Fibromyalgia and Life Insurance: Symptoms, Ratings, and More

Fibromyalgia is by no means rare. Approximately 2% of the U.S. population, or about 4 million Americans, are diagnosed with fibromyalgia. (Source: CDC) That number would fill over 48 MetLife Stadiums.

Some estimates put the number much higher – at around 4% of the U.S population. (Source: American College of Rheumatology)

It’s also not rare to wonder whether a life insurance purchase is possible after a fibromyalgia diagnosis.

The short answer is: YES.

The longer answer is: Yes, but it can be complicated. It depends on a number of factors, including the severity of your fibromyalgia.

Let’s analyze three things, so you can be prepared to buy life insurance:

Fibromyalgia and Life Insurance: Symptoms and More

Fibromyalgia (fi·bro·my·al·gi·a) is a condition that causes pain all over the body (also referred to as widespread pain), sleep problems, fatigue, and often emotional and mental distress. -Centers for Disease Control and Prevention

Called abnormal pain perception processing, people with fibromyalgia experience pain differently and are more sensitive to it.

Common Symptoms of Fibromyalgia

• Widespread pain
  • Pain and stiffness all over the body
• Fatigue
  • Tiredness lasting throughout the day
• Cognitive difficulties
  • Inability to concentrate
  • Memory problems
• Depression
• Anxiety
• Sleep problems
• Headaches
  • Often including migraines

Less Common Symptoms of Fibromyalgia

• Tingling or numbness in hands or feet
• Pain in the face or jaw
  • Symptoms of TMJ (temporomandibular joint syndrome)
• Digestive problems
  • Symptoms of IBS (irritable bowel syndrome)

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Causes of Fibromyalgia

While physicians don’t know exactly what causes fibromyalgia, they believe a number of factors may increase the odds of its development:

1. Genetics – Researchers are investigating potential genetic mutations, possibly making a person more susceptible.
2. Infections – Some illnesses appear to trigger fibromyalgia in some people.
3. Physical trauma – Injuries can be a trigger point. (Lady Gaga tore a hip muscle.)
   1. For example, a car accident or athletic injury.
   2. Repetitive injury to a specific joint, like your knee.
4. Emotional trauma – psychological stress can alter the way your body communicates with the spinal cord and brain, making you more susceptible to pain.
   1. PTSD, post-traumatic stress disorder, is common for fibromyalgia patients.

Risk Factors

1. Gender – Females are twice as likely to be diagnosed with fibromyalgia than men.
2. Family history – Fibromyalgia runs in families. You’re more likely to have fibromyalgia if a close blood relative has been diagnosed.
3. Other disorders – Fibromyalgia is not an autoimmune, muscle, joint, or inflammation disorder. However, you are more at risk of developing it if you have:
   1. Lupus
   2. Rheumatoid Arthritis

Diagnosis

Encouragingly, doctors continue to refine and improve the process for diagnosing fibromyalgia. You can expect the following:

• Blood work – while there are no blood markers to indicate fibromyalgia, blood work is often performed to rule out other conditions or health problems.
  • Complete blood count
  • Erythrocyte sedimentation rate
  • Cyclic citrullinated peptide test
  • Rheumatoid factor
  • Thyroid function test
• 3+ months of widespread pain – assessment of pain is the most important criteria for a diagnosis. You will be asked about:
  •  Pain and symptoms over the past week, based on the total number of painful areas out of 19 parts of the body plus the level of severity of these symptoms:
    • Fatigue
    • Waking unrefreshed
    • Cognitive (memory or thought) problems
  • Symptoms lasting at least three months at a similar level
• Other disorders – doctors will need to rule out whether a different disorder could be causing fibromyalgia symptoms.

Treatment of Fibromyalgia

• Medications – there are a number of drugs prescribed to treat fibromyalgia. (Lyrica, Cymbalta, and Savella have been approved by the Food and Drug Administration to specifically treat fibromyalgia) :
  • Duloxetine (Cymbalta) and milnacipran (Savella) – work by changing the levels of serotonin and norepinephrine in the brain to control pain levels.
    • Older drugs of the same class may be prescribed: amitriptyline (Elavil) and cyclobenzaprine (Flexeril).
  • Other antidepressant drugs.
  • Pain relief medications:
    • NSAIDs (non-steroidal anti-inflammatory drugs) : over-the-counter or prescription strength.
      • Often prescribed to treat the pain triggers.
    • It’s strongly recommended to avoid opioid narcotic pain medications.
      • Tramadol (Ultram) is prescribed for periodic intense pain.
  • Anti-seizure medications can often help control fibromyalgia pain.
    • For example, pregabalin (Lyrica) was approved to treat fibromyalgia.
• Therapy – has proven to be a key component in the treatment of fibromyalgia:
  • Physical therapy – exercises to improve strength, flexibility, and stamina.
  • Occupational therapy – improvements to your work area to prevent bodily stress.
  • Counseling – coping strategies to handle stressful situations and increase your belief in yourself.
• Self-care – fibromyalgia symptoms decrease when there’s a priority to:
  • Reduce stress
  • Get enough sleep
  • Maintain a healthy lifestyle
  • Exercise regularly
  • Pace yourself and pay attention to the symptoms

(Source: Mayo Clinic)

Life Insurance and Fibromyalgia

There are five things life insurance companies will ask you about your fibromyalgia:

1. Diagnosis date

Life insurance companies want to know how long you have had fibromyalgia. The longer you have experienced symptoms, the higher your risk for negative side effects.

