The rate you’re offered for life insurance, in part, reflects how healthy you are. That’s where the medical exam comes in. It gives your insurer a complete picture of your health and helps them set your premium — which is the amount of money you pay each month or year for coverage. But if you’d rather not take a physical, you have options.
What can I expect during the medical exam?
If you need to undergo a medical exam, your insurer will send a technician to your home or office. You can’t have your own doctor perform the exam, but you can schedule the visit at a time that’s convenient for you.
The whole thing typically takes around 30 minutes, and consists of two parts: A survey of your personal and family medical history, and a physical exam.
Part 1: Questions about your medical history
The technician begins by asking about your personal medical history, as well as that of your parents and siblings. Generally, insurers don’t factor in family members aged over 60 or 70.
Expect to hear questions like:
Do you smoke? If so, how much?
Do you drink alcohol? If so, how much?
Do you exercise regularly?
Have you ever had surgery?
Have you ever had a heart attack?
Have you ever been hospitalized or had a prolonged illness?
Have you noticed any changes in your skin recently?
Have you ever experienced anxiety or depression?
Are you currently taking any medications or undergoing treatments?
Do any medical conditions run in the family?
Do you ever have chest pain?
Do you ever have difficulty breathing?
Do you have high blood pressure or cholesterol levels?
Part 2: The physical exam
Afterwards, the technician will conduct a physical exam. This may involve:
Recording your height and weight
Recording your blood pressure
Running an electrocardiogram if you’ve reported heart issues
Taking a saliva, urine and blood sample
Testing your cognitive skills if you’re a senior
Measuring your cholesterol levels
You then need to authorize the technician to pass on your medical records to your insurer.
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How do I get the results of my life insurance medical exam?
If you request to receive the results, your insurer will send a copy to your primary care doctor — usually within a couple of business days.
Depending on the system your doctor uses, you can then call or access the online portal to view your results.
Using the results from a recent medical exam
If you’ve taken a medical exam within the past two years, your insurer may be able to use those results to determine your rates.
This situation may arise if you applied for coverage with a life insurance company, but ultimately decided to go with a different insurer.
Why do I need to take a medical exam?
The medical exam — or paramedical exam — is part of the application process for traditionally underwritten life insurance policies. The results help your insurer assess your risk level and are a significant factor in determining how much you’ll pay for coverage.
But if you need coverage quickly or you’re uncomfortable with the idea of taking a physical, you can opt for a no-exam policy. However, you can expect to pay a higher premium.
How your rating class affects premiums
Once your insurer has the information they need about your health and lifestyle, it assigns you to a rating class. Think of it as a risk category — the higher the classification, the less risky you are in the eyes of the insurer.
If you land in a higher rating class, you’ll score a cheaper premium. But if you end up in one of the lower rating classes, you’ll be charged more for coverage to compensate for that risk.
The names of rating classes vary among insurers. But generally, these are the classifications from best to worst:
Preferred Plus
Preferred Nonsmoker
Standard Plus
Standard Nonsmoker
Preferred Smoker
Standard Smoker
Can I fail the medical exam?
There’s no such thing as “failing” the medical exam. But if your results are poor, your insurer may raise your rates or put you in a lower rating class.
If you have a serious health condition or don’t meet your insurer’s strict set of requirements, you may be denied coverage. In that case, you can look into no-exam policies that are issued without a medical exam.
Can I retake the life insurance medical exam?
Yes — but you’ll need to wait until you’ve had your policy for at least one year. If your health has improved significantly, or you believe your first medical exam didn’t yield the most accurate results, you can request to take another exam.
Knowing that you may have another opportunity to take the exam might help to relieve any anxiety around it.
How to pass life insurance medical exams
Set yourself up for better results and make the medical exam go smoother by doing the following:
Write down your doctors’ names and contact details, and list any medications you take. The technician will ask about prescription and over-the-counter drugs, so having a list handy will make the exam easier.
