Everything you need to know about the life insurance exam

The life insurance medical exam confirms the details you provided to the carrier when you first applied but also uncovers new information that could affect your premium.

Reina-Marszalek 1600

Reina Marszalek

Published June 5, 2019


  • There are a few simple ways to prep and pass the exam

  • After the exam, your insurance company will determine your insurance rating classification

  • The results of your medical exam play a direct role in how much you pay for coverage

When you begin shopping for life insurance, you may soon learn about the life insurance medical exam. When you purchase life insurance, you are quoted a rate that becomes the premium you’ll pay to keep the policy in effect. Your medical history, including your current health status, is one of the most important factors insurance companies use to determine what to charge you for your coverage.

That’s why the process of determining your premium, called underwriting, almost always includes a health exam that the insurance company uses to get a direct read on your current health.

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What is the medical exam?

The medical exam, technically called a paramedical exam, is a standard part of both life and disability insurance, and it not only confirms the details you provided to the carrier when you first applied but also uncovers new information that could affect your premium.

The life insurance health physical is free to you – the life insurance company pays for it, and you can keep your results.

Why you need a medical exam

If preliminary research has put you off the thought of an insurance medical exam, you may be tempted to skip the whole affair and avoid the trouble. However, most insurance companies will require you to submit a health evaluation when you apply for life insurance. They want to verify that the information you provided (height, weight, health habits, medical history, etc) are accurate so they can offer you an accurate life insurance rate. The better you “score” on your health exam, the more desirable your policy and premium will be.

In addition to other factors like your age, family medical history and lifestyle, the results from the medical exam help determine your life insurance 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 insurance classifications

  • Preferred Plus. Also 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.
  • Preferred. Considered 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 Plus. If 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.
  • Standard. This 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.
  • Substandard. Unlike 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%.

Common conditions the medical exam looks for

The medical physical and the health questions you answer reveal a lot about the risk your health poses to the insurer. The less healthy you are, the riskier you are, so your premiums will be higher if you’re sicker or 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. Worth noting, 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 pay out 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.
  • 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 carrier.

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What happens during the medical exam?

After you submit your life insurance application, you'll need to schedule the medical exam. A broker like Policygenius can help you coordinate your appointment during a phone interview. While the word “interview” might conjure up anxiety, there’s no need to worry. The call is quick, easy, and designed to help you get the best possible life insurance for your lifestyle and health history.

During or after your call, the life insurance carrier will work with you to set up an appointment time. You may also schedule a time with the medical exam company that works with the insurance company, such as ExamOne.

Getting a paramedical exam is just like going to your doctor to get a physical. However, the life insurance company knows that scheduling an appointment can be difficult, so you can choose to have the medical technician come to your home or work. The whole thing should take about 30 minutes.

The tech will perform the routine health checks you expect from your regular doctor. That means checking your pulse and blood pressure and recording your height and weight (and figuring out your body mass index).

If you’re an older applicant or you’re applying for a large amount of life insurance coverage, you may also have to undergo an electrocardiogram, or EKG, where the technician will put electrodes on your skin 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.

You’ll have to take a blood test, so be ready for that if you’re afraid of needles. In many cases, you’ll have to provide a urine sample too.

How to pass the medical exam

It's important to keep in mind that there's no "passing" the health exam. Your results will help determine the cost of your policy but most people will be able to get some level of coverage regardless of how their exam results turn out.

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

The first thing you can do to prepare is to be completely upfront about any conditions you have when initially applying for the life insurance policy. The underwriter will be doing his or her 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 up front.

Wondering how to get a better classification? You can give some of these things a try. Just remember, your health classification is made up of several different factors. You're welcome to try these out but it's not guaranteed that one tip or another will sway your results.

  • Fast 6-8 hours prior to. 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 if you're worried about your medical exam results

Feeling worried about the outcome of your medical exam? Try not to think about it from a traditional doctor/patient perspective. Carriers assess based on risk, so something you might think is alarming or not a problem at all might be viewed radically differently by the carrier. Your best bet is to wait and see what they tell you and then you can figure out next steps.

If the carrier 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 a retake if you can prove it's an anomaly. One way to demonstrate that is if your medical records show otherwise normal readings.

What happens after the medical exam

After the paramedical exam, the technician will submit your information to the insurance company to complete the underwriting process.

If all goes according to plan, you should 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. The record can be used to apply with other life insurers, if need be, or for other types of insurance, including disability insurance, for up to six months.

In some ways, receiving the life insurance health exam is kind of like getting a physician’s checkup for free, although, like a trip to your usual doctor, it does become part of your health record and could be factored into future insurance premium quotes.

In an ideal situation, you’ve already been getting plenty of exercise, watching your diet and staying clear of environmental toxins. If you’ve been keeping healthy, you’ll pass the medical exam with flying colors and score a low premium on your life insurance policy.

Life insurance without the medical exam

Don’t want to take a health exam for coverage? 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:

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’ll get coverage more quickly because you won’t have to go through so many hoops.

Simplified life insurance carriers determine your premium by having you fill out a health questionnaire. The questions are geared toward 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

These policies are for seniors with health issues who can’t qualify for traditional term life insurance, but need a policy to help cover end-of-life costs and outstanding debts, Premiums are generally high and coverage amounts are limited. You can learn more about these policies — also known as guaranteed life insurance — here.

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 might not be enough to cover that.