Key takeaways
Taking a life insurance medical exam offers a clearer picture of your health and medical history, helping them assess and determine your premium and coverage eligibility.
You can expect the exam to take just 15 to 45 minutes at your home or office, at no cost to you, combining a quick medical history questionnaire with standard vitals, blood, and urine samples.
Preparing ahead of time by staying hydrated, skipping caffeine, and getting a solid night's sleep helps ensure your vital signs reflect your true health.
Choosing no-exam alternatives like simplified issue or guaranteed acceptance policies lets you skip the physical, though you may face higher costs and lower coverage limits.
Checking your workplace benefits is a smart move, as employer-sponsored group plans often give you baseline coverage without requiring health questions or physical exams.
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Life insurance rates are based on a number of factors that determine the amount of financial risk the life insurance company takes when it approves a policy. That’s why life insurers often require applicants to have a life insurance medical exam. It’s an important way to assess the applicant’s health and determine if they’re even insurable — and if so, how much to charge in premiums to offset the company’s risk. If you’re getting life insurance — or just thinking about it — this article can answer some of the most common questions about life insurance medical exams:
Why life insurance companies require a medical exam
Most people are eligible to buy life insurance in some form. Still, the type of policy, level of coverage, and cost depend on several factors unique to each applicant's situation. As a routine part of the life insurance application process, the medical exam helps the insurer assess an applicant’s health status. Your age, overall health, family history, lifestyle habits (such as whether you're a smoker), and other factors help the life insurance company estimate your life expectancy. The longer your life expectancy, the lower your risk and cost to insure — and vice versa.
Some policies let you skip the medical exam and only ask a few questions about your health; others don't even ask health questions. These no-exam choices may appeal to people who want to avoid medical exams during the application process, but that doesn't necessarily mean they're a good deal. Policies that don't ask for health information typically have to charge more per $1,000 of coverage because the insurer must assume the applicant has medical issues.
If you're buying a substantial policy to provide for your family, it generally makes sense to get a "medically underwritten policy." If the insurer can assess good health through that process, you may qualify for lower premiums and broader coverage options. In fact, if you have a well-managed medical condition (such as high blood pressure) but are otherwise in good health, it may still make sense to get a medically underwritten policy. After all, reviewing the exam data can help identify medical conditions and potential risks instead of forcing the insurer to assume the worst. That's worth keeping in mind, because the price of coverage is often smaller than people expect: over half of Americans think life insurance costs about three times more than it actually does, according to Andy Gordon, Head of Individual Life Insurance at Guardian.1
Concerned about keeping life insurance protection as you age? Consider a permanent policy.
Life insurance comes in two primary types — term life insurance and permanent life insurance.
Term life insurance lets you get a large amount of coverage at a relatively low cost. However, that coverage only lasts for a limited period of time — or “term” — which usually ranges from 10 to 30 years. Once the term is over, there’s nothing left to the policy. If you want continued protection, you have to apply for new coverage.
Permanent coverage — like whole life insurance or universal life insurance — provides life insurance that does not expire. As long as your premiums are paid up, your policy will stay in force.2 It also builds cash value over time.3 Importantly, you can access the policy’s cash value via loans or withdrawals while still keeping the policy in force.4 Because it provides more value, permanent insurance costs significantly more than term life insurance — at least at first.
Either type of coverage may require a medical exam, especially if you're getting a large policy. So, say you're relatively young and healthy, and qualifying for coverage won't be an issue. You could get a term policy and save money initially. However, when the term expires, you'll have to apply for new coverage, and rates will be higher because you're older. In the meantime, you could also develop a health condition, such as diabetes or a heart arrhythmia, that further drives up your cost of coverage or maybe even disqualifies you from getting a medically underwritten policy. Instead, you'd have to apply for a no-medical-exam policy, but you'll pay even more — if you can get the same amount of coverage. These policies typically have coverage limits.
On the other hand, if you get a permanent whole life policy when you're young and healthy, your premiums will never go up or down and will always be based on the health rating you had when you applied. So if you get coverage at age 30, whole life premiums will be higher than they would be for a 20-year term policy. But fast-forward two decades: if you apply for a new 20-year term policy at age 50, the cost could be nearly four times higher — even if you're in good health. (See for yourself by trying out our life insurance calculator and entering different ages.) But the monthly premiums of a whole life policy will be the same as they were at age 30 — and the protection will last as long as you live.
What takes place during the life insurance exam?
If the policy you're applying for requires a medical exam, the exam is usually scheduled as part of the application process, and the life insurance company will arrange for it and cover the costs. A professional will usually contact you to schedule your appointment, and the examiner will come to your home or office. The exam usually takes 15 to 45 minutes, depending on what's required. There are typically two parts: a questionnaire and a basic physical exam. Some applicants also complete additional lab testing depending on age, coverage amount, or specific health concerns.
Part 1: The questionnaire
The policy underwriters (insurance company professionals who assess your risk) will consider both your medical and lifestyle information, so the questionnaire will likely cover the following:
Family medical history.
Your prescriptions.
Current and previous doctors’ contact information.
Details of current diagnoses.
Recent doctor visits.
Part 2: The life insurance physical exam
The examiner will record your weight, height, body mass index (BMI), and vitals — including your pulse and blood pressure. Depending on your circumstances and the insurer's requirements, you may also have the following tests:
Urine sample.
Blood test.
Electrocardiogram (EKG).
X-rays.
Treadmill stress test.
Cognitive ability test.
What the blood and urine tests look for
The lab work is the part of the exam most people wonder about. The samples are screened for common health markers that help underwriters gauge long-term risk, including:
Cholesterol and triglyceride levels (heart health).
