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Penny Gusner Consumer Analyst

Open wide: Oral swab testing can reveal drug and tobacco usage

To find out if you're as healthy as you say you are on your life insurance application, insurance companies sometimes require saliva samples. The test is simple. A swab is rubbed on the inside of your cheek, and the sample is sent to a lab.

"It doesn't hurt at all, and it literally takes five seconds," says Dr. Jim Palmier, medical director of ExamOne, a Quest Diagnostics company.

The procedure may be short and sweet, but that little sample of saliva can tell a lot about you. Do you smoke? Do you do drugs? Have you been infected with HIV or hepatitis B or C? The answers will impact your life insurance quotes.

Saliva used for younger applicants and lower amounts 

Not all life insurance companies use swab tests, and those that do don't necessarily use them for every applicant. Palmier says insurers tend to rely on saliva samples for younger life insurance applicants and people who purchase policies with lower face amounts. Insurers do not use the swab test for genetic testing.

"Urine and blood would be considered the gold standard in testing," Palmier says.

Saliva samples are a less-expensive alternative insurers use when they don't think fuller screening is necessary.

New York Life Insurance Co., for example, uses swab tests on all applicants 18 and older for policy face amounts from $50,000 to $99,000, says Stephen Bloom, New York Life's first vice president and chief underwriter. Blood tests are used for people 18 and older who apply for policy face amounts of $100,000 and over.

Saliva tests are cheap and easy

Life insurance swab tests have been in use for more than two decades. In the early years, life insurance companies operated their own laboratory facilities in their home offices. Later, they began contracting with labs, such as ExamOne and Examination Management Services Inc. (EMSI) 

Use of swab tests first began to increase 25 years ago, along with the use of urine and blood samples. The use of such tests has leveled off in recent years, says Kim Anderson, senior vice president of the Insurance Services Division at EMSI.

Swab tests have a couple of advantages over blood and urine tests for insurers:

  • Less invasive for the customer
  • Less costly for the company 
  • Doesn't require a licensed medical professional to collect

The test is so easy, in fact, that life insurance agents themselves collect the swab samples from clients in some instances, Anderson says. In others, medical professionals conducting exams administer the swab tests.

What life insurance companies want to know 

Life insurance companies vary in the types of tests they run on saliva samples. Palmier says insurers most commonly want to know whether the applicant is a drug or tobacco user or is HIV-positive. Insurers are especially interested in cocaine use because of the risky behaviors that accompany abuse of that drug, he says, but the samples can also be tested for use of other drugs. Swab tests are also used for detecting methamphetamine.

To find out whether you're a smoker, the lab tests the sample for cotinine, a chemical the body makes from nicotine. If you're not a regular smoker, and you just happen to take a few puffs on a friend's cigarette at a party, the level of cotinine probably won't be detectable after a couple of days, Palmier says.

But if you're a regular smoker, it will take longer for the level to drop. The length of time could vary from several days to two months in rare cases, Anderson says.

"If you're truly a smoker it'll come up positive," Palmier says. It's best to be honest about your lifestyle when making a life insurance application. Lab tests likely will catch you in a lie.

To ensure an accurate test, Palmier recommends not eating anything right before the test. If you do happen to eat or drink something, rinse your mouth out with water.

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