Heart disease is the leading cause of death in the United States, and Florida — with its large retiree population — has a high prevalence of cardiac conditions including heart attacks, stents, bypass surgery, heart failure, and arrhythmias. If you have a cardiac history and are applying for life insurance in Florida, you are not automatically uninsurable — but the underwriting process will be more involved, the outcome less predictable, and the premium higher than for applicants without cardiac history.
This guide explains what carriers look for when underwriting cardiac cases, what the typical outcomes are for different conditions, and how to approach the process to get the best offer available to you.
When a Florida life insurance carrier receives an application from someone with a cardiac history, the underwriter evaluates a comprehensive set of clinical factors rather than simply flagging the condition and declining. The key metrics are:
| Condition | Time Since Event | Typical EF / Function | Likely Rating |
|---|---|---|---|
| Single stent placement | 2+ years | EF 55%+; no symptoms | Standard to Table 2 |
| Single stent placement | 1–2 years | EF 50%+; stable | Table 2–4 |
| Single stent placement | Under 12 months | Any | Postpone — reapply after 12 months |
| CABG (bypass surgery) | 3+ years | EF 50%+; no heart failure | Table 2–4 |
| CABG (bypass surgery) | 1–3 years | EF 45–55% | Table 4–6 |
| Heart attack (MI) — uncomplicated | 2+ years | EF 55%+; no heart failure | Table 2–4 |
| Heart attack with reduced EF | 2+ years | EF 35–45% | Table 6–8 or decline |
| Paroxysmal atrial fibrillation | Ongoing, controlled | Normal cardiac function | Standard to Table 2 |
| Congestive heart failure | Any | EF below 40% | Table 6–8 or decline |
| ICD (implantable cardioverter-defibrillator) | Any | Any | Table 6–8 or decline; guaranteed issue typically best option |
A heart attack is one of the most common cardiac events in the underwriting world. Most major carriers will not consider a new life insurance application within the first 6–12 months following a heart attack. During this window, they will typically issue a postponement rather than a declination, meaning they want to wait and see how recovery progresses before making an underwriting decision.
After 12 months, carriers will request an Attending Physician Statement (APS) from the treating cardiologist covering the event details, current status, ejection fraction from the most recent echocardiogram, current medications, exercise tolerance, and any follow-up testing. Based on this information and the factors described above, an offer is typically in the range of Table 2 to Table 4 for uncomplicated single-vessel events with good recovery, and higher tables or declination for multi-vessel disease, reduced EF, or complications.
Coronary artery disease (CAD) — including history of coronary stenting (PCI) — follows a similar underwriting logic. A single stent placed 2–3 years ago in a patient who is now stable, has normal EF, is on a standard cardiac medication regimen, and has had no recurrent events is generally insurable at Standard to Table 2 in most Florida carriers. The underwriter is evaluating the severity of the underlying CAD and the adequacy of the revascularization, not simply the fact that a stent was placed.
Atrial fibrillation (AFib) is surprisingly insurable in many forms. Paroxysmal AFib — intermittent episodes that convert back to normal rhythm either spontaneously or with medication — is the most favorable type for underwriting purposes. If the AFib is not associated with structural heart disease, stroke history, or heart failure, and is well-controlled with medication (anticoagulants and/or rhythm-control drugs), Standard to Table 2 rates are achievable at most Florida carriers.
Persistent or permanent AFib, where the heart remains continuously in the abnormal rhythm, is less favorable — carriers view the chronic heart rate abnormality as a higher risk. The presence of a prior stroke or blood clot attributable to AFib elevates the risk further.
For Florida residents with severe cardiac histories — significant heart failure with reduced EF, implantable defibrillators, recent multiple cardiac events, or conditions that consistently result in declination — guaranteed issue life insurance is typically the most realistic option for coverage. As noted, coverage amounts are limited ($5,000–$25,000), a graded benefit period applies, and premiums are higher per dollar of coverage than traditionally underwritten policies. But for final expense planning and basic coverage, it provides an accessible option when traditional underwriting is closed. Florida residents can explore additional coverage options at Sunstate Coverage.
Have a cardiac history? An independent Florida agent can compare carriers and find the most favorable offer for your specific situation.
Get a Life Insurance Quote with Heart HistoryMost carriers require a minimum waiting period of 6–12 months after a heart attack before they will consider a new application. During the waiting period, the carrier needs to see documented recovery, normal or near-normal cardiac function (ejection fraction), and a stable medication regimen. After 12 months, insurable offers are possible at table ratings. The exact waiting period and outcome depend on the severity of the event, your age, ejection fraction, and the specific carrier's underwriting guidelines.
Ejection fraction (EF) measures the percentage of blood the left ventricle pumps out with each contraction. A normal EF is 55–70%. Lower ejection fractions indicate reduced heart pumping function, which correlates with higher mortality risk. Carriers use EF as a key quantitative indicator of heart health after cardiac events or in patients with known heart disease. An EF below 40% typically results in a significant table rating or declination; EF of 50% or above post-event is much more favorable.
Yes, in many cases. Paroxysmal atrial fibrillation (intermittent AFib) that is well-controlled with medication and not associated with other cardiac conditions is often insurable at Standard to Table 2 rates. Persistent or permanent AFib, particularly when associated with heart failure, stroke history, or poorly controlled heart rate, results in higher table ratings. The underlying cause of the AFib and how well it is managed are the key factors.
Yes. Guaranteed issue life insurance — which requires no medical questions and accepts any applicant within the eligible age range (typically 45–85) — is available in Florida regardless of cardiac history. Coverage is limited, typically $5,000–$25,000, and there is a 2–3 year graded benefit period during which only premiums are returned for non-accidental death. It is primarily used for final expense purposes, not income replacement.