What Is BasicMed? The FAA Medical Alternative for Pilots, Explained

BasicMed is an alternative way to meet the FAA’s medical requirement to fly. Instead of holding an FAA medical certificate, a qualifying pilot completes a medical exam with their own state-licensed physician and an online medical education course, letting them fly many small aircraft under the rules in 14 CFR § 61.113(i) and 14 CFR Part 68. Congress created it in 2016 to reduce the burden of repeat trips to an Aviation Medical Examiner for healthy private pilots.

For a lot of pilots, that one change is the difference between flying on their own schedule and being grounded waiting on a medical appointment. BasicMed does not replace the medical certificate for everyone — there are real limits on aircraft size, passenger count, altitude, and speed — but for the everyday recreational flyer in a four-seat single, it is often all you need.

What is BasicMed in plain terms?

BasicMed is a set of FAA rules that lets a qualifying pilot fly without holding a current FAA medical certificate, as long as they complete a physician exam and an online medical course on a recurring schedule. It lives in 14 CFR Part 68 and the privilege to use it is written into 14 CFR § 61.113(i). Congress directed the FAA to create it through the FAA Extension, Safety, and Security Act of 2016, and it took effect on May 1, 2017.

The idea behind it is simple. The FAA decided that a healthy private pilot flying a small airplane for fun does not necessarily need to repeat the full Aviation Medical Examiner process every few years. Instead, you partner with a physician who knows you, work through a standardized checklist, and educate yourself on aeromedical factors.

It is important to be precise about what BasicMed is not. It is not a medical certificate, and it is not a self-certification free-for-all. You are still legally responsible for not flying when you have a condition that would make you unsafe — that rule in 14 CFR § 61.53 never goes away, medical certificate or not. BasicMed simply changes how you document your fitness, not whether you have to be fit.

Who qualifies for BasicMed?

To use BasicMed you must have held a valid FAA medical certificate — any class — at some point after July 14, 2006, and that certificate cannot have been revoked, suspended, or withdrawn. This is the rule that surprises new pilots: BasicMed is a continuation pathway. If you have never held an FAA medical, you still have to earn at least one before BasicMed becomes available to you.

You also need a current and valid U.S. driver’s license, and you must comply with any restrictions on it (corrective lenses, for example). You hold at least a U.S. private pilot certificate or higher, and you are flying within the operating limits laid out in Part 68. The privilege applies to U.S.-registered aircraft within the United States, with limited reciprocity to a few other countries that have agreed to recognize it, such as Mexico and the Bahamas.

There is one more piece people forget. If your most recent FAA medical application was denied, or your most recent medical certificate or authorization was withdrawn, you cannot jump to BasicMed to get around that. You have to resolve the FAA medical question first.

How do you get BasicMed?

Getting BasicMed is a three-step process you can complete in an afternoon plus one doctor visit. First, you take the FAA’s free online medical education course — offered through providers like AOPA or the Mayo Clinic — and save the certificate of completion. Second, you have a physical exam with any state-licensed physician, who works through the FAA’s Comprehensive Medical Examination Checklist (CMEC). Third, you keep both documents with your logbook.

Here is the recurring schedule, because BasicMed has two different clocks running:

The physician you see does not have to be an Aviation Medical Examiner — it can be your regular family doctor. That is one of the biggest practical advantages: you can fold the exam into a routine physical you were going to get anyway. The physician checks the items on the CMEC, discusses any concerns with you, and signs the form. You do not send the CMEC to the FAA; you keep it. The completed checklist and the course certificate are your proof if the FAA ever asks.

One thing to watch: the course completion is logged with the FAA electronically when you finish it, so the agency does have a record that you completed the education piece. Keep your paperwork organized — a folder in your flight bag or a scan on your phone is enough.

What aircraft and operations does BasicMed allow?

BasicMed lets you fly aircraft authorized to carry no more than 6 occupants, with a maximum certificated takeoff weight of 6,000 pounds or less. That occupant count is the pilot plus a maximum of 5 passengers. You must fly no higher than 18,000 feet MSL and at an indicated airspeed of 250 knots or less. The flight has to be a non-commercial operation — personal flying, not for hire or compensation. These limits come straight from 14 CFR § 61.113(i).

That envelope covers the overwhelming majority of general aviation. A Cessna 172, a Piper Cherokee, a Cessna 182, a Beechcraft Bonanza, even many light twins like a Piper Seminole — all of those fit inside the BasicMed box. You can fly day or night, VFR or IFR, as long as you hold the appropriate ratings. The medical pathway does not restrict the kind of flying; it restricts the size of the machine and the purpose of the flight.

