What Is the Life Insurance Medical Exam?

Most life insurance policies require a medical exam. Your medical history and current health determine, more than anything else, your health rating. The better your rating, the lower your premium, so it is important you prepare well for your medical exam.  

What is the medical exam?

The insurance medical exam is a simple physical exam. It is a standard part of the underwriting process or the process the insurance companies ask you to go through before they approve your application. A medical exam helps the insurer understand your current health and well-being.

So, who pays for a life insurance medical exam?

The insurance company covers the cost of the exam, so there is no expense to you, except 20-30 minutes of your time. However, if you want to take the medical exam a second time to qualify for a lower premium rate, you may have to cover the cost yourself.

Why do life insurance companies require a medical exam?

Insurance companies must consider each applicant’s individual risk factors. Certain factors may determine which groups and categories applicants are classified into. If you belong to a group regarded as high-risk, you will receive higher premiums.

To understand the level of risk applicants pose, insurance carriers try to gather as much information about their health as possible. This is where the medical exam comes into the picture. It not only reveals an applicant’s present health but also indicates their risk of developing certain health conditions in the future. Equipped with this knowledge, insurers can calculate their rates correctly.

There are three reasons why insurance companies ask you to undergo the life insurance health exam:

1. To confirm the information provided in the application is true.
2. To know your full medical history. The medical technician will ask you a series of questions to find out your medical history in detail.
3. To discern any underlying health conditions that you might not have declared or be aware of. The insurer will also verify nicotine or drug use. They will match the results of your medical test with the information provided in the application.

What does a life insurance medical exam cover?

Insurance companies want to know the following information about you:

• Height and weight – Insurers use this information to know your body mass index (BMI). Those with an average BMI for their weight and height class are likely to get lower premium rates.
• Tobacco use – Insurers will ask if you have used tobacco in any form in the last 1 to 3 years. Because tobacco use is the leading preventable cause of death. It can increase your premium rate significantly.
• Medical history – Insurers will ask health-related questions and run blood and urine tests to understand your health history. A complex medical history can raise the cost of insurance.
• Family medical history – Since certain diseases, like diabetes, tend to be hereditary, insurers also ask about the medical history of your family members.
• Alcohol and drug use – Insurers will ask about your weekly alcohol intake. Heavy alcohol or drug use is likely to raise the cost of insurance.
• High-risk occupations – You will be asked your occupation. If you work a high-risk job, like professional mountain biking, you will have to pay more for coverage.

Dangerous hobbies – Carriers will also ask you about your hobbies. A dangerous hobby, like skydiving, can bump up your premium rate.

• Driving record – Insurance companies will inquire about your driving record over the last few years. Specifically speaking, they want to know if you have had any DWI/DUI convictions or any other driving violation recently. A poor driving record may put you in a high-risk category.

Where to get a life insurance medical exam

You do not have to visit a medical center or a hospital for this life insurance medical exam. You can have the paramedical examiner visit you at your home or office at a time convenient to you. The medical technician will ask health-related questions and run some tests. The whole process is not likely to take more than 30 minutes.

What happens during the medical exam?

The medical exam for life insurance has two parts.

1. Medical Questionnaire

The paramedical examiner will ask you some health-related questions to help the underwriters get a complete picture of your current health. Questions frequently asked during a life insurance health exam include:

• Your medical past including any health conditions or procedures you have had, medications, or hospitalization
• Your family’s medical history
• Lifestyle habits like smoking, recreational drug use, drinking, and exercise
• If you have any conditions such as anxiety or depression
• Doctors that you have visited recently

You must answer these questions truthfully. If the insurer later finds out you lied or withheld information, it may discontinue the coverage or deny the claim in the event of your death.

2. Physical Exam

The medical technician will perform a routine health check-up. This includes checking your height, weight, blood pressure, and pulse, as well as taking urine and blood samples. If you are older or applying for a larger benefit amount, the technician may ask you to take the electrocardiogram (EKG) test to monitor your heart’s health. Men over the age of 50 may have to undergo the prostate-specific antigen (PSA) blood test, which helps identify prostate abnormalities.

The paramedical examiner will calculate your BMI using your weight and height readings. The blood samples, on the other hand, help in disease screening. The paramedic will use them to screen for a broad range of medical conditions, including:

• High blood pressure
• High cholesterol
• Diabetes
• HIV/AIDS
• High triglycerides
• High live enzymes
• Nicotine usage
• Recreational drugs usage

All in all, the medical exam for life insurance is fairly simple, quick, and painless. It helps the insurer to test you for a number of health conditions. That, in turn, allows them to accurately assess your life expectancy and calculate your premiums.

How to prepare for your life insurance medical exam

A life insurance health exam is different than other tests you may have taken over the course of your life, like the driving test. There is no “passing” or “failing"  as such. Also, most factors that affect the result are out of your control.

With that said, you can take certain steps to improve your chances of qualifying for lower premium rates.

Start with being upfront about your health when completing the life insurance application. The underwriter will carefully peruse your medical records and the results of your medical exam. If you did not disclose something that you should have, that will only delay the approval process. Also, the actual premiums may be considerably higher than the initial quote in this case.

Apart from that, you can take the following steps to prepare for the exam day.

24 hours before the medical exam

• Avoid alcohol, caffeine, and high-sugar foods
• Limit high-cholesterol foods
• Avoid taking over-the-counter medicines (They may interfere with the test results)
• Keep a photo ID handy (e.g. driver’s license, health card, or passport)

8 hours before the medical exam

• Fast for at least 8 hours before the exam to ensure your blood sugar reading is not skewed. You may want to schedule the test early in the morning to avoid staying hungry all day
• Make sure you are well-hydrated
• Avoid excess activity or exercise to prevent a spike in your blood pressure and heart rate
• Avoid smoking

What happens after the medical exam?

Worried about how the results will affect your life insurance application?

Try not to think too much about it because the outcome is beyond your control. How you see your health may not always be how the underwriters see it. So, something that may look serious to you might be not a problem at all as far as the insurer is concerned.

If the results throw a radically abnormal reading, the insurer may request you retake the medical exam. For instance, if the urine test shows a presence of protein, the carrier may ask you to provide a urine sample again to obtain a correct reading. Likewise, if your blood pressure was abnormally high or low, the insurer may agree to your request to retake the medical exam if your previous medical records show that the latest reading is an anomaly.

However, if there is no cause for a retake, the paramedical examiner will submit the results to the insurer. The underwriters will study your profile, and you will learn about their decision within three to four weeks.

What happens if you fail a life insurance medical exam?

If the results do not match the information provided on the application form, the insurer may deny your request.

If you did not pass the medical test or feel the results are inaccurate, you may want to request the insurance carrier to provide you with a copy of the results. This way, if you were turned down because of a health problem you were not aware of, you can address it immediately. On the other hand, if you did not pass because of a mistake on the part of the insurer, you can request to take the medical exam again.

Remember, denial is not the end of the road for you. Just because an insurance carrier has turned you down, does not mean others will too. Apply for a policy with other insurance companies since some may be less conservative than others regarding specific health conditions.

If an underlying condition disqualifies you from buying traditional life insurance, other options are still available:

• Check if your employer offers group life insurance as part of the employee benefits program. Group policies do not require a medical exam, so you can qualify regardless of your health.
• Opt for a no medical life insurance policy. As the name suggests, these policies do not involve a medical exam. While the coverage amount is generally small, some coverage is better than no coverage.

Conclusion

The life insurance health exam is the top factor affecting your life insurance premiums. While many things that influence your test results are out of your control, preparing well for the exam can give you the best chance to qualify for a better health rating and, consequently, a lower premium rate.