Everything you need to know about the life insurance medical exam

The life insurance medical exam is a determining factor in how much you pay for premiums — so what can you do to qualify for the lowest rates?

Nupur GambhirRebecca Shoenthal author photo

Nupur Gambhir & Rebecca Shoenthal

Published September 24, 2020


  • Life insurance companies use the medical exam to determine your health classification, which determines the cost of your policy

  • Your past and present health have the most influence on the results of your medical exam

  • No medical exam policies allow you to skip the exam, as long as you meet some qualifications

When you’re applying for life insurance, you’re usually required to take a medical exam as part of the underwriting process.

Your medical history and current health status are the biggest determining factors in what health classification you receive, which in turn determines how much you pay for life insurance.

Favorable results on the medical exam can mean cheaper premiums and more coverage, so it’s important to be as prepared as possible.



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What is the medical exam?

The medical exam (also called the paramedical exam is essentially a health physical and is a standard part of the life insurance application process. It not only confirms the details you provided to the life insurance company when you first applied but also uncovers new information that could affect your premium.

The insurer covers the costs of the medical exam, though if you ask to take the medical exam a second time to receive a lower premium rate, you may be asked to pay for it yourself.

Is a medical exam required for life insurance coverage?

Because life insurance companies determine the premiums you pay based on your likelihood of dying, the medical exam is required in order to get traditional life insurance coverage.

In addition to other factors like your age, family medical history and lifestyle, life insurance companies use medical exam results to determine your life insurance health classification.


From best (lowest premiums, lowest risk) to worst (highest premiums, highest risk), the life insurance classifications are Preferred Plus, Preferred, Standard Plus, Standard and Substandard.

A closer look at life insurance health classifications

Check out the graph below to see how life insurance companies rate you.

Preferred PlusAlso known as Preferred Elite, Super Preferred, or Preferred Select, this is the most desirable (and affordable) classification. Since the insurance company considers you to be in tiptop shape, you pay the lowest possible premiums.
PreferredConsidered the second-best classification, you might not get all the perks of a Preferred Plus membership but you’re still in good standing with your insurance company.
Standard PlusIf you fall into this category it means your overall health is good but you might have a few issues that place you out of the higher classes.
StandardThis category indicates that your height/weight ratio is likely not ideal, your medical test came back with a few issues, and your family history is likely impacting your health picture too.
SubstandardUnlike the other classifications, this category is based on a table rating system (using letters or numbers) caused by a recent health problem or health issues in your past. You can expect to pay the price of a Standard category premium plus an additional 25% the further down the letters or numbers you go. For example, if you’re Substandard A or 1, you will pay the Standard price + 25%. If you’re Substandard D or 4, you will pay the standard price + 100%.

Why do you need to take the medical exam?

The medical exam reveals a lot about the risk your health poses to the insurer. The less healthy you are, the higher the risk of insuring you, so you can expect that your premiums will cost you more if you have a more checkered medical history.

The health exam tests for a number of conditions, including the following:

  • High blood pressure. Your test could reveal the existence of beta-blockers, a medication to control high blood pressure, so it’s best to bring up the beta-blockers beforehand rather than try to hide your high blood pressure.
  • Elevated cholesterol. This condition increases your risk for heart disease and stroke.
  • Hyperglycemia, or elevated glucose. This could be an indicator of diabetes.
  • Nicotine usage. Smoking and tobacco use play a major role in determining your premium because they could cause so many health problems, from shortness of breath to various cancers. And vapers don’t get off easy, either: nearly every insurer considers e-cigarettes in the same category as regular cigarettes.
  • Recreational drugs. This one should be obvious. If you’re asking a life insurance company to payout in the event of your untimely death, you can bet they won’t look too fondly on recreational drugs, no matter how careful you are, though there are insurance companies that will give marijuana users competitive rates.
  • HIV/AIDS and hepatitis. Along with other diseases, you’re going to be tested for these, which greatly increase the risk of insuring you to the insurer.

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What happens during the medical exam?

During or after your initial phone interview, the underwriter will work with you to schedule the medical exam at a time that is convenient for you. You may also schedule a time with the medical exam company that works with the insurance company, such as ExamOne.

