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What do Life Insurance Medical Exams Test For? [How to Avoid the Blood Draw]

life insurance drug test

There is one factor that will dramatically change how much you pay over the course of your life insurance policy – the life insurance medical examination.

Whether you choose a term life insurance or permanent life policy, the cheaper life insurance rates will typically be found with a medical examination because it allows the insurer to get to know your current state of health.

Accelerated Underwriting

But, one alternative to taking the life insurance physical exam is to choose a company that offers accelerated underwriting.

It is similar to no exam life insurance, but accelerated underwriting goes deeper into your medical and lifestyle background, using big data to determine what life insurance health rating you should receive.

Your life insurance health rating determines your premium. And know this, a company cannot choose to charge you more or less than someone else who shares your health rating, gender and age.

At IBUSA, we work with the top no exam companies and the more innovative accelerated underwriting companies. Please give us a call today to see if you qualify and check out our article highlighting the benefits of taking an exam versus no exam life insurance.

One last note, many people are concerned about life insurance with coronavirus. Click the proceeding link to learn more.

So, with that said, let’s get back to what life insurance medical exams test for.

Table of Contents

The Life Insurance Medical Exam Process

Before we jump into the finer details of the exam, we should point out that an examination will normally take place at your home or place of business.

After starting with your height and weight, you will move on to blood pressure. Make sure you are nice and calm before you get it checked because your blood pressure needs to be below 145/90 to be eligible for the top health rate class.

After these simple details have been obtained, you will be asked to provide a urine sample and the professional will then take a blood sample to finish.

Here is a tip on the blood draw and urine sample,

Drink a lot of water before the exam.

Alternatively, choose a no medical exam policy to avoid the blood draw altogether.

For older clients and those looking for a large death benefit, an EKG may also be required.

Furthermore, there will be various questions coming your way like who your current doctor is and whether you have been to visit them recently.

Finally, you will be asked provide your driving license or some form of identification.

The Life Insurance Physical Exam Questions 

Generally, these are simple questions that look to cover your health and lifestyle on a daily basis.

If you have already been asked some health questions by your agent, you will notice that these are very similar.

These questions are thorough because the insurer is trying to work out how healthy you are and how much of a risk it would be to insure you.

However, they are also looking for any inconsistencies that might exist between your answers since these are immediate red flags for an insurance company.

Life Insurance Medical Exam Details

When undertaking a life insurance medical exam, it should take anywhere up to 30 minutes assuming that everything goes smoothly.

If an EKG is part of the exam, this can add fifteen minutes on top but it can still be done within 45 minutes.

After completion, the nurse will take your urine and blood samples and send them off to the lab and you can expect a personal review within 1-2 weeks.

Essentially, your samples will reach a professional lab company who then assess and prepare the results for the underwriter. Based on your results, you will be offered a rate class for the policy.

Life Insurance Blood Test and Urine Sample 

All things considered, there are many reasons why life insurance companies will take these samples but they can be split into five different categories.

Within each category, there are various different signs that they look for and we have provided each category below.

5 Categories

Heart and Arteries

Cholesterol – Although there are good and bad types of cholesterol, it is a fatty substance that is needed by the body for lubrication.

However, current medical literature states that too much of the bad type and you could experience blockages in the arteries which increases the likelihood of a stroke or heart attacks.

For insurance companies, you will notice that they all offer different parameters for what is ‘acceptable’.

The good news is many of the top life insurance companies are okay with elevated cholesterol. There are even some companies that will offer you a preferred best rate class with cholesterol less than or equal to 300.

HDL/LDL – With HDL, this is often called the ‘good cholesterol’ as it prevents a build-up of LDL (bad cholesterol) and protects the arteries – men should aim for 40 HDL while women require 50 HDL.

With LDL, this leads to blockages and sometimes needs stents as a cure.

In your assessment, an LDL/HDL ratio will be calculated to see your risk of heart disease. Then, there will also be a cholesterol/HDL comparison.

You want the best HDL/Choleserol and HDL/LDL ratio possible. A cholesterol/HDL ratio below 4.5 is ideal.

Diuretic in Urine – With medications for high blood pressure, they act as a diuretic so presence of this in the urine will show if you are taking a HBP medication.

Triglycerides – As a type of fat found in the blood, you will be eligible for the best health rating if your levels are below 150. If above this, the risk of higher premiums becomes increased.