Blood sugar, including glucose and A1C (diabetes indicators).
Liver and kidney function.
Nicotine or cotinine (tobacco use).
HIV and hepatitis.
Alcohol, prescription, and recreational drug markers.
Protein or blood in urine (possible kidney issues).
You can usually request a copy of your results from the lab. If something unexpected turns up, it's worth following up with your own doctor — the exam is a risk assessment, not a diagnosis.
How to prepare for your life insurance exam
To help save time filling out your questionnaire, it helps to gather the information that will likely be asked for, including:
A copy of your driver’s license or other photo ID.
A list of prescriptions, including the dosage amounts.
Names of any doctors you’ve seen in recent years (typically five years).
Types and dates of any surgeries you’ve had in recent years.
You can't change your health overnight, but a few simple steps can help your results reflect it accurately. And there's a bonus: only 40% of working Americans say they're good at keeping up with routine doctor visits, and 19% have skipped appointments because of medical costs — so for many people, the exam doubles as a free health snapshot they wouldn't otherwise get.5
The week before your exam:
Eat well: Limit high-cholesterol foods, salt, sugar, and fat.
Skip nonessential over-the-counter medications: Antihistamines and decongestants can raise blood pressure and glucose levels.
Avoid alcohol: It can negatively impact liver enzymes and cause dehydration.
Increase your water intake: Being well hydrated flushes toxins in your body that may impact your blood and urine samples.
12-24 hours before the exam:
Avoid strenuous exercise: It can impact your blood pressure and cholesterol readings.
Go to bed early: Sufficient sleep supports healthy vital signs, such as pulse and blood pressure.
Day of exam:
Schedule it early in the day, if possible.
Avoid caffeine.
Fast if you're asked to — and even if you're not, skip food and drinks other than water for several hours beforehand. It helps keep glucose and cholesterol readings accurate.
Drink a glass of water shortly before your exam.
Wear lightweight clothing (for your weigh-in) and a short-sleeve shirt (for the blood draw).
Once your exam is complete, the results go to the company's underwriting team. The underwriting process can take as little as a day or two, but more often, a few weeks. During that time, an underwriter will look over the details of your application, your health information, and your lifestyle to determine your insurance risk class: the larger the policy, the more detailed the underwriting process.
Once underwriting is completed, you'll find out if you were approved and at what rate. An experienced financial advisor can help you understand the factors insurers typically consider during underwriting and set realistic expectations about potential coverage and premium outcomes. However, there may be instances where a person is approved for life insurance coverage but not for the total amount of coverage requested due to risk factors uncovered during the underwriting process.
How to avoid having a life insurance exam
As we've noted, if you're in good health — especially if you're a nonsmoker — you're most likely going to pay less for medically underwritten life insurance that may include a health exam. However, if you have been denied coverage or believe you have a medical condition that would result in denial, there are two kinds of policies that never require a medical exam.
Simplified issue insurance requires a health questionnaire but not a physical exam. These policies generally have coverage limits (a maximum of $500,000 is typical), and premiums are higher.
Guaranteed acceptance insurance is a type of life insurance that does not deny coverage for health reasons. There are typically no health-related questions or exams — but there may be a waiting period until you qualify for a benefit payout. Final expense policies usually fall into this category, and coverage limits are lower than even a simplified issue policy: generally, $50,000 or less, depending on the provider. While monthly premiums may appear low, the cost per $1,000 of death benefit is almost always higher than other forms of coverage.
Workplace life insurance
Many companies offer employer-sponsored life insurance plans as an employee benefit. These plans feature affordable group rates and may not require a health exam unless you apply for coverage over a certain limit. If offered by your employer, this could be an excellent choice, especially if you have health issues that limit your ability to purchase other coverage. Just don't assume it's all you need. “It's wonderful when employers offer life insurance as a benefit, and it's a great foundation. But for most people, it's not sufficient on its own,” says Andy Gordon, Head of Individual Life Insurance at Guardian. Employer plans typically cover one to two times your salary, while financial experts generally suggest five to 10 times your income — and the coverage usually ends when you leave the job.6
Explore your options
If you're looking to purchase life insurance and want more guidance about how to get a policy that fits your needs at a price you can afford, Guardian can help you find a nearby financial advisor who can help guide you to the right solution.
Frequently asked questions about life insurance medical exams
Insurers often require a life insurance medical exam. It typically consists of two parts: a questionnaire and a physical exam. The examiner will often come to your home or office and perform a short physical examination that includes basic height and weight measurements, a check of your vital signs, including pulse and blood pressure, and taking blood and urine samples, which are used to review health markers and identify potential risks.
It helps to gather certain information related to your medical history, since the exam starts with a questionnaire. For the physical exam, it's a good idea to take care of yourself in the week leading up to the exam by eating well (avoiding alcohol, and limiting salt, sugar, fat, and high-cholesterol foods), drinking more water, and getting plenty of sleep.
Not always. Most medically underwritten policies — especially larger ones — require an exam, but simplified issue and guaranteed acceptance policies don't, and many workplace plans skip it up to a certain coverage amount. Skipping the exam usually means higher premiums and lower coverage limits, so if you're in good health, taking it is often the better deal.
Nothing — the insurance company arranges the exam and covers the cost. The examiner will typically come to your home or office at a time that works for you.
It depends on the insurer, but fasting for several hours beforehand (water is fine) is a good idea either way, since it helps keep your blood sugar and cholesterol readings accurate. Scheduling the exam early in the morning makes this easier.
