Is BasicMed Right for You?

BasicMed is the soon-to-be adopted medical ­certification standard for private pilots written into a new Part 68 of the Federal Aviation Regulations. The FAA in January adopted the rules after a long, and at times contentious, fight with aviation groups that had for years pressed for third-class medical reform. The revised regulations that take effect on May 1 will permit many thousands of pilots to skip their periodic visits to an aviation medical ­examiner (AME) and instead take a free online aeromedical factors course every two years and visit their personal physician for a checkup ­every four years.

Proponents say the changes will help stem the decline in GA activity while also making life much ­easier for holders of ­special-issuance medicals. The Aircraft Owners and ­Pilots ­Association and ­Experimental ­Aircraft Association led the fight for BasicMed, which involved a ­Herculean effort on Capitol Hill and required a literal act of Congress to become a reality. The resulting legislation isn’t perfect, as detractors are quick to point out, but neither is it the abject failure that some pilots make it out to be. Like most things involving big government bureaucracies, BasicMed is a compromise. Here’s what the new rules mean to you.

Starting on May 1, 2017, private ­pilots who have held valid medical certificates anytime in the 10 years prior to July 15, 2016, may opt to forego the third-class medical process and instead fly under BasicMed ­standards. The 10-year look-back period applies to both regular and special-issuance medicals. Pilots whose most recent medical certificates were revoked, suspended, withdrawn or denied will need to obtain a new medical certificate one time before they can operate under the reforms. Pilots who have never held an FAA medical certificate, including student pilots, will need to obtain one as well.

Pilots who opt to go the BasicMed route must hold a valid U.S. driver’s license and visit a state-licensed physician once every four years for a “comprehensive” checkup. They’ll obtain a signed form from their doctor they must keep in their logbooks that essentially certifies the applicant is fit to fly. The form can be paper or digital, and it doesn’t need to be carried with you when you fly. No details of the exam will be reported to the FAA. You’ll also need to take an online aeromedical factors course every two years, which will be offered for free by AOPA. There is a quiz at the end that you can keep taking until you pass. As part of that process, you’ll agree to let the FAA check the National Driver Register for DUI and other motor vehicle offenses. Pilots who are clinically diagnosed with mental health and other medical conditions, ­meanwhile, must certify that they are under the care of a doctor once every two years.

Several operating limitations apply under BasicMed, but they are actually less restrictive than originally envisioned. You can fly any aircraft that has a maximum certified takeoff weight of 6,000 pounds or less and is not authorized by its type certification to carry more than six people. There is no limit on engine type or power, number of engines or gear type; you can operate day or night, both VFR and IFR; you can fly at altitudes below 18,000 feet and speeds under 250 kias. You may not fly for compensation or hire, although flight instructors acting as PIC can operate under BasicMed (designated pilot examiners, however, must still hold a ­medical certificate).

You’ll also be limited to flying within the United States, since the ­International Civil Aviation Organization doesn’t recognize BasicMed. You can act as a safety pilot under BasicMed only if you’re acting as PIC while performing the duties of a ­safety pilot. The statutory language prescribing BasicMed says it only applies to pilots acting as PIC. Therefore, BasicMed cannot be exercised by safety pilots who are not acting as PIC but are required crew members. If you hold both a third-class medical and BasicMed approval, you can switch back and forth between the operating limitations of either, but you can’t do so during a flight.

A couple of caveats about aircraft that may be operated under BasicMed: Any aircraft is eligible, not just type-certified airplanes. That means helicopters and Experimental airplanes are included. The aircraft, however, must have been certified with six or fewer seats. This is an important point, since it means that an airplane like the Piper ­Cherokee Six that was type-certified to have as many as seven seats doesn’t meet BasicMed requirements, even if your airplane has only six seats. A workaround would be to seek a supplemental or amended type certificate for the aircraft authorizing no more than six seats. The same process can be used in aircraft with certified takeoff weights over 6,000 pounds to bring them into compliance with BasicMed.

A concern many pilots have about BasicMed centers on the requirement that they visit their personal physician every four years. Some doctors have said they won’t sign the FAA form due to liability concerns, although this could change once BasicMed is better understood in the medical community. The remedy, of course, is to find a doctor who will sign the form, which could turn out to be your AME.

