Life Insurance Medical Exam: What You Need to Know

Understanding Life Insurance Medical Exams

When you apply for coverage, most insurers want a clear picture of your health. That’s where the life insurance exam comes in. It’s similar to a quick physical and usually handled by a nurse or medical professional. The process is free to you, arranged by the insurance company, and can be scheduled at home or at a local exam office.

Why Do Life Insurance Companies Require a Medical Exam?

Life insurance companies use medical exams to better understand your health and lifestyle so they can assess risk and set rates fairly and accurately.

The information gathered during the exam is used in several ways:

• Pricing: Exam results directly influence premiums. Applicants in better overall health typically qualify for lower rates, while certain conditions may increase costs or limit coverage options.
• Risk assessment: The exam helps insurers understand long-term health risks, including how factors like blood pressure, cholesterol, or nicotine use affect life expectancy.
• Verification: Results help confirm the health and lifestyle information provided on your application, reducing guesswork and pricing errors.
• Controlled conditions: Because exams follow standard procedures, they create a consistent baseline. For people with chronic conditions, this can actually work in your favor by showing that a condition is well-managed rather than assumed to be uncontrolled.

What Happens During a Life Insurance Medical Exam?

The exam itself is straightforward and usually takes less than an hour. A nurse or paramedical professional gathers health information through questions, vitals, and lab work.

How Long Does the Exam Take?

Most exams take 20–30 minutes. The process starts with paperwork and health questions, followed by a vitals check and any required lab work such as blood and urine samples. If the insurer has requested extra screenings, it could run closer to an hour. Still, the appointment is generally quick compared to a doctor’s visit.

What Tests Are Included?

The examiner will check your height, weight, blood pressure, and pulse. Collecting saliva, blood and/or urine samples is common, and these are used to screen for conditions such as diabetes, high cholesterol, or kidney disease. In some cases, an EKG test may be added to look at heart health. The examiner also asks about your prescriptions, medical history, and lifestyle choices.

How Life Insurance Exam Results Affect Approval and Premiums

Life insurance medical exam results play a central role in underwriting decisions. After your exam, the results are reviewed alongside your application, medical history, and other records to assess risk and determine both approval and pricing.

Applicants with strong vital signs and favorable lab results may qualify for preferred or super-preferred rate classes, which typically come with lower premiums. 

If exam results show potential health concerns, underwriting may assign a standard or sub-standard risk class instead. 

Read: Understanding Life Insurance Waiver of Premium Rider

Life Insurance Risk Classes Explained

After your medical exam results are reviewed by the insurance company’s underwriting team, you’re placed into a risk class. This classification determines how your premiums are priced relative to other applicants with similar health profiles.

Most insurers use variations of the following categories:

• Preferred Plus: Reserved for applicants with excellent overall health, strong lab results, and no significant risk factors such as nicotine use or unmanaged conditions. These policies typically receive the lowest available rates.
• Preferred: Assigned to applicants in very good health who may have minor, well-controlled issues but still present lower-than-average risk.
• Standard Plus: Often used for applicants whose results fall between preferred and standard categories, reflecting average health with some favorable factors.
• Standard: The most common rating. Applicants may have manageable health conditions or average exam results that don’t qualify for preferred pricing but are still insurable at standard rates.
• Substandard/Table-Rated: Applied when exam results show higher risk. Premiums are increased based on severity, often using table ratings that add cost in defined increments. Table ratings are used to adjust premiums when health risks fall outside standard categories. Rather than declining coverage, insurers apply a structured pricing increase based on the level of risk involved.

Medical exam results help determine where you fall, but they aren’t the only factor. Age, family history, treatment history, and how well a condition is managed all influence classification. That’s why two people with the same diagnosis may receive different rates. For example, controlled blood pressure with consistent readings can be viewed very differently than untreated or fluctuating results.

Can You “Fail” a Life Insurance Medical Exam?

You can’t technically pass or fail a life insurance medical exam. When people ask how to pass, they usually mean how to get the best possible health rating and premium. The exam is simply a snapshot of your overall health that insurers use to assign risk.

