You’re probably tired of taking tests and being judged in your life. It starts with high school SAT exams to get into a good college, then your college graduation GPA to get a good job and begin a successful career. Professional certifications, licensing, the list goes on and on; we get tested a lot in order to achieve something. Well, it’s no different to get a life insurance policy… most insurance carriers you apply with require that you complete specific medical exams in order to qualify for that policy and to determine your rate classification (how much you will pay for premiums). But that’s exactly the point of life insurance medical exams—to determine your risk factors to insurers and to try to save you money on policy premiums. Yes, it is possible to avoid the blood test and exam by applying for non-medical, or simplified issue life insurance policies with some companies and could be a good option for some.
Typical Life Insurance Medical Exam Process
• Drawing a blood sample
• Providing a urine sample
• Measuring height, weight, pulse rate, and blood pressure
• EKG—electrocardiogram to check for normal heart rhythm
• Health questions to confirm the information listed on your application and your list of current physicians or medical providers.
What Is a Life Insurance Blood Test and Why Is It Necessary?
The majority of life insurance companies require blood work at the time of your application in order to get a detailed, physiological health profile. It is technically called fully or medically underwritten life insurance. Here is what the insurance companies are looking for:
• To confirm that what you attested to about your health on the insurance application is true.
• To look for diseases (kidney, liver, diabetes, HIV) and any negative risk factors that will make you uninsurable, or rated in a high-risk category because of the statistical chances of dying prematurely.
• The blood labs will pick up prescription drugs you failed to list, illegal drugs you failed to disclose, or tobacco use. Marijuana use is now evaluated based on the legality of it in your state of residence, or other factors that are individually rated.
Insurance company underwriters also evaluate you based on your age, gender, your family history (for instance, whether your parent(s) died of cardiovascular disease), even your credit history and driving record, but ultimately on the evidence of your blood work results, which will reveal specific health conditions.
Why does a positive exam matter? Because the healthier you are, the lower your risk of life-threatening illnesses, the lower your premiums will be.
The insurance agent will order the medical exam with an independent paramedical exam company after you fill out your application. You determine when and where to take it at your convenience and it is free of charge to you; the insurance company pays for it. A nurse from the independent exam company will draw your blood, do an EKG (electrocardiogram), measure your blood pressure readings, weigh and measure your height, and request a urine sample at the time of your test.
Divulging Prescription Medications
If you take medicines prescribed by your medical provider, disclose them on your application. The first reason is that you should be truthful; secondly, your blood work will reveal evidence of those medications. Additionally, insurance companies can order your prescription records from databases such as the Medical Information Bureau (MIB) where that history is kept. Those records will show all medicines prescribed, even if you’re no longer taking them. So, be honest in answering the health questions on your application. If you are medicated to control high blood pressure, high cholesterol, diabetes, or anti-depressants, it is important to divulge them. These alone might not increase your policy rate but it will make an underwriter look closer in scrutinizing your application. One thing to remember is that an experienced, independent life insurance agent can steer you to companies with more lenient guidelines about these medical conditions to get you the most preferred rate.
Illegal Drugs and Tobacco Use
• Illegal vs. Legal Drugs: If it’s illegal and you use it; you will be rejected for life insurance coverage period. Blood and urine tests will pick up amphetamines, cocaine, and opiates (heroin, opium).
• Prescription Opiates: Such as fentanyl, codeine, and morphine are legal as long as you have medically-approved reasons for their use and not prolonged usage. Because of the widespread prescription opiate abuse in this country, underwriters will definitely take a closer look at applicants on these drugs.
• Marijuana Exception: The only exception to the “illegal” drug rule is marijuana because insurers have differing guidelines for its consumption. This is another case of taking the advice of a knowledgeable, independent insurance agent to help you find “friendly” carriers with more lenient marijuana usage rules.• Tobacco Use: The life insurance medical exam urinalysis screens for nicotine and cotinine in your system in order to determine your tobacco usage. While the body absorbs nicotine quickly, it will be detectable in urine for up to 4 days for occasional smokers. For long-term, heavy users, it will take as long as a month to disappear. If you’re using a nicotine patch to kick the habit or puff on a cigar from time to time, you will likely test positive and be classified by insurance companies as a smoker. Don’t try to hide any tobacco habits because disclosing it could help you in the long run with insurers.
Because smokers receive some of the highest life insurance rates, applicants often think that quitting prior to an insurance medical exam is sufficient to qualify for a preferred rate. This could backfire. It could cost you more to be honest up front, but you can appeal to the insurer a year later to be re-classified and qualify for a cheaper non-smoker rate.
What Exactly Is the Blood Test Looking For?
The human body is a complex machine made up of a long list of ingredients— mainly oxygen, carbon, hydrogen, and nitrogen (a lot of that in the form of water). Scientists estimate that the volume of blood is only about 7% of our body weight. Seems insignificant in the big picture but that liquid or nutrient of life is powerfully meaningful. This is probably more information than you will ever know about why your blood tells a colorful story and what some of the many items in a blood profile your doctor (and insurance underwriters) look for to evaluate your overall health.
• Cholesterol: This fatty substance is quite prolific in our bodies but too much of it can build up a plaque that clogs our arteries, reducing blood flow and oxygen. What’s considered “healthy” cholesterol ranges have gone down in the last two decades, now between 140 and 199 mg/dL.
• HDL: This so-called “good” cholesterol, a/k/a High-Density Lipoproteins, fights against the artery-clogging attack on our bodies from the “bad” cholesterol. The higher it is, the better, protecting us from arterial or heart disease.
• LDL: This is the “bad” one— Low-Density Lipoproteins—which block our arteries. High levels of this one is what concerns doctors and underwriters. The optimal level is below 129 mg/dL.