Getting a medical exam for life insurance is similar to going to your doctor to get a physical. However, life insurance companies usually work with you to accommodate your schedule, and you can choose to have a medical technician come to your home or work. Normally, the whole process takes about 30-45 minutes and includes two parts:

  1. A verbal questionnaire where you’ll answer a series of questions about your health, lifestyle and social habits
  2. A physical exam in which the examiner will measure your height and weight, check your blood pressure and collect blood and urine samples

During the verbal portion of the exam, the tech will ask you a series of health-related questions to help the insurer confirm the information on your application. Expect questions about the kinds of prescriptions you’re taking and which doctors you’ve seen recently. This is usually where the medical examiner will be able to get a full scope of your health, so don’t lie or withhold information during your initial interview.

During the medical exam, the technician will perform the routine health checks you would expect from your regular doctor at an annual physical. That means checking your pulse, blood pressure, and using your height and weight to figure out your body mass index, as well as providing a blood test and urine sample. Older applicants or people applying for a large amount of life insurance coverage may also undergo an electrocardiogram or EKG to measure your heart’s electrical activity. Male applicants over the age of 50 may also be asked to conduct a prostate specific antigen (PSA) test.

How to “pass” the medical exam

It's important to keep in mind that there's no "passing" or “failing” the life insurance medical exam. Your results will help determine the cost of your policy, but those results are determined by your overall health and elements that are mostly out of your control.

That being said, there are a few steps you can take to give yourself the best shot at lower rates.

From the get-go, you should be completely upfront about any conditions you have when applying for life insurance. The underwriter will do their homework, so you'll only delay the process if the medical tech discovers health concerns you never mentioned. Plus, your actual premiums will look much different than your quotes (spoiler: they’ll be higher) if you don’t disclose a condition upfront — or your beneficiaries could be denied the death benefit if the insurer discovers that you lied later on.

Aside from that, there are a few things you can do before exam day to position yourself for the best possible test results. Just remember, your health classification is made up of several different factors, so it's not guaranteed that one tip or another will sway your results.

  • Fast 6-8 hours prior to the exam. The medical exam requires a fast to make sure your blood sugar and cholesterol numbers are not skewed. Pro tip: Try to schedule your appointment in the morning so you aren’t hungry all day.
  • Make sure you’re hydrated. Drinking lots of water ahead of your exam will help flush out your body and dilate your veins so that they’re easier to find during the blood test.
  • Avoid strenuous exercise. When you do an intense workout, it can cause your blood pressure to spike and that might be picked up on in your urine sample. To avoid a false read on the test, try not to exercise for a full day before your exam.
  • Try a cleanse. If you’ve been toying with the idea of a diet and lifestyle overhaul, now is the time to strike. Skip the alcohol, caffeine (if you can’t go without a daily cup, mention it to the examiner), over-the-counter medications (including herbal supplements), sugar and tobacco.
  • Quit smoking. For this tip to be effective, it should be enacted well in advance of your exam date. Keep in mind, kicking the habit a day before your test will hardly nudge your premium because signs of smoking stay in your blood for up to a week. Plus, the insurer looks at your smoking habits across the last 36 months.
  • Keep your medical contacts handy. Make sure you have your recent doctor’s names and phone numbers written out. This simple step will save you tons of time.
  • Know your medical history. Have your family history and your personal medical history readily available. You will be asked about your parents’ health conditions and your own diagnoses and surgeries over the last several years so it’s best to have this information top of mind.
  • Wear a lightweight outfit. You will be weighed in whatever you’re wearing so you’ll want to wear thin and lightweight materials to keep the number as accurate (and favorable) as possible. Keep your clothes loose and comfortable and consider wearing short sleeves for easy bloodwork access.

What happens after the medical exam

Feeling worried about the outcome of your medical exam? Try not to think about it from a traditional doctor/patient perspective. Life insurance companies make assessments based on risk, so something you might think is alarming or not a problem at all might be viewed radically differently by the life insurance company.

If the insurer sees a drastically abnormal reading, they might request a follow-up appointment. For example, if you have protein in your urine, they might request two separate follow-ups on different days to get an accurate read. If you have an abnormally high blood pressure reading, you might be able to retake the exam if you can demonstrate that your medical records show otherwise and prove that it’s an anomaly.

