Understanding Life Insurance Blood Tests

When applying for life insurance, a medical exam — including a blood test — is often part of the process. Blood tests allow insurers to get a clear picture of your health and assess any potential risks. While many applicants go through this exam, it’s possible to skip it under certain circumstances. For example, some insurers offer accelerated underwriting, where healthy applicants may qualify without a medical exam. There are also options like guaranteed issue and simplified issue policies that provide coverage without the need for a full medical checkup, making it easier for certain individuals to get life insurance without the added step of an exam.

Bankrate is here to help you explore why life insurance companies use blood tests, what specific health markers they look for and how you can best prepare to make the process as smooth as possible.

Why do life insurance companies use blood tests?

Life insurance companies use blood tests as part of the medical exam to help underwriters determine an applicant’s risk class, which ultimately affects the cost of the policy. Blood test results, along with other health data gathered during the exam, give insurers a clearer picture of your overall health, lifestyle factors and potential medical risks. By assessing these results, insurers can more accurately gauge your life expectancy, placing you into a risk category that helps determine the policy premium. Generally, healthier individuals receive lower premiums, while those with higher health risks may face higher costs or limited options.

For applicants considering fully underwritten policies — such as traditional term life, universal life and whole life insurance — medical exams with blood tests are often a standard requirement. These types of policies offer more comprehensive coverage and can have lower premiums, especially for those in good health, because they allow insurers to carefully assess risk. In contrast, policies like guaranteed issue or simplified issue life insurance often bypass the need for a medical exam and blood test but may come with higher premiums and limited death benefits due to the reduced underwriting.

What happens during the life insurance medical exam?

The life insurance medical exam is designed to be convenient, allowing applicants to choose whether it takes place at home, at work or at a designated exam center. The entire process typically lasts about 15 to 30 minutes and involves a few key steps:

Verification of information: The examiner asks questions to confirm the answers you provided on your application.
Measurements: Your height and weight are recorded.
Urine and blood samples: Samples are taken to assess various health markers.
Blood pressure and pulse: Vital signs like blood pressure and pulse rate are measured.
EKG (if applicable): An EKG may be required for older applicants or those seeking a higher coverage amount to check heart health.

With these results, underwriters can more accurately evaluate your health and assign the appropriate risk class, ensuring a premium that reflects your individual profile.

What life insurance blood tests test for

Life insurance blood tests have several purposes. They may provide specific information about your health and verify what you have stated in your application. For example, if you stated in your application that you are not a smoker, but your blood test indicates the presence of nicotine in your blood, that may raise a red flag for the company.

Insurance companies may use blood tests to look for the following:

HIV or AIDS: HIV and AIDS are far more manageable health conditions for many people than they used to be. If you are getting proper care for your HIV, you may not be denied coverage, but you may pay a higher premium.
STDs: Having a sexually transmitted disease does not mean you will not be able to get a policy. If you have or have had one, you’ll likely want to include that information on your application so that the company is aware prior to the blood test.
Cholesterol: Your insurer is usually interested in your total cholesterol level and the ratio of total cholesterol to HDL cholesterol. Ultimately, your cholesterol level can have an impact on your risk group and policy premium.
Hemoglobin A1C, glucose levels: Hemoglobin measures your long-term blood sugar levels. If it is elevated above 5.7 percent, you could be at risk of diabetes. Glucose measures blood sugar levels at the time of testing. An optimal range prior to eating is 80-130 mg per deciliter.
Kidney disease: As is true for all chronic conditions, if you have kidney disease, there may be a greater chance you will be turned down for a policy, and you will probably pay more for coverage.
Diabetes: Diabetes usually makes it more difficult to acquire life insurance. However, if your diabetes is actively managed, you may still qualify for coverage.
Recreational or illegal drugs: Testing for substances like marijuana, cocaine or other drugs helps insurers gauge risk. The presence of recreational drugs can influence underwriting decisions or even disqualify an applicant, depending on the policy’s guidelines.
Prescription medications: Insurers often check for the presence of prescribed drugs in your blood to verify any treatments you’re undergoing. Disclosing your prescriptions on the application is important to avoid misunderstandings during the underwriting process, as it helps clarify that these medications are part of a managed health plan rather than recreational or undisclosed use.
Nicotine: Any sign of nicotine or cotinine in your system will likely lead to higher rates. If you are wearing a patch, use a nicotine vape or chew nicotine gum, you may want to indicate this in your application since the blood test cannot differentiate how the nicotine entered your system.
Liver disease: A blood test will check liver enzymes for various factors, including total bilirubin, protein, albumin and globulin. It can also see if you have any form of hepatitis, which is a liver disease that can affect your health and may affect your life insurance premium and risk class.
Enzyme levels: Checking your enzyme levels can show if there is inflammation around your organs, which could include some cardiac or liver conditions. The results may prevent you from being approved or alter your final life insurance risk group and rate.

