Life Insurance With a Pacemaker or ICD
Published on November 3, 2026 last updated on November 3, 2026Condition guide
Life Insurance With a Pacemaker or Defibrillator (ICD)
Yes, you can get life insurance with a pacemaker or ICD. A pacemaker alone is often not the problem. The reason you needed it is. Many people qualify for a level (simplified issue) policy with full coverage from day one. If not, graded/modified or guaranteed issue (ages 18–85, exact range varies by carrier) is the fallback.
Updated November 3, 2026
Can you get life insurance with a pacemaker or ICD?
Yes. A pacemaker or an implantable cardioverter defibrillator (ICD) does not automatically shut you out of life insurance. Underwriters, the people who decide whether to approve an application, do not really care that you have a device. They care about the heart condition that made your doctor recommend it, and about how stable you have been since.
That is good news, because it means the outcome ranges widely. Someone who got a pacemaker for a slow heartbeat, feels fine, and has had no hospital stays may be approved for a level (simplified issue) policy. Someone with an ICD after a cardiac arrest and ongoing heart failure will probably need graded/modified or guaranteed issue coverage. Where you land depends on your history, not on the device alone.
Pacemaker vs ICD: why the difference matters to underwriters
The two devices look alike on an X-ray, but they treat different problems. According to Penn Medicine, a pacemaker senses a heartbeat that is too slow and sends small electrical impulses to bring it back to a normal pace. An ICD does everything a pacemaker does, and it can also deliver a shock to stop a dangerously fast rhythm. Medtronic puts it simply: a pacemaker treats a heart beating too slowly, and an ICD treats a heart beating too fast.
The NIH notes that pacemakers are also used in some people with heart failure, where pacing helps the heart chambers contract together. That is a different situation from a pacemaker placed for a slow pulse, and underwriters treat the two differently.
How underwriters tend to read each device
A pacemaker placed for a slow heart rate, with no heart failure or other major heart disease, is usually viewed as a treated, stable condition. An ICD tells the underwriter you were considered at high risk for a dangerous heart rhythm. That is a more serious signal, so ICDs more often lead to a graded/modified or guaranteed issue outcome. This is a broker’s general read, and every carrier has its own rules.
| Device | What it treats | Typical underwriting read |
|---|---|---|
| Pacemaker (slow heart rate) | Heartbeat that is too slow | Often treated as stable if no other heart disease; level (simplified issue) is possible with some carriers |
| Pacemaker or CRT device with heart failure | Heart failure plus rhythm problems | Heart failure usually drives the decision; graded/modified or guaranteed issue is more likely |
| ICD | Dangerous fast rhythms (and slow ones, in most models) | Higher-risk signal; level is harder, graded/modified or guaranteed issue more common |
The table is general guidance, not a promise. Eligibility varies by carrier.
What decides your outcome
When a carrier asks about your heart, these are the things that tend to move the answer. The questions differ from one application to the next, so treat this as a checklist of what to be ready to explain.
- Why you got the device. A slow heart rate on its own is a very different story from a cardiac arrest, a heart attack, or heart failure. This is the single biggest factor.
- How long ago it was placed. Many simplified issue applications ask about heart treatment, hospital stays, or procedures within a set window, often the last one to two years. A device placed three years ago with no problems since looks very different from one placed three months ago.
- Whether you have had shocks, hospital stays, or device problems. An ICD that has fired recently signals active rhythm trouble.
- Other heart conditions. Heart failure, a prior heart attack, or coronary artery disease can each push you down the ladder. Our guides on congestive heart failure and life insurance after a heart attack explain how those play out.
- Your medications. Blood thinners and heart rhythm drugs are common with devices. Some carriers ask about specific drug names.
- Tobacco use, age, height and weight. These change price and sometimes eligibility, regardless of the device.
Why many pacemaker patients get declined for the wrong reasons
Most declines I see are not because of the pacemaker. They happen because the person applied to a carrier whose questions happened to catch something else in their history, such as a hospital stay for the same episode that led to the device. Different carriers ask different questions, which is why one decline does not mean every carrier will decline you. If you have been turned down, read our page on what to do after a decline before you move to guaranteed issue.
Your coverage options, in order
Work down this list and stop at the first one you qualify for. Each step down costs more per dollar and may delay the full payout.
| Coverage type | Health questions | Medical exam | Waiting period | Best for |
|---|---|---|---|---|
| Level benefit (simplified issue) | A few yes/no questions | None | None; full payout from day one | Stable pacemaker patients with no other major heart disease |
| Graded / modified benefit | Fewer or more lenient questions | None | Reduced payout for natural-cause death, usually the first 1–2 years (varies by carrier) | Those with recent heart events or a history that fails level questions |
| Guaranteed issue | None | None | About 2 years (varies by carrier); premiums returned plus interest on early natural death | Recent ICD, heart failure, or declined everywhere else |
1. Level benefit (simplified issue)
This is the goal. You answer a handful of yes/no health questions, there is no exam, and the full benefit pays from day one. Our simplified issue guide explains how the questions work. If your pacemaker was for a slow heartbeat and you have been stable for a while, ask for quotes here first.
2. Graded / modified benefit
If a level application would be declined, graded/modified is the middle ground. The questions are easier, but if you die of natural causes in the first 1–2 years (varies by carrier), your family receives a reduced payout, often premiums plus interest, rather than the full face amount. Accidental death is typically covered in full, though that varies by carrier.
3. Guaranteed issue
No health questions at all. You cannot be turned down for health reasons, within the carrier’s age and state rules. In exchange you pay more for less coverage, and a waiting period applies, typically about 2 years (varies by carrier), with premiums returned plus interest if you die of natural causes during it. Coverage amounts are usually small, built to pay for final expenses. Read the full guaranteed issue guide for the details.