Beta Adrenergic Blockers – Finally, this will look for all signs of medication relating to high blood pressure, heart defects, or arrhythmias.


Alkaline Phosphatase – As an enzyme in your blood, having too much is potential evidence of a bone or liver disease.

Alanine Aminotransferase (ALT) – Again, this is an enzyme and shows whether liver disease is likely or elevated.

Aspartate Aminotransferase (AST) – If you have high levels here, it could be a warning of muscle, liver, or heart disease.

After this, there are a number of smaller things that are checked including total Protein, total Bilirubin, Globulin, Albumin, and Gamma Glutamyl Transpeptidase (GGT).

Kidney and Bladder

Blood Urea Nitrogen – With this, you can see the overall health of a person very well and a normal range is considered to be between 10-25.

Creatinine – If this is high, there is a possible danger of kidney disease.

Leukocyte Esterase – With this, life insurance companies are looking for enzyme as this could be proof of bladder or kidney infections.

Urine pH Screen – Here, insurers can see how acidic the urine is and the normal result would be between 4-8.

Hemoglobin Screen – If hemoglobin is found within the urine, this could be evidence of a kidney or urinary tract infection.

After these five, there will also be tests for Urine Creatinine, Proteinuria, Microalbumin, and your Protein/Creatinine ratio will be assessed.


Fructosamine – As this measures your blood sugar levels over a period of two or three weeks, particularly high or low results could suggest health issues.

Urine Glucose – As the name suggests, this checks the amount of glucose within your urine because a high result could be a sign of diabetes. Ideally you want your blood glucose to be below 120.

Hemoglobin A1C – Over the last 90 days, your blood glucose will show and anywhere below 5.7 can be considered regular. If you’re a little above this, you sit in the pre-diabetic zone. As soon as you pass 6.5, this is considered diabetic within the application for life insurance.


Although we have now seen the four main areas that are tested in the life insurance blood tests and urine samples, there are two final areas with the first being Serum HIV – over time, this can lead to AIDS.

Also, Cotinine is a big one within a life insurance medical exam because this is a byproduct of nicotine. Despite much research, we aren’t quite sure how long nicotine stays in the body but insurers can gauge tobacco use by Cotinine.

Testing for Drugs in the Medical Exam 

Typically, life insurance companies will carry out a drug exam in addition to checking the overall health of your body and these are similar to the ones some employers use.

Depending on the insurer, your urine will be used and it may be paired with blood for other tests.

During this process, the insurer will be checking for nicotine, marijuana, amphetamine, methamphetamine, opiates, cocaine, methadone, barbiturates, benzodiazepines, and phencyclidine.

If your test results come back and show any one of these substances, you will be declined for life insurance automatically.

Marijuana and Tobacco Use

However, it should be noted that an increasing amount of companies are allowing nicotine and marijuana – with this, the consumption level will depend on individual rules set out by the insurer.

For the most part, the ‘2X’ rule has been gaining traction in recent times and this says that an applicant can receive the best rates if they consume marijuana less than twice per year.

With others more favorable to Marijuana use, it can be more frequent and even up to three times per week with marijuana friendly life insurance companies.

When it comes to the frequency rules, you don’t necessary qualify for the best rates automatically because this relies on other sections of your application. This being said, it does mean that you have an opportunity to qualify as a non-smoker.

Drug Addiction

For the more serious drugs such as heroin or cocaine, they lead to automatic rejections because life insurance companies do not allow current drug abusers.

If you are now clean after being addicted to drugs in the past, life insurance is achievable as most companies have a set amount of time for which you must be clean – this is normally three years with no relapses.

Alongside the life insurance medical examination, you will also be asked some questions and you may need to answer follow-up questions if you suggested previous drug use.

If you are currently a drug user, you will find it hard to receive coverage from any insurer in the market.

Even when a company offers guaranteed issue life insurance to you, it will be expensive versus a more traditional underwritten policy.

If you are now drug free, you will find that many companies will offer you life insurance as long as you have been drug free for a certain period of time.

Life Insurance Heath Ratings

Life insurance companies are looking into all of these different areas for one purpose, to assign a risk to you, known as your life insurance health class or health rating.

There are multiple life insurance health ratings available, including:

  • Preferred Best or Preferred Plus
  • Preferred
  • Standard Plus
  • Standard
  • Substandard or Table Rated

Different Companies Offer Different Health Ratings

It is important to understand that different insurance companies will assign a different health rating to you based on your health and lifestyle.

