All about life insurance urine tests

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

Logan Sachon

Logan Sachon

Published October 23, 2018

When you think of taking a urine test, the first thing that comes to mind is likely a when a prospective employer requests you take one for a job offer. But company drug tests aren’t the only time you may have to pass a urine test: Did you know life insurance companies may make you take one before they offer you life insurance coverage? And the urine tests life insurance companies administer test for more than drugs.

Life insurance urine tests aren’t uncommon. Along with blood tests, they’re a normal part of the life insurance application process. But what are life insurance companies looking for in urine test results, and how can you avoid them?


Why life insurance companies test urine

To understand why a life insurer might as 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 premiums. If you die while the policy is active, 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.

That means before a company sells a life insurance policy, they need to know the likelihood of an applicant dying over the life of the policy so they can price the premiums accordingly. If an applicant is likely to die while their policy is in place, whether 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 your average physical in that it gives life insurance companies a comprehensive picture of your health.

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

That’s not to say you’re uninsurable if a life insurance company uncovers anything. There have been so many advances in modern medicine that conditions like diabetes and even HIV are much more manageable than in the past. You can still get covered even if you are facing a medical issue. Policygenius can help you apply to the carrier that can offer the best coverage the best premiums for your situation. Read more about the best life insurance companies for people living with certain medical issues.

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What life insurance companies use urine tests for

A lot of what the insurance company needs to know about your health they can learn from your medical records or an interview with you, but conducting medical tests, including a urine test, gives them 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. Why do life insurance companies test for drugs? Because, depending on the drug, there can be major health implications.

If a life insurance company detects amphetamine/methamphetamine, cocaine, opiates, PCP, barbiturates, benzodiazepines, or methadone in your system, you’re likely to be disqualified from receiving coverage. One drug that’s an exception, though, is marijuana.

Life insurance urine testing do test for THC (more formally THC-COOH) which can stay in your system for anywhere from a few days to a few weeks, so urine tests are a reliable way to test for marijuana use. But unlike other drugs, a positive result for marijuana doesn’t tank your chances of getting covered, and may not even affect your life insurance rates all that much.

Marijuana is in a legal grey area, legalized in some places but not others, and life insurance companies are similarly split in how they treat it. But it’s not its legality (or not) that insurance companies are worried about; they lump marijuana and cigarette smoking in the same category, and 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 category ranging from Preferred Plus to Substandard. Then there’s a specific Smoker designation; this can raise rates considerably.

Nicotine and related cotinine, which is an alkaloid found in tobacco, can stay in the body and be detected by a nicotine test or cotinine 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.

Health issues

Besides foreign substances in the body, 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 of the things looked for in a urine test, and the corresponding potential red flags, include:

  • 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, a urine test may still reveal potential issues.

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.

How to avoid life insurance company urine tests

As far as medical tests go, urine tests are relatively unintrusive. Still, some applicants may want 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, predictive models, and behavioral economics) to set your premiums. These are non-standard, but are slowly become more availalble.

  • Simplified issue life insurance (also called simplified term): 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.

About the author

Insurance Expert

Logan Sachon

Insurance Expert

Logan Sachon is the co-founder of The Billfold, a groundbreaking personal finance site for millennials that was named one of Time's 25 Best Blogs of 2012. Her work has been published in New York Magazine, Glamour, The Guardian, BuzzFeed and more.

Policygenius’ editorial content is not written by an insurance agent. It’s intended for informational purposes and should not be considered legal or financial advice. Consult a professional to learn what financial products are right for you.

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