Select Term Medical
Requirements
Paramedical exams, if required, will be arranged by AFBA at
no additional cost. In most cases, exams may be performed in
the privacy of your home or office. All applicants requesting
Ultra-Preferred or Preferred pricing will require a paramedical
exam regardless of age or coverage amount.
For Standard contribution
applicants residing overseas only, AFBA may accept a copy of
a complete military physical less than twelve (12) months old,
provided it includes blood lipids (long physical with bloodwork/SF88 & SF93
or equivalents). Additional information may be required at the
discretion of AFBA and its underwriter.
Select Term Medical Requirements
| Age |
$100,000 |
$101,000
-
$150,000 |
$151,000
-
$200,000 |
$201,000
-
$250,000 |
$251,000
-
$300,000 |
$301,000
-
$400,000 |
$401,000
-
$500,000 |
| 60-70 |
|
|
|
|
|
|
|
| 50-59 |
|
|
|
|
|
|
|
| 40-49 |
|
|
|
|
|
|
|
| 30-39 |
|
|
|
|
|
|
|
| 20-29 |
|
|
|
|
N/A |
N/A |
N/A |
| |
Complete
Statement of Health (SOH) |
|
| |
Complete
Statement of Health (SOH), Paramedical Exam, Blood Profile
and Urinalysis |
|
| |
Complete
(SOH), Paramedical Exam, Blood Profile, Urinalysis and
Resting EKG |
Click here to read the PDF instructions for Applying
Preferred Checklist Questions
If applying for Preferred pricing, these questions will be asked
during the medical interview. These questions are only one factor
considered in making a determination of eligibility for a preferred
price class. All applicants seeking a preferred price class will
be subject to a paramedical exam, including blood and urine samples.
A final decision regarding the price class will be based on our
underwriting guidelines and experience.
- In the past 24 months, have you used any tobacco products, nicotine gum, nicotine patch, nicotine nasal spray, or similar nicotine-containing products?
- Have you been treated for or been advised to have treatment for the use of drugs or alcohol?
- Do you have a record of conviction for driving while intoxicated (DWI) or driving under the influence of alcohol (DUI) in the last 10 years, or for any moving violations in the last 5 years? (If "yes," list all incidents below, giving the month, year, and offense.)
- Have you been treated for or been advised to have treatment for any of the following:
- Blood pressure?
- Cholesterol?
- Heart disease?
- Diabetes?
- Any cardiovascular disease?
- Cancer (excluding non-melanoma skin cancer)?
- Do you engage in any of the following hazardous activities: aviation; parachuting; hang-gliding; ultralighting; ballooning; gliding; space travel; SCUBA diving below 60 feet; cave, air-supplied or salvage diving; white water rafting or kayaking; auto, motorcycle or motorboat racing or stunting; rock or mountain climbing; bungee jumping?
(If "yes," describe below, giving your level of expertise, frequency of participation, and level of risk. For aviation activities, give purpose of flights, crew position, type of aircraft, and number of hours flown yearly. Do not include flight in regularly scheduled commercial aircraft or any activities performed only pursuant to military, police, fire, or EMS duty.)
- Did either parent die of a heart attack (i.e., myocardial infarction, coronary artery disease) or congestive heart failure before age 60, to the best of your knowledge?
- If 5Star Life is unable to offer you the price class you applied for, will you accept another price class for an additional cost?
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