Whether you apply for instant coverage online or go the traditional route, in some way, shape, or form, an insurance carrier will review your health information and risk factors before issuing a policy.
The question these days is whether that review will be automated or in person.
If you need an in-person medical exam, also called a paramedical exam, the process has changed in recent years. In the past, an in-person exam covering your full health history, including a blood or urine sample, and possibly an EKG was required.
Below, we’ll share when a life insurance exam may be required, what to expect, and how to prepare.
Key Takeaways
- Life insurance medical exams used to involve lengthy questionnaires, but these days they are lab-based. Expect a nurse to take basic measurements, check your blood pressure and pulse, and collect blood and urine samples. It takes about 20-30 minutes.
- Well-controlled hypertension can qualify you for the best life insurance rates.
- Height and weight are two of the most important factors, so be honest with your agent when giving your measurements. Insurance companies use proprietary build charts, so they won’t all interpret your measurements the same way. Any weight you lost in the last year over 10 pounds will be added back at 50% to your current weight.
- Depending on your age, health history, and risk factors, you could be approved for a policy without an exam.
- If you do take an exam, the insurance company keeps all medical information strictly confidential and uses it only for underwriting purposes.
What is a Life Insurance Medical Exam?
A life insurance medical exam used to be a lengthy ordeal that involved plenty of poking and prodding by nurses.
Back then, a nurse would come to you, ask a long series of medical questions, take a detailed medical history, and do blood and urine tests, as well as height, weight, pulse, and blood pressure. For older applicants or higher face amounts, they may also do an EKG; for seniors over 70, they may do a cognitive assessment.
These days, life insurance medical exams are primarily lab-based. With the advent and use of AI in the underwriting process, most insurance companies are trying in every way possible to avoid ordering medical exams, and depending on your age and the amount of insurance, some companies will underwrite up top $10M worth of insurance, using your labs from your primary care provider if completed within the last 12months
Those labs include blood, urine, height, weight, pulse, and blood pressure. You can usually avoid the lengthy medical questionnaire, except in some cases, like high coverage amounts or if you are older than 70.
Who Pays for a Life Insurance Medical Exam?
The life insurance company will be the one to pay for the exam; there is no out-of-pocket cost to you, the applicant. Insurance companies not only pay, but they will provide the results free of charge. In essence, you get a complete blood panel at no charge.
The insurer will arrange the exam and hire and coordinate a paramedical testing service/nurse to conduct the exam. This is a free service to you and an important part of the insurance underwriting process, if needed. You can choose to have the examiner come directly to your home or office at a scheduled time.
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Is a Paramedical Exam Always Required?
In the past, it had been, but as the underwriting process has evolved, a greater percentage of life insurance applications are being approved without requiring an insurance medical exam
We can thank COVID as much as AI for a more streamlined approach to life insurance underwriting over the years. The insurance underwriting process has evolved significantly in recent years, providing you with three avenues to get a life insurance policy:
- Instant issue: You fill out a short questionnaire online and know within minutes whether you are approved or not. This is a Yes-or-No process, and these policies are mainly limited to personal, not business, use.
- Accelerated underwriting: This is mostly automated but may involve a medical professional reviewing your application and requesting medical reports from your treating physician.
- Traditional underwriting: The former default option; if you go the traditional route, it will require a medical exam, including labs, as well as medical reports from your doctor(s).
What if I Have a Pre-existing Condition?
A common misconception is that any significant health condition means a life insurance application will be declined.
Major carriers have nuanced approaches to evaluating impairments, and many conditions that seem disqualifying are insurable at Standard or even Preferred rates when well managed. For example, Banner Life’s underwriting “sweet spots” illustrate this well:
- Treated and controlled hypercholesterolemia (high cholesterol) may still qualify for Preferred Plus rates.
- Treated and controlled hypertension (even a combination of treated HTN and cholesterol together) can still reach Preferred Plus.
- Former cigarette smokers who have been smoke-free for 3 years may qualify for Preferred Plus rates.
- Asthma on two or fewer medications, when well controlled, can still qualify for Preferred rates.
- Anxiety or depression with a single prescription medication, well-controlled, is eligible for Preferred rates.
- Mild to moderate sleep apnea with good compliance for one year and no residual symptoms can qualify for Preferred.
- Controlled Type II Diabetes is eligible for Standard Plus rates.
- A personal history of certain cancers can qualify for Standard Plus or better, depending on the type, date of onset, and treatment effectiveness.
Principal Financial takes a similar approach through its Healthy Lifestyle Credits (HLCs) program. This program evaluates an applicant’s risk profile across multiple factors (blood pressure, cholesterol, pulse, weight, family history, and preventive screening history) and assigns positive or negative points. Favorable credits can eliminate or reduce a table rating by up to two tables, or improve a Standard or better risk up to one full class. This means someone who might otherwise be rated at Table 2 could qualify for Standard rates, dramatically lowering coverage costs.
How Long Does a Life Insurance Medical Exam Usually Take?
Those lengthy questionnaires are out. Instead, expect a brief meeting with a nurse to take your vitals and collect blood and urine samples for a full lab workup. In many cases, the exam can be as brief as 20-30 minutes.
During the exam, expect the nurse to take the following measurements:
- Blood pressure. A normal range is 140/80 or less. Well-controlled hypertension can still get the best rate for life insurance.
- Height and weight. This is one of the most critical factors, so be honest with your agent because each insurance company has proprietary build charts. Any weight you have lost in the last 12 months over 10 points will be added back at 50% (for example, if you lost 20 pounds in the last 12 months, they will add 10 pounds to your current weight).
