Life Insurance for People With HIV: Progress and Persistent Challenges Today

Securing life insurance has historically been one of the most difficult challenges for people with HIV. For decades, insurers automatically denied coverage to anyone with an HIV diagnosis, viewing them as uninsurable risks. While this stigma persists in many insurance markets, the landscape has shifted significantly. Thanks to modern antiretroviral therapy and medical breakthroughs, people with HIV can now expect lifespans comparable to those without the virus—a dramatic change from the 1980s when an AIDS diagnosis meant an average life expectancy of just one year.

This medical progress has prompted several major life insurance companies to reconsider their policies. Today, people with HIV have more options than ever before, though challenges remain substantial.

Why Life Insurance Companies Are Now Serving HIV-Positive Applicants

The transformation in insurance availability reflects a fundamental change in how the medical community understands and treats HIV. “HIV is much more understood than when it was first discovered in the 1980s,” explains Chris Abrams, a life insurance agent and founder of Abrams Insurance Solutions in California. “Treatment prevents most cases from progressing to AIDS.”

A handful of major insurers now actively write policies for people with HIV. Abrams has successfully helped HIV-positive clients obtain coverage through American National, John Hancock, and Prudential. Guardian Life also recently began accepting applications from healthy individuals living with HIV, offering both term and whole life policies.

According to Mark H. Lewy, Guardian’s chief medical director, the expansion reflects confidence in modern treatment outcomes. Even during the COVID-19 pandemic, which slowed some approval processes, insurers have continued writing new policies. “I recently had an HIV-positive client approved for coverage,” Abrams reports, demonstrating ongoing momentum in this market segment.

The Real Cost: Premium Multipliers and Strict Medical Requirements

While access has improved, the financial barrier remains substantial. People with HIV pay significantly more for life insurance than applicants without the condition. For a standard term life insurance policy, someone with HIV might pay approximately ten times the premium of a healthy person without HIV, according to Jeremy Hallett, CEO of Quotacy, a Minneapolis-based life insurance brokerage.

Insurance companies impose rigorous conditions before approving coverage. Guardian Life requires applicants to be between ages 20 and 60, with at least two years of consistent antiretroviral therapy (ART)—a daily medication regimen that suppresses HIV in the bloodstream. John Hancock maintains stricter standards, accepting only applicants ages 30 to 65 who have received at least five years of effective treatment.

Both companies mandate ongoing care from an HIV specialist and automatically deny coverage to anyone with a history of substance abuse, intravenous drug use, hepatitis, or an AIDS diagnosis. Even when applicants meet all stated requirements, approval is not guaranteed. Some qualified candidates have faced denial with unclear explanations.

“If someone is denied, they should be able to demand the reason,” says Scott Schoettes, counsel and HIV project director for Lambda Legal, a nonprofit providing HIV advocacy services. Transparency remains a significant issue in the approval process.

Finding Coverage When Standard Policies Aren’t Available

For people with HIV unable to qualify for traditional coverage, alternative pathways exist. Many employers provide group life insurance as an employee benefit without requiring medical exams. “Group policies represent the best opportunity for anyone with HIV,” Hallett emphasizes. He recommends maximizing available group coverage, which often provides one to three times an employee’s annual salary in death benefits.

Guaranteed issue life insurance offers another option. These policies typically limit eligibility to people 45 and older, and death benefits may not pay out during the first two years. Coverage amounts are modest—often capped at $25,000—but these policies are stackable. Applicants can purchase from multiple insurers to increase total death benefits.

What’s Changing for People With HIV in Insurance

Recent developments suggest expanded opportunities ahead. In early 2022, the FDA approved a monthly injectable HIV treatment, offering an alternative to daily oral medication. This advancement could be transformative; since insurance companies typically require years of consistent medication adherence before approving coverage, monthly treatments may help more applicants qualify.

California has also implemented significant legal protections. Starting in 2023, the Equal Insurance HIV Act prohibits state insurers from denying life insurance or disability income insurance based solely on an applicant’s positive HIV test result. Governor Gavin Newsom signed this legislation in September 2022, marking a watershed moment for anti-discrimination protections.

However, the law addresses access rather than affordability. Scott Schoettes notes the critical gap: “While the move to provide life insurance to people with HIV is positive, what we really need is to eliminate discriminatory pricing.” Cost reduction remains the unmet challenge for people with HIV seeking life insurance coverage.