Buying life insurance is important to protect loved ones. But consumers purchasing a policy may need to undergo a life insurance medical exam. Here's what's involved in a life insurance exam, as well as some insight into why this is a common requirement.
What is a life insurance medical exam?
A life insurance medical exam is a physical that is typically requested by a life insurance company. It's part of the process of buying life insurance in most situations. The purpose is to provide insurance companies with the information they need to set premiums. Life insurers usually pay for it, and there is both a verbal questionnaire and a physical exam.
Medical questionnaire
How do life insurance companies check an applicant's medical background? Generally, by asking questions as part of the life insurance application process. During the life insurance exam, consumers will be asked about their past health status. They'll be asked questions about their lifestyle and social habits, as well as their general health.
Physical exam
A life insurance physical is part of a life insurance application process. During the life insurance physical exam, the medical professional performing the process will check weight, collect a blood and urine sample, and check blood pressure.
Why do life insurance companies require an exam?
Life insurers require an exam because insurance companies want to assess the likelihood of paying out claims. To do this, the insurance company wants to know as much as possible about an applicant's physical health.
The insurer wants to see if the potential policyholder has medical conditions that could make their death during the term of coverage more likely. The insurance company also wants to make sure an applicant isn't hiding any possible health issues.
Is an exam required for life insurance?
A life insurance medical exam is required by most life insurance providers -- but not all. A small number of life insurers offer term life insurance with a reasonable amount of coverage without requiring a medical exam. They've harnessed new technologies and algorithms to determine who to cover.
There are also some guaranteed issue life insurance policies that provide coverage without mandating a life insurance medical exam. However, coverage limits are often low with these policies. There may also be restrictions such as a lengthy waiting period before the full death benefit is paid.
What do life insurance companies test for in the medical exam?
When a potential policyholder undergoes a life insurance health exam, the purpose is to identify red flags that could make insuring a policyholder too risky. While there may be slight variations in what different insurers test for when a consumer undergoes a life insurance exam, here are some common things insurers look for.
High blood pressure
High blood pressure is a common life insurance test, as high blood pressure can increase the risk of heart attack, stroke, or other cardiac issues.
Blood sugar
As part of a life insurance blood test, insurers may look for elevated blood sugar that could be indicative of diabetes. Diabetes also comes with health risks that could result in a higher risk of an insurer paying out a death benefit.
Nicotine use
Smoking increases the risk of many medical problems, including various types of cancer. As a result, a life insurance medical exam will involve an assessment of current and past nicotine use. Many carriers offer life insurance for smokers, though premiums are significantly higher.
High cholesterol
There's a higher risk of a stroke or heart disease when a person has high cholesterol. A life insurance exam will test cholesterol levels.
Recreational drugs
The use of recreational drugs is a major risk factor that life insurers consider. An exam will look for evidence of recreational drug use. However, some insurers are willing to accept marijuana users, especially as more states have relaxed the laws on cannabis.
Serious diseases
Finally, life insurers use blood tests to look for serious diseases. This can include conditions such as HIV or AIDS, as well as hepatitis. While some insurers provide coverage for people with HIV, others don't -- and a serious illness could make it impossible or expensive to get life insurance.
How to prepare for the medical exam
It's important to follow the life insurance company's instructions when preparing for a life insurance medical exam. These may include fasting prior to the exam to avoid skewing blood sugar and cholesterol levels.
Drinking water prior to the exam can help flush toxins from the body and dilate veins, making it easier for the technician to draw blood for the blood test. It's also a good idea to avoid strenuous exercise immediately before the exam to avoid elevated blood pressure.
Also, consumers should review their medical history to ensure they can provide accurate, honest answers when asked about their health status. Failing to provide accurate information could result in an insurance company denying an application, canceling the policy, or refusing to pay death benefits.
What happens during the life insurance physical?
During the life insurance physical, a medical professional is typically dispatched to the applicant's home or office. The process will take around 45 minutes or less and will include a nurse or medical technician asking questions, as well as a physical examination. The life insurance exam usually includes:
- A height and weight check
- A blood pressure check
- The collection of blood and urine samples
In addition to a life insurance medical exam, insurers may also employ other techniques to find out information about a potential policyholder's health status. This could include checking your records with the MIB (formerly the Medical Information Bureau), which includes information from past life insurance and health insurance applications. Other potential sources of information include your prescription drug history, driving records, and a criminal background check.
