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What is the life insurance medical exam?

Fact-checked with HomeInsurance.com

As you get older and have more dependents counting on you, there are ample benefits to having a life insurance policy. But before you can get approved for coverage, the insurance company will want to know more about your medical history, health risks and lifestyle. The life insurance medical exam helps insurance providers evaluate your level of risk and calculate your premium. If you’re thinking about applying for life insurance, here’s what you should know about the medical exam.

What is the medical exam?

The life insurance medical exam is a physical evaluation, like a regular checkup, that tells the insurance company how healthy you are. It includes a full workup of health markers, such as blood pressure and weight, as well as prescriptions you take, surgeries you’ve had and family health history. The medical exam usually takes place in your home, but you may have the option to visit a facility approved by the life insurance company. 

Is the medical exam required for life insurance coverage?

A medical exam is required for most, but not all life insurance policies. Simplified issue and guaranteed issue life insurance policies don’t require applicants to undergo medical screening.

However, choosing a policy that doesn’t require a medical exam isn’t necessarily the best option. Simplified issue and guaranteed issue life insurance policies are much more expensive than other policies. If you opt out of the medical exam, the insurance company assumes you are high-risk, and raises your rate as a result.  

Based on the findings of the medical exam, the insurance company will give you a classification. The four most common life insurance health classifications include:

Life insurance health classifications

ClassificationEligibility requirement
Preferred PlusNear-perfect bill of health, with normal blood pressure, weight, cholesterol, etc. You don’t take any regular medications or smoke.
PreferredGood overall health, but may have a few minor conditions, like high blood pressure. This category includes people who have risky hobbies or a dangerous job.
Standard PlusGood overall health, but may have a few acute health issues, including obesity. Little to no family history of disease.
StandardThe most common category, where people are of average health, take regular medication for at least one condition, and have a family history of some diseases. 

Why do you need the medical exam?

Life insurance companies require a medical exam to help them determine how much you risk you carry. Healthy people are less risky to insure than people with existing health issues, or a family history of disease. It also helps them determine your rate. The healthier you are, the less you’ll pay for your insurance. 

During the medical exam, here are some of the things the insurance company will look at:

  • Blood pressure: Blood pressure is a good indicator of overall health. If you have high blood pressure, you could be at risk for other medical conditions, and you probably take regular medication. 
  • Weight: Obesity is another thing life insurance companies look at. Being overweight increases your risk of developing other disorders, and even premature death. 
  • Cholesterol: If you have high cholesterol, you face a higher risk of heart attack and stroke. Your cholesterol also says a lot about your diet.
  • Drug and alcohol use: During the medical exam, you’ll be asked to disclose how often you drink alcohol, and if you use recreational drugs. Marijuana is sometimes an exception, but heavy drug and alcohol users will pay a huge premium for insurance.  
  • Smoking: Smokers are a life insurance company’s biggest enemy. Smoking is linked to countless health conditions, so it’s very risky to insure people who smoke.

What happens during the medical exam?

The life insurance medical exam has two parts. It starts with a phone interview, and the second step is the physical exam. Here’s what you can expect in each stage.

Stage 1 

The first stage is the phone interview. During the interview, a representative from the insurance company will ask you a series of basic health questions to validate the information on your application. You might be asked to tell them about your pre-existing health conditions, family history, medications you take and what you do for work. They’ll also schedule your in-person exam during this time.

Stage 2

The second stage is the physical exam. To start, your vitals will be taken — like your height, weight, and blood pressure. You’ll also need to give a blood and urine sample. Older people might be required to take an electrocardiogram (EKG) to test heart health. 

The doctor will probably ask you to reiterate your family history, personal health history, and the prescriptions you take. During this stage, the doctor is looking to confirm that the health details you provided on your application are accurate, and to check for any missed information.

Where can you get a life insurance medical exam?

Life insurance medical exams are usually done in your home, which makes it pretty convenient. The insurance company will send a medical technician to your house with the proper equipment to take your vitals and collect samples. You might even be able to take the exam at your office.

However, some insurance companies allow you to visit an approved hospital or medical center for the exam. Usually, they request an unbiased, third-party medical professional to administer the exam, so you can’t just make an appointment with your regular physician. 

How to pass the medical exam 

The life insurance medical exam isn’t a “pass” or “fail” test. It’s used to gauge your level of health and determine the price of your policy. However, the medical exam is important, and you want to optimize your chance of getting a good rate. If you’re planning to apply for life insurance, it’s never too early to start preparing for the medical exam.

  • Gather your medical records: Before you take the medical exam, contact your doctor and ask for a recent copy of your medical records. This should include everything from your surgical history to your recent blood work results. That way, you can verify information and provide a physical copy to the insurance company.
  • Kick your smoking habit: If you’re a smoker, now is the time to quit. Your medical records will still show that you have a history of smoking, but you’ll qualify for a much lower rate if you can prove that you quit.
  • Lose some weight: Overweight people pay a higher rate for their life insurance. Before you take the medical exam, focus on cleaning up your diet and exercising more to drop a few pounds.

Here are some things you can do on the day of your medical exam.

  • Fast before the exam: Before the exam, it’s recommended to fast for 6-8 hours so you have nothing in your stomach. This has less to do with your weight, and more to do with your blood sugar and cholesterol readings. If you’ve recently eaten a big meal, especially junk food, it could cause your readings to be higher than they normally are.
  • Hydrate: You’ll need to give a urine and blood sample during the exam, so make sure you drink plenty of water on the day of your exam. That makes the sample collection process much easier. 
  • Avoid hard exercise: Don’t exert too much energy or take part in strenuous activity within 24 hours of your medical exam. Your blood pressure and heart rate could spike, causing an inaccurate reading.

What happens after the medical exam

After the medical exam, all you have to do is wait. An insurance underwriter will review the findings of your medical exam, compare it to your application and calculate your rate. If there are any abnormalities with your exam, you might be contacted about a follow-up test.

The wait time will vary based on a number of things. You could get the results back in as little as a few weeks, or as long as a few months. If you’re eager to get coverage, you can ask the insurance company for a copy of the results and apply for a policy from another provider for a maximum of six months.

What if I fail the medical exam?

Failing the medical exam—meaning you are denied coverage—can happen for a few reasons. It usually means that you provided information on your application that did not match the findings from your medical exam. If you fail, here’s what you should do.

  • Ask for a copy of the results to verify the reason for being denied. Check to make sure the insurance company didn’t accidentally make a clerical error.
  • Review the results with your doctor. If there’s a health issue you didn’t know about, you can get treatment, update your medical records, and reapply.

The takeaway

  • The life insurance medical exam is required for most policies.
  • Simplified issue and guaranteed issue life insurance are the only policies that don’t require a medical exam.
  • The medical exam helps the insurance company determine your level of risk so they can set your premium.

The life insurance medical exam is simply a way for insurance companies to gauge how healthy you are. It’s nothing to be afraid of, but there are ways to prepare for it. It’s almost impossible to “fail” the exam, unless you provide false information on your application. If you’re honest about your medical history from the start, you shouldn’t have any issues getting life insurance coverage.

Elizabeth Rivelli

Elizabeth is an insurance writer for coverage.com, where she covers insurance providers and reviews policies to help consumers find comprehensive and affordable coverage for every area of their life. She has more than three years of writing experience for top online insurance and finance publications.

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