All about life insurance urine tests

Urine tests are a common part of life insurance medical exams.

Rebecca Shoenthal author photo


Rebecca Shoenthal

Rebecca Shoenthal

Licensed Insurance Expert

Rebecca Shoenthal is an insurance editor and licensed Life, Health, and Disability agent 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.

Updated October 19, 2020|6 min read

Policygenius content follows strict guidelines for editorial accuracy and integrity. Learn about our

editorial standards

and how we make money.

When you think of taking a urine test, the first thing that comes to mind is likely a doctor’s appointment or an employer request. But company drug tests aren’t the only time you may have to pass a urine test: Many life insurance companies require a urinalysis before offering life insurance coverage. And the urine tests life insurance companies administer check for more than drugs.

Life insurance urine tests aren’t uncommon. Along with blood tests and a medical exam, they’re a normal part of the life insurance application process.

Insurance companies use urine test results to evaluate your health profile during underwriting. Urine tests help confirm your application information and in turn determine how much you’ll pay in premiums.

We’ll explain what the life insurance urine test is used for and how you can avoid the test altogether by applying for alternative life insurance coverage options.

Key Takeaways

  • Insurance companies use urine tests as part of the medical exam to learn more about your overall health and determine your premium rates

  • Urine tests can reveal traces of hard drugs, THC, and nicotine, and can show glucose levels, red/white blood cell counts, and more

  • Marijuana use is treated differently by each insurance company

  • Accelerated underwriting, simplified issue, and guaranteed issue life insurance are non-traditional policies that do not require a medical exam or urine test

Why life insurance companies test urine

To understand why a life insurer might ask for a urine sample, you have to know the basics of how term life insurance works. You pay for a life insurance policy through monthly or annual premiums. If you die while the policy is in force, the life insurance company pays your beneficiaries a lump sum of money called a death benefit. If the policyholder doesn’t die and the policy term ends, the life insurance company doesn’t pay out anything.

Before an insurance company sells a life insurance policy, they need to know the likelihood of the applicant dying during the policy’s term so they can price the premiums accordingly. If an applicant is likely to die while their policy is in place – because they’re elderly, have a chronic health condition, or take part in risky hobbies – they’ll pay more than someone who is likely to outlive their policy. The process of evaluating how risky you are to insure is called underwriting, and blood and urine tests are an important part of the underwriting process.

When do life insurance companies test urine?

One of the main aspects of underwriting is the paramedical exam, also called the life insurance medical exam. This life insurance medical exam is similar to a physical and gives life insurance companies a comprehensive picture of your health beyond the written application.

Urine tests and blood tests, a medical history interview, and prescription drug checks all play a role in the life insurance medical exam. If the results reveal high blood pressure, a history of heart disease, or any other underlying medical conditions, the insurance company could raise your life insurance premiums.

That’s not to say you’re uninsurable if a life insurance company uncovers anything during underwriting. Obtaining life insurance with chronic medical conditions is possible, and often more affordable than people expect, especially if your condition is well-maintained. Conditions like diabetes, HIV, and high cholesterol do not lead to automatic application denial. Every insurer treats conditions differently. An independent broker like Policygenius can help you find an insurance company that offers the most affordable coverage for your situation.

Ready to shop for life insurance?

Start calculator

How life insurance companies use urine tests

Your medical records and phone interview with the insurance company only provide limited information about your health. Conducting medical tests, including a urine test, give underwriters a full picture of your current health. Here are a few of the things that life insurance urine testing can be used to uncover:

Drug use

Along with blood tests, urine tests play a big role in life insurance drug testing. Depending on the types of drugs a urinalysis reveals, there can be major health implications in the eyes of an insurer.

If you’re currently using hard drugs or painkillers that haven’t been prescribed to you by a doctor, you’re likely to be disqualified or denied coverage. A life insurance urine test detects drugs like amphetamines/methamphetamines, cocaine, opiates, phencyclidine (PCP), barbiturates, benzodiazepines, and methadone. One drug that’s an exception, though, is marijuana.