How to prepare for a life insurance blood test

The life insurance company or medical examiner may give you instructions on how to prepare for your exam and blood test. Additionally, following these steps may help you get ready for a blood test:

1. Schedule your exam carefully

Try to set your exam for the morning when your body is naturally fasted. Plan a calm time when you won’t be rushed or stressed.
Why? A morning exam provides naturally fasted results, which may improve accuracy in blood sugar and cholesterol readings. Less stress can keep your blood pressure in a normal range.

2. Stay hydrated and eat well

In the days before your test, drink plenty of water and eat balanced meals. Avoid salty, fatty or processed foods that might impact your test results.
Why? Hydration makes blood draws easier and ensures a clean urine sample. Eating balanced meals can improve blood pressure and cholesterol, making results more favorable.

3. Get adequate sleep before your exam

Aim for a full night’s sleep (7 to 8 hours) the night before your exam.
Why? Resting well can stabilize blood pressure and stress levels, support more accurate readings and help you feel ready.

4. Bring relevant medical information and identification

Bring a government-issued ID to confirm your identity, and if possible, carry a list of any medications or key medical history points.
Why? Having these details on hand avoids delays if questions arise during the exam and helps ensure a smooth process.

5. Avoid strenuous activities prior to your exam

Skip intense workouts within 24 hours before your appointment. Light activity, like a walk, is fine.
Why? Intense physical activity can raise blood pressure and heart rate, which could lead to results that don’t reflect your usual health profile.

6. Wear comfortable, lightweight clothing

Choose loose clothing that allows easy access for blood draws.
Why? Comfortable clothing helps you feel at ease and makes it easier for the examiner to complete the process smoothly.

Can I skip a life insurance blood test?

The idea of a medical exam can feel nerve-wracking, but it’s not as scary as it sounds. For those who prefer to avoid the exam altogether, there are life insurance options that might let you skip it. Some companies offer accelerated underwriting, where eligible applicants — based on factors like health history and age — may qualify for traditional coverage without an exam. If guaranteed no-exam options, like simplified issue or guaranteed issue policies, are a better fit for you, keep in mind that they tend to come with higher premiums and lower coverage amounts due to the limited health information required.

If you’re not a fan of needles, you’re not alone. Let your examiner know. They can note your concerns, and understanding this may help make the process smoother and more comfortable for you.

Remember, the life insurance medical exam is designed to be simple and unobtrusive. It’s a quick check that could mean a lifetime of peace of mind. And even if you have health challenges, chances are you’ll still have coverage options — this is about securing care for loved ones, no matter where your health stands today.

Frequently asked questions

Most life insurance companies use medical exams to determine eligibility and pricing for certain types of life insurance policies. However, whether the exam is required and whether it includes a blood test likely depends on a few factors, such as your age, the company you’re working with and the policy type you’re pursuing.
Yes, depending on the type of policy, it’s possible to get life insurance without a blood test. Guaranteed issue policies don’t require a medical exam or even a health questionnaire, making them ideal for those with health challenges. These policies typically offer modest coverage amounts and come with higher premiums due to the unknown health risks involved.

Alternatively, some term life insurance policies with accelerated underwriting allow eligible applicants to skip the exam without impacting premiums. These options can offer significant death benefits, sometimes reaching into the millions, and may be a great fit for those who qualify. Additionally, simplified issue policies often skip the exam but require a short health questionnaire. While these have slightly higher premiums, they offer an accessible route to coverage without the blood test.
There are several substances, foods and more that could impact your blood test results. Here are a few common ones to steer clear of before your exam:
- Tobacco products: Nicotine can raise blood pressure and influence certain test markers, which could affect your rates.
- Marijuana: Both recreational and medicinal use can show up on your test, so check with your insurer if it’s medically prescribed.
- Alcohol: Alcohol affects liver enzyme levels and can lead to dehydration, potentially impacting your test results. Avoid it for at least 24 hours before the test.
- Heavy, greasy foods: High-fat meals may temporarily elevate cholesterol levels, so opt for balanced meals in the days before your test.
Yes, it could be possible to be denied life insurance based on blood test results if they reveal health concerns that increase risk for the insurer. Blood tests check for a range of factors like cholesterol levels, blood sugar, liver and kidney function and the presence of drugs or nicotine. If any serious conditions or risk factors are detected — such as unmanaged diabetes, untreated high blood pressure or signs of organ disease — an insurer may decide not to offer coverage to avoid the risk you present. However, not all conditions lead to outright denial; in many cases, they may adjust your premiums based on your health profile.

For those concerned about potential test results, guaranteed issue or simplified issue policies are options that don’t require blood tests but come with higher premiums and lower coverage amounts.