For example, if you have diabetes, some companies will automatically give you a substandard rating.

However, some of the diabetic friendly life insurance companies will offer you a standard, or even preferred health rate class if your diabetes is well controlled.

The difference in your life insurance premium from a substandard rating to a preferred rating is huge. So it definitely pays to choose a company that caters to your health or lifestyle.

Medical Exam Tips

Often, people get nervous about the medical exam and they don’t exactly know what to do in the lead up to it taking place so we have compiled a few tips for you today.

It all starts around 24 hours before the exam is due to take place and this is the point where you should stop consuming sugar, alcohol, and caffeine.

In addition, you should also avoid over the counter drugs as these could tamper with your results.

On the day of the exam, try to stop eating around eight hours before and you should also avoid any strenuous exercise.

An hour before the exam, try a glass of water as this will help you to provide the urine sample which is an area where many struggle.

As mentioned, the examination can take place wherever you would feel the most comfortable from the office of the professional to your workplace or home.

With this in mind, choose a location that will allow you to relax and provide the suggested samples.

Medical Exam FAQs

What if the appointment is cancelled? 

If you need to cancel the appointment because something important has come up, you will need to contact your life insurance agent who will re-arrange on your behalf.

Alternately, you might be able to contact the professional company carrying out the exam directly.

Sometimes, it will be the vendor cancelling the appointment so you will be contacted with a new appointment time. If the vendor cancels more than once, you are welcome to contact your agent to see if there is a faster process.

How much the life insurance physical exam cost? 

Since it is part of your application for life insurance, it won’t cost you a dollar. Just because you aren’t paying anything, this doesn’t mean that you have to choose them either.

Over the years, insurers have become used to applicants choosing to go elsewhere even after the medical examination. As you can see, this is a great way to check your overall health and you should even receive a copy of your health report.

What if I disagree with the lab results? 

Thanks to technology, the results are now extremely accurate with medical exams but you may still feel as though you had an off day or that the results are wrong.

If this is true, you can request a second exam but there are a couple of problems with this.

First, some insurers don’t do second examinations.

Secondly, your first exam will still be considered as opposed to it being ‘forgotten’.

With most policies, you will have a chance to request a new medical exam at some point in the future – normally at a renewal point.

If the results are worse than the first, you can have these scratched to continue using the first. If the results are better, you can ask the insurer to consider your new medical exam when working out your new rate.

What happens after the life insurance medical exam?

Once you are all finished, the blood and urine samples will be sent to the lab and you can resume your normal routine.

As the results come in, they will be assessed by the insurance company and you may be asked some more questions by the underwriter.

For example, the results could uncover a medical condition and they may need more information before calculating a premium. If not, you will receive a quote and you can decide whether to keep shopping or buy the policy.

What if I choose not to accept the policy?

As mentioned previously, you are not under any contracts even through the examination process so you have the right to walk away at any point.

Instead of undergoing a different medical exam for each company, you can have the first and then use these results to shop around which is important to keep in mind.

Often, people will decide against shopping around because they think a new medical exam is required for each.

As long as the exam has been taken within six months, it will be valid for all applications.

Don’t forget, all medical exams will go on your health record for the foreseeable future. Ultimately, this means that your very first medical exam will be taken into account in all future applications for life insurance even if you have a newer exam in the application.

Should You Undergo a Medical Exam?

This all depends on your needs and your unique situation. If you are currently ill or have a disease/condition that would prevent you from being accepted with a medical exam, you might want to look towards simplified issue life insurance.

If you are young and healthy but you have not had a physical exam for awhile, maybe you want to err on the side of caution and avoid an exam, rather than find out you are not as healthy as you thought you were.

Further, some no exam policies have provisions in them that prevent the policy from paying out 100% of the death benefit in the first 2-3 years. These type of policies have a graded benefit which means that the full death benefit will not go to the beneficiary if you die within a certain time after the policy has been set up.

For many that have no concerns about their health, the medical examination may be worth the effort because it only takes around 30-45 minutes and you may benefit from lower premiums for the years ahead. Also, you may qualify for accelerated underwriting that allows you to bypass the exam altogether.


What decision is best for you comes down to your unique scenario and this is why choosing a top notch life insurance agency, such as the team at IBUSA, will come in handy to help you make the best decision for you, based on your unique needs, health and lifestyle.

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