When you die, funeral costs and end-of-life expenses can quickly add up. If you leave any family behind, they’ll also need money to survive. Life insurance can cover these essentials, but many people face high premiums or outright denials because of their health. Fortunately, you still have options even if you can’t get traditional coverage. Learning about those options can help you make wise decisions to help yourself and your family after you’re gone.

Demystifying Underwriting, Premiums, and Denials

Insurance companies determine your risk, coverage, and premiums through a process called underwriting. Investopedia explains that this risk assessment examines your age, health, lifestyle, occupation, hobbies, family medical history, and other related factors. Insurers look at connections between these and morbidity rates, considering certain factors that lead to earlier death:

• History of tobacco use
• Occupational hazards
• Risky hobbies
• Personal history of chronic illness
• First-degree relatives with chronic illnesses
• Mental health challenges
• Male gender
• Poor driving record

Men often pay higher premiums for several reasons: shorter average lifespans, riskier lifestyles and occupations, and greater risks for conditions such as diabetes and heart disease. Males are also twice as likely to die by suicide and less likely to seek mental health treatment than women. With transgender people seeking insurance coverage, some companies use birth certificate gender markers in quotes. As a result, some trans men may pay lower rates than trans women.

Higher Risk? You May Still Get Permanent or Term Life

Certain risk factors can lead to higher premiums or denial of coverage. However, PolicyGenius reveals that most insurers use four health classifications in underwriting: Preferred Plus, Preferred, Standard Plus, and Standard. Every insurer treats chronic illnesses and other risk factors a little differently; for example, one company may consider diabetes riskier than another. They also look at how long you’ve had the condition plus how well you follow your doctors’ treatment recommendations. For instance, people with diabetes who consistently maintain low A1C numbers plus good diet and exercise regimens could still pay lower premiums.

The sticking point, however, is having multiple negative risk factors. Consider a 44-year-old man with diabetes, cardiovascular disease, and a history of depression. He’ll probably struggle to find life insurance at all, much less a policy with affordable premiums. This doesn’t mean that he can’t get permanent life, which offers coverage for his entire lifetime plus a buildable cash value, or even term life policies. But his options will be a little more limited than those for a younger, healthier person.

Tips to Improve Your Outcomes

As a person with a chronic illness, you’ll need to take some additional steps to get the best possible coverage and rates. NerdWallet’s Alice Holbrook recommends working with an independent agent who consults with an impaired risk specialist. These pros know which companies may offer the best rates and policies for people with your risk profile. While you’re at it, it doesn’t hurt to get documentation from your healthcare providers. Test results are useful, but other records from your doctors can also be helpful. The goal is demonstrating that your conditions are well managed: Insurers may consider this during underwriting and assign a better classification with lower premiums.

Other Possible Coverage Options

If traditional whole or term life policies aren’t viable options, you can still find coverage in other ways. Those currently employed should consider purchasing group life policies, which usually offer death benefits based on one’s yearly salary. Simplified issue and guaranteed issue policies do not require medical exams, but you’ll pay higher premiums for lower coverage amounts.

Life insurance is an important investment. It may be harder for people with chronic illnesses to find policies with favorable terms and premiums, but it’s not impossible. Following doctors’ recommendations, documenting your condition, and working with specialized pros can help you get the coverage you need.