer may not match another's.

Expect direct questions about your heart. Legal & General gives heart conditions as an example of a pre-existing condition you'll need to disclose. Octopus Legacy's application asks about angina, a heart attack, valve problems, heart enlargement, cardiomyopathy or any heart surgery. It asks separately about a stroke or a transient ischaemic attack (TIA, a mini stroke).

In Royal London's guide, an underwriter can accept you at ordinary rates (no extra charge) or add an extra premium (a rating, or loading). It can also exclude part of the cover, postpone the decision for a set period or, in extreme cases, not offer cover at all. Our guide to possible outcomes explains each one.

What a premium loading means

Royal London's guide writes extra risk as a percentage added to the standard rate, such as 100%, or as a yearly amount for each £1,000 of cover. A +50% loading means you pay one and a half times the standard premium. At +100%, you pay double.

The standard premium itself depends on your age, so a lower loading at an older age doesn't mean a lower price. The Exeter and Vitality publish ranges for their life cover loadings:

It's possible, depending on your age, how long ago it happened and your recovery. In The Exeter's Real Life guide, a single treated heart attack with good recovery would get a mild (50% to 75%) to moderate (100% to 225%) rating. Where it falls depends on your age and the time since.

What insurers ask and what evidence they need

The Exeter's guide asks when the heart attack happened and whether you still have symptoms such as angina (pain or tightness in the chest). It also asks if you've had more than one heart attack or other significant conditions.

It asks about your treatment too, such as a stent fitted during coronary angioplasty to open blocked arteries. Bypass surgery, another treatment, uses an artery from elsewhere in your body to take blood around a blockage.

It needs a targeted report from your GP, though it may be able to use your latest cardiology follow-up report instead.

Had a stent or angioplasty for narrowed arteries without a heart attack? You'll still need to declare it where the form asks. Octopus Legacy's application, for example, asks about any heart condition and any heart surgery.

How Royal London sets its terms

Royal London's guide sets life cover terms after a heart attack mainly by your age at the time, how long ago it happened and the number of heart vessels involved. A higher BMI, family history, other conditions and whether smoker rates apply count on top.

• Royal London's basic rating may be reduced if you've had angioplasty or bypass surgery, have no ongoing chest pain, or show good exercise capacity on an exercise tolerance test.
• It may be increased if you have ongoing chest pain or poor exercise capacity on the test. Your treatment and test results may also change the rating, or mean it can't offer cover.

Each percentage in the table is added to Royal London's standard rate, and the standard premium itself depends on your age.

Yes, depending on the condition, your treatment and how well it's controlled. In The Exeter's Real Life guide, a mild, well-controlled arrhythmia (irregular heartbeat) with no complications would get a mild rating (50% to 75%).

Forms don't all use the same names. Octopus Legacy's, for example, asks about angina, heart valve problems and any heart surgery. Coronary heart disease may also appear as ischaemic heart disease or coronary artery disease.

Valve disease doesn't always need treatment, but severe valve disease usually needs surgery to repair or replace the valve.

Arrhythmias include atrial fibrillation and supraventricular tachycardia (SVT), and some people have a pacemaker fitted under the skin to correct the rhythm. If yours is treated and controlled, with no related stroke, The Exeter can use evidence you supply yourself.

The Exeter's Real Life guide sets out what it asks and the likely terms for arrhythmias and cardiomyopathy (diseases of the heart muscle):

Yes, and with normal readings it may not cost more. Royal London's guide shows ordinary rates (no extra charge) on life cover when your blood pressure and cholesterol are normal.

You're usually considered to have high blood pressure (hypertension) with a reading of 140/90 or higher at a check by a healthcare professional, or 135/85 or higher at home. High cholesterol only shows up in a blood test. Both make a heart attack or stroke more likely.

How Royal London's guide rates blood pressure and cholesterol

• Normal blood pressure or cholesterol means ordinary rates on life cover, and on critical illness, total permanent disability and income protection cover too.
• If your blood pressure or cholesterol is raised, the rating depends on how far it's raised.
• If you were diagnosed under 30, or are under close review, a loading may still apply.
• After a referral to a hypertension or lipid (cholesterol) clinic, or hospital investigations, it will usually need evidence.

You may be asked for an up-to-date reading. Royal London's paramed screening, for example, is a nurse's visit that includes a basic check of your height, weight, blood pressure and urine.

Several risk factors add up. Royal London's decision also takes in a higher BMI, family history, other conditions and smoking. Some conditions add to each other's risk, such as high blood pressure and high cholesterol, so the final loading may be more than the two loadings added together.

Living with overweight or obesity also makes a heart attack more likely. If your weight is a factor, see high BMI life insurance. Blueberry Life says it specialises in type 1 and type 2 diabetes. It also offers term life insurance for people with high blood pressure, high cholesterol or a high BMI.

You can, depending on your age, how long ago it happened and how severe it was. At The Exeter, a single TIA (mini stroke) would get a mild rating (50% to 75%), but it can't cover multiple strokes.

A TIA is less severe than a full stroke, so The Exeter says it's important to make the distinction when you apply. In its guide, a mild stroke in middle age more than three years ago, with good recovery and no risk factors, would get a moderate rating (100% to 225%). It may be higher or lower depending on the time since recovery, your age at diagnosis and how severe the stroke was.

