Life Insurance Medical Exam: What It Is & How It Works

A basic medical exam is a normal part of the life insurance application and underwriting process. Your medical history and health status are determining factors in what health classification you receive, which determines how much you pay for life insurance. The exam is pretty convenient — it takes about 30 minutes and an examiner can meet you in your home or office. If the medical exam shows that you are in good health, you'll get cheaper premiums. We'll explain the process so you can be as prepared as possible.

Key takeaways

The life insurance medical exam is similar to an annual physical with your doctor.
The medical exam tests for any health conditions you might have and verifies your smoking status.
No-medical-exam policies allow you to skip the exam, as long as you meet the insurer’s qualifications.

What is the medical exam?

The medical exam is a standard part of the life insurance application process. It's used to confirm your health status and determines your health classification and premium. The insurer covers the costs of the medical exam, even when you choose to have the examiner travel to you.

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Is a medical exam required for life insurance coverage?

A medical exam isn't always a requirement and there are some no-medical-exam life insurance policies that use previous medical records in lieu of the medical exam. If you're not eligible for a no-medical-exam policy due to your health, you will need to take a medical exam to get coverage.

From best (lowest premiums, lowest risk) to worst (highest premiums, highest risk), the life insurance classifications are Preferred Plus, Preferred, Standard Plus, Standard, Preferred Smoker, Standard Smoker, and Table Ratings 1 to 10.

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 and the higher your premiums.

What happens during the medical exam?

During or after your initial phone interview, the underwriter will work with you to schedule a medical exam at a convenient time.

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

A verbal questionnaire: You'll answer a series of questions about your health, lifestyle, and social habits, including questions about current prescriptions.
A physical exam: The examiner will measure your height and weight, check your blood pressure and collect blood and urine samples.

If you’re older or applying for a large amount of life insurance coverage, you may also undergo an electrocardiogram or EKG to measure your heart’s electrical activity.

What do life insurance blood tests look for?

The health exam, including blood tests and urine tests, assesses you for several medical conditions, including:

Elevated cholesterol: Your risk for heart disease and stroke increases if you have high cholesterol.
High blood pressure: Your test could reveal high blood pressure or the usage of beta-blockers, a medication to control high blood pressure.
HIV/AIDS and hepatitis: Along with other diseases, you’re going to be tested for HIV/AIDS and hepatitis, which increase the risk of insuring you.
Hyperglycemia or elevated glucose: This could be an indicator of diabetes.
Organ issues: Kidney infections, liver problems and other organ-related issues can show up on a life insurance test.
Prostate cancer: Male applicants over the age of 50 may also be asked to conduct a prostate-specific antigen (PSA) test.

Results that show any of the above may lead to higher premiums or, in severe cases, a declined application. If you purposely conceal information that’s revealed after the medical exam, your application could be denied or your coverage could be canceled. The life insurance company may also note on your Medical Information Bureau (MIB) report that you were dishonest, causing other companies to deny you coverage in the future.

What do life insurance drug tests look for?

One factor that determines whether you get approved or denied for coverage, and what premiums you’ll end up paying, is the results of the life insurance drug test conducted with your blood and urine tests. Here are a few of the things that insurers are looking for:

Drug use: Life insurance drug tests can detect drugs like amphetamines/methamphetamines, cocaine, opiates, phencyclidine (PCP), barbiturates, benzodiazepines, methadone, and marijuana.
Nicotine: Nicotine and cotinine, which is an alkaloid found in tobacco, can stay in the body and be detected by a urine test for at least several days; bodies process nicotine differently.
Diuretics: Urine tests can detect diuretics which may be a sign of blood pressure medication, so it’s important you are honest about any health conditions you have from the beginning.

Over-the-counter cold remedies like Nyquil, nasal sprays, cough syrups, and sinus treatments can trigger false positives for everything from amphetamine to opiates to MDMA. Allergy medicine like Benadryl and Claritin-D can also cause problems. If you have a headache leading up to your drug test, it amy make sense to take aspirin instead of generic or name brand ibuprofen.

What happens if you fail the life insurance drug test?

If a potential issue is flagged by the drug testing, the life insurance company may do some more digging to confirm the findings, which can delay the application process.

If the life insurance drug test detects nicotine and/or cotinine, which is an alkaloid found in tobacco, you may have to pay two to three times higher premiums than a nonsmoker. If you lied about smoking on your application, the insurer will consider that fraud, and they could decline your application, cancel an existing policy or refuse to pay the death benefit to your loved ones after you die.

If you’re currently using hard drugs or painkillers that haven’t been prescribed to you by a doctor, you will be ineligible for coverage. If you use marijuana, you can still get coverage. Some insurance carriers will classify marijuana users as smokers and offer the same rates as tobacco users, while others will decide your coverage and premiums based on how often you use cannabis.

Do life insurance companies check medical records?

In order for life insurance companies to access your complete medical history, you’ll need to sign a HIPAA life insurance waiver. Without disclosing your medical background to insurers, you will not be able to get life insurance coverage. They need this information to determine how much you’ll pay in policy premiums. Your health information cannot be used for any other purpose aside from determining your life insurance rates.

After signing a HIPAA waiver, life insurers can ask your providers for the following information:

Health and medical history
Financial background
Driving records
Criminal records

Again, this information can only be used to determine your eligibility for a policy and how much you’ll pay in policy premiums. HIPAA waivers are only eligible for two years, so if you postpone your life insurance application, you may have to sign another waiver if you resume your application after 24 months.

