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Third Class Airman Medical ReformBasicMed FAQs

BasicMed and AOPA's Fit to Fly

Third class medical reform is here and the FAA now calls it BasicMed. It's a big victory for the general aviation community and something that AOPA worked years to achieve. But it’s also a complex issue and we know you have questions. That's why we've developed a suite of online resources called Fit to Fly to help you make the most of BasicMed. Here are our answers to the most common questions we’re being asked about the FAA rule.

Are we there yet?

The FAA Extension, Safety, and Security Act of 2016 was signed into law in July of 2016 and the FAA has named the new rules BasicMed and set May 1, 2017 as the day the regulations will be effective.

In the meantime, pilots need to continue to comply with the current medical certification requirements in order to fly.

Will medical reforms expire?

No! Neither the federal law nor the new rules contain an expiration date.

Who can fly under these reforms?

Hundreds of thousands of pilots can potentially fly under BasicMed. Under the reforms, pilots who have held a valid medical certificate any time in the decade prior to July 15, 2016 may not need to take another FAA medical exam. The 10-year lookback period applies to both regular and special issuance medicals. Pilots whose most recent medical certificate was revoked, suspended, withdrawn, or had his or her most recent application for a medical certificate denied will need to obtain a new medical certificate (regular or special issuance) before they can operate under the reforms. Individuals who have never held an FAA issued medical certificate, such as new student pilots, will need to go obtain an FAA issued medical certificate (regular or special issuance) one time only.

After meeting the initial requirements to fly under the reforms, pilots will need to visit a state-licensed physician at least once every four years and take the free online medical education course on aeromedical factors every two years. The course will be available for free on AOPA’s website.

The course is just one of a range of resources for pilots and physicians that AOPA is launching to help people take full advantage of BasicMed. We’re calling them our “Fit to Fly” resources and they include an interactive tool that helps you determine if you qualify for BasicMed and other important information for you and your doctor.

What will I have to do to take advantage of these new regulations?

Once you meet the basic qualifications for BasicMed, you’ll have to meet several requirements to be qualified to fly under the new reforms.

At least once every four years, you’ll need to visit a state-licensed physician. At the visit, you’ll need to provide your physician with an FAA-generated checklist, and your physician will need to affirm that your physician discussed all items on the checklist with you during the examination, discussed any medications that you are taking that could interfere with your ability to safely operate an aircraft or motor vehicle, and performed an examination that included all of the items on the checklist. Your physician will also certify that he or she is not aware of any medical condition that, as presently treated, could interfere with your ability to safely operate an aircraft. You will then need to include the completed checklist in your logbook. You do not need to report the outcome of the visit to the FAA unless you are specifically requested to do so.

Every two years, you’ll also need to take online medical education course in aeromedical factors and keep the certificate of completion in your logbook. The training is free and will be available through the AOPA Air Safety Institute. At that time you’ll need to provide the FAA with some of the same certifications you do today, such as an authorization for the National Driver Register to provide your driving record to the FAA, and a statement that you understand that you cannot act as a pilot in command, or any other capacity as a required flight crew member, if you know or have reason to know of any medical condition that would make you unable to operate the aircraft in a safe manner.

AOPA has an interactive tool to help you see if you may qualify for BasicMed as well as a suite of other resources for pilots and physicians.

What operating limitations will apply to pilots flying under the reforms?

The new rule only allows Pilots to fly certain aircraft that are operated pursuant to several conditions.   The aircraft must meet the following requirements:

  • The aircraft is authorized under Federal law to carry not more than 6 occupants; and 
  • The aircraft has a maximum certificated takeoff weight of not more than 6,000 pounds.
    The pilot must operate the aircraft covered in accordance with the following flight conditions:

The aircraft is not carrying more than five (5) passengers;

  • At an altitude not more than 18,000 feet MSL; 
  • At an indicated air speed not exceeding 250 knots;
  • VFR or IFR in qualified aircraft if appropriately rated;
  • Not for compensation or hire, including that no passenger or property on the flight is being carried for compensation or hire; and
    Within the United States (unless authorized by the country in which the flight is conducted).

