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 Gambhir

Nupur Gambhir

Published February 3, 2020

KEY TAKEAWAYS

  • The medical exam is a required part of the life insurance application that insurers use to determine what health classification you receive and how much you pay for life insurance premiums

  • While your past and present health are the biggest determining factors of the results of your medical exam, there are a few steps you can take to give yourself a leg up during the exam

  • People who don’t want to take the medical exam still have life insurance coverage options, though those options tend to be costly and often don’t provide enough life insurance coverage

When you’re applying for life insurance, you’re required to take a medical exam as a part of the underwriting process. Your medical history and current health status are usually the biggest determining factors in what health classification you receive, which in turn determines much you pay for life insurance, so you want to be as prepared as possible.

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What is the medical exam?

The medical exam, which is essentially a health physical, 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 the risk you pose as an applicant, the medical exam is a necessary indicator of your health and is required by life insurance companies 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 the results from the medical exam 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 take a closer look at how life insurance companies qualify you.

HEALTH CLASSIFICATIONELIGIBILITY
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 snapshot 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 minutes, though there can be exceptions.

During the medical exam, the tech 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.

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

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 be doing 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 from 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 best position yourself for the best possible test results. Just remember, your health classification is made up of several different factors. You're welcome to try these out, though 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 don’t have to starve 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. 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.
  • Make sure you 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 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 in your favor) 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 request 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 8-10% each year that you age. 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? There are life insurance policies that let you skip the medical exam, but they generally tout higher premiums since the insurer has less information about your risk of death. 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 you can’t be rejected from 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 get 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.