Due to HIPAA compliance, life insurance companies cannot sell your information and your personal history will not be readily available to anyone other than the insurer. It can only be disclosed to another life insurance company if you are applying for a new policy and a red flag pops up, such as multiple policy denials. However, this is generally very rare.

But you should know that when you apply for life insurance, the insurance company will evaluate your risk using the MIB, which contains information about all your life insurance applications from the last three to five years, including:

When you previously applied for life insurance
Dates of diagnoses and treatments for health conditions
Confirmed medical conditions
Types of treatment you received
Where your medical history originated

That information can be used in conjunction with your medical exam and other records to make sure your current application isn’t missing any important information. The MIB does not keep your medical records on file, and uses medical codes without any personal identifiers that can be used for identity theft.

How to prepare for the life insurance medical exam

There's no "passing" or “failing” the life insurance medical exam. Your results will help determine the cost of your policy, but they are based on 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.

Be upfront. You should be completely honest about any conditions you have when applying for life insurance to avoid any delays or possible fraud.
Eat healthy foods.In the days leading up to your test, avoid high-sodium and sugary foods, which can raise your blood pressure or cholesterol.
Fast six to eight hours before the exam. The medical exam requires a fast to make sure your blood sugar and cholesterol numbers are not skewed. Pro tip: Schedule your appointment for the morning so you aren’t hungry all day.
Stay hydrated. Drinking lots of water ahead of your exam will help flush out your body and dilate your veins so they’re easier to find during the life insurance 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 in your urine sample. To avoid a false read on the test, try not to exercise for a full day before your exam.
Avoid certain medications. Don’t take over the counter cold remedies and allergy medication like Nyquil, nasal sprays, cough syrups, sinus treatments, allergy medication, and ibuprofen, as they can trigger false positives.
Quit smoking. To make a positive difference, you should quit well in advance of your exam date. 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 three years.
Gather important info. Having your recent doctors’ names and phone numbers, as well as your family’s medical history written out, will save you tons of time.
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 your weight as accurate as possible. Keep your clothes loose and comfortable and consider wearing short sleeves for easy bloodwork access.

What happens after the medical exam

If the insurer sees abnormal results that don't match your application, they might request a follow-up appointment. For example, if you have protein in your urine, they might request another test on a different day to get an accurate read. 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 within a few weeks, but the process can take up to six weeks.

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

If the medical exam doesn’t provide the health classification that you had hoped for, you still have a few options:

Purchase the policy or a short-term life insurance policy so you have some preliminary coverage. Then ask for reconsideration in a year or two. A year of progress can make a big difference in how much you pay for life insurance premiums.
Shop around for other life insurance companies that might give you better rates for your individual health history. You can even use your medical exam to apply for a policy with another insurer or to apply for other types of insurance policies, such as disability insurance, for up to six months.

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

Life insurance coverage without the medical exam

Want to skip the health exam? You can still get affordable coverage without taking the medical exam — 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 Brighthouse and Lincoln Financial. Instead of requiring a medical exam, they do a thorough evaluation of your previous records to determine your coverage.

Brighthouse Financial

4.3

Policygenius rating

Best overall

Fast coverage

Best for young adults

Brighthouse Financial offers a low-cost no-medical-exam term life policy available exclusively through the Policygenius marketplace.

Pros

Fast-tracked coverage with SimplySelect
Very affordable
Convertible options available

Cons

Only few term lengths available
No rate reconsideration

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Lincoln Financial

4.7

Policygenius rating

Best overall

Lincoln Financial offers a no-medical-exam term life policy with quick decisions and affordable rates for shoppers of all age ranges, including marijuana users.

Pros

Affordable for older applicants
No-medical-exam option available
Fast turnaround
Low rates for marijuana users

Cons

Expensive permanent policies
Few online tools

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Other no-medical-exam policy options

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

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 pricier life insurance premiums.
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. There are some downsides of group life insurance: it usually doesn’t offer enough coverage on its own and if you leave your job, the coverage won’t come with you.
Simplified issue life insurance: 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. The coverage is limited and isn't available for people with certain medical backgrounds.

While there are some steps you can take to ensure the life insurance exam goes as smoothly as possible, staying healthy 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.

Frequently asked questions

What does a life insurance medical exam test for?

The life insurance medical exam records your height, weight, and blood pressure. It uses blood and urine tests to screen for any health conditions, such as high blood pressure or high cholesterol. It also tests for drug use and nicotine and cotinine to determine if you should receive smoker rates.

Why do they test blood and urine for the life insurance medical exam?

Insurance companies use blood and urine samples to learn more about your health profile. Health is one of the factors underwriters use to determine policy rates. Blood and urine tests can reveal information about drug/nicotine use and other underlying health issues.

How do I pass a medical exam for life insurance?

You cannot pass or fail the life insurance medical exam. But you can position yourself to get the best possible results by forming healthy habits, such as moderate exercise. You should also have any medical documentation prepared for your examiner.

What should you not do before a medical exam?

You should not smoke, drink alcohol, or do drugs before your life insurance medical exam. Also avoid strenuous exercise the day before your exam because it can cause a spike in blood pressure.

Do life insurance companies look at your medical records?

Yes. Life insurance companies evaluate your medical background — alongside other factors — before offering you coverage. Your medical history, family background, and lifestyle choices all determine how much you pay for life insurance.

Additional reporting by Brian Acton