Yes. Both conditions are among the most common things underwriters see, and neither is close to an automatic decline. What changes is the rate class, and by how much depends on numbers that are written down rather than judged case by case.
The mistake that costs applicants money is not the condition. It is applying to a carrier whose published thresholds happen to sit on the wrong side of their numbers, and taking that answer as the market’s answer.
High blood pressure
Carriers publish their cutoffs in underwriting guides written for agents. Banner Life’s guide, dated March 2026, sets them out precisely.
Preferred Plus requires blood pressure “not greater than 135/85.” Preferred requires “not greater than 140/90.” Standard Plus allows up to “145/90,” and Standard allows up to “156/94.”
Read what that means for a treated applicant. Somebody on medication whose readings sit at 128/78 meets the Preferred Plus threshold on the number. Treatment itself does not disqualify them at most carriers, because the underwriter is pricing the reading, not the prescription.
What underwriters actually want is evidence of control over time. Three things carry weight:
- A documented history of stable readings in your physician records, not one good reading at the exam
- Consistent treatment, with the same medication over a period rather than frequent changes suggesting the condition is not settled
- Absence of the complications that hypertension causes, meaning no left ventricular hypertrophy, no kidney involvement, no history of stroke or cardiac event
Uncontrolled hypertension is a different case, and so is hypertension diagnosed very recently, because there is no track record to read. An applicant diagnosed two months ago and still adjusting medication is often better served by waiting six months than by applying now and carrying a rating for the life of the policy.
One practical note. The reading taken at the paramed exam is a data point that can decide a class. Caffeine before the appointment, a rushed drive, an argument in the car, all move the number. Book the exam early, arrive with time to sit down, and skip the coffee.
Type 2 diabetes
Diabetes underwriting turns on one figure more than any other: hemoglobin A1C, which reflects average blood glucose over roughly the previous three months. It is a control measure, which is exactly what an underwriter wants.
A commonly published set of bands for type 2 runs like this. An A1C under 6.5 is treated as excellent control and can reach Standard Plus. Between 6.6 and 7.3 is good control and typically lands at Standard. Between 7.4 and 8.2 is fair, and usually produces a table rating in the range of Table 2 to Table 4. Between 8.3 and 9.0 is poor control, generally Table 5 or higher, and often pushed toward a simplified issue product. Above 9.0 is treated as uncontrolled, and guaranteed issue may be the only route.
Each table adds roughly 25% to the Standard premium, so a Table 4 case pays about double Standard. The distance between an A1C of 7.2 and an A1C of 7.6 is therefore not medical trivia. It is the difference between Standard pricing and roughly a 50% surcharge for the life of the contract.
Beyond the A1C, underwriters read:
- Age at diagnosis. Diabetes diagnosed at 55 underwrites more favorably than the same diabetes diagnosed at 30, because the expected duration of exposure is shorter.
- Duration. How long you have had it, and whether control has held across that period.
- Complications. Retinopathy, neuropathy, nephropathy and any cardiac history are what actually drive mortality, and their presence outweighs a good A1C.
- Other risk factors. Build, blood pressure, cholesterol and tobacco compound with diabetes rather than being read separately.
- Treatment. Diet and oral medication generally underwrite better than insulin, though insulin use beginning after age 40 with a stable A1C below 7.5 remains competitive at several carriers.
Type 1 diabetes
Type 1 is underwritten separately and more conservatively, because onset is typically in childhood and the duration of exposure by the time somebody applies is long.
Table ratings are the normal outcome rather than the exception, and a small number of carriers write it much better than the rest. This is a category where the choice of carrier changes the answer more than anything the applicant can do, and where going to the wrong carrier first produces a decline that then has to be disclosed to the next one.
Why carriers disagree so much
Every threshold above belongs to a specific carrier. The next carrier’s build chart is different, its blood pressure cutoffs are different, and its treatment of a controlled condition may be different again.
Carriers also specialize deliberately. Some have built a book around diabetes and price it more finely because they understand it better. Mutual of Omaha, Prudential, Banner Life, John Hancock and Corebridge Financial are all named regularly among the more workable carriers for diabetic applicants, and Mutual of Omaha in particular is often described as one of the most diabetes-friendly.
That is the whole case for shopping a rated case rather than accepting the first answer. A file that is Table 4 at one carrier can be Table 2 at another with identical medical records, because the two carriers reached different conclusions about the same numbers.
What to do before you apply
- Get your current numbers. Your most recent A1C and a set of recent blood pressure readings. Applying without knowing them is applying blind.
- Do not guess on the application. Carriers query prescription databases and the MIB. An undisclosed condition that surfaces later is a far worse problem than a rating, because it raises a misrepresentation question.
- Consider timing. If your A1C is trending down and sits near a band edge, three more months of records can be worth more than any negotiation.
- Bring your history. A prior rating or decline is the single most useful thing to disclose to an independent agent at the first conversation, because it changes which carrier the case goes to.
- Ask about reconsideration. Most carriers will review a rated policy after a period of improved control, typically a year or more, and reduce or remove the rating. That request has to be made; it does not happen automatically.
If you have already been declined
A decline at one carrier is not a decline by the industry. It is one underwriter’s reading of one file against one set of guidelines.
It does need handling honestly, because the MIB records it and the next carrier will see it. What an independent agent can do is take the file to a carrier whose published guidelines actually fit it, and where the case is worth a pre-underwriting conversation, run it informally before a formal application is submitted.
Apex holds direct appointments with more than 20 carriers and quotes every case across them. If you have a condition you expect to be a problem, or you have been rated before, talk to a member of our team. You can also read how rate classes are decided.
Underwriting figures quoted here are published guidelines current as of 2026 and vary by carrier and over time. Nothing here is medical advice or an offer of coverage. No policy is bound until a carrier issues it in writing.
