10 things you need to know about BasicMed

This story was updated Dec. 2, 2024, to reflect changes to the regulation.

Since it went into effect May 1, 2017, nearly 80,000 pilots are flying under BasicMed.

And while considered a “big success” by aviation advocates, many pilots remain confused about BasicMed.

That was evident at EAA AirVenture Oshkosh 2018 where multiple forums held on BasicMed attracted capacity crowds — as well as lots of questions from pilots.

The basics of BasicMed

A general aviation pilot can fly under BasicMed by fulfilling these requirements:

• You must have a current valid driver’s license,
• You must have held a medical certificate that was valid at any time after July 15, 2006,
• You must not have had your most recent application for a medical denied,
• You must complete a physical exam with a physician — it does not have to be an Aviation Medical Examiner —every four years, and
• You must complete an online medical course every two years. Courses are offered by the Aircraft Owners and Pilots Association (AOPA) and the Mayo Clinic.

BasicMed also limits the type of flying you can do:

• Your aircraft must be certified for seven occupants or less,
• You can only fly six passengers, plus yourself as PIC,
• The aircraft is limited to 12,500 pounds takeoff weight,
• Flights can only be within the U.S. and U.S. territories, as well as the Bahamas, which has accepted BasicMed,
• You must fly below 18,000 feet MSL,
• You must fly at 250 KIAS or less,
• You cannot not fly for compensation or hire.

Still interested in flying under BasicMed?

1. New to aviation? You’ll need to get a medical certificate.

“After that, pilots can fly under BasicMed forever, as long as they fly a BasicMed-compliant aircraft and never fly for compensation or hire,” FAA officials note. “Most student pilots will still hold their first medical certificate when they apply for their private pilot certificate.”

2. Age matters.

In looking at whether BasicMed is right for you, your age plays a factor. According to aviation advocates, for pilots over 40, the third class medical is valid for only two years, while under BasicMed you have to visit the doctor every four years. If you are under 40, a third class medical is valid for five years, so it may be a better bet.

Older pilots — say 70 and above — can still fly under BasicMed, but insurance companies may require a yearly exam, rather than every four years as for younger pilots. Your insurance company also may require a third class medical, so check with it before making your decision.

3. It’s OK to still want a third class medical — and you can have a third class medical and BasicMed at the same time.

Many pilots still want a third class medical and it is required if your flying is beyond the requirements for BasicMed.

“You’re supposed to declare whether you are flying under BasicMed or a third class medical,” says Brent Blue, an AME who spoke to a standing room only crowd at Oshkosh. “Although I’m not sure who you are supposed to declare that to.”

4. If you are turned down for a third class medical, you can’t fly under BasicMed.

If you aren’t sure whether you could pass a third class medical exam, do some research. You can call your AME or officials at any of GA’s alphabet groups, such as AOPA or the Experimental Aircraft Association (EAA), and run the facts by them to see if you are going to have a problem.

Aviation advocates also recommend going to an AME or a doctor who is a pilot or is interested in aviation, as he or she may be more willing to help you navigate the system.

5. It’s important to know that expiration dates are different for BasicMed than third class medicals.

While a third class medical expires on the last day of the month, BasicMed expires on the actual date of your last exam.

6. There’s a lot of talk in the aviation community that some doctors don’t want to sign off on BasicMed, fearing liability.

That’s “fake news” according to aviation insiders.

Aviation advocacy groups have worked to educate doctors about BasicMed and you can help further that by educating your own practitioner. Many pilots print out information about BasicMed, including the form the doctor will use, before their appointment to give doctors a chance to familiarize themselves with the process. When making the appointment, make sure to ask for extra time so you can explain everything in detail.

Your doctor still says no?

“If you have a physician like that, go to another doctor,” Blue says.

In fact, if you run into several doctors who say no, just keep looking for one who will say yes.

Blue adds that the BasicMed physical is very similar to physicals truck drivers must get, so if you find a place that does those physicals that’s one way to find another provider.

7. You don’t have to worry about FAA officials looking at your medical records.

All the FAA receives after a BasicMed examination is the proof that you took — and passed — the exam.

“No one can report your records to the FAA unless you release them or they are subpoenaed,” Blue notes.

8. You’ll still need a special issuance — but just once — if you have issues in these three areas: Psychiatric, Neurological and Cardiac.

“You’ll have to jump through some hoops to get the special issuance, but once you get it, then you’re good to go,” Blue notes.

And forget about what required a special issuance before BasicMed.

A lot of pilots continue to question — perhaps finding it hard to believe — that they no longer need a special issuance for many of the conditions that previously required a special issuance and costly tests every year.

“If the condition isn’t on the list, you don’t have to do anything as you’re OK under BasicMed,” Blue told the Oshkosh crowd.

According to FAA officials, you need a special issuance if you “newly develop” or have never held a special issuance for the following medical conditions since the last time you received a FAA medical certificate:

Mental Health

• Personality disorder severe enough to have repeatedly manifested
  itself by overt acts,
• Psychosis,
• Bipolar disorder, or
• Substance dependence within the previous two years.

Neurologic

• Epilepsy,
• Disturbance of consciousness without satisfactory medical
  explanation of the cause (You pass out for an unknown reason), or
• A transient loss of control of nervous system functions without
  satisfactory medical explanation of the cause.

Cardiac

• Myocardial infarction (heart attack),
• Coronary heart disease that has required treatment,
• Cardiac valve replacement,
• Heart replacement.

If you experience a heart attack or one of the other conditions on the list while flying under BasicMed, you will be required to go through the special issuance process one time.

If this happens, aviation advocates recommend you send all the pertinent records, including hospital records, a letter from your doctor, and more, in one package. That way the FAA isn’t coming back to you time and again to get more information.

If the information packet is complete, you could have your special issuance within eight to 12 weeks. If FAA officials have to keep coming back to you for information, it could be much longer.

It’s best to have your AME call the FAA about four to six weeks after the packet is sent to “nudge” them to make a decision, according to Blue.

“The FAA gives most people their special issuances,” he adds.

In fact, the people who are denied make up less than 1% of the total applications for a special issuance. Most denials, according to FAA officials, are because the pilot did not submit the required records.

9. You can continue to fly for charities, such as Angel Flight, under BasicMed.

Be sure to check with each charity you fly for, as some may still require a third class medical.

10. Self-certify is still the name of the game.

“We self-certify our abilities to fly every time we fly,” Blue says. “We’ve done a great job under the new BasicMed rules, so let’s keep it that way.

Like so many other things in aviation — as in life — BasicMed has positives and negatives that need to be evaluated on a case by case basis. You can learn more at the FAA’s website, as well as the websites for AOPA and the Experimental Aircraft Association.