Heart Attack and Coronary Artery Disease History and Life Insurance

Last updated September 2026

A history of heart attack or coronary artery disease is one of the more heavily reviewed categories in underwriting, but it’s far from an automatic decline.

Heart Attack: at a glance

Time since the event matters enormously — several years out with a clean recovery is viewed very differently than the first year after.
Ejection fraction, cardiac rehab completion, and controlled risk factors since the event all factor in.
Carrier appetite varies widely here — one company's decline can be another's standard offer.

How Underwriters Look at It

Time since the event matters a great deal — someone several years out with a clean recovery and no further symptoms is viewed very differently than someone in the first year after a heart attack or stent placement. Underwriters also look at ejection fraction, whether you’ve completed cardiac rehab, and how well related risk factors like cholesterol and blood pressure are controlled since the event.

Ejection Fraction and What It Means

Ejection fraction (EF) measures how much blood your heart pumps out with each contraction, and it's one of the key numbers underwriters review after a cardiac event, per the American Heart Association:

Ejection Fraction	Category	General Underwriting Significance
55% – 70%	Normal	Generally the most favorable range post-event
41% – 49%	Mildly reduced	Reviewed alongside symptoms and overall cardiac function
40% or below	Reduced	More heavily reviewed; ongoing cardiology follow-up and stability matter most

Ranges per the American Heart Association (see Further Reading below). EF is one factor among several — recovery, rehab completion, and risk-factor control also matter.

What Can Help Your Rate

More time elapsed since the event with no recurrence
Completion of cardiac rehabilitation
A normal or near-normal ejection fraction on your most recent echocardiogram
Well-controlled cholesterol, blood pressure, and blood sugar since the event

What to Expect When You Apply

Carriers will typically request records from your cardiologist, including recent test results. This is a category where carrier appetite varies widely — one company’s decline can be another’s standard offer — so comparing multiple carriers matters more here than almost anywhere else.

This is general education, not medical advice, and it doesn't guarantee a specific rate class or approval. Underwriting depends on your full health history and the guidelines of the insurer you apply with.

Frequently Asked Questions

Can you get life insurance after a heart attack?

Yes, in many cases, especially with more time elapsed, a clean recovery, and well-controlled risk factors since. The first year after an event is typically the hardest to get favorable terms.

Does a stent placement count the same as a heart attack?

It's reviewed similarly — underwriters look at the reason for the stent, recovery, and cardiac function since, regardless of whether it followed a heart attack or was preventive.

What if my ejection fraction is reduced?

It will be reviewed more closely, but stability and ongoing cardiology care still matter — this doesn't automatically mean a decline.

Why does carrier choice matter so much for heart history?

Cardiac history is one of the categories where carriers' risk appetites diverge the most, so a decline or high rate at one company is often not representative of what others would offer.