What Is BasicMed?
BasicMed is an alternative to the traditional FAA medical certificate, created by the FAA Reauthorization Act of 2016 and codified in 14 CFR 68. It allows eligible pilots to fly without holding a current FAA medical certificate, provided they meet specific requirements and operate within defined limitations.
Under BasicMed, you visit any state-licensed physician (not necessarily an AME) for a physical examination using the FAA's Comprehensive Medical Examination Checklist (CMEC). The physician completes the checklist, and you complete an online medical education course through the AOPA or Mayo Clinic's approved program. Both must be completed every 48 calendar months.
BasicMed was designed to reduce the burden of the traditional medical certification process for pilots who fly for personal or business purposes in smaller aircraft. It does not replace the traditional medical system — it provides an alternative pathway for eligible pilots.
Traditional Medical Certificates: Class 1, 2, and 3
The FAA issues three classes of medical certificate under 14 CFR Part 67, each with different standards and validity periods. All require an examination by an FAA-designated Aviation Medical Examiner (AME).
Class 1 is required for airline transport pilot (ATP) operations. It has the most stringent medical standards and is valid for 12 months if you are under 40, or 6 months if you are 40 or older. Required for Part 121 and Part 135 operations.
Class 2 is required to exercise commercial pilot privileges. It is valid for 12 months regardless of age. Required for commercial operations where a first-class is not mandated.
Class 3 is the minimum for private pilot operations. It is valid for 60 months if you are under 40, or 24 months if you are 40 or older. This is the most common medical certificate for recreational pilots.
All three classes share basic medical standards for vision, hearing, cardiovascular health, neurological function, and mental health — but the Class 1 standards are more restrictive, particularly for cardiovascular and neurological conditions.
BasicMed Eligibility and Restrictions
To use BasicMed, you must meet all of the following criteria: you must have held a valid FAA medical certificate at some point after July 15, 2006. Your most recent application for a medical certificate must not have been denied, revoked, suspended, or withdrawn. You must not have been diagnosed with certain conditions that are specifically disqualifying under BasicMed.
Aircraft limitations: The aircraft must not exceed 6,000 pounds maximum certificated takeoff weight. You are limited to no more than 6 passengers (5 passengers plus you). Maximum airspeed is 250 knots indicated. Maximum altitude is 18,000 feet MSL.
Operational limitations: BasicMed is valid for operations under Part 91 only. You cannot use BasicMed for Part 121, 135, or other commercial operations. You cannot fly for compensation or hire. If you operate internationally, the destination country must accept BasicMed — many do not.
Disqualifying conditions: Certain medical conditions require a special issuance medical certificate and cannot be addressed through BasicMed. These include specific cardiac conditions (such as myocardial infarction or cardiac valve replacement), neurological conditions (such as epilepsy), and mental health conditions that have required specific FAA review.
When to Choose BasicMed vs Traditional Medical
Choose BasicMed if: You fly for personal or business purposes under Part 91, your aircraft is under 6,000 lbs, you stay below 18,000 feet, and you prefer the convenience of visiting your personal physician rather than an AME. The 48-month validity is also more convenient than the 24-month Class 3 cycle for pilots over 40.
Choose a traditional medical if: You fly commercially (Part 135 or 121), you fly aircraft over 6,000 lbs, you operate above 18,000 feet (Class A airspace), you fly internationally to countries that do not recognize BasicMed, or you are building time toward an ATP certificate and want to maintain a Class 1 or Class 2 medical.
Cost comparison: A BasicMed physician visit is typically $75-$200 with your regular doctor, plus the online course (currently free). A Class 3 AME exam costs $100-$200. A Class 1 exam may cost $150-$300 or more. The cost difference is usually minimal — the primary advantage of BasicMed is convenience and the longer validity period.
Strategic consideration: If you currently hold a valid medical and have no medical issues, maintaining it preserves your options. If you let your medical lapse and later develop a condition, you may face a special issuance process that would not have been an issue during routine renewal. Some pilots maintain a Class 3 and keep BasicMed as a backup.
Mental Health Considerations
Mental health is one of the most complex areas of aviation medical certification. The FAA requires disclosure of mental health conditions, medications, and treatments on both the traditional medical application (FAA Form 8500-8) and the BasicMed CMEC.
Under the traditional system, conditions such as depression, anxiety, ADHD, and PTSD require special issuance authorization. The FAA evaluates these on a case-by-case basis. Some SSRI antidepressants are now approved under the FAA's SSRI pathway (specifically sertraline, fluoxetine, citalopram, and escitalopram at approved dosages), but the approval process involves a waiting period and ongoing monitoring.
Under BasicMed, your examining physician evaluates your mental health as part of the CMEC. The physician has the authority to determine whether your condition is compatible with safe flight, but certain conditions still require FAA special issuance regardless of the BasicMed pathway.
The FAA is actively working to reduce stigma around mental health in aviation. If you have a mental health condition, consult an aviation medical examiner or AOPA's medical services before making decisions about which pathway to pursue. Hiding a condition is both dangerous and a violation of federal regulations.