The Exeter asks for the date of the stroke, your age then and your treatment. It also asks about any remaining physical or mental problems and ongoing risk factors such as high blood pressure or smoking. It wants your latest stroke clinic review report, or otherwise a GP report.

Royal London's guide gives an indication of life cover terms for non-smokers after a single stroke:

Each percentage is added to Royal London's standard rate, and the standard premium itself depends on your age. Royal London says it may be able to improve on these terms, depending on the exact nature of the stroke. A higher BMI, family history, other conditions and smoking count too.

Possibly, but it can be harder than getting life cover. Insurers may exclude conditions, charge more or refuse cover. Critical illness cover pays out if you're diagnosed with one of the conditions named in your policy.

Under the minimum standards of the ABI (Association of British Insurers), every critical illness policy covers cancer, heart attack and stroke, each to at least the ABI's model wording. Here's how three insurers treat an existing heart condition:

• After underwriting (how the insurer weighs your health), Aviva may only offer its Critical Illness Plan at a higher premium than first quoted, with some benefits excluded, or both.
• Legal & General says you can still apply for its Critical Illness Cover after a diagnosis, though some conditions may be excluded or cover refused.
• Royal London's guide says it can't offer critical illness cover, total permanent disability, waiver of premium or income protection after a heart attack. After a single stroke, its table for non-smokers shows critical illness, total permanent disability and income protection as unable to offer at every stage, even after 10 years.

With an exclusion, Royal London says it may not be able to consider a claim for the excluded condition, but you're still covered for everything else. Life cover can work differently: Vitality's underwriting guide says it never applies exclusions to its Life Cover.

For critical illness claims, the ABI's model heart attack wording needs a definite diagnosis of acute myocardial infarction (the medical name for a heart attack) with death of heart muscle. It doesn't cover angina without a heart attack.

Its stroke wording doesn't cover a TIA, and high blood pressure itself is a common exclusion from critical illness policies. Our guide to critical illness cover for heart attacks explains claims in more detail.

Does a family history of heart disease affect cover?

Insurers may ask about your close family too. Before its phone health interview, Forester Life asks for details of serious conditions such as cancer, heart attack or stroke in you or your immediate family.

Royal London's family history table covers coronary heart disease, including heart attack and angina in relatives. It assumes no family history of stroke or type 2 diabetes in relatives under 60.

Say you're under 45. With one affected relative, the table shows ordinary rates. With two, the youngest diagnosed before 60, it shows a 50% loading on life cover and 100% on critical illness, total permanent disability and income protection.

If you're over 60 when you apply, it shows ordinary rates whatever your family history.

• Critical illness cover: how it works and what it pays
• Critical illness cover conditions: what policies cover
• Critical illness cover for heart attacks
• Critical illness calculator

Before you apply, gather your medical details and make sure you can answer every health question fully.

1. Gather your dates, readings and clinic letters Note the dates of any heart attack, stroke or procedure, your medicines, and your latest blood pressure and cholesterol readings. The Exeter may accept your latest cardiology follow-up or stroke clinic review report instead of a GP report.
2. Answer every health question fully and accurately You have a legal duty to take reasonable care not to make a misrepresentation (give incomplete or misleading information). Royal London says it's better to tell it too much than too little, and that vague answers lead to more questions and possible delays. If an answer changes before the cover starts, tell the insurer.
3. Check your GP report if you want to see it first In England, Wales and Scotland, the Access to Medical Reports Act 1988 applies: the insurer must tell you and get your consent before it asks your doctor for a report. If you ask to see it first, your doctor can't send it until you have, or until 21 days pass without you arranging to. In Northern Ireland, the request is made under the Access to Personal Files and Medical Reports (Northern Ireland) Order 1991.
4. Ask when to reapply if postponed, or compare other insurers If you're postponed, the insurer may be able to offer terms after a set period, so ask when it would look again. Turned down? Another insurer may see it differently: see what to do if you're refused. The British Heart Foundation suggests talking to an insurance broker. Our broker partner, Reassured, compares quotes from a panel of leading insurers, free and with no obligation.
5. Know the limits of over 50s plans Guaranteed acceptance over 50s plans (usually for ages 50 to 85) don't ask about your health, but full cover typically starts only after a waiting period. On some plans it's 12 months, and if you pass away in that time from anything other than an accident, the premiums are refunded. The payout is fixed and doesn't keep up with rising prices, and MoneyHelper warns you might pay in more than your family gets back.

Some over 50s plans ask optional health questions instead. National Friendly's Over 50s Life Cover has two. One asks whether, in the last five years, you've had, been diagnosed with, been treated for or attended a consultation for heart disease, a stroke or certain other conditions. If you answer them, you might be offered a bigger payout and a qualifying period (the wait before the full payout) of six months instead of two years.

• Guaranteed life insurance: plans for ages 50 to 85 that don't ask about your health
• Over 50 life insurance: how over 50s plans work
• Life insurance for smokers
• High BMI life insurance
• Life insurance calculator: how much cover you might need