2. Severity

The degree to which fibromyalgia negatively affects your life is a major determinant of whether you qualify for traditional life insurance. We can place fibromyalgia into three general categories.

Let’s consider what each of these examples might look like (for informational purposes only):

1. Mild – your fibromyalgia is well-controlled. You regularly see your physician. Minimal medication is required. For example, over-the-counter pain medications are used to control pain triggers. You lead an active lifestyle, working full-time and hiking regularly.
2. Moderate – while you visit your physician regularly, you will experience some difficulties managing your chronic pain. At times, it interferes with daily activities, such as work. You have been prescribed Cymbalta at a low dose.
3. Severe – your fibromyalgia is uncontrolled. The chronic pain you experience prevents you from working or performing daily activities. You sporadically visit your physician. You have been prescribed Lyrica and Savella.  When the pain is unbearable, you also take Ultram. Your pain has caused depressive episodes, and you are seeking counseling from a therapist.

Read more: Can you get life insurance when you have chronic pain?

3. Medications

Life insurance underwriters want to know what type of medication you are taking. Underwriters (that’s who evaluates risk for the life insurance companies) are concerned about potential negative side effects.

Be prepared to communicate the medications you are taking, the dosage, and the frequency of use.

Common fibromyalgia medications include:

• Acetaminophen (Tylenol)
• Ibuprofen (Advil)
• Naproxen Sodium (Aleve)
• Tramadol (Ultram)
• Duloxetine (Cymbalta)
• Milnacipran (Savella)
• Cyclobenzaprine (muscle relaxant)
• Gabapentin (Neurontin)
• Pregabalin (Lyrica)

4. Other conditions

Often, other medical conditions accompany fibromyalgia. You will be asked whether you have additional health concerns during the application process.

For example, it’s more common for people with fibromyalgia to experience:

• Obesity
• Depression
• Anxiety
• Migraines
• Sleep disturbances

5. Lifestyle

You will also be asked about your lifestyle when you apply for traditional life insurance.

• Are you employed?
  • Do you need to miss work as a result of fibromyalgia? If so, how often and how many days?
• Do you use tobacco products?
  • Do you use illicit drugs?
• Are you able to perform daily activities?
• Do you lead an active, healthy life?

Keep in mind: Healthy habits can be communicated during the application process via a Cover Letter. Life insurance rates are often improved when an agent effectively communicates the positive health aspects of an applicant.

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Apply For Life Insurance with Fibromyalgia

When you apply for traditional life insurance (think term or whole life policies for a larger amount), there are three possible outcomes:

1. Approval – You are approved for traditional life insurance. Consider this a best-case scenario. If your fibromyalgia is well-controlled and on the mild side, it’s common to be approved at Standard rates.
2. Rated – You are approved for traditional life insurance, and you will pay a surcharge on your premiums (the amount you pay in exchange for life insurance). Surcharges range from 25 – to 200%. If your fibromyalgia is closest to the moderate category, and you experience some (but not a lot) negative effects from your fibromyalgia, it’s likely your life insurance application will be approved and Rated.
3. Decline – You are declined for traditional life insurance. Often, a decline occurs if your fibromyalgia is severe. This means your fibromyalgia negatively impacts your life on a larger scale.
   1. Important- even if you have previously declined life insurance due to fibromyalgia, do not give up. Not all life insurance carriers view fibromyalgia in the same light. Approval can happen with another carrier, depending on your circumstances.
   2. Also important – if traditional life insurance is not available to you, there are other life insurance options. A Graded Benefit or Guaranteed Issue life insurance policy can provide coverage if you are unable to purchase traditional life insurance.

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Fibromyalgia Insurance Coverage: The Bottom Line

Most life insurance companies are going to “care” if an individual has a diagnosis of Fibromyalgia because Fibromyalgia is considered a pretty serious pre-existing medical condition that is characterized by widespread pain throughout the body.  Living with a chronic condition like fibromyalgia can be difficult.  Some insurance providers are better than others for Fibromyalgia life insurance and other neurological conditions.

First and foremost, collaborate with an independent life insurance agent. That way, you will receive multiple quotes from multiple carriers for a life insurance policy. Independent agents are not held captive to a particular carrier and your best interest is at heart.

Fibromyalgia creates important life insurance considerations, and you’ll want an expert agent to partner with you to navigate the application process.

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