What Do Insurers Look for in a Life Insurance Blood Test and Medical Exam?

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When you submit an application for life insurance, the insurer will usually request a medical exam to determine whether you have any diseases, if you’re at risk for any diseases, and to determine your drug use. The exam may involve a physical, blood test, urine test and EKG, as well as questions about your medical history. Medical exams are standard for most term and permanent life insurance policies, and provided for free by the insurer, as it gives them the opportunity to confirm your health details.

What’s Involved in a Life Insurance Medical Exam?

Life insurance medical exams are typically handled by third party businesses, such as ExamOne, that insurers hire to handle testing. Once your application has been reviewed, your agent or the testing company will reach out to schedule an exam. The tests are quite simple and can take place at your home, your work or a local exam center. Just note that you’ll be asked to fast for the 8 to 12 hours preceding a medical exam, so we recommend scheduling yours in the morning.

A standard life insurance physical consists of a:

  • Driver’s license check (to confirm your identity)
  • Blood sample
  • Urine sample
  • Measurement of your height, weight, pulse and blood pressure
  • EKG (usually only required for seniors or if you want a large death benefit)
  • Series of health questions (including the list of physicians you’ve seen recently and confirming the information in your application)

This entire process usually takes less than 30 minutes. The only exception is if you’re asked for an EKG, in which case you should expect the exam to take an additional 15 to 20 minutes. Some insurers may also ask for a saliva sample or X-rays, but these are relatively rare.

Depending on the testing company, your results will either be provided to you after their analysis or you can specifically request a copy of the results. This is an important precautionary measure to take though, if everything goes well with the exam, you won’t need the results. However, if the insurer comes back with a much higher quote due or you’re denied coverage due to poor exam results, you’ll want to know why.

What is Tested for in a Life Insurance Medical Exam?

Life insurance medical exams are designed to assess your health, confirm the information on your application and screen for illegal drug use.

Health Factors

The height and weight measurements during a life insurance medical exam are used to determine whether you’re overweight, according to standards set by the insurer. The exam company will also take your blood pressure. Elevated figures for either of these tests could indicate you’re at a higher risk for a heart attack or other health issue which the insurer wants to avoid.

Blood and urine tests during a life insurance medical test screen for dozens of health indicators and conditions, such as:

  • HIV and AIDS
  • STDs
  • Cholesterol, including LDL and HDL, and triglycerides (poor levels correlated with heart disease)
  • Hemoglobin A1C, fructosamine and glucose levels (as an indicator of whether may you have diabetes)
  • Creatinine, hemoglobin and proteins (to identify kidney disease)
  • Urine acidity (can indicate kidney issues or diabetes)

Confirmation of Application Responses

Your blood and urine samples will be tested for prescription drug use, tobacco use, and whether you have any diseases. In addition, you may be weighed and asked questions about your lifestyle. While the insurer already collected this information during the application process, they will be checking that your test results and answers are consistent. They will also be checking that your responses match data from the Medical Information Bureau, prescription database and DMV records.

This is why it’s important to answer all questions from the insurer and testing company honestly, even if they make you uncomfortable, or you can be denied coverage. So, for example, if you take antidepressants or other medication, it’s better to disclose this early to the insurer, as they will find out. Insurers also have a 2 year window from the time you purchase coverage during which, if they find you’ve provided false or misleading information, they can cancel your policy.

Drugs and Nicotine

You’ll be declined for life insurance coverage if a blood or urine test indicates you use any illegal drugs, such as amphetamines or opiates. The only exception to this rule is marijuana, as each insurer evaluates marijuana consumption differently. If you use marijuana regularly, you should consult an independent insurance agent to determine which insurance companies to apply with. For example, MetLife offers preferred rates even if you smoke multiple times per week, while Primerica doesn’t accept any such habits for term life insurance applicants.

The life insurance medical exam also screens for nicotine and cotinine in the urinalysis in order to determine your tobacco usage. The test isn’t binary and can indicate whether you’re a regular smoker or if you’ve quit recently. However, the test won’t be able to identify how nicotine came into your system, so if you’re using a patch to quit smoking or have the occasional cigar, you’ll likely be classified as a smoker. That’s why you should indicate any details regarding the reason nicotine or cotinine would be in your system in the initial application. Many insurers don’t mind a celebratory cigar a couple times a year, but won’t be very accepting if you don’t disclose it.