What will the checklist for the medical exam involve?

The checklist will have two parts—questions to be answered by the pilot in advance of the exam and a list of items for the doctor to include in the examination. The questions will be similar to those asked on the standard third class medical application and include identifying information like name and address, date of birth, a short medical history and listing of current medications, and information about whether you’ve ever had an FAA medical certificate denied, suspended, or revoked. Just as you do now, you’ll have to affirm that your answers are true and complete and that you understand you can’t fly if you know or have reason to know of any medical deficiency or medically disqualifying condition.

The second part contains a list of items for your physician to cover during the examination. The items are similar to those covered in an FAA medical certification exam and include:

Head, face, neck, scalp Nose, sinuses, mouth, throat Ears and eardrums
Eyes Lungs and chest Heart
Vascular system Abdomen and viscera Anus
Skin G-U system Upper and lower extremities
Spine, other musculo-skeletal Body marks, scars, tattoos Lymphatics
Neurologic Psychiatric General systemic
Hearing Vision Blood pressure and pulse

Your physician will exercise his or her discretion to address any other medical conditions identified in the exam and determine if additional tests are needed. Your physician will need to affirm that he or she has performed an examination and discussed all the items on the FAA checklist, including medications, with you. Your physician will also have to affirm that he is unaware of any medical conditions that, as presently treated, could interfere with your ability to safely operate an aircraft.

Doesn't the checklist mean that this is really just the same as a third class medical exam?

No. The current third class medical process requires the doctor to note whether a patient’s condition is “normal” or “abnormal” and explain any abnormal findings. Under BasicMed, the physician is directed to conduct a medical examination and “address, as medically appropriate, any medical conditions identified.” In addition, the results of the exam are not sent to the FAA. Instead, the pilot will keep the completed checklist in his or her logbook and provide it to the FAA only if requested.

Is it out of the ordinary for doctors to be asked to sign this kind of a form?

Doctors are often asked to affirm that a patient is medically fit for a specific job or activity. Many physicians are willing to administer such exams. To help make doctors more comfortable with the requirements, AOPA is working with medical organizations and physicians groups to provide educational materials and information about what the checklist requires and a doctor’s role in providing patients with these types of exams.

Where can I get a copy of the checklist for my doctor?

The FAA should make applicable checklist available closer to May 1, the day the regulations are effective.

What is the best way to educate my doctor about the checklist before asking him/her to sign it?

AOPA has resources for physicians available online and we are developing additional materials to help doctors understand the regulations and their responsibilities. But the pilot also needs to be ready for the conversation and a good way to do that is to explore AOPA’s online suite of Fit to Fly resources or contact the AOPA Pilot Information Center at 800/USA-AOPA (872-2672) Monday through Friday, 8:30 a.m. to 6 p.m., Eastern time or email [email protected].

Can I go to any doctor for the general medical exam required every four years? How will the FAA know that I complied with that rule?

The new rule says that the comprehensive medical exam must be conducted by a state-licensed physician. The FAA notes that “all States license medical doctors (M.D.s) and doctors of osteopathic medicine (D.O.s) as physicians, although Federal and some State laws may permit the licensure of other persons, such as doctors of dental surgery (D.D.S.) as physicians. While the FAA expects that a specialist physician, (e.g., D.D.S., dentist, podiatrist) who does not also hold an M.D. or D.O. would not have the breadth of training to conduct a medical exam as required in this rule, the FAA will rely on each State-licensed physician to determine whether he or she is qualified to conduct the medical exam[.]” To demonstrate compliance, just make a note of the examination in your logbook and keep the completed checklist in your logbook. ” To demonstrate compliance, just keep the completed checklist in your logbook (if you use an electronic logbook, you must keep a clearly legible electronic copy in that logbook). There’s nothing to report to the FAA unless specifically requested. AOPA recommends you have a doctor who has the best knowledge and history of your health so you both can make a proper determination of your medical fitness to fly.

