Do You Qualify for Living Benefits Life Insurance? Requirements Explained

Living benefits can transform a life insurance policy from something that only helps after you're gone into something that supports you while you're alive. But not everyone automatically qualifies. Insurance companies have specific criteria you need to meet in order to get a policy that includes living benefits—and to access those benefits when the time comes.

What Are Living Benefits?

Living benefits allow you to access a portion of your life insurance policy’s death benefit if you experience a qualifying health event. These events typically include:

• Terminal illness: A diagnosis with a life expectancy of 12–24 months or less
• Critical illness: Conditions like cancer, heart attack, stroke, or major organ failure
• Chronic illness: The inability to perform two or more daily activities like bathing, dressing, or eating, or suffering from cognitive decline like Alzheimer’s

Do You Qualify to Buy a Policy With Living Benefits?

When applying for life insurance that includes living benefits, you must go through underwriting. Here’s what insurers typically consider:

1. Age:
Most providers offer living benefits to applicants under a certain age—commonly up to 70. The younger you are when applying, the more likely you are to qualify and pay lower premiums.

2. Health History:
Applicants with a clean bill of health are more likely to be approved. If you’ve been diagnosed with a serious illness in the past, it may limit your access to certain riders.

3. Lifestyle Factors:
Smoking, high-risk occupations, or extreme hobbies can affect your eligibility. Insurance companies assess your overall risk level before offering coverage.

4. Policy Type:
Living benefits are more commonly available in term life and whole life policies from certain providers. Not all policies include them, so it’s essential to confirm at the time of purchase.

Do You Qualify to Use Living Benefits?

Even if your policy includes living benefits, you’ll need to meet specific requirements to access them. Here's what most insurers will ask for:

1. Medical Certification:
You’ll need documentation from a licensed physician confirming your diagnosis. For terminal illness benefits, this includes written proof of a limited life expectancy.

2. Functional Impairment Assessment:
For chronic illness benefits, you must show that you’re unable to perform two or more activities of daily living or are experiencing cognitive decline. Insurers may request an evaluation from a healthcare provider.

3. Claims Forms and Review:
You must complete claim forms and provide all requested documentation. The insurer will then review the claim and determine the payout amount based on your policy’s terms.

What Affects Your Eligibility?

• Timing: Applying for life insurance while you're still in good health increases your chances of qualifying for policies with living benefits.
• Policy Structure: Some companies offer living benefits as built-in features, while others require you to add riders. Be sure to compare policies before buying.
• Company Guidelines: Each insurer has its own rules for what conditions are covered and how benefits are triggered. Always read the fine print or consult with an agent.

Final Thought

Qualifying for life insurance with living benefits—and accessing those benefits later—depends on several factors, including your health, age, and the policy itself. If you’re in relatively good health now, it’s a good time to secure coverage that includes these features. They can make a significant difference when facing a health crisis, offering financial help when you need it most. Speak with a licensed life insurance agent who specializes in living benefits to find out which options are available to you.