For private pilots under the age of 40, who are required to obtain a third-class medical certificate only once every five years, BasicMed might seem like a hassle since it requires more-frequent doctor visits and the online course. That’s a valid point, and many younger pilots will likely opt to continue obtaining third-class medicals. Once you’re over 40, however, BasicMed doubles the time interval between seeing a physician from two years to four, plus it should be less costly because medical insurance typically covers physicals but not third-class medical exams. If you have any concern that you might not pass your third-class medical exam, BasicMed can eliminate the risk that your medical will be denied or you’ll need to apply for a special-issuance medical.

When the push for third-class medical reform began in earnest five years ago, pilots held out hope that a driver’s license medical, similar to what is available to sport pilots, could be adopted for use by private pilots. The data showed that sport pilots were no more likely to suffer an inflight medical emergency than private pilots holding third-class medicals. Only a small percentage of accidents — ­under 1 percent — were the result of medical impairment, anyway. And so began a monumental fight to reshape the regulations that culminated last summer with Congress directing the FAA to adopt third-class medical reform.

The FAA didn’t craft BasicMed, Congress did in July 2016 with legislation voted on by the House and the Senate. In order to secure the needed votes for the bill to pass, compromise was necessary. It didn’t help matters that the Air Line Pilots Association at the 11th hour voiced concerns about sharing the skies with “medically unfit pilots,” ­leading to tweaks to the rules such as the 10-year look-back period adopted in the final version.

The biggest beneficiaries of the new rule, of course, will be pilots flying on special-issuance medicals. If you’ve had a special-issuance medical within the 10-year look-back period and your medical status is unchanged, you should be able to fly under ­BasicMed 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, you will have to apply for a one-time special issuance for that condition.

“The benefit of BasicMed to special-issuance medical holders can’t be understated,” says AOPA President Mark Baker. “Now instead of dealing with the FAA, you can make decisions about your health with your personal doctor. Instead of spending thousands of dollars for unnecessary stress tests that might cause you to give up flying, your own doctor can assess your health in ways that make sense and cost you a lot less money.”

Under the FAA’s existing regulations, Baker said, pilots flying with special-issuance medicals are expected to repeat the process every year. Often, they must send enormous amounts of documentation to the FAA for evaluation, unnecessarily repeat expensive medical tests for health conditions that are unchanged, and can spend weeks or months grounded while they wait for the FAA to review their file. BasicMed eliminates these costs and delays by putting medical care decisions into the hands of pilots and their doctors rather than the FAA. This fact alone makes BasicMed a huge win for pilots.

When you visit your personal doctor for your exam, he or she must sign a four-page form that includes a one-page medical checklist with items very similar to the third-class medical exam. AOPA has crafted “Fit to Fly” tools on its website to assist doctors who may have questions about the process. Although BasicMed uses the term “state-licensed physician,” a nurse practitioner can perform the exam as long as a doctor signs the form. Some pilots have balked that BasicMed calls for potentially embarrassing checks of anatomy, but these are actually requirements of a third-class medical exam today. If you’re concerned, our advice is to schedule your BasicMed exam with an AME.

At the time of this writing, the exam form was still under review by the Congressional Office of Management and Budget, but it was expected to be available well in advance of the BasicMed start date. There had been some concerns that an executive order issued by President Trump dealing with new federal regulations might delay BasicMed’s start date, but the FAA says the reforms are expected to take effect on schedule.

Another concern that has been raised about BasicMed is what effect it may have on the light-sport aircraft industry. When manufacturers of light-sport aircraft began designing small, two-seat airplanes to take advantage of the relaxed rules a decade ago, they did so with the knowledge that a major inducement to fly an LSA was the driver’s license medical offered through the Sport Pilot certificate. While it remains to be seen if sport pilots suddenly flock to larger and more capable airplanes once BasicMed takes effect, the reality is likely to be that a small percentage of pilots turn away from the light-sport market. LSAs are about pursuing fun over utility, and the vast majority of sport pilots fly these light two-seaters because they suit their needs and budgets. And the fact that the Sport Pilot medical process remains less ­restrictive is certain to make a percentage of pilots think twice before stepping up to BasicMed.

So, is BasicMed right for you? That depends on several factors. If you’re young and healthy, you might be better off obtaining a third-class ­medical once every five years and shifting to BasicMed later in life. If you think you might want to fly outside the United States, perhaps on a vacation to the Caribbean, Mexico or Canada, or if you want to fly higher and faster than BasicMed allows, a third-class medical is the answer. But if you fit in the sweet spot where BasicMed makes sense — that is, you’re over 40, don’t fly for hire or outside the country, and fly below 18,000 feet and 250 kias in airplanes weighing less than 6,000 pounds and with six or fewer seats — it’s a great option. And if you require a special-issuance medical, it might be your only realistic choice.