Almost all life insurance companies require that new policyholders undergo a medical examination before their insurance policy is activated. This exam, also known as a paramedical examination, is used to determine your current medical condition and your life expectancy. The results of this exam along with your medical records are used to assign your health rating by the underwriting department, which will be used to determine your monthly (or annual) life insurance premiums.
The medical exam is important to a life insurance company because it gives them a chance to assess the overall health of an applicant. Based on the results, life insurance companies can calculate your life expectancy pretty accurately with their mortality tables. As long as they can assess your life expectancy, they can extend coverage and price a policy accurately.
While the exam can create a lot of anxiety for many clients, it does not need to. If you understand what is checked during an exam and why they are checking your health you will take the mystery out of the process. Your exam information is 100% private and can not be released to anyone due to HIPAA regulations.
In this article we cover:
- Can you get a policy without an exam?
- Who performs the exam?
- The exam has no cost to applicants
- What an exam checks for
- Preparing for an exam
- What to do if you fail
Is it Possible to get a Policy Without a Medical Exam?
There are some ways to get a life insurance policy without a medical exam. For example, if you are under 40 years old and are buying a small amount of life insurance coverage (low death benefit), you may be given a policy with no medical examination requirement. Be forewarned, however, as these no-exam life insurance policies also consider those with poor health when these policy rates are set. A life insurance policy issued without a medical exam will sometimes cost more money than a policy issued with full underwriting. A policy issued without a health exam is simply considered a higher risk for the insurance company.
The most common way to get a life insurance policy without a medical examination is to get life insurance through your employer. These employer-sponsored plans are group policies that typically offer a multiple of your salary as the death benefit. This is often the most economical way to get life insurance coverage, but it is usually not sufficient to cover all of your needs. These are a form of group life insurance, which does not typically require any sort of underwriting.
Additionally, there are many life insurance companies that specialize in high-risk life insurance (such as smokers, cancer survivors, and those with a history of heart disease). These policies are usually very expensive and the insurance company will not usually write policies of this nature with a large death benefit (although it varies depending upon the severity of the issue). There are even guaranteed life insurance policies, that are issued without any underwriting besides a short health questionnaire.
Who Performs the Paramedical Exam?
The exam is performed by a life insurance company nurse, it can not be performed by your own doctor. In practice, there are large paramedical exam companies in the marketplace that employ thousands of nurses all over the country. The life insurance company will contact one of these third party companies in most cases, who will assign a nurse to do the exam. The applicant is typically able to choose a preference between a male or female nurse, and schedule the exam at a time that is convenient for them. The exam is typically performed in the prospective insured person’s home, the paramedical examiner comes right to you!
There is a blood test included in most life insurance medical examinations, so a trained professional nurse needs to administer the blood test by drawing blood from the insured. There is no way around the paramedical company performing the exam.
Does the Exam Have a Cost?
No, it is free. The life insurance company does pay to have the exam performed, but they pay it out of their pocket because they expect to make money on the policy. Even if you ultimately decline the policy or cancel early, you will not be billed for the exam. You may also take multiple exams from different companies, and they will all be free. If you are applying for multiple policies at the same time, the life insurance company does require that you disclose this fact.
What Do Insurance Companies Check For In The Medical Exam?
There is no industry standard when it comes to medical exams. Different life insurance companies will check for different things when they examine you. There may also be a different exam process within the same company for policies of different sizes. A larger policy will require a more detailed exam than a smaller policy. With that being said, the typical exam usually entails:
The physical exam usually entails:
- Blood pressure check– Life insurance companies typically will measure your blood pressure during the exam. Generally, companies want to see blood pressure under 140/90, but higher blood pressure won’t cause them to deny you coverage. You may be assigned a lower health rating though and pay a bit more for coverage.
- Height and weight measurements- Life insurance companies want to do a calculation to make sure that your body mass index (BMI) is not in the obese range. At least 42% of Americans are obese though according to the CDC, and being obese by itself is not a factor that would cause a decline in coverage.
- Waist and chest measurements- A high waist circumference is correlated with worse mortality and health outcomes. It is best to keep a thin waste for the purposes of the exam.
- Lung capacity check- A life insurance company wants to make sure that you are not suffering from COPD or other similar lung issues.
The blood test is usually only taken for larger policies and looks for:
- Your cholesterol levels- You can obtain life insurance with high cholesterol, but you may be assigned a lower rating. If you have high cholesterol, life insurance companies like to see that you are controlling it with medication.
- Whether or not nicotine is present– Users of tobacco pay more for life insurance, because tobacco use has been shown to cause cancer.
- Diabetes- Diabetes can be controlled and does not disqualify coverage from life insurance.