Otherwise, the technician will submit your information to the insurance company to complete the underwriting process. Usually, you’ll hear back with your actual quote in a few weeks’ time. However, depending on the follow-up, the process can take anywhere from three to eight weeks.

You can request a copy of your medical results from the insurance company and use the records to apply for a policy with other insurers, or even other types of insurance policies, such as disability insurance, for up to six months. Like a usual trip to your doctor, your life insurance medical exam becomes a part of your record and can be factored into life insurance quotes you receive in the future.

What to do if you don’t receive the results you want

If the medical exam doesn’t provide you with the results or health classification that you had hoped for, you can proceed in a few different ways:

1. Purchase the policy so you have some preliminary coverage and then ask for reconsideration in a year or two. A year of progress, whether it be a year without smoking or losing weight for health reasons, can make a big difference in how much you pay for life insurance premiums.

2. Shop around for other life insurance companies that might give you better rates for your individual health history.

3. Purchase a short-term life insurance policy and re-apply for traditional coverage after a few years, when your health or any other individual circumstance may have improved.

Whichever option you pursue, you’ll want to keep in mind that even for a healthy individual, the cost of purchasing life insurance increases on average by 4.5-9% each year that you age, according to quotes offered by Policygenius in 2020. A Policygenius agent can work with you to determine what the best option is for you.

Getting life insurance coverage without the medical exam

Want to skip the health exam? You can still get coverage without taking the medical exam at a competitive price — though the application process is no less thorough. If you’re in good health, you may be eligible for instant decision life insurance policies from Lincoln Financial and Brighthouse. Instead of requiring a medical exam, they do a thorough evaluation of your previous records to determine your coverage.

Lincoln TermAccel

Lincoln TermAccel is a competitive policy for individuals in good health — though if you have a more complicated medical history, it may be harder to get approved for coverage. Policies are available to individuals 18-60, with some age restrictions for 30-year terms and smokers.

How does Lincoln TermAccel work?

Lincoln TermAccel offers all the perks of a term life insurance policy — without an in-person medical exam for individuals 18-60. Instead, the insurer conducts a phone interview that is followed by a deep dive into your insurability via your prescription history, motor vehicle report, and medical history. Most of the time, this is enough information to warrant an application approval (or denial), but additional labs might be required if something in your background check is flagged as a risk.

The entire process takes about two to three days — compared to the usual wait time of four to six weeks for a traditional life insurance policy.

The policy is especially valuable to people who may not get an affordable no medical exam policy elsewhere. Marijuana smokers who don’t work in the industry can get competitive rates and smokers have a better chance of getting coverage than they would with other accelerated life insurance policies.

Even though the application process for a Lincoln TermAccel policy usually doesn’t require a medical exam, the coverage you can get is comparable. Term length offerings include 10-, 15-, 20-, or 30-year terms and the death benefit amount can be anywhere from $100,000 to $1 million. Policyholders have the option to convert their coverage into a whole life insurance policy at the end of its term. Other supplemental coverage options include the accelerated death benefits rider, children’s life insurance rider, and waiver of premium rider.

How much does Lincoln TermAccel cost?

Lincoln TermAccel premiums are some of the lowest in the industry. According to Policygenius quoting data, here’s how much you can expect to pay with a Preferred health classification for a $500,000 policy:

Monthly premiums for women


Monthly premiums for men


Brighthouse SimplySelect

Brighthouse SimplySelect is a no medical exam term policy that offers coverage comparable to a traditional term life insurance policy almost immediately. You can get a term length of 10, 20, or 30 years and up to $2,000,000 in coverage.

The application process forgoes the medical exam but includes a phone interview and a review of the following information:

  • Previous physicals and labs
  • Pharmacy records
  • Prior diagnoses and procedures
  • Medical billing records
  • Credit history
  • Driving history
  • Relevant public information such as criminal history or bankruptcy

Your financial justification for a policy will also be reviewed — and the death benefit amount will depend on your age and income. Within 24 hours of your phone interview, you’ll know if your application has been accepted, rejected, or if it has been “referred to the underwriter”. If your application is accepted, you’ll sign off on the policy via DocuSign and your coverage will be active. If it’s referred to the underwriter, the insurance company needs to ask you some additional questions before they make a decision.