If your results reflect overall good health paired with healthy habits such as proper diet and exercise, avoiding tobacco, and abstaining from excessive alcohol, you may qualify for lower premiums. If health issues are found, the insurer may raise your rates, limit the policy amount, or in some cases even decline coverage.

What If Your Results Aren’t Ideal?

A less-than-ideal result on your medical exam doesn’t mean you’re out of options. As part of the underwriting process, insurers will use your health exam results to assign you to a risk class, which affects your premium. Even if your life insurance rates are higher, you may still qualify for coverage.

If your application is declined, you can explore alternatives. Some insurers offer simplified issue or guaranteed issue policies, which don’t require an exam but provide smaller death benefits. Others may let you reapply after addressing health concerns, such as improving blood pressure or cholesterol.

Accelerated Underwriting vs. Standard No-Exam Policies

It’s important to distinguish accelerated underwriting from no-exam options like guaranteed or simplified issue.

With accelerated underwriting, insurance companies still review your health history, prescriptions, and other records, but you can skip the physical exam and lab work. Guaranteed issue and simplified issue types of life insurance, by contrast, don’t require detailed health review, but they may cost more and offer lower coverage amounts.

These options are often considered after a traditional exam is declined or when applicants want to avoid a medical exam.

When to Wait and Reapply if Your Health Improves

If your medical exam results aren’t ideal, it may be worth waiting to reapply. Insurers often look closely at health markers like blood pressure, cholesterol, and weight. Improving these numbers, along with showing consistent results at your next checkup, can help move you into a better risk class.

Bigger lifestyle changes like quitting smoking can make an even greater difference, since tobacco use dramatically increases premiums.

Read: Can I Get Life Insurance as a Smoker?

How to Prepare for a Life Insurance Medical Exam

Preparation won’t change chronic conditions, but it can prevent temporary factors from pushing your results into a higher risk category.

The goal is to make sure your results reflect your everyday health, not temporary changes caused by stress, food, or lack of sleep. A few easy steps leading up to the exam can help you feel more comfortable and confident on exam day.

Preparation Checklist:

• Get good rest: Aim for a full night’s sleep before your appointment.
• Stay hydrated: Drink plenty of water so it’s easier to provide a urine sample and keep your blood pressure steady.
• Bring documentation: Have a list of your medications, doctors, and recent health history handy.

What to Avoid:

• Limit caffeine and alcohol: Both can affect your vital signs.
• Watch your food intake: Don’t eat salty or fatty foods that can temporarily raise blood pressure or cholesterol.
• Skip strenuous exercise: Heavy workouts 1-2 hours before the exam can cause elevated blood pressure and heart rate.

These behaviors won’t change underlying health conditions, but they can prevent temporary factors from skewing your results.

Read: Reasons Life Insurance Won't Pay Out

Can You Get Life Insurance Without a Medical Exam?

Yes. Insurance companies offer three main ways to get coverage that don’t require a medical exam. Each of these options vary in how much health information you need to provide, and also vary by insurer availability:

Alternatives to Life Insurance Medical Exams

• Accelerated underwriting: You answer health questions, and insurers review records such as prescriptions or past medical visits. No physical exam or lab work is required.
• Simplified issue: A short health questionnaire replaces the exam. Coverage amounts are usually smaller than traditional policies.
• Guaranteed issue: Approval is automatic, with no health questions asked. Premiums are higher and coverage amounts are limited. Can be a good option for people with more serious medical conditions.

These choices are helpful for people who want fast approval, have health concerns, or simply prefer to avoid the medical exam process.

Ethos: No Medical Exam Life Insurance Options

No medical exam life insurance can be a good fit if you want faster approval or prefer to avoid a physical exam. These policies typically rely on health questions, prescription history, and other records instead of lab work, which can make the application process quicker and more convenient. Coverage amounts and pricing vary by option, and some no-exam policies may cost more or offer lower limits than fully underwritten coverage.

Ethos offers no medical exam options where applicants simply answer a few health questions during the application process. There’s no physical exam required, and you can apply online in just minutes.