- HIV status–It can be very difficult to obtain life insurance coverage with a positive HIV test. As new treatments are developed and life expectancy is extended, hopefully, life insurance companies will start to extend more coverage options to clients. HIV can also be tested with a saliva swab.
- Immune disorders- Immune disorders can make it very difficult to obtain life insurance coverage because they can increase the risk of death significantly.
The results from the life insurance blood test are not available immediately but must be sent to a lab for processing. Usually, the blood draw is fairly small and only requires one or two vials. A trained paramedical nurse draws the blood so the client can trust that it is done professionally.
The urine sample will test for:
- Current medications you are taking– Make sure that you disclose any medications that you are taking. It will not benefit you to hide them from the life insurance company, and they can uncover them in the urine test. Lying will cause more problems, and could even lead to a life insurance claim being contested.
- The presence of drugs such as cocaine- Life insurance companies do not typically like to see hard drug use. Marijuana will not usually cause a decline of coverage, but will likely assign you a “smoker” rating. Do not lie about marijuana use to the company, and each life insurance company has it’s own rules regarding pot use.
- Kidney health- Poor kidney health may be a sign of more severe illness.
In cases of high-value life insurance policies (of over $2.5 million), the life insurance medical exam might also have the patient do a treadmill EKG, chest X-rays, and/or MRIs.
The specifications of your test will be determined by your life insurance company and will differ based on your policy type and size of your policy.
Can You Prepare For Your Medical Exam?
Although the future policyholder cannot mask most major medical conditions, there are several things you can do in order to improve the medical exam results. These things include:
- Schedule your examination in the morning
- Get plenty of rest and a good night’s sleep before your examination
- Avoid stressful activity before your examination (arguments, driving in traffic, etc.)
- Do not engage in high intensity or strenuous physical activity within 24 hours of your examination
- Do not drink alcohol within 24 hours of your examination
- Do not consume coffee or other high caffeine items within 6 hours of your examination
- Do not smoke or chew tobacco within an hour of your examination
- Limit your consumption of high sodium and high cholesterol foods (like bacon and eggs) within 24 hours of your examination
The tips above won’t be able to work magic, but they are the best things you can do within a short period of time to achieve optimal results on your life insurance medical exam.
Checking The Results Of Your Medical Exam
Life insurance companies typically will not automatically send you the results of the medical exam. The Fair Credit Reporting Act requires life insurance providers to let you know if they denied your application for insurance or if they placed you in a higher risk life insurance policy. If you are not placed in this category and still would like to know the results of your exam, you will have to write to your insurance company to request the results. Some insurance companies also have been known to share the results with your doctor.
In addition, all life insurance companies will share the results of your exam with the Medical Information Bureau (MIB). This institution allows all life insurance companies to view the results of your exam. You can request a copy of your medical exam results from the MIB in order to get an idea of what insurance companies will see and have access to.
Keep in mind that state laws dictate what an insurance company can and cannot share. With that being said, most states will not restrict you from viewing the results of your exam.
What to Do if You Fail your Medical Exam
If you do not pass your medical exam, you may still have options. Each life insurance company has its own rules about underwriting. If your condition is identified, you can probably find coverage through another provider with more leniency towards your specific issue. You may also have the opportunity to improve. If for instance you have very high cholesterol, but you are not taking medication, you may be able to show that medication brings it under control and re-take your exam. You can also affect cholesterol, blood pressure, diabetes, and weight with diet. Do not assume that you can not improve your health significantly by bringing your conditions under control and losing weight.
If you are still not able to pass a medical exam, you can look for other options. There are “no medical exam” policies, but you may still need to attest to the fact that you do not have certain conditions to the best of your knowledge such as cancer or HIV. There are also guaranteed issue policies, that will not disqualify coverage for any reason. These types of policies are more expensive, but they do give you some coverage. They may also have a 2-year waiting period before a death claim can be filed, so if a death occurs during the first two years the policy will not pay out a claim.
Group Life Insurance
This is a great option for people who are looking to avoid a medical exam. Typically these policies are offered through work by an employer. The downside is that the policy size is usually limited to $250,000, and the standard coverage may be limited to one year salary. The upside is that there is no underwriting and these are typically some of the least expensive policies.
A burial policy, or final expense policy, is a small whole life insurance policy meant to pay the costs associated with a funeral and burial. These policies do not require medical exams because they are small and priced for seniors with short remaining life expectancies anyway. These policies may be a bit more expensive compared to their size as a result, but affordable overall due to their small size. They are not meant for people under 65 years old.
Get a Small Policy
Each life insurance company has its own requirements, but smaller policies probably do not require an exam. Some companies may set the threshold at $50,000, and some are as high as $250,000. You can find a company with a high tolerance to write policies without passing an exam.