The Brighthouse SimplySelect policy comes with supplemental riders. This includes a term conversion rider, which allows you to convert your coverage into a whole life insurance policy at the end of its term. You can also add an accelerated death benefit rider, which pays out some of the death benefit while you’re still alive if you are diagnosed with a terminal illness.

How much does Brighthouse SimplySelect cost?

Check out the graphs below to get an idea of how much you might pay for a Brighthouse SimplySelect policy. Your actual premiums will vary depending on your individual circumstances.

Average premiums for women:


Average premiums for men:


Methodology: Sample monthly premium rates based on 20-year term life insurance policy for a non-smoker in Preferred health rating; quotes based on policies offered by Policygenius in 2020.

Other no medical exam policy options

If you’re unable to get coverage from Brighthouse or Lincoln Financial because of age or health restrictions, there are still other life insurance policies that let you skip the medical exam, but they generally tout higher premiums. Here’s a quick guide to the main types of no medical life insurance policies out there:

Guaranteed issue life insurance

Guaranteed life insurance coverage is a type of life insurance that is, as the name suggests, “guaranteed” as long as you can pay the life insurance premiums. While this might be beneficial for people who are otherwise unable to acquire life insurance — perhaps due to health or any other prohibitory circumstance — the caveat is that it is typically one of the most expensive life insurance products per dollar of coverage, and pays out a comparably low death benefit to your beneficiaries.

Due to the high cost and relatively low payout, a guaranteed policy should only be utilized for life insurance coverage as a last resort.

Group term life insurance

Group life insurance is a type of life insurance policy that is offered by employers and doesn’t require a medical exam — or even an initial interview.

The downside of group life insurance is that it usually doesn’t offer enough coverage and often needs to be supplemented with a traditional life insurance policy. And, if you leave your job, the coverage won’t go with you.

However, some life insurance is better than none, and if you need to skip the medical exam, a policy guaranteed by your employer can at least offer some financial security for you and your loved ones.

Simplified issue life insurance

If you’re young and healthy, you might qualify for simplified issue life insurance. You’ll likely pay a higher premium than you would for traditional term life insurance at the same coverage amount, but you won’t have to wait as long to get life insurance coverage because there are fewer hoops to jump through.

Simplified life insurance policies determine how much you pay for your premiums by having you fill out a health questionnaire that asks questions geared towards your health, including whether you have any serious illnesses or habits that could affect your health.

While there are obvious benefits to simplified life insurance plans such as expedited coverage and less hassle, you should be aware of a few caveats. Since insurers are creating a plan for you based on limited information, they tend to be more cautious in their assessment and charge more to cover you. The coverage itself could also be more limited for that very same reason.

Final expense insurance

Final expense life insurance policies are for seniors with health issues who can’t qualify for traditional term life insurance but need a policy to cover end-of-life costs and outstanding debts. Premiums are generally high and coverage amounts are limited.

While final expense insurance is affordable for those on a budget and it can provide peace of mind for your family members, it doesn’t provide as high of a pay-out as term or whole life insurance plans do. Depending on the cost of funeral arrangements, credit card bills, medical bills and other expenses, these policies still might not be enough.

A life insurance policy that requires a health evaluation is usually going to get you the best life insurance rates. By verifying your height, weight, health habits, and medical history, insurers can offer you an accurate life insurance quote.

Your past and present health, as well as your family’s health history, are the biggest determining factors of your medical exam results.

While there are some steps you can take to ensure the exam goes as smoothly as possible, staying healthy in the years leading up to shopping for life insurance is the best way to get a more favorable health classification. Telling the truth throughout the application process and comparing companies will get you the cheapest rates for the financial protection you need.

Insurance Expert

Nupur Gambhir

Insurance Expert

Nupur Gambhir is an insurance editor at Policygenius in New York City. Previously, she has worked in marketing and business development for travel and tech. She has a B.A. in Economics from Ohio State University.

Insurance Expert

Rebecca Shoenthal

Insurance Expert

Rebecca Shoenthal is an insurance editor at Policygenius in New York City. Previously, she worked as a nonfiction book editor. She has a B.A. in Media and Journalism from the University of North Carolina at Chapel Hill.

Policygenius’ editorial content is not written by an insurance agent. It’s intended for informational purposes and should not be considered legal or financial advice. Consult a professional to learn what financial products are right for you.

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