Where can I find the online medical education course?

The online medical education course will be available through the AOPA Air Safety Institute.

How much does the course cost?

The course will be free of charge and you do not need to be an AOPA member.

How long will it take? What happens if I can’t finish it in one sitting?

It will take about an hour to complete the online course. You can save your progress and return to the quiz, but you won’t be legal to fly under the reforms until it is completed and you have received the proof of completion.

Once I complete the online medical course, what proof do I need?

You will receive an online certificate of completion. You’ll need to print it out and keep it in your logbook.

Can I act as a safety pilot for flight in simulated instrument conditions under BasicMed if I do not hold a medical?

Only if you are acting as the safety pilot and the PIC. If you are not acting as PIC in this scenario, then you are a “required crewmember” who must possess a valid medical certificate. Since BasicMed only applies to the pilot acting as PIC, it does not apply to required crewmembers.

I am taking a medication that is currently on the disallowed list. Once the new rule become effective, can I fly and take the non-allowed medication?

It depends. When you visit your physician for the BasicMed examination, the checklist that you and your physician complete will list any prescription or non-prescription medication that you currently use, as well as information such as the medication name and dosage. Your physician will then address, as medically appropriate, any medications the individual is taking and discuss the medication’s potential to interfere with the safe operation of an aircraft or motor vehicle. Certain medications are not safe to be used at all while flying and others require a reasonable waiting period after use. Pilots, in discussion with their physician, should consult available aeromedical resources to understand potential flight hazards associated with any medications being taken, such as whether the underlying condition the medication is being taken for makes flight unsafe, or to understand side-effects that may be unnoticeable before flight but could impair the ability of a pilot to make sound decisions. In addition to the BasicMed rules, pilots taking medication must also comply with existing Federal Aviation Regulations, such as the self-grounding requirements of FAR 61.53 and FAR 91.17’s prohibition on operations while using any drug that has affects contrary to safety. AOPA’s online medical education course will include medication considerations when evaluating you fitness to fly. AOPA is also continuing to work with the FAA concerning the use of certain medications under BasicMed rules.

I understand I will need to get a one-time special issuance medical if I have certain medical conditions. What are those conditions?

The conditions are described in the legislation and are limited to an established medical history of the following:

Cardiovascular: myocardial infarction (heart attack); coronary heart disease that has required treatment; cardiac valve replacement; and heart replacement. Neurological: epilepsy; a transient loss of control of nervous system functions without satisfactory medical explanation of the cause; and disturbances of consciousness without satisfactory medical explanation of the cause.

Mental Health: personality disorder that is severe enough to have repeatedly manifested itself by overt acts; psychosis defined as a case in which an individual has manifested or may reasonably be expected to manifest delusions, hallucinations, grossly bizarre or disorganized behavior, or other commonly accepted symptoms of psychosis; bipolar disorder; and substance dependence within the previous two years as defined in FAR 67.307(a)(4).

Pilots who have a clinically diagnosed mental health or neurological condition will be required to certify every two years that they are under the care of a state-licensed medical specialist for that condition. Details of how that certification process will work have not yet been determined.

Pilots with a cardiovascular condition will still need to get a one-time special issuance, but successful completion of a clinical evaluation will satisfy the process for getting an Authorization for Special Issuance of a medical certificate with no mandatory waiting period.

How does this help me if I'm on special issuance?

If you have had a special issuance medical within the 10-year lookback period and your medical status is unchanged, you should be able to fly under the exemption provided you meet all the other qualifications, including being under the treatment of a physician for your medical condition. If you develop a new condition that requires a special issuance medical certificate you will have to apply for a one-time special issuance for that condition.

What if my regular or special issuance medical expires before the law takes effect?

