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The lowdown on life insurance medical exams
When you apply for a life insurance policy, you’re traditionally required to undergo a medical exam – but not always. It depends on what type of policy you want to buy and how much you’re willing to pay. There are three different types of policies -- underwritten, simplified or guaranteed.
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- Underwritten policies require you to undergo a medical exam arranged by your insurance company and answer questions on your personal and family medical history.
- Simplified issue policies require you to answer some medical questions but you are not required to undergo a medical exam.
- Guaranteed issue policies do not require you to answer questions or take a medical exam.
Which one is best for you? If you're healthy, or suffer from a few minor medical problems, you're likely to get the best life insurance quotes from an underwritten policy. Simplified issue and guaranteed issue life insurance policies are generally pricier because they assume you may be hiding a risk.
If you're buying term life or whole life insurance, you'll likely be asked to undergo a medical exam. These are typically performed by licensed paramedicals who are often independent contractors hired by the insurance company. They will schedule a visit to your home for the exam and bring all the necessary supplies. The life insurance company foots the bill for the exam.
Health questions
After you apply for a policy, your agent or life insurer will contact a paramedical service and ask it to arrange a medical exam for you. You must have the exam or your application won't be processed.
The life insurer may request an attending physician's statement (APS) from your doctor, but you cannot have the life insurance medical exam done by your own physician.
A basic exam calls for your medical history (even though you've already supplied it on your application), height and weight, blood pressure, pulse, and blood and urine samples. Beyond that, tests will vary based on you.
For example, MetLife will order an in-home EKG for applicants ages 41 and older who are applying for face amounts of more than $1 million. For applicants ages 61 and older who are applying for $1 million policies and higher, MetLife requires an exam by a medical doctor chosen by MetLife (not your own doctor). The doctor will ask the same medical questions as a paramedical and get your height, weight, blood pressure and pulse, plus do a brief medical exam such as listening to your heart.
Jacki Goldstein, Vice President of Life Underwriting at MetLife, emphasizes that this is not a comprehensive medical exam and does not include sensitive issues, such as a breast exam for women. Goldstein also stresses that the M.D. life insurance exam is not a substitute for good routine medical care.
When age and face amounts get higher, a treadmill test may be required. For example, MetLife requires treadmill tests for applicants ages 51 to 70 applying for more than $10 million in insurance.
If you're applying for a low face value policy, you may not even be asked to do a paramedical exam. For example, if you're age 40 and applying for $50,000 of life insurance, MetLife requires no specific tests or measurements. And for some cases, MetLife asks for a "simple paramed" exam, encompassing the basic measurements and blood and urine work but without the paramedical question list. Guidelines for tests will vary among life insurance companies.
What are they looking for?
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Tips for a better exam Certain health conditions simply cannot be masked, but to obtain the best possible results, here are some recommendations. • Get a good night's rest the night before your exam. • Don't drink for at least eight hours before the exam. • Avoid coffee, tea or other caffeinated drinks such as soda for at least one hour prior to the exam. • Limit salt intake and high-cholesterol food 24 hours before your exam. • Don't engage in strenuous physical activities 24 hours before the exam. Source: Exam & Profile Services, Beaver Dam, Wis. |
Insurers are interested in your health because it affects your life expectancy.
If you suffer from a health condition that could shorten your life, it will increase your premium. Your blood and urine samples will be tested for HIV, cholesterol and related lipids, liver or kidney disorders, diabetes, hepatitis, prostate specific antigen (PSA) and immune disorders. The urine sample may also be tested for certain medications, cocaine and other drugs.
Your lab results will be sent to an underwriter for review. You may request a copy of the results, and some insurers will automatically send you a copy. If there's an abnormality in your results, consult with your personal physician. Abnormalities aren’t unusual and don’t necessarily translate into problems with your life insurance application.
After an underwriter reviews your application and medical exam results, he will determine your premium. If questions arise about your health, the insurer may request additional information or medical tests. If you are very ill — chronically or terminally — your application will be declined and you’ll have to look for a high-risk carrier or one that offers guaranteed issue life insurance.
Don't let your money go up in smoke
Smokers pay higher premiums for life insurance because their mortality rate is higher. If nicotine shows up in your results, you'll be considered a smoker. The test also detects nicotine from a transdermal patch.
After the results
If your test results correlate with the classification used for your original life insurance quote, you'll have no problem getting that rate. If a medical problem is discovered, you might be offered a life insurance policy with a higher premium.
There are two types of risk ratings: "flat" ratings, sometimes called temporary flat extras, and "table" ratings. Underwriters assess health conditions based on a sophisticated table to determine how to rate certain health conditions.
For instance, a flat rate may apply for a limited time if you just had surgery. But if you have high-blood pressure, you could receive a table rating, which increases premiums by a set amount for the duration of the policy -- depending on your medical condition and age. If you disagree with a rating you receive, contact your agent. Agents can try to revise your rating based on supplemental medical tests – if they prove you qualify for a better rating.
Even if you end up declining the life insurance policy, your test results become part of your record in MIB Group's database (formerly the Medical Information Bureau), a clearinghouse of medical information that insurers share which stores information for seven years after you apply for a life, health, disability income, long term care or critical illness insurance policy.
MIB is jointly owned by about 470 insurance companies. So, if you go shopping around for other life insurance, remember that your medical information is accessible to other insurers in the near future. Note that MIB's database does not contain actual medical records but rather codes that represent medical conditions and tests, hazardous hobbies and even your bad driving record. If you want to check your MIB file, or dispute information in it, you can obtain one free report annually.
No way, you say?
Life insurance medical exams are really quite routine. But if you want to avoid a medical exam, you could buy a simplified issue life insurance policy, which requires only that you answer a few medical questions, or a guaranteed issue life insurance policy, which requires neither an exam nor questions.
Keep in mind, though, that if you're in general good health, or even with a history of some health issues, you'll likely get a much better rate by buying the underwritten policy that requires a medical exam.
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