What Insurers Look for in a Life Insurance Blood Test & Exam

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When you apply for life insurance, you'll usually need a medical exam. This checks to see if you have a disease or are at risk for one. They will also look for any current drug use. The exam may involve questions about your medical history and a physical, blood test, urine test and electrocardiogram (EKG).

Medical exams are standard for most term and permanent life insurance policies. They're provided for free by the insurance company.

What's involved in a life insurance medical exam?

Life insurance companies usually hire a third party, such as ExamOne, to handle medical exams. Once your application has been reviewed, your agent or the testing company will reach out to schedule an appointment. The tests are quite simple and can take place at your home, workplace or a local exam center.

A standard life insurance physical includes:

  • Driver's license check (to confirm your identity)
  • Blood sample
  • Urine sample
  • Measurements of your height, weight, pulse and blood pressure
  • EKG (usually only for seniors or if you want a large death benefit)
  • Series of health questions to confirm the info in your application, plus a list of doctors you've seen recently

The process usually takes less than 30 minutes, unless you're asked for an EKG. Those take another 10 to 20 minutes. Some companies ask for a saliva sample or X-rays, but it's not common.

Depending on the testing company, your results will be provided to you after the analysis or you can request a copy.

Getting your results is important, even if everything goes well with the exam. If the insurance company comes back with a much higher quote or you're denied coverage due to the exam, you'll want to know why.

What is tested for in a life insurance medical exam?

Life insurance medical exams assess your health, confirm the info on your application and screen for illegal drug use.

Health factors

Height and weight measurements from the exam determine if you're overweight, according to the insurance company's standards. The exam company will also take your blood pressure. Higher numbers could mean you're at higher risk for a heart attack or other health issues that the company wants to avoid.

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

  • HIV and AIDS
  • Sexually transmitted diseases
  • Cholesterol, including LDL, HDL and triglycerides (poor levels are associated with heart disease)
  • Hemoglobin A1C, fructosamine and glucose levels (indicators of diabetes)
  • Creatinine, hemoglobin and proteins (to find kidney disease)
  • Urine acidity (for kidney issues or diabetes)

Confirmation of application responses on drug and tobacco use

Your blood and urine will also be tested for tobacco, nicotine and prescription and recreational drugs. You may be weighed and asked about your lifestyle. This checks that your test results and application answers match.

The company will also check that your responses match data from the Medical Information Bureau, prescription database and DMV records.

It's important to answer all questions honestly, even if they make you uncomfortable. Otherwise, you can be denied coverage. So, for example, if you take antidepressants or other medications, it's better to tell them right away.

Insurance companies usually have two years from the time you buy coverage to find false or misleading info. If they do, they can cancel your policy.


The life insurance medical exam might look for nicotine and cotinine in your urine to see if you use tobacco. The test can show whether you're a regular smoker or even an occasional one.

The test can't identify how nicotine got into your system. So if you're using a patch to quit smoking or have the occasional cigar, they could classify you as a smoker.

That's why you should give details about any nicotine or tobacco use in your application. Many companies don't mind a celebratory cigar a couple of times a year. But they won't be very accepting if you don't tell them about it.

How long does nicotine stay in your system?

Nicotine and cotinine stay in your blood between one and 10 days after you've stopped smoking or using tobacco. It stays in your urine for a shorter period of time, but it can be detected in your hair much longer.

How long nicotine is in your urine or blood depends on what type of tobacco you use, how often you smoke or use tobacco and how your body processes it. Everyone's body is different. While you might want to stop smoking before a life insurance test, you should still tell the company that you smoke. If you lie and say you don't smoke but they find evidence that you do, your application will be denied.

Smokers face some of the highest life insurance rates, so some people try to quit before the exam to get better rates. Even if you do trick them, they can deny the death benefit if you die from a smoking-related disease.

Since the company can cancel your coverage anytime if they discover you smoke, it's better to be honest on the application.


You won't get life insurance if a blood or urine test shows you use drugs recreationally, such as amphetamines or opiates. The only exception is marijuana, which many companies allow. But they may charge you higher rates because of it.

If you use marijuana regularly, you should talk with an independent insurance agent to determine where you should apply. For example, MetLife still considers you a nonsmoker if you smoke marijuana than once per week.

What you should do to prepare for a blood and urine test

Preparation for a life insurance medical exam starts during the application process. You should be ready to answer questions about your health, lifestyle and medical history over the past five years. This will make your initial quote more accurate.

If the rate is too high, you can switch to another company without going through weeks of underwriting. In addition, companies will try to confirm all of your answers If they find any inconsistencies later on, they may deny you coverage.

There are some things you can do to prepare for an exam.

  • Get a good night's sleep the day before your exam
  • Drink a glass of water about an hour before your appointment
  • Make sure you bring a photo ID
  • Be prepared to discuss any health issues at the exam.

During the life insurance medical exam, make sure to answer every question honestly. Remain calm for a low resting heart rate. And stand as straight as possible for your height measurement. Your height-to-weight ratio can directly affect your quotes, so don't risk slouching.

What not to do before a medical exam

There are also some things you should avoid doing before a life insurance exam.

  • Limit salty foods and foods high in cholesterol, like eggs and cheese, starting a day before your exam
  • Don't drink alcohol for 12 hours before your exam
  • Don't do heavy or intense exercise for 12 hours before your exam
  • Don't drink caffeine or use any nicotine products for an hour before your exam

If you want to be very cautious, stay away from chemicals and foods that could cause inaccurate results. They're unlikely to be an issue, because medical testing has gotten much better in recent years, but you may want to avoid:

  • Poppy seeds: Can cause false positive for opiates
  • Ibuprofen and other NSAIDs: Can raise blood pressure
  • Cold remedies and decongestants: Can cause false positive for amphetamines or opiates

Talk to your doctor about any medications you are taking. Don't stop taking a medication before a life exam unless you've talked with your doctor first.

What to do if you're denied coverage

If you're denied life insurance based on your medical exam, first figure out the reason. Request a copy of your test results from the exam company. Ask your insurance company too. If the results seem off, request a second exam.

For example, your life insurance exam results may show high blood pressure. If it's well within normal range at your annual physicals, something may have just been off that day.

If the exam results are accurate, your next steps depend on the medical issue. As a simple rule of thumb, there are three primary paths to getting coverage through a different company:

Reason coverage was declined
Life insurance options
Your measurements were slightly outside the company's accepted range or showed you're at risk for an illness.If you applied for permanent life insurance, reconsider term coverage. Then ask an independent agent for quotes from companies that accept your health measurements.
The results showed you have (or may have) a medical condition (such as prediabetes) that has a moderate impact on life activities.Ask an independent agent whether any companies offer term life insurance for people with your exam results. If not, apply for simplified issue life insurance, which doesn't require a medical exam. Depending on the company, you may be able to get up to $250,000 in coverage. Just note that once you're diagnosed with a disease, this option may not be available.
Your exam results showed you have a serious illness or condition (such as kidney disease).Once you've been diagnosed with a medical condition, you may be limited to guaranteed acceptance life insurance. These policies offer whole life insurance, but typically with less than $50,000 for the death benefit.


Medical info in this article is from various sources. Always contact your doctor about specific medical questions and scenarios.

Editorial Note: The content of this article is based on the author's opinions and recommendations alone. It has not been previewed, commissioned or otherwise endorsed by any of our network partners.