Do life insurance companies call your doctor?
Life insurers generally do not directly ask questions of a person's doctor. Instead, the insurer will ask an applicant for medical information and will arrange for a life insurance medical exam to be conducted by a medical professional of its choosing.
In many cases though, with the permission of the policyholder, an insurer may request medical records from an applicant's doctor's office. It may request an attending physician statement (APS), which is a statement from your provider that gives context about any pre-existing conditions or your general health. However, doctors cannot just disclose patient information to a life insurer without the patient's permission, as doing so would violate federal laws protecting privacy.
Do life insurance companies check medical records?
Life insurance companies may request medical records during the underwriting process. They do this to determine if a policyholder was honest in their answers to medical questions and to look for red flags that could suggest an increased risk of providing coverage. They must obtain permission from the applicant first.
Do life insurers check your credit?
Life insurers may run a credit check. This is more common with life insurance companies that use algorithms and publicly available information to approve people for policies without a life insurance medical exam.
What happens after the exam?
In most cases, insurers will already be aware of any medical issues based on the information provided by the applicant. However, sometimes abnormalities will be uncovered and an insurer may request additional medical assessments. For example, if a life insurance exam shows high blood pressure, the insurer may request a follow-up test to see if it has remained elevated.
Applicants can request a copy of their results after the exam. The information will be sent to the insurer's underwriting department, which will review the results of the life insurance medical exam. Based on this information, the insurer will set premiums. Applicants will then be notified of whether they are approved for coverage and what their premiums will be.
What if I'm not happy with the results?
If an applicant isn't happy with the results of a life insurance exam, there are a few options:
- Buy coverage anyway, even if the premiums are higher, and request reconsideration after some time passes. This has the benefit of allowing the applicant to get immediate protection.
- Shop for life insurance from another company. This may result in the same issues arising. But some insurers are more forgiving than others of various medical conditions.
- Request a follow-up exam. Often, an applicant will have to pay for this if the insurer is satisfied that the results of the initial testing were accurate.
- Work with a life insurance agent. Insurance professionals often know which carriers are likely to offer coverage to those with pre-existing conditions.
What if I'm denied coverage?
If an applicant is denied coverage after a medical exam, they can:
- Attempt to correct the issues resulting in the denial, such as by quitting smoking or getting high blood pressure under control with medication.
- Shop with other insurers that may have less stringent qualifying requirements for similar coverage.
- Obtain a guaranteed issue life insurance policy that doesn't require a medical exam.
How to get a life insurance medical exam
To get a life insurance medical exam, apply for insurance coverage. The insurer will arrange for the exam to occur at its own cost. The medical exam will take place at the applicant's home or workplace.
Options for life insurance without a medical exam
There are several options for no medical exam life insurance, some of which are better than others. Note that even if you have an underlying health condition, undergoing a medical exam could still help you obtain more coverage at a lower cost.
Simplified issue life insurance
With simplified issue life insurance, you can typically avoid a medical exam. Instead, life insurance companies base decisions on third-party records and your answers to a health questionnaire. Sometimes this is a good option for people who need coverage to begin right away and can’t wait for a life insurance medical exam and full underwriting.
Guaranteed issue life insurance
Guaranteed issue life insurance is life insurance that is available to everyone regardless of medical status. Many insurers offer these policies, although they often have relatively low coverage limits. Many guaranteed issue policies have waiting periods, such as a two-year delay until the full death benefit pays out.
Group life insurance
Group life insurance may be available as a workplace benefit. It's often possible to obtain a set amount of coverage through an employer's group life insurance plan without a life insurance medical exam.
Final expense insurance
Final expense insurance is a small life insurance policy designed to cover funeral costs. Most final expense insurance policies are guaranteed issue policies. That means no life insurance medical exam is required. However, these policies provide limited protection. They only help families cover a small amount of costs after a death.
RELATED: See The Ascent's guide to the best life insurance with no exam.
Fact Checked
Ashley Maready