Avoid alcohol, caffeine and fatty foods the day before the exam. These foods and beverages can elevate your cholesterol and blood pressure readings, which may lower your rating class. Also, alcohol is dehydrating — and this may make it harder for the technician to draw your blood.
Save any high-intensity workouts on the day of the exam until after. Exercise raises your blood pressure and pulse rate, and may affect the rate class you end up in. It’s fine to go for a walk, but avoid any strenuous cardio or strength workouts.
Get a good night’s sleep. When you’re well-rested, your blood pressure levels are naturally lower. Plus, sleep may help to reduce any anxiety you have around the exam.
Steer clear of smoking on the day of the exam. The less nicotine you have in your system, the better your rating class will be. Avoid smoking marijuana for 30 days before the exam too, even if it’s legal in your state — some insurers classify marijuana users as smokers and charge higher rates.
Try not to schedule your exam during your menstrual period. Your insurer may request you submit another urine sample, so it’s best to wait or reschedule your exam for another time.
How long can I expect nicotine to show up on a test?
Most blood tests will show if you’ve smoked within the last three weeks, depending on the test. It takes at least three days for nicotine to leave your blood, but insurance providers test for another compound — cotinine — that’s formed after nicotine enters your body. Cotinine can stay in your body for up to three weeks or longer.
Different tests are used to determine whether you have nicotine or cotinine in your system. Some are more sensitive than others, measuring the concentration of compounds in your system to determine whether you’re a smoker or simply live with one.
What should I do if I have a fear of needles?
Tell the technician at the beginning of the medical exam. Remember, these technicians are medical professionals, so they’ll be used to hearing these kinds of concerns.
They may note your fear of needles in your file, and your insurer may take this into consideration if your anxiety caused a spike in blood pressure.
Must read: What happens if I lie during the medical exam?
A life insurance application is a legal document, and you have a duty to disclose any information that could help your insurer calculate your risk level.
Your insurer will cross-check the results of your medical exam with sources like the Medical Information Bureau and prescription drug databases. If they find out you lied or omitted information, you might be charged a higher premium — or denied coverage.
And if you die during the first two years of taking out a policy — aka the contestability period — your insurer has the right to investigate your claim. If they discover you lied in your application, your beneficiaries might not receive the full death benefit. So, withholding information not only puts your life insurance coverage at risk — but might also affect your loved ones when you die.
Life insurance policies that don’t require a medical exam
If you need under $100,000 in coverage and want to skip the medical exam for whatever reason, these are your options:
Simplified issue life insurance. With simplified issue policies, you won’t have to take the medical exam — but you’ll fill out a health questionnaire. It’s made up of about 20 yes or no questions. Approval isn’t guaranteed. But if your application is accepted, your policy could be issued the same day.
Guaranteed issue life insurance. Sometimes called guaranteed acceptance life insurance, this policy is open to anyone, and approval is guaranteed. It forgoes both the medical exam and health questionnaire. Since the insurer has no information about you, this type of coverage can be capped as low as $2,000 or $10,000.
Group life insurance. This type of life insurance offered by employers as part of your employee benefits. If you choose to enroll in group life insurance, you’re not required to complete a health questionnaire or take a medical exam. Your employer covers all or most of the premium, too.
Instant-approval term life insurance. Some fintech companies sell term life policies with accelerated underwriting. Typically, you’re asked to fill out a few basic questions about your health and family medical history. Complex algorithms then scan your public records to verify your answers. You’ll find out if you’re approved immediately, and your policy can be issued within hours or days.
Life insurance is a game of risk, and the medical exam gives your insurer an idea of how healthy you are. It then uses this information to determine your rating class and premium.
While the medical exam is a simple physical, some people may find it invasive. If you’d prefer not to take one, compare life insurance companies that offer no-exam policies.
Katia Iervasi is a lead writer and spokesperson at NerdWallet and a former editor at Finder, specializing in insurance. Her writing and analysis on life, disability and health insurance has been featured in The Washington Post, Forbes, Yahoo, Entrepreneur, Best Company and FT Advisor. She holds a BA in communication from Australia's Griffith University. See full bio
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