HIV-Positive and Seeking Life Insurance? Here's What's Actually Possible in 2024

For years, getting life insurance as an HIV-positive person felt impossible. Insurance companies treated an HIV diagnosis like a financial death sentence, automatically rejecting applications without second thought. But things have shifted dramatically. With modern antiretroviral therapy (ART), people living with HIV now have life expectancies comparable to those without the virus. A growing number of insurers are finally catching up to this medical reality, though the path to coverage remains far from straightforward.

Why insurers are starting to say “yes”

Back in the 1980s, when HIV first emerged, an AIDS diagnosis meant roughly one year to live. Insurers completely avoided the risk. Today’s treatment landscape is unrecognizable. “HIV is much more understood than when it was first discovered in the 1980s,” explains Chris Abrams, a California-based life insurance agent who specializes in helping HIV-positive clients secure policies. Modern medications can prevent HIV from ever progressing to AIDS in most cases.

Insurance companies have noticed this transformation. Guardian Life recently opened doors to HIV-positive applicants, and Abrams has successfully placed HIV-positive clients with American National, John Hancock, and Prudential. “Healthy individuals living with HIV now have access to both whole life and term life policies,” according to Mark H. Lewy, Guardian’s chief medical director. The momentum is real—Abrams reports approving an HIV-positive client just last week, even as COVID-19 temporarily slowed some underwriting processes.

California is also pushing change through legislation. The state’s new Equal Insurance HIV Act bans life insurers from denying coverage based solely on an HIV-positive test result, a significant legal victory.

Here’s the catch: costs and strict eligibility rules

The good news comes with a major asterisk. If you do qualify, expect to pay significantly more than someone without HIV. A typical term life insurance policy might cost an HIV-positive applicant roughly 10 times what a healthy person would pay, according to Jeremy Hallett, CEO of Quotacy, a Minneapolis-based life insurance brokerage.

Insurers also set stringent requirements. Guardian Life requires applicants to be between 20 and 60 years old and demonstrate at least two years of consistent antiretroviral therapy. John Hancock is even more demanding: they cover ages 30 to 65 with a minimum of five years of effective treatment. Both companies mandate ongoing care from an HIV specialist doctor. Anyone with a history of substance abuse, intravenous drug use, hepatitis, or an AIDS diagnosis faces automatic rejection.

Even meeting all these criteria doesn’t guarantee approval. Scott Schoettes, counsel and HIV project director for Lambda Legal, an HIV advocacy nonprofit, notes that some applicants have been denied despite checking every box. “If a person is denied, they should be able to demand the reason for being declined,” he says—though transparency isn’t always guaranteed.

When standard policies don’t work: alternative routes

Can’t secure a standard term or whole life policy? You’re not alone, and options do exist.

Group life insurance through your employer is often the easiest path. Most employer-sponsored group policies skip the medical exam entirely, making them accessible to people with HIV. Hallett calls these “the best opportunity for anyone with HIV” and recommends maxing out whatever group coverage your employer offers—often one to three times your annual salary.

Guaranteed issue life insurance is another fallback. These policies typically limit eligibility to people 45 and older, and they cap death benefits (usually around $25,000 or less). There’s also a waiting period—benefits won’t pay out during the first two years. But here’s the workaround: these policies are “stackable,” meaning you can purchase from multiple insurers to gradually build up your total death benefit.

What’s ahead: treatment innovations and legal shifts

Two developments suggest more options could emerge for HIV-positive insurance seekers. First, the FDA approved a monthly injectable HIV treatment in January, offering a real alternative to daily ART pills. Since insurers currently require years of proven medication adherence, a once-monthly injection could help more people qualify by making consistent treatment more feasible.

Second, California’s policy shift starting in 2023 is significant—but incomplete. The state now bans insurers from denying coverage based on HIV status alone. However, the law doesn’t address pricing discrimination. Schoettes puts it plainly: “While I applaud the move to provide life insurance to people living with HIV, what we really need is to get it to a place where it’s no longer discriminatory in its pricing.”

The conversation is moving in the right direction, but true equity in life insurance for HIV-positive individuals still has miles to go.