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Is a physical exam required for health insurance?

Keep in mind...
  • Most health insurance does not require a physical exam
  • Life insurance does require a physical exam
  • You are responsible for paying for any required physical exam

With all the regulations and laws surrounding the subject, it can be difficult to know what you have to do to get health insurance. There is a large variety of health insurance plans that offer different levels of coverage and different deductibles. Some of these plans are provided by an employer to their employees as a benefit for their continued employment.

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Other health insurance plans are purchased individually by a person on their own and do not involve their employer in any way. Whichever the case, sometimes it is hard to know what is required in order to obtain health insurance.

Personal Health Insurance

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Personal health insurance is also known as individual health insurance. It is not part of a group policy and thus can be more easily adjusted to fit those who are on it. Some employees choose to opt out of employer-sponsored health insurance plans and look for insurance independently personal health insurance addresses. For whatever reason, the insurance provided by their employer simply does not suit their needs or their budget.

Individual health insurance plans are also made to insure family members like spouses or kids. Children may have to be claimed as dependents, but the policy will likely accept them as such.

Life Insurance

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Life insurance is one of the major forms of health insurance. Life insurance protects against monetary loss that would happen due to the premature death of an insured person. As one of the most common types of health insurance, it is important to know what life insurance is and how physical exams might or might not affect it.

A beneficiary must be named on the life insurance and they acquire the proceeds, which protects them from any financial consequences the insured person’s death might have on them. This benefit is called a death benefit and a life insurer pays it after considering the insured’s completed premium payments.

How does life insurance work?

Life insurance operates under the premise that it will award a financial compensation known as a benefit to your beneficiaries if you die. The benefit is only awarded if you as the policyholder pay your monthly premium.

In the event that others depend on your income for their financial security, life insurance is a good idea.

Even without people who are dependent on you financially, life insurance will help pay any bills related to your passing. So it is still a good idea for those who are unmarried or single.

Does Life Insurance Require a Physical Exam?

The majority of health insurance policies do not require a physical exam. Despite the many regulations involved with the health care industry, that is not one of them. However, life insurance is sometimes different depending on certain factors.

Quite a few life insurance companies do need you to undergo a physical exam. This is to see if you are eligible for their coverage. This can vary based on your health, age, the requirements of the insurance company, and how much life insurance you are interested in purchasing.

Why does life insurance require a physical exam?

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As stated previously, the main purpose of a physical exam for life insurance is to determine whether or not you qualify for their coverage. A life insurance company will examine the results of your physical exam to figure out if they should offer you life insurance and what sort of health risks you have.

Who pays for the physical exam?

In the event that a physical exam is considered necessary by the insurance company, who is responsible for paying for it is certainly a valid concern. You might think that the insurance company would pay for it since they are the ones who decided that it is necessary. However, it is the insured person who must handle the cost of the medical examination.

Even though life insurance companies are generally the ones who require physical exams, it is not a guarantee. You might not have to get one due to various factors.

Guidelines for Exemption from Physical Exams

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Earlier, it was mentioned that life insurance companies might not necessarily require a physical exam in order to determine your eligibility for life insurance. They consider certain factors when making this decision. One of those factors is your age.

Obviously, as you get older, the insurance company is taking a greater risk by insuring you. The health history attributed to you and how much life insurance you are looking to get are also factors considered in their decision.

Health Insurance and Physical Exams

So, we have covered that physical exams are often required for consideration when you apply to get life insurance. However, this is more of an anomaly than the general rule of health insurance. Most health insurance companies do not require you to undergo a physical exam as part of their requirements.

Only life insurance will want you to undergo a physical exam so that they can evaluate your health and determine your insurance rates. Other health insurance providers will generally not ask for this.

How do life insurance companies use the information?

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Life insurance companies collect quite a bit of personal medical data in the midst of your physical exam. They first utilize this information to see if you are eligible for their life insurance coverage. Following this, the insurance company will use it to determine your health risk, something that directly impacts the cost of your coverage.

Applicants with higher risks typically receive coverage at higher costs. This is simply because the insurance company itself is taking more of a risk in insuring such a person.

Comparing Health Insurance

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Comparing health insurance is a vital step in making sure that you acquire the necessary coverage and benefits while also not going over your budget. Some plans are cheaper but do not give you benefits you need and others are too expensive to consider. You might know the four ‘metal’ categories for health insurance plans, but those are completely unrelated to the quality of care.

It is crucial to consider both your monthly premium and deductible when examining a plan. Since you must pay both out of pocket, they are central components to any health care plan. Some plans allow you to visit any doctors or facilities while others restrict your access to those inside the network.

Answering the Question

In a general sense, the answer to the question “Is a physical exam required for health insurance?” remains a firm no. This might not be the case only when one examines life insurance, which must evaluate individuals and adjust their coverage accordingly. For all other types of health insurance, a physical exam is almost certainly completely unnecessary for coverage.

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