Rheumatoid Arthritis, also known as RA or atrophic arthritis, creates important considerations when purchasing life insurance. Understanding rheumatoid arthritis (RA), and how a life insurance carrier thinks about RA, is crucial to making an informed life insurance decision.
Rheumatoid Arthritis Overview
Fairly common, with approximately 200,000 new U.S. cases annually, rheumatoid arthritis is a chronic inflammatory disorder. It occurs when, for unknown reasons, the body’s immune system begins attacking its own joints and tissues.
RA is a systemic inflammatory disease that manifests itself in multiple joints in the body. This inflammation usually affects the lining of the joints (synovial membrane), but can also affect other organs. Medical diagnosis is required. – Centers for Disease Control and Prevention
- Imaging and lab tests are required
- Duration of condition can last for years or be lifelong
- No cure presently
- Can be diagnosed at any age, but most commonly between 40 – 60 years
- 75% of those with RA are women
Known as a systemic condition because it can affect different regions of the body, RA presents itself differently in individuals. Varying symptoms can arise acutely or subtly, making it a puzzling condition to diagnose in its early stages.
The American College of Rheumatology lists the following as the most common symptoms:
- Morning stiffness that lasts 1-2 hours (or all day)
- Loss of energy
- Low grade fever
- Loss of appetite
- Firm lumps, called rheumatoid nodules, which grow beneath the skin in places such as the elbow and hands
Causes and Risk Factors
While doctors don’t know what the cause of rheumatoid arthritis is, there appears to be a genetic factor.
While your genes don’t actually cause rheumatoid arthritis, they can make you more susceptible to environmental factors — such as infection with certain viruses and bacteria — that may trigger the disease. – The Mayo Clinic
The Mayo Clinic lists the following as risks for developing RA:
- Gender – women are more likely to be diagnosed with RA
- Age – although you can develop RA at any age, it often begins between the ages of 40-60 years
- Smoking – cigarette smoking increases your risk for RA
- Environmental Exposures – Asbestos and silica exposure appear to increase your risk, although poorly understood at present
- Obesity – particularly in women diagnosed before the age of 55
It’s important to see a rheumatologist (a physician specializing in RA) for a diagnosis of rheumatoid arthritis since symptoms can be vague and varying. A number of steps take place for a proper determination of RA:
- Physical exam – check joints for warmth, swelling, redness
- Blood tests – look for specific telltale results
- Anemia (low red blood cell count)
- Rheumatoid factor (a blood protein found in 80% of RA patients overtime)
- Anti-CCP (antibodies to citrullinated peptides – pieces of proteins, found in 60-70% of RA patients)
- X-rays and imaging – usually performed to assess and monitor the severity of RA
Again, no single test is used to diagnose rheumatoid arthritis, especially early on. Rather, a rheumatologist will consider the results of multiple measurements (physical, blood, and imaging) for an accurate conclusion.
Treatment Options For RA
Thankfully, therapy for rheumatoid arthritis has vastly improved over the last few decades.
Current treatments give most patients good or excellent relief of symptoms and let them keep functioning at, or near, normal levels. With the right medications, many patients can achieve “remission” — that is, have no signs of active disease. – American College of Rheumatology
While there is no cure for RA, doctors can treat symptoms, sometimes aggressively, for a positive result of “remisson” (no sign of active disease). Early diagnosis and treatment is instrumental to favorable longterm results.
- Heating pad – Relieves and soothes muscle and joint pain.
- Stretching – Improves circulation and increases flexibility and range of motion.
- Supplements – Fish and plant oils to reduce joint stiffness.
- Tai Chi – Slow, deliberate movements combined with deep breathing to relieve stress and pain.
- NSAIDS – Non-steroidal anti-inflammatory drugs reduce inflammation, fever and pain. Over the counter NSAIDS include ibuprofen (Motrin IB, Advil) and naproxen sodium (Aleve). Prescription strength NSAIDS are also available.
- Steroids – Reduce acute symptoms of inflammation and pain. Physicians often prescribe corticosteroids, such as Prednisone, temporarily to treat pain and swelling with the goal to eventually taper off steroids.
- Disease-modifying Antirheumatic Drugs – In addition to treating symptoms, DMARDS (such as Rheumatrex, Arava, Plaquenil, and Azulfidine) have shown to be highly effective at slowing the progression of RA. Joint and tissue health can be preserved.
- Biologic agents – Considered a newer class of DMARDS (Orencia, Humira, Kineret, etc.), these medications are biologic response modifiers. Biologic agents can target specific areas of the immune system to combat inflammation.
- Immunosuppressants – Not often used currently, but can suppress the immune system’s response to inflammation.
Surgery may be considered if other means of treatment are ineffective. Restoration of joint movement or the correction of a deformity can be accomplished with surgery.
- Synovectomy – removes inflamed lining (synovium) of the joint, such as the hands, knees, and elbows.
- Tendon repair – tendons and joints and repaired and reconnected.
- Joint fusion – surgically fusing a joint to provide stability and pain relief.
- Total joint replacement – metal or plastic prosthetic joints replace damaged joints.
RA Factors Affecting Life Insurance
There are some important components that insurance carriers look at when deciding whether they will approve life insurance.
- Date of diagnosis – because RA is considered a chronic condition, insurance companies want to know how long you have been treating RA. Their concern is the longterm effects drugs used for RA management has on the body.
- Duration and frequency of RA flareups – the more often you have flareups, and how long they last, increases your risk for joint and tissue damage.
- Deformity – insurance companies want to know if you have (and what type) a deformity. For example, a mild deformity of the wrists or fingers or a major deformity of the knees or hips.
- Disability – the inability to live independently and perform the daily activities of living, due to a disability, negatively affects your life insurance rating.
- Medication – how often and what type of drugs used in your treatment plan.
- Parts of body affected – areas of the body, and to what degree affected by RA. For example, mild wrist pain or lung and kidney damage.
Can I Be Approved For Life Insurance With RA?
In many cases, you can be approved for traditional, fully-underwritten life insurance (the kind that requires a medical exam). Understandably, it can feel discouraging if you have read online about life insurance denial for those with RA. Approval for life insurance and the amount of your life insurance premiums (payments) will be dependent on the RA factors we discussed. Let’s evaluate three different scenarios for life insurance underwriting (evaluating the risk and determining premium amount) with rheumatoid arthritis.
- Standard Approval – ideal situation. In order to be approved at standard rates, your RA will need to be well-controlled with mild medications, like NSAIDS (non-steroidal anti-inflammatory drugs). Well-controlled rheumatoid arthritis means minimal flare-ups of joint pain and swelling, no evidence of organs affected by RA, no disability, and documented regular check-ups with your rheumatologist.
- Rated Approval – mild/moderate RA. Insurance carriers will be looking for longterm treatment with medications such as steroids and DMARDS, a mild deformity, and/or mild disability. A rated approval means you still qualify for life insurance, but will have a premium surcharge of somewhere between 25 – 200%.
- Decline – severe RA. If primary organs are involved, major deformity, and/or the inability to perform daily tasks independently have occurred, a decline of standard life insurance is usually the result. In this case, we can examine if a graded death benefit life insurance policy makes sense.
Apply For Life Insurance With RA
We specialize in working with clients with rheumatoid arthritis find the highest quality protection at the best prices available. If you have RA and are seeking out life insurance, it’s crucial to collaborate with an agent with a deep understanding of RA. At Rheumatoid Life Insurance, our job is to be your advocate. As an independent life insurance agency, we will cross-reference the top-rated life insurance companies to find the best rate for which you can be approved.
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