If your regular or special issuance medical certificate expires before the new regulations take effect (May 1, 2017) and you want to continue flying, you will need to renew it in order to keep flying while the FAA completes its rulemaking process. Whether or not you choose to renew your medical certificate to cover the gap period, you will be allowed to fly as soon as the new rules take effect, provided you had a valid medical at some time after July 14, 2006 and you meet other requirements under the new legislation. To be clear, the 10-year timeframe is based on the expiration date, not the issuance date, of your last medical certificate.

What if my regular or special issuance medical expires before the new regulations take effect?

If your regular or special issuance medical certificate expires before the new regulations are effective on May 1 and you want to continue flying, you will need to renew it in order to keep flying while the FAA completes its rulemaking process. Whether or not you choose to renew your medical certificate to cover the gap period, you will be allowed to fly as soon as the new rules take effect, provided your medical expired within the 10-year window following enactment of the legislation and you meet other requirements under the new legislation. To be clear, the 10-year lookback is based on whether you held a regular or special issuance medical certificate at any point in the 10 year period, not the issuance date, of your last medical certificate.

Will this affect me if I still want to fly as a sport pilot?

Not at all. You may still fly light-sport aircraft (LSA) with at least a sport pilot certificate and a valid driver’s license, in accordance with the existing Federal Aviation Regulations.

Can I fly under these rules as a CFI?

Yes, the FAA final rule for BasicMed does apply to the person acting as PIC, including flight instructors. As an example, the FAA has noted that flight instructors meeting the requirements of the new rule may act as PIC while giving flight training without holding a medical certificate, regardless of whether the person receiving flight training holds a medical certificate.

Do the new rules include twin-engine operations?

As long as the twin engine aircraft is not authorized under Federal law to carry more than 6 occupants and has a maximum certificated takeoff weight of not more than 6,000 pounds, you will be able to fly a twin-engine aircraft as long as you operate in accordance with the additional conditions in the new rule, listed above.

Will I be able to get insurance if I fly under these new rules?

AOPA went straight to the source and surveyed our insurance carriers. We learned that, nearly across the board, medical reform should have no negative impact on insurance coverage. What most of our carriers told us is that if a pilot is in compliance with FAA regulations, then in many cases that pilot may be in compliance with their company insurance requirements as well.

Nevertheless, as each insurance policy may be different, the best course of action is to read your policy and consult with your insurance company.

What if I just want to keep getting a third class medical certificate every two or five years?

You can do that. Just keep doing what you’re doing, including making regular visits to the AME, renewing your medical certificate as required, and complying with the current Federal Aviation Regulations that apply to your medical certificate.

What if I want to fly an aircraft with more than five passengers or that weighs more than 6,000 pounds, fly faster than 250 knots, or fly at altitudes above 18,000 feet msl?

If you want to exercise privileges outside of those established under BasicMed, you’ll need to keep going through the medical certification process to obtain the appropriate class of FAA issued airman medical certificate. That means visiting an AME for your medical exam and renewing your medical certificate as needed.

My aircraft has a MTOW above 6,000 lbs. Can I carry less fuel on board to keep below 6,000 lbs. and then fly under the new rule?

No. A "covered aircraft" which conforms to the limitations of the new rule is defined as one that is authorized under Federal law to carry not more than six occupants; and has a maximum certificated takeoff weight of not more than 6,000 pounds.

My aircraft has 7 seats including the pilot in command. Can I fly it under the new rule if I only carry five passengers?

No. A "covered aircraft" which conforms to the limitations of the new rule is defined as one that is authorized under Federal law to carry not more than six occupants; and has a maximum certificated takeoff weight of not more than 6,000 pounds.

My aircraft is capable of flying at 300 kts. Can I fly it under the new rule?