Smokers receive some of the highest life insurance rates, so some people try to quit for a period of time prior to their medical exam and qualify for better premiums. Nicotine and cotinine can stay in your system from a few days to several weeks after smoking, so it’s unlikely that you’ll be able to pass a life insurance test for tobacco if you are a smoker. In addition, since the insurer can cancel your coverage if they later find out that you smoke, it’s better to be honest during the application.

What Should You do to Prepare for a Life Insurance Blood and Urine Test?

Preparation for a life insurance medical exam starts during the application process. You should be ready to answer all questions about your health, lifestyle and medical history over the past 5 years. This will make your initial quote more accurate, allowing you to decide if the company’s premiums are too high and switch to another insurer before going through a multi-week underwriting process. In addition, insurers will try to confirm all the answers you provide, so any inconsistencies later on may lead to you being denied coverage.

Starting a few days before the medical exam, you’ll want to eat healthy foods and drink plenty of water. Specifically, you’ll want to eat more of food that raises your good cholesterol (such as avocado, nuts and salmon) while reducing your intake of fried or sugary food (which can raise your blood glucose or blood pressure). Drinking more water helps to clear chemicals out of your system, open your veins and, on the day of your exam, prepares you to give a urine sample.

During the life insurance medical exam, make sure to answer all questions honestly, remain calm (you want a low resting heart rate) and stand as straight as possible for your height measurement. Your height-to-weight ratio can directly impact your quotes, so don’t risk slouching.

What Not to do Before a Life Insurance Medical Exam

Beginning 1 to 2 days before a life insurance medical exam, you should stop or reduce your intake of coffee and alcohol. In addition, you should tone down your exercise routine, as this can lead to elevated proteins in your urinalysis.

If you want to be particularly cautious, there are also several chemicals and foods that have the potential to trigger inaccurate exam results. Medical testing has improved significantly over time so, while they’re unlikely to cause issues, you may want to avoid:

  • Poppy Seeds - Can cause false positive for opiates
  • Vitamin B12 or Riboflavin Supplements - Can cause false positive for marijuana
  • Tonic Water - The quinine can cause false positive for cocaine
  • Ibuprofen - Can cause false positive for marijuana
  • Sleeping Pills - Can cause false positive for barbiturates
  • Cold Remedies & Decongestants - Can cause false positive for amphetamines
  • High Protein Snack Bars - Can cause false positive for marijuana

What to do if You’re Denied Coverage

If you’re denied life insurance based on the results of your medical exam, the first thing to do is determine the reason why. You should ask the insurer and make sure to request a copy of your test results from the company that performed the analysis. In the case that something looks wrong, request a second exam from the insurer. For example, if your life insurance exam results show high blood pressure but your annual physical results have always been well inside the normal range, something may have just been off that day.

In the case the exam results were accurate, the medical issue will determine the appropriate next steps. As a simple rule of thumb, there are 3 primary paths to getting coverage through a different insurer:

Reason Coverage was DeclinedLife Insurance Options
Measurements were slightly outside insurer’s accepted range or showed you’re at risk for an illness.If you were applying for permanent life insurance, you’ll want to reconsider term coverage given how tremendously minor health issues can increase quotes. Then ask an independent agent for quotes from multiple insurers that accept your health measurements in their underwriting guidelines.
Results indicated you have (or may have) a medical condition that has moderate to low impact on your life activities (such as pre-diabetes).Ask an independent agent whether any insurers offer term life insurance for people with your exam results. If not, you’ll want to apply for simplified issue life insurance, as this doesn’t require a medical exam. Depending on the insurer, you may be able to get up to $250,000 in coverage. Just note, once you’re diagnosed with a disease, this option may not be available.
Exam results showed you have an illness or condition that is likely to significantly impact your life activities (such as kidney disease).Once you’ve been diagnosed with a life-impacting condition, you may be limited to guaranteed acceptance life insurance. These policies offer whole life insurance coverage, but are typically limited to less than $25,000 to $50,000 in death benefit.

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