Life Insurance Medical Exams: What to Expect

When applying for life insurance, you’ll likely be asked to take a life insurance medical exam. Don’t take it lightly: The insurer will use the results to set your premium and even decide whether to sell you a policy.

What is a life insurance medical exam?

A life insurance medical exam is similar to any routine health exam or annual checkup. In this case, it’s conducted at the request of your insurer as part of a life insurance application.

The medical exam assesses your health and any risks that might be related to insuring your life. Insurers use this information to decide if you’re eligible for a policy and to assign you a rate based on age, health and other lifestyle factors, such as smoking.

» MORE: How to buy life insurance without a medical exam

Why you should take a life insurance medical exam

Taking a medical exam for your life insurer might be a hassle, but the key benefit is it can lower your life insurance rate.

If you’re healthy for your age, an exam is likely to result in less expensive life insurance premiums. The more information an insurer has about your health, the less risk the company takes on insuring your life.

What to expect during a life insurance medical exam

After you submit your life insurance application, the insurer will hire a paramedical professional to arrange the exam. Your own doctor can’t perform it, but you’ll get to choose the place and time. You won’t need to undress, but wear a short-sleeved shirt for the bloodwork.

During the exam, you’ll be asked the same personal and family health questions that were on your application to double-check the information. The life insurance exam itself will take about 30 minutes and is paid for by the insurer.

The physical part of the exam typically includes:

⚖️ Recording height and weight.
🩺 Measuring blood pressure.
🧪 Collecting urine or saliva samples.
🩸Taking bloodwork.
🫀 Possibly an electrocardiogram or treadmill EKG, depending on your age and the policy amount.
🧠 Cognitive and mobility testing, depending on your age.

You’ll also need to provide a signature for the release of your medical records.

» MORE: Compare life insurance quotes

What you’ll be tested for in the life insurance medical exam

While every insurer has its own process for the medical exam, you can expect you'll be screened for some or all of the following:

During the exam 🩺

Unhealthy body mass index (BMI). ⚖️ A body mass index over 40 may raise red flags for insurers.

High blood pressure levels. 🩸Life insurers are typically looking for uncontrolled high blood pressure or erratic blood pressure levels.

Early signs of Alzheimer’s or other memory impairments in older applicants. 🧠 Cognitive screening is usually required only for applicants age 60 and up.

In the bloodwork 💉

HIV and other immune disorders.
Cholesterol levels.
Elevated blood sugar levels.
Liver and kidney functions.
Diabetes.
Hepatitis.
Cocaine and other illegal drugs.
Prostate-specific antigen (PSA) levels, which can indicate prostate cancer.
Nicotine use (cotinine), whether from cigarettes, e-cigarettes, cigars, pipes, chewing tobacco, nicotine gum or patches.
Marijuana use (companies vary widely in their pricing of life insurance for marijuana smokers; some will give smoking rates to marijuana users).

You can request a copy of your medical exam results once life insurance underwriting is complete. Typically, requests must be made in writing, though if you worked with a life insurance broker or agent, they may be able to get a copy for you. It’s worth getting the results so that you can share them with your regular doctor.

» MORE: Life insurance for smokers — and quitters

How to prepare for a life insurance medical exam

A few days before the exam

Start eating balanced, healthy meals for the sake of your cholesterol and blood pressure levels.

The night before the exam

Avoid alcohol.
Collect paperwork you may need to avoid a last-minute search in the morning. Have your picture ID, a list of the medicines you take (with dosages and frequency), and a written health history, including diagnoses, treatment dates and your doctors’ names and contact information.
Get a good night’s sleep.
If your exam is in the morning, aim to eat your last meal at least eight hours before. Fasting can help you achieve optimal results.

The morning of the exam

The best thing to do immediately before your appointment is to sit calmly and drink water. Avoid anything that could affect test measurements, including:

Working out.
Drinking a lot of caffeine.
Eating a salty or high-fat breakfast.
Using nicotine within an hour of the exam.

During the exam

During the exam, be as honest and upfront as possible. Provide your complete medical history and make sure to accurately list the details of any doctors or hospitals you’ve visited. The insurance company will probably require those reports, so this will avoid delays in your application process.

No medical exam life insurance options

While it’s true that you’ll usually get better rates if you opt to take a life insurance medical exam, it might not be the right option for everyone. Older adults with health conditions could have an easier time qualifying for the following no-exam life insurance options.

Guaranteed issue life insurance

Guaranteed issue life insurance policies are small permanent policies with smaller coverage amounts that pay for final expenses such as burial costs. Not only is this life insurance offered without an exam, but the application for guaranteed life insurance has no health questions. The downside to this no-questions-asked life insurance policy is a much higher premium.

Simplified issue life insurance policies

Simplified issue life insurance applications skip the exam and ask a few basic health questions. However, as part of the approval process, insurers may dig into more data on your prescription drugs, driving record and information you’ve given as part of previous life insurance applications.

Group life insurance

Group life insurance is coverage available through your employer. Rates are set for the group as a whole and your employer typically pays all or most of the premium. Unfortunately, group life insurance policies are typically capped at one to two times your annual salary and aren’t portable — meaning you’ll lose coverage if you leave your job. Some employers give you the option to buy supplemental life insurance to top up your coverage, though you might find a better policy by shopping on your own

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Frequently asked questions

Does drug use automatically disqualify you from life insurance?

It depends. Illegal drugs detected in your bloodwork often result in denial of coverage. Prescription drugs for which you do not have a prescription also raise red flags if they show up in your blood sample.

However, the response to evidence of marijuana may depend on whether recreational use is legal in your state. Keep in mind that insurers may also offer you a smoker's rate if marijuana or nicotine use is detected in your blood test.

What medical conditions could disqualify you from life insurance coverage?

While it is possible to get life insurance with a pre-existing condition, there are certain medical complications that make it difficult to qualify for a policy. These include severe asthma, a current cancer diagnosis, uncontrolled high cholesterol or diabetes, HIV, evidence of significant heart disease and ongoing mental health issues that require hospitalization.

Can your insurer tell from the medical exam that you smoke?

If you’re a smoker and you’ve failed to disclose that as part of your life insurance application, your nicotine use will almost certainly be exposed through your life insurance medical exam. That’s because urine, blood, and in some cases saliva samples can be used to screen for cotinine, a chemical your body produces to process nicotine that stays in your system for days or even weeks.