Yes, if you do not exceed 250 knots indicated airspeed. The aircraft must be operated as follows: the covered aircraft is not authorized to carry more than 6 occupants (and is not carrying more than the pilot and five passengers) and has a maximum certificated takeoff weight of not more than 6,000 pounds. The individual is operating the covered aircraft under visual flight rules or instrument flight rules. Also, the flight, including each portion of that flight, is NOT: carried out for compensation or hire, including that no passenger or property on the flight is being carried for compensation or hire; at an altitude that is more than 18,000 feet above mean sea level; outside the United States, unless authorized by the country in which the flight is conducted; or at an indicated air speed exceeding 250 knots.

Does the new rule apply to aircraft besides airplanes, for example, helicopters?

Yes. The rule makes no distinction among category or class of aircraft. As long as the aircraft meets the provisions for “covered aircraft” you can fly it in accordance with limitations in the new rules, listed above.

What if I want to fly outside of the United States?

You can fly under the medical reform provisions outside of the United States only if authorized to do so by the country in which the flight is conducted. It’s a good idea to check with AOPA or the aviation authority for the country in which you intend to fly to determine what conditions you will need to meet to fly internationally.

Will I still need to get a flight review?

Yes. The reforms will not affect the rules for flight reviews.

What do I have to carry with me in order to exercise the new rule?

You’ll need to carry a valid state-issued driver’s license (and comply with all medical requirements or restrictions on that license) and your pilot certificate. You’ll need to have (but not necessarily carry) a logbook containing the completed medical examination checklist as well the certificate showing your most recent completion of the online medical education course that will be available from the AOPA Air Safety Institute.

I had a standard third class medical exam within the past four years – could it count as the BasicMed exam?

No. The BasicMed regulations require an exam by a state licensed physician performed in accordance with the new rules, and the completion of the medical examination checklist.

Should I plan to surrender my current unexpired medical certificate in order to fly under BasicMed to avoid possible future action by the FAA if something happens and my current medical application has not yet expired?

You are not required to surrender your valid medical certificate to fly under BasicMed. If you hold a valid medical certificate and also meet the requirements of BasicMed, you can choose to fly under the BasicMed rules. However, even if a pilot chooses to operate under BasicMed rules and is not exercising the privileges of his or her medical certificate, the FAA still has the authority to pursue enforcement action if there is evidence that the pilot does not meet the medical certification standards for that medical certificate. Generally speaking, a pilot who knows or has reason to know of any condition that would make them unsafe for flight must ground themselves whether they hold a medical certificate or fly under BasicMed. So, before you surrender any airman certificate, consider contacting an attorney experienced in aviation-related legal matters or AOPA’s Pilot Protection Services program.

I had a third class medical in January 2016 that is valid until 2018. When the new regulations become effective, will my AME medical meet the requirement for a physical exam every four years and I will be eligible until 2020 when I would need a physical exam with my own doctor?

Your previous third class medical exam will not meet the requirement for the physical exam.

I have one of the three conditions listed as requiring a one-time special issuance medical (cardiac, neuro, psych). I held a special issuance medical a few years ago, do I have to get another one in order to use the new rule?

Probably not. The law states that you must have held a special issuance for one of the specific conditions named in the language, so if your most recent medical was not denied and you have held a special issuance for that condition previously at any point since July 15, 2006, you should be eligible under the new regulations. It would be a good idea for you to call the AOPA Pilot Information Center at 800/USA-AOPA (872-2672) Monday through Friday, 8:30 a.m. to 6 p.m., Eastern time or email [email protected]. For a more in-depth review, consider enrolling in AOPA’s Pilot Protection Services program.

I've still got questions, now what?

We’ve tried to answer the most common questions our members are asking. We’ll keep this page updated as we get new information. In the meantime, feel free to contact the AOPA Pilot Information Center at 800/USA-AOPA (872-2672) Monday through Friday, 8:30 a.m. to 6 p.m., Eastern time or email [email protected]. For a more in-depth review, consider enrolling in AOPA’s Pilot Protection Services program.

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