Which route fits which situation
| Your situation | Most likely route | Why |
|---|---|---|
| Pacemaker for slow pulse, placed over two years ago, no other heart disease | Level (simplified issue) | Treated and stable; worth shopping several carriers |
| Pacemaker placed within the last year | Level if the carrier allows, otherwise graded/modified | Recent procedure questions often apply |
| ICD, no shocks, no hospital stays recently | Graded/modified, possibly level with some carriers | Risk signal is higher but stability counts |
| ICD plus heart failure or recent hospital stay | Guaranteed issue | Most underwriting questions will not pass |
| Declined by every health-question carrier | Guaranteed issue | Only option that cannot decline you for health |
These are broker rules of thumb, not carrier guarantees. The only way to know is to compare real quotes.
Mistakes that cost people coverage
- Jumping straight to guaranteed issue. It is easy to say yes to the policy that never asks a question. If you could have qualified for level coverage, you gave up full day-one protection and paid more for it.
- Applying to several carriers at once with guesses. Each answer needs to match your medical records. Guessing at dates or diagnoses can lead to a decline, or a claim problem later.
- Calling it “just a pacemaker” when it was not. If the device came with a diagnosis such as heart failure, the application asks about the diagnosis, not the device. Answer what is asked, accurately.
- Not asking when a rating would improve. Many people with a graded or guaranteed policy can later apply for better coverage after a year or two of stability. Waiting costs nothing if you keep the policy in force.
- Dropping a policy before the replacement is approved. Never cancel until the new coverage is issued and in force. Our guide on when to replace a policy covers the order of steps.
Costs and waiting periods
Price depends on your age, sex, state, tobacco use, coverage amount, and carrier, so I will not quote a number that would apply to everyone. As a general pattern, level (simplified issue) costs the least per dollar of coverage, graded/modified costs more, and guaranteed issue costs the most. Our page on guaranteed issue cost by age shows how age changes the math.
On the waiting period: guaranteed issue policies typically hold back the full death benefit for about 2 years (varies by carrier). If the insured dies of natural causes in that window, the beneficiary receives the premiums paid, plus interest. After the waiting period, the full benefit pays for any cause. Graded/modified policies usually have a shorter reduced-payout period of 1–2 years (varies by carrier). See what happens if death occurs during the waiting period for examples.
Does the waiting period matter for a device patient?
It can. Heart rhythm problems are exactly the kind of risk a waiting period is built around. If your health is uncertain, a policy with a waiting period still protects against accidental death in many cases, and it still returns your premiums. It is better than no coverage, but it is not the same as full day-one protection.
How to apply the smart way
- Write down your history. Note the diagnosis behind the device, the implant date, any hospital stays, and your current heart medications. Your cardiologist’s office can help fill in dates.
- Ask for level (simplified issue) quotes first. An independent broker can check several carriers’ questions against your history without you filling out applications that get declined.
- Use graded/modified next if level fails. The reduced-payout period is usually shorter than a guaranteed issue waiting period.
- Take guaranteed issue only as the fallback. Keep the policy amount sized to final expenses and match it to your budget.
- Revisit in a year or two. Your device date gets older, and options may open up. We check back on request.
NIH notes that most people with a pacemaker see their doctor several times a year, and that a device usually lasts several years before part or all of it needs replacing. Underwriters tend to like that regular follow-up, since it shows the condition is monitored. Keep your appointment records handy.
Common questions
Can I get life insurance with a pacemaker?
Yes. Many people with a pacemaker qualify for coverage. Whether it is level (simplified issue), graded/modified, or guaranteed issue depends on why you needed it, how long ago it was placed, and your overall heart health. Eligibility varies by carrier.
Is it harder to get insurance with an ICD than with a pacemaker?
Usually, yes. An ICD means your doctor judged you at higher risk for a dangerous fast heart rhythm, so many carriers treat it as a stronger risk signal. You can still get coverage, often through graded/modified or guaranteed issue.
Will the insurance company ask for my medical records?
Level (simplified issue) carriers may check prescription databases and, in some cases, medical records, even with no exam. Graded/modified and guaranteed issue generally do not review your health. Always answer questions accurately.
Can I be declined for guaranteed issue because of my device?
No. Guaranteed issue does not ask health questions, so a pacemaker or ICD cannot be a reason for denial. You must still meet the carrier’s age and state rules (ages 18–85 (varies by carrier), exact range varies by carrier).
What if I die in the first two years of a guaranteed issue policy?
If death is from natural causes during the waiting period (about 2 years, varies by carrier), your beneficiary typically receives the premiums you paid plus interest rather than the full benefit. Accidental death is often covered in full, but check the policy.
Can I switch to a better policy later?
Often yes. After a year or more of stability, you can apply for level or graded coverage and keep your current policy until the new one is approved. Do not cancel first.
Do I need to tell the insurer about the device if the application does not ask?
Answer the questions you are asked, accurately and completely. If a level application asks about heart treatment or devices, say so. Guaranteed issue does not ask, so there is nothing to disclose on health.
Sources
- National Heart, Lung, and Blood Institute (NIH): Pacemakers
- NHLBI: Living with a pacemaker
- Penn Medicine: So You Have an Arrhythmia: ICDs and Pacemakers (2022)
- Medtronic: Pacemaker vs ICD
The bottom line
A pacemaker or ICD does not make you uninsurable. Start with level (simplified issue) coverage, step down to graded/modified if you need to, and use guaranteed issue only when the cheaper options are closed. The reason you got the device matters more than the device.
I compare the questions across carriers so you do not apply blind. Request a free quote or call (215) 999-3168 and we will go through your history together.