If you’re shopping for a life insurance policy, you know that health problems will result in a higher premium. But what are the most expensive medical conditions?

Any medical problem that reduces your life expectancy will result in higher life insurance quotes, so the most “expensive” conditions are those that have the greatest impact on how long you’ll live.

The #1 most expensive life insurance risk factor: Smoking

#1: Heart disease

The condition that will cost you the most is heart disease – even more than a history of cancer (more on that later).

“If you’ve had a heart attack, the damage to your heart in many cases is not reversible. The more damage to the heart, the more it takes to keep it going, so your life expectancy is reduced,” explains Anna Hart, MS, SRN, principal and consulting underwriter with ARH Consulting in Eastland, Texas.

#2: Diabetes

If you’re diabetic, the type of diabetes you have impacts rates – and even your ability to find a policy. If you have Type 1 diabetes that you developed as a youth, it may take some shopping around to even find a company willing to insure you. If you have adult-onset diabetes and take oral medication, or can control your diabetes through diet, you’ll be able to garner a lower life insurance rate than an insulin-dependent diabetic, says Hart.

If you have Type 2 diabetes, it will pay to shop around. Life insurance companies apply “debits” and “credits” in determining your premium. A health problem will result in debits – meaning you’ll pay more. But some life insurance buyers can offset debits with credits. For example, an overweight person (debit!) who is in good health (credit!) can get a better rate that reflects their health.

Richard Bergstrom, FSA, MAAA, principal of Bergstrom Consulting in Seattle, Wash., and fellow of the Society of Actuaries, explains that each insurance company has its own way of applying debits for specific medical conditions. One company might apply 50 debits for diabetes, while another applies only 25 debits.

#3: Cancer

As with diabetes, the type of cancer you’ve had determines your premium. Insurers make a distinction between external and internal cancer. For example, a sun-related cancer, such as a lesion on the nose, may have little or no impact on life insurance rates, says Hart.

But a history of breast cancer will cause most insurers to proceed with extreme caution; some companies may not want to sell you a policy for one to 10 years after your cancer, in order to see whether treatment was effective. Even after that, you may be charged a “flat extra” – that’s an extra premium you pay for a specified period of time.

Bergstrom says that flat extras are based on your age of diagnosis, your age now, and the stage of cancer. For example, a cancer survivor might be charged an annual flat extra of perhaps $25 for every $1,000 in coverage for a specified period.

As with any condition, if you don’t like the price you’re offered, shop around. Even breast cancer survivors can be insurable. Hart notes that MetLife was one of the first companies to offer life insurance sooner rather than later to women with a history of early breast cancer.

Patients with stage 4 cancer will not be insurable.

#4: Obesity

Carrying extra weight isn’t the problem – it’s the medical complications that come with it: heart disease, hypertension, diabetes and so on.

Yet, “you can be overweight and still be fit,” says Hart.

It’s possible for obese people to get preferred rates if they’re healthy, and each insurance company will set its own standard for what is “healthy.” Bergstrom explains that if you have enough positive factors going for you (like good blood pressure and good cholesterol levels), the credits for those can offset the obesity enough to push you into a preferred rating.

#5: Pulmonary disease

Seasonal asthma won’t affect life insurance rates, but if you’ve battled asthma since you were a kid, expect a higher price. Asthma can lead to chronic bronchitis and emphysema, which impact life expectancy.

Life insurance shopping tips

Hart and Bergstrom offer this advice for life insurance shoppers who have medical conditions:

• Do your own quote research; look online for rates.
• Be honest on your application.
• Provide as much information as possible.
• Answer your own questions (don’t have a spouse fill out your application).
• Make sure to provide your doctor’s name, address and phone number on your application
• If you’re on medication, note the type, what it’s prescribed for, the dosage and how long you’ve been taking it.
• Don’t be afraid of the phone interview conducted by an insurer that’s reviewing your application; it’s routine for companies to go over your application answers again. The paramedical professional for your medical exam will ask the same questions again, too.