• Triglycerides: This is another type of fat found in our bodies. You want to see these lipids below the number of 150. Overweight people or diabetics may have higher readings.
Signs of Diabetes
• Blood Glucose: The amount of sugar in your blood is a marker of whether or not you are at risk of developing diabetes. A healthy blood glucose range is between 60 and 99 mg/dL. Lower or higher levels can indicate glycemic issues.
• Urine Glucose: High sugar levels in our urine is another sign of diabetes. You want to test “negative” for this.
• Haemoglobin A1C: This Glycated haemoglobin test tells you your average level of blood sugar over the past 3 months. Haemoglobin is a protein found in red blood cells, which give blood it’s ruby red color and carries oxygen through your body. The normal range is between 4%-5.6%. Anything higher puts you a greater chance of getting diabetes.
• Alkaline Phosphatase: AP is a liver enzyme with normal levels at less than 125 U/L. Elevated levels could detect liver or bone disease.
HIV Antibody: These antibodies in the blood are disease-fighting proteins that the body produces in response to HIV infections. It can take months for a person’s body to produce enough antibodies to detect HIV infection.
The Truth Will Set You Free
There is no point in lying on an insurance application. The truth will be revealed after you take that blood test. The underwriter reviews your application on the assumption that you are being truthful in your answers to questions about your health, prescription drug use, blood pressure readings, height & weight. This will determine whether they reward you with the best rate for your policy. So reveal it all on that important application, don’t leave anything out, because the blood work does not lie. If during the application process an underwriter finds that you described yourself as the picture of health, and your blood analysis and blood pressure readings come back to reveal negative risk factors, your rate will go up. Fraud never pays off and will cost you in the end.
Tips to Schedule Your Life Insurance Medical Exam
The life insurance approval process can take weeks to complete so the sooner you get started, the better.
• Schedule your medical exam within days of filling out your application. Nothing else can happen on the road to the approval process until your medical results are posted and in the hands of the underwriter who will be reviewing your case.
• Schedule First Thing in the AM.
Because you have to fast about 8 hours before your exam, you’re better off doing it early morning for your own physical comfort.
• Pad Your Time
Why put yourself under pressure by squeezing in your important medical exam on a busy day when you have to rush off to a business meeting or any other appointment. While you should expect the examiner to take no more than an hour of your time, it’s best to be relaxed during the testing and not watch the clock. That’s a recipe for stress, and an elevated blood pressure reading.
Preparation for Your Life Insurance Exam
• Fast While You Sleep. As we just said, avoid eating 8-12 hours before your exam so you can have a “clean” fasting blood draw. Only water is allowed. That is why having your exam first thing in the morning is ideal because you will essentially fast while you sleep.
• Avoid Fatty, Salty Foods. Reducing your fat intake not only makes dietary sense, it could help you score better on your blood work. Best to avoid eating red meat, high salt foods, and sugar at least a day or two before your exam.
• Stay Hydrated. We know water is a key ingredient to good health, so drink plenty of it a few days before the test. Among other benefits, water helps clear your body of toxins.
• Take An Alcohol Break. Wine, beer, or hard liquor creates inflammation in the body and water retention so it’s best to avoid any alcohol in the days leading up to your exam.
• Cut Down On Coffee And Other Stimulants. Since “white coat hypertension” (high blood pressure readings in the doctor’s office) is real, the opposite should be true in the comfort of your own home. Don’t ruin it by drinking coffee or energy drinks before your exam. You want to keep your blood pressure and heart rate low and steady.
• Don’t Skip Your Prescriptions. Continuing your normal medicine regimen is critical before your exam. If you normally take your hypertension medication in the morning, do so to avoid a spike in your blood pressure.
• Be Prepared With All Your Medical Information. The more organized you are, the faster the process of reviewing your life insurance application will be. Gather your pertinent medical records, list of medicines, physician’s contact information, and your driver’s license to provide to the medical examiner.
What Happens after The Exam?
You’re in the home stretch now but remember the life insurance application process can sometimes get a little tedious. Make yourself available to your agent in case the insurer has any questions or concerns that you need to clarify. Being proactive is key. For instance, we often hear from underwriters how difficult it is to get in touch with physicians who are listed on insurance applications. If you contact your primary care physician and let them know ahead of time that they will be contacted about your life insurance application it could definitely expedite the process. This way they can be ready to respond to the insurance company’s request for what is called “Attending Physicians Statements (APS)”, which is your medical history with that doctor. This usually happens after completion of your insurance medical exam. Now, sit back and try to relax. The ball is in the court of the carrier’s underwriter.
You Have a Right to Request Your Test Results
Your medical test results are kept highly confidential and protected by the Health Insurance Portability and Accountability Act of 1996 HIPAA laws For your own protection you must request your test results directly from the exam company, who will send them to you by regular mail. The only other option is to access them via the insurance company’s web portal, but not all carriers offer this. The one person who cannot provide your results is your life insurance agent because they don’t have access to it, again because of privacy concerns. By the way, your exam results do not expire for 6 months, so in a worse case scenario that you are denied coverage by the first carrier with which you applied, you can use these results with the next company. You can also appeal the denial or contest the results of the exam or any of the medical information used to deny you coverage. It’s best to discuss this with your agent to guide you as to the best move.
In conclusion, if you don’t have an aversion to needles and don’t need a policy in a hurry, it may pay to apply for a fully underwritten policy that requires a life insurance medical exam. If you are in relatively good health, it will probably save you money. But if you need to push a rush on coverage—for a divorce settlement agreement, or a business loan— you might have to opt for non-medical life insurance policy options. Some have instant approval or simplified issue but those policies will generally be more expensive than medically underwritten term life insurance.