BasicMed Explained: What Pilots Need to Know

What Is BasicMed?

If you've been flying for a while, you know the drill: every few years, you sit down with an Aviation Medical Examiner (AME), go through the exam, fill out MedXPress, and hope everything clears without a hitch. For many pilots, the traditional FAA medical certification process works fine. But for others — especially those managing chronic conditions, taking medications, or simply looking for a simpler path — the process can be stressful, expensive, and time-consuming.

Enter BasicMed. Enacted by Congress on July 15, 2016, as part of the FAA Extension, Safety, and Security Act (FESSA), BasicMed provides an alternative pathway that allows eligible pilots to fly certain aircraft without holding a current FAA medical certificate. Instead of going through the traditional AME process, pilots complete a medical education course and visit any state-licensed physician for a comprehensive exam.

Since its launch in May 2017, over 60,000 pilots have opted into BasicMed — and that number continues to grow. But is it right for you? Let's break it down.

The History: How BasicMed Came to Be

The seeds of BasicMed were planted with the creation of the Sport Pilot certificate. Sport Pilots were the first to fly powered aircraft with nothing more than a valid driver's license — no FAA medical required. The catch? Significant restrictions: two-seat aircraft only, VFR, below 10,000 feet, under 120 knots, no Class B airspace, and no flying for hire.

In 2011, the EAA and AOPA began petitioning the FAA to extend a similar driver's license medical concept to replace the Third-Class medical certificate. Their argument was straightforward: the data from Sport Pilot operations showed no meaningful increase in medical incapacitation events. If it was safe enough for Sport Pilots, why not expand it?

After two years of working with the FAA and getting little traction, AOPA and the EAA took their case to Congress. The result exceeded expectations. When the law passed in 2016, BasicMed covered more than the original proposal — allowing aircraft with up to six seats, operations up to 18,000 feet, IFR or VFR, and speeds up to 250 knots.

Who Can Use BasicMed?

Not every pilot is eligible. To fly under BasicMed, you must meet all of the following requirements:

• Hold a valid U.S. driver's license — This serves as your baseline medical qualification.
• Have held an FAA medical certificate issued after July 14, 2006 — If you've never held one, or your last one expired before that date, you'll need to obtain a one-time FAA medical from an AME first.
• Your most recent medical certificate was not revoked, suspended, or withdrawn — And your most recent application must not have been denied. If either applies, BasicMed is not available until you first obtain a new Special Issuance or regular medical certificate.
• Complete an approved online medical education course — The FAA-approved course (available through AOPA and other organizations) covers aeromedical factors and must be retaken every 24 calendar months.
• Undergo a comprehensive medical examination by a state-licensed physician — This doesn't have to be an AME. Your regular doctor can perform the exam, using the FAA's Comprehensive Medical Examination Checklist (CMEC). This exam must be completed every 48 calendar months (4 years).

Aircraft and Operating Limitations

BasicMed comes with specific restrictions on what you can fly and how you can fly:

• Aircraft weight: Maximum authorized takeoff weight of 6,000 lbs.
• Seating: No more than 6 seats.
• Altitude: Cannot fly above 18,000 feet MSL.
• Speed: Cannot exceed 250 knots indicated airspeed.
• Passengers: Maximum of 5 passengers.
• Compensation: Cannot fly for compensation or hire (most Part 91 operations are fine).
• Location: Operations must be within the United States unless authorized by the country being flown to. (Note: some countries have begun accepting BasicMed, but many have not.)

For the vast majority of general aviation pilots flying piston singles, light twins, or even some light turboprops, these restrictions are not limiting at all.

The Comprehensive Medical Examination Checklist (CMEC)

The physician exam under BasicMed uses the FAA's CMEC — a standardized checklist that covers the major body systems. Your physician will review:

• Medical history and current medications
• Neurological function
• Cardiovascular health (including blood pressure)
• Mental health screening
• Vision and hearing
• Substance use and dependence screening
• General physical examination

The physician does not need to be an AME, and the exam results are not reported to the FAA. The signed CMEC is kept by the pilot and must be available for inspection upon request. This is a significant difference from the traditional medical process, where your AME submits findings directly to the FAA.

Important Exclusions: When BasicMed Is Not an Option

BasicMed has specific exclusions for certain medical conditions. Under 14 CFR Part 68, you cannot use BasicMed if you have been diagnosed with:

• Mental health conditions requiring a Special Issuance — including psychosis, bipolar disorder, or severe personality disorder
• Neurological conditions requiring a Special Issuance — including epilepsy, disturbance of consciousness without satisfactory medical explanation, or a transient loss of control of nervous system function
• Certain cardiac conditions — including myocardial infarction, coronary heart disease treated or found to require treatment, cardiac valve replacement, or heart replacement

If any of these apply to you, the traditional Special Issuance pathway through an AME remains your route to medical certification.

BasicMed vs. Traditional FAA Medical: A Comparison

So, Should You Use BasicMed?

The answer depends on your individual situation. Here are some general guidelines:

BasicMed probably makes sense if:

• You fly for personal use only (not professionally)
• Your aircraft falls within the weight and seat limits
• You have a condition or take a medication that makes the traditional FAA process burdensome
• You're operating on a Special Issuance that requires expensive, repeated testing not covered by insurance
• You have a good relationship with your primary care physician who understands your health well
• You prefer the privacy of not having exam results reported to the FAA

Sticking with the traditional medical probably makes sense if:

• You have no significant medical issues and the AME visit is straightforward
• You fly aircraft that exceed BasicMed limits (weight, speed, altitude, or seats)
• You fly internationally and need ICAO-recognized medical certification
• You may pursue professional flying in the future (BasicMed doesn't qualify for First or Second-Class privileges)
• You're already comfortable with your AME and the current process

A word of caution:

BasicMed does not exempt you from the obligation to self-assess your fitness to fly. Under 14 CFR 61.53, all pilots — regardless of which medical pathway they use — are prohibited from acting as PIC if they know of, or have reason to know of, any medical condition that would make them unable to operate the aircraft in a safe manner. BasicMed shifts more of the responsibility onto you and your physician. That's a feature, not a bug — but it means you need to take that responsibility seriously.

How Go Flight Medicine Can Help

Whether you're considering the switch to BasicMed, trying to determine if you qualify, or weighing the pros and cons of BasicMed versus a Special Issuance pathway, we're here to help. Our team specializes in aviation medical certification and can walk you through the specifics of your situation.

We've helped pilots navigate complex scenarios where the answer isn't obvious — cases where a Special Issuance might actually be simpler, or where BasicMed provides a clear advantage. Every pilot's medical situation is different, and there's no one-size-fits-all answer.

Have questions about BasicMed? Schedule a consultation and let's figure out the best path forward for your flying career.