- Pulse. Try to relax as much as possible to get an accurate reading. If you tend to be anxious during exams, the nurse can take your pulse while you are lying down.
In addition to the above readings, a nurse will also take the following samples.
The Urine Sample
A urine specimen will always be collected during a paramedical exam. The insurance company determines the tests, and a laboratory performs them. The test results are sent only to the insurance company and used for underwriting.
Blood Testing
Blood testing provides important information for underwriting purposes. A laboratory completes a wide range of tests, and it sends the results only to the insurance company.
Experienced personnel draw less than one ounce of blood from a vein into 1-3 vials. You may be required to fast for 4-12 hours, depending on the insurance company’s requirements. You should advise your examiner if you have had previous problems such as fainting, nausea, are currently taking large doses of aspirin, or have difficulty clotting or bruising easily.
Each insurance company selects the tests it needs for underwriting. Portamedic collects and prepares blood for analysis; the insurance company instructs the lab on specific tests. You are required to sign a consent form and a chain-of-custody form for your own protection.
Electrocardiogram (EKG) – Rarely Required
If required, you may also get an EKG (also sometimes called an ECG). An EKG is only required for older ages at very high insurance amounts, exceeding $3M-$5M.
An EKG is a quick, safe, and painless test that records the electrical signals moving through your heart. You will be asked to lie down flat with your shirt unbuttoned in order to place the leads on your chest. Women must remove stockings prior to the exam. The best preparation is to remain calm and totally relaxed to prevent muscle interference.
Lab Results a Life Insurance Medical Exam Tests For
So what are life insurance companies looking for when reviewing your blood and urine samples? They’ll pay close attention to the following:
- Cholesterol
- HDL and LDL
- Hepatitis
- HIV
- Glucose
- Triglycerides
- Marijuana usage
- Nicotine/Tobacco usage
For a full list, check out our guide to life insurance medical labs for a complete breakdown of what will be tested and how to prepare.
What Happens Next?
All of the information obtained during the paramedical examination is strictly confidential and for insurance purposes only. The lab will share the results with you and the insurance company to help evaluate your individual policy.
After a careful review, you will learn whether your coverage is approved or denied. If all goes well, this will be the last major hurdle to cross before acquiring a life insurance policy. Typically, you’ll receive your results in 7-14 days.
Tips to Prepare for a Paramedical Exam
If a life insurance medical exam is required, don’t worry. It’s not a bad sign or a sign that you’ve done anything wrong. Here are a few final tips to help you prepare for your upcoming exam so that you can go in with the best state of mind and health:
- Schedule it early in the day: Some medical exam tests, like blood tests, may require you to fast before the exam. That makes the morning an ideal time so that you don’t have to fast for long during the day.
- Eat and drink healthier: You can’t change your entire health history in one week, but you can try to take meaningful steps to improve your diet, which can impact cholesterol and triglyceride levels. Limit salt intake and eat a healthy diet rich in fruits, vegetables, and some lean meats. Avoid processed foods where possible. Also, limit alcohol and avoid caffeine.
- Drink water beforehand: Drinking water beforehand can help you produce blood and urine samples more easily during the exam. Staying hydrated can also help reduce your chances of fatigue after giving a blood sample.
- Get plenty of sleep: Sleep is one of the most vital aspects of good health. Poor sleep can raise blood pressure, tempt you to eat unhealthy foods, and create other detrimental health effects. Stick to a consistent sleep schedule and get enough sleep the night before.
- Avoid intense exercise: Regular exercise is healthy, but exercising on the same day as the exam can worsen your results. Exercise can temporarily raise your blood pressure and pulse rate and can also affect blood cholesterol and protein levels, which could worsen your results or require retesting.
This is far from an exhaustive list, but it should give you a good head start on getting into the best state possible before your exam.
No Matter Your Health History, Get a Free Life Insurance Quote in Seconds
An insurance medical exam is primarily blood, urine, height, weight, pulse, and blood pressure. Historically, when the nurse came out to complete your insurance medical exam, they would ask detailed questions about your prior health history. Now, your agent handles this directly through an online process or an interview with the insurance company.
Let’s address a common misconception: if you have a medical condition, that doesn’t mean you can choose a company that won’t require an insurance exam and get approved.
All insurance companies will ask medical questions to uncover pre-existing conditions. Even if companies offer you a policy without an exam, they still need all the medical facts. With the advent of AI, life insurance underwriters can quickly access health insurance codes and electronic health records that reveal your complete medical history.
The good news is that all insurance companies are trying to approve applications without the added hassle and cost of labs for an insurance exam. Ultimately, the insurance company’s underwriting stance will determine whether an exam is required.
So, a yes/no automatic approval without labs is not the normal underwriting process. In nearly all cases, underwriters assess the lab requirement during the underwriting process. Most insurance companies reserve the right to ask for labs at any time.
If you’re in perfect health, negotiating this process is relatively easy. In other words, life insurance companies are doing everything possible to approve you without a medical exam.
However, in cases where there are pre-existing conditions, there still may be opportunities depending on your circumstances to avoid labs. It is crucial that you work with an insurance broker who has knowledge of the most competitive insurance companies and their stance on insurance physical requirements. If you misstep and choose the wrong insurance company, the underwriting process could be significantly more complicated with less than optimal results.
We will offer you a free consultation and provide you with the best path given your circumstances. Within a few minutes, our insurance brokers can assess your situation and provide the guidance you need to avoid hassles and ultimately save the most money.
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