If you or someone you know has a substance abuse disorder, help is available.

Life insurance urine tests detect traces of tetrahydrocannabinol (THC), a substance in marijuana that can stay in your system for anywhere from a few days to a few weeks. Urine tests are a reliable way to test for marijuana use, but unlike other drugs, a positive result for THC doesn’t tank your chances of getting covered. It may not even significantly affect your life insurance rates.

Marijuana is in a legal grey area – legalized and/or decriminalized in some states but not others – and life insurance companies are similarly split in how they account for marijuana use. It’s not its legality that insurance companies are worried about. Insurance companies often lump marijuana and cigarette smoking in the same category, so if you use marijuana you could be assigned a smoker’s rating, leading to much higher premiums.

→ Read more about marijuana use and life insurance rates.


Another substance that’s commonly looked for in life insurance medical tests is nicotine. When life insurance companies see how risky an applicant is to insure, they classify the applicant in a health category ranging from Preferred Plus (the best) to Substandard. Then there’s a specific Smoker/Nonsmoker designation, which can raise rates considerably if you’re a smoker.

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. If an insurer detects nicotine or cotinine in your urine, your premiums will be higher. Smoker or tobacco premiums can be two to three times higher than nonsmoker premiums.

Health issues

Life insurance companies also use urine tests to detect existing or potential health issues.

By analyzing a urine sample, companies can determine a wide variety of health risks. Some potential red flags include abnormal amounts of:

  • Hemoglobin (kidney infection)

  • Creatinine (kidney disease)

  • Bilirubin (liver problems)

  • Glucose (diabetes)

  • Red blood cells (blood disorder or organ problems)

  • White blood cells (infection)

Urine tests can also detect diuretics, which may be a sign of blood pressure medication. Even if you don’t disclose a health condition on your initial application, a urine test may still reveal potential issues.

That’s why it’s best to be upfront from the beginning when applying for life insurance. Not only are life insurance companies able to check for inaccuracies on your application, but lying on your application is considered insurance fraud, and could lead to a decline of coverage or death benefit denial for your beneficiaries later.

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

Ready to shop for life insurance?

Start calculator

How to avoid life insurance company urine tests

As far as medical tests go, urine tests are relatively unintrusive. Still, some applicants may not want to take a life insurance urine test – or undergo any aspect of the life insurance medical exam. No-medical exam life insurance policies allow applicants to bypass the paramedical exam. There are three types of no-medical exam policies:

  • Accelerated underwriting: Some insurance companies offer fully-underwritten, no-med exam applications that use traditional info sources (like medical records) and non-traditional info sources (like credit profiles, driving records, and criminal history) to set your premiums. Policygenius offers accelerated underwriting through Lincoln, Brighthouse, Banner Life, and Prudential, for healthy individuals between the ages of 18 to 60, with some exceptions.

  • Simplified issue life insurance: You still have to answer health questions, and if you have a history of serious health problems, the life insurance company may decline to offer you coverage without a full medical exam. Can be much more expensive than fully-underwritten life insurance.

  • Guaranteed issue life insurance: Doesn’t ask any health questions. This type of insurance is very expensive and offers low policy amounts, but could be a good option if you’re in poor health or can’t find coverage otherwise.

→ How can Policygenius help me find the right policy?

Life insurance urine test FAQs

Why do they test 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. Urine tests can reveal information about drug/nicotine use and other underlying health issues.

Can I skip the life insurance urine test?

If you’d rather avoid a urine test, or a medical exam altogether, some companies offer no-medical exam policies. Accelerated underwriting, simplified issue, and guaranteed issue life insurance policies may be available and do not require a medical exam.

Can you retake the life insurance medical exam?

In some cases, insurers will allow you to retake the medical exam. If the insurance company sees a drastically abnormal reading, they might request a follow-up appointment. But this generally only applies if you can demonstrate that your medical records show that the results are an anomaly (such as a high blood pressure result but no prior history). If drugs are detected in your urine, it’s unlikely you’ll be allowed a follow-up exam.