Asthma is a growing medical problem in the United States, and a growing concern for life insurance companies facing a rise in the number of insureds with this condition.

The National Center for Health Statistics (NCHS) reports about 22.2 million Americans (7.7 percent) had asthma in 2005 (the latest figures available). Women have an asthma death rate 45 percent higher than males. NCHS statistics show that deaths from asthma really begin to spike around age 60. In total, 4,055 died from it in 2003.

"While that may seem like a small number, by comparison it is actually astronomical," says Dr. Alison Moy, medical director for Liberty Life Assurance Co. of Boston. "Asthma is a very serious condition that can kill you."

Despite the serious nature of asthma, many of those with the condition can buy affordable life insurance.

The severity of your asthma will largely determine how much more you might have to pay for life insurance. A person with severe, persistent asthma is going to pay more for life insurance than someone with a mild, intermittent variety. Just as important as the severity of your asthma is how you respond to treatments.

Insurance companies weigh asthma differently in determining life insurance rates. If you have asthma, it pays to shop around and compare rates from several different companies.

The medical community has established goals for asthma treatment, which can help reduce life insurance rates if they are met.

According to the National Institutes of Health, the goals of asthma treatment include:

• No symptoms or low severity of symptoms such as wheezing, coughing, shortness of breath and chest tightness.
• Sleeping through the night without asthma symptoms.
• No time off from school or work due to asthma.
• Full participation in physical activities.
• No emergency room visits or stays in the hospital.
• Few or no side effects from asthma medicine.

Insurers will want to know how well you are achieving these goals. Insurers will also want to know your "peak flow meter" readings and the results of pulmonary function tests. The peak flow meter is a simple test that many asthmatics perform at home. The pulmonary function test is more detailed and should be performed by your doctor at least once a year. Both of these tests indicate how well you are breathing, allowing doctors and your insurance company to determine how asthma is affecting you.

When medication fails to control your asthma properly, it can lead to higher life insurance rates, even if you believe your asthma is having little impact on your lifestyle.

On the other hand, if you stay active in spite of your asthma, and you haven't suffered any "exacerbating episodes" for the past one to three years — such as missing work or taking an unscheduled trip to the doctor because of an asthma flare up — your life insurance application will be viewed more favorably.

According to the National Institutes of Health, nearly all asthma patients can become free of symptoms with proper treatment. There are new medications that can help you maintain long-term control of your symptoms.

An asthmatic with a track record of very good control can have a near normal life expectancy. If it has been more than two or three years since your asthma caused an unscheduled doctor visit, and it hasn't caused you to miss work, you shouldn't have much trouble getting your life insurance issued with "standard" or even "preferred" premium rates.

In general, the more severe your last serious episode of asthma was, the longer you will have to wait before you can get the best-priced life insurance. If you went to the emergency room after an asthma attack, you will need to show a longer history of meeting your goals — perhaps as long as five to seven years depending on the circumstances and severity.

"If someone was hospitalized for their asthma 10 years ago but has shown good control since then, as evidenced by acceptable pulmonary function tests, a stable medical regimen and good follow-up care, it may not affect their application," says Dr. Jill Mocarski, a medical director at Northwestern Mutual. "Depending on the interval history, it may not affect their insurability. Each case has to be taken in context of the entire medical history."

Frequent, less severe and recent asthma episodes can also cause problems in applying for life insurance. Those symptoms might suggest you are failing to follow your medication regimen or might need to change your treatment.

If you are a smoker with asthma, life insurance can be very expensive. Insurers will generally charge significantly higher smoker rates in addition to any higher rates linked to your asthma.

Even if you are a healthy nonsmoker, your insurer will want to see that you have been going to your doctor at least twice a year to have your condition monitored, and you should list all of the medications you are taking on your life insurance application. In many cases, insurers will use the number and types of medications you are taking as an indicator of the severity of your condition, but they will be more concerned with how you are responding to your treatment.

If you have recently changed medications, you may want to wait a year or two before applying for life insurance. That will give you time to establish a history of meeting your goals on the new regimen, which could lead to lower rates for life insurance.