Taking a medical exam is a routine part of applying for life insurance. Your medical history and health status play into how risky the insurer considers you to be, which affects how much you’ll pay for your coverage.
The exam is quick, convenient, and resembles an annual physical at your doctor’s office. The appointment takes less than 30 minutes and an examiner can meet you in your home or office. The results of your exam will help the insurer confirm your health status and give you a fair price for the coverage you need.
What is the medical exam?
The medical exam is similar to an annual checkup. The insurer will send an examiner out to your home or workplace. They’ll measure your height, weight, and blood pressure, and take a blood and urine sample.
The results of the exam will confirm your health status and help the insurer evaluate your overall risk. The insurer will use this information to set the price of your insurance. If the insurer feels confident that you’ll outlive the policy, your insurance will be cheaper. If you’re more likely to die while the policy is active, your insurance will be more expensive.
What should you expect during the life insurance medical exam?
During your initial phone interview, your life insurance agent will schedule a medical exam for you at a convenient location, such as your home or workplace. Normally, the whole process takes about 30 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 an older adult or you’re applying for a multi-million-dollar life insurance policy, you may also undergo an electrocardiogram (ECG/EKG), which measures your heart’s electrical activity, to provide the insurer with more detailed health information.
What do life insurance blood tests look for?
Life insurance blood tests and urine tests assess you for several medical conditions, including:
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.
If your results show any of the above, it could 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, which could cause other companies to deny you coverage in the future.
What do life insurance drug tests look for?
Life insurance companies also use blood and urine tests to screen for drug use, which can affect your application approval and your premiums. 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.
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 medicines like Benadryl and Claritin-D can also cause problems. If you have a headache leading up to your drug test, it may make sense to take aspirin instead of generic or name-brand ibuprofen.
What happens if you fail the life insurance drug test?
If you test positive for drugs on your medical exam, the life insurance company will ask follow-up questions to confirm the findings, which can delay the application process.
If the life insurance drug test detects evidence of tobacco use, you may have to pay two to three times higher premiums than a non-smoker. 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’ll 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?
Yes — with your approval. In order for life insurance companies to access your complete medical history, you’ll need to sign a HIPAA life insurance waiver. You won’t be able to get life insurance coverage unless you’re willing to disclose your medical records. 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
Again, this information can only be used to determine your eligibility for a policy and how much you’ll pay in premiums.
Do life insurance companies share information with each other?
Due to HIPAA compliance, life insurance companies cannot sell your information. Your personal history won’t be available to anyone other than the insurer. It can only be disclosed to another life insurance company in rare situations — for example, if you’re applying for a new policy and a red flag pops up, such as multiple policy denials.
When you apply for life insurance, the insurance company will evaluate your risk using the Medical Information Bureau (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
This information will be combined with your medical exam and other records to make sure your current application isn’t missing any important information.
The MIB doesn’t keep your medical records on file, and uses medical codes without any personal identifiers to prevent 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’re 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.
What happens after the medical exam?
The medical technician will submit your information to the insurance company to complete the underwriting process. Usually, you’ll hear back from the insurer with your final rate within four to six weeks. From there, the insurer will make you a formal offer of coverage. If you accept, you’ll sign the paperwork, pay your first premium, and your coverage will begin.
If the insurer sees abnormal results that don’t match your application, they might request a follow-up appointment or ask clarifying questions about your health history.
What should you do if you don’t get the results you want?
If your medical exam results cause the insurer to raise your premiums, there are options for you to consider:
Purchase the policy they offer you so you have some coverage in place. Then, depending on the reason for your rate change, you can change your health or lifestyle and typically ask for reconsideration in a year or two. For instance, if nicotine was detected in your urine, you can typically apply for non-smoker rates a year later, provided you stop using nicotine products.
Shop around for other life insurance companies that might give you better rates for your individual health history and medical exam results.
Whichever option you pursue, keep in mind that even for someone with no health complications, the average cost of life insurance increases by 4.5% to 9% each year that you age, so getting some coverage in place as soon as you can will help you save money in the long run. A Policygenius agent can work with you to determine the best coverage options for your unique profile.
Can you get life insurance coverage without the medical exam?
There are some no-medical-exam life insurance policies that use previous medical records in lieu of the medical exam. Instead, you’ll typically complete a health interview online or over the phone, and the insurance company will verify the information against your medical records and the MIB.
For example, if you have few health conditions and risk factors, you may be eligible for instant decision life insurance policies from Brighthouse Financial and Legal & General America, (which also does business as Banner Life and William Penn). Working with a Policygenius expert can help you determine if you qualify for any no-exam life insurance options.
Other no-medical-exam policy options
If you’re unable to get traditional life insurance 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 and lower payouts.
Guaranteed issue life insurance is a type of whole life insurance that offers small coverage amounts and near-certain approval. There are far fewer health qualifications to get approved.
Simplified life insurance policies require a health questionnaire instead of a full exam. This type of policy has fewer health qualifications than traditional life insurance, but may still be unavailable for people with certain medical backgrounds.
Group life insurance is a type of life insurance policy offered by employers as part of a benefits package. It doesn’t require a medical exam or health interview. Coverage amounts are usually one to two times your salary, and you can’t take the coverage with you if you change employers. While group policies offer usually less coverage than most people need, they’re a great way to get some coverage in place when your options are limited.
Whether or not you take the life insurance medical exam, working with an independent broker like Policygenius can help you navigate the application process and compare policy options that are tailored to your needs.
Additional reporting by Brian Acton