What you cannot do is just as important. You cannot fly for hire — no carrying passengers or cargo for compensation, no commercial operations. You cannot fly outside U.S. airspace unless the destination country specifically allows it. And you cannot exceed those size or speed numbers, even by a little. Fly a turbine business jet, a heavy twin, or any aircraft above 6,000 pounds and you are back to needing a medical certificate.

If you are early in your training and trying to understand where the medical fits in the bigger picture of becoming a pilot, the Angle of Attack Private Pilot Ground School walks through certificates, ratings, and the regulations that govern them in plain language, so the medical question stops feeling like a maze.

How is BasicMed different from a third-class medical?

A third-class FAA medical certificate is issued by an Aviation Medical Examiner and is the traditional way private pilots meet the medical requirement; BasicMed is the newer alternative that uses your own physician plus an online course instead. Both let you fly the same kinds of small aircraft for personal flying — the difference is in how you qualify, who examines you, and a few operating limits.

The biggest practical differences come down to who does the exam and what happens to your paperwork. With a third-class medical, you see an AME, the results go into the FAA’s MedXPress system, and the FAA issues (or defers) the certificate. With BasicMed, you see any physician, the checklist stays with you, and there is no FAA-issued certificate at all.

There is no single right answer between the two. A pilot chasing an airline career or flying for hire needs the certificate. A pilot who flies a 182 to see family on weekends, who dreads the paperwork and the cost of repeat AME visits, often finds BasicMed is the smoother path. Many pilots actually keep a valid third-class medical and qualify for BasicMed so they have options.

What medical conditions still need a Special Issuance?

Even on BasicMed, three categories of medical conditions require a one-time FAA Special Issuance before you can fly: certain cardiovascular conditions, certain neurological conditions, and certain mental-health conditions. These are the conditions the FAA decided are serious enough that a physician’s checklist alone is not sufficient — the agency wants to clear you once through its formal process.

On the cardiovascular side, a heart attack (myocardial infarction), coronary heart disease that has required treatment, cardiac valve replacement, or a heart replacement generally need that one-time Special Issuance. On the neurological side, conditions such as epilepsy, a disturbance of consciousness without a clear cause, or a transient loss of nervous-system control without a clear cause are on the list. On the mental-health side, conditions like a personality disorder severe enough to have shown repeated overt acts, a psychosis, a bipolar disorder, or substance dependence within the past two years require clearance.

The important nuance: it is a one-time Special Issuance for BasicMed purposes. Once the FAA grants it for that condition, you generally do not have to keep re-applying the way you might under the traditional medical certificate process — you can then manage ongoing fitness through your BasicMed physician and the § 61.53 self-grounding rule. If you think you might be in one of these categories, talk to an Aviation Medical Examiner before you assume BasicMed closes the door — it usually does not, it just adds one FAA step at the front.

A grounded-by-paperwork lesson from Alaska

I have lived the medical-certificate waiting game, and it is one of the most frustrating things in flying. I have flown a Cessna 172 around Alaska for years, and there is nothing worse than perfect weather, a clear schedule, and a piece of paper standing between you and the airplane. When you fly out of smaller communities like I do, the nearest Aviation Medical Examiner can be a flight or a long drive away — the medical visit itself becomes a trip you have to plan.

I have watched friends and students get tangled up in medical-certificate timing more times than I can count. Not because anything was wrong with them — but because the renewal clock ran out, or a routine question on the application turned into a deferral, and suddenly a healthy pilot was sitting on the ground for weeks waiting on the system. For a lot of those folks, BasicMed was the release valve. They could see their own doctor, who already knew their history, knock out the checklist, and get back to flying without the AME bottleneck.

That is the real lesson I pass along: BasicMed is not about cutting corners on your health. The honest pilot still grounds themselves when they are not fit to fly — that is airmanship, not paperwork. What BasicMed does is take a healthy, recreational pilot out of a bureaucratic loop that was never really about safety in the first place. For the right pilot, it is one of the best things to happen to general aviation in a generation.

PLT Study Guide

These FAA Learning Statement Codes (PLT codes) map to the knowledge behind BasicMed and aviation medical requirements. They appear on FAA knowledge tests and tie directly to the regulations in 14 CFR Part 68 and 14 CFR § 61.

• PLT538 — Regulations: BasicMed. The core code for this topic. Know that BasicMed is authorized under 14 CFR Part 68 and § 61.113(i), that it requires a physician exam every 48 months and an online course every 24 calendar months, and that it applies to aircraft of 6,000 pounds or less carrying no more than 6 occupants, operated no higher than 18,000 feet MSL and at 250 knots indicated or less.
• PLT427 — Regulations: medical certificate requirements / validity. Understand when an FAA medical certificate is required, the relationship between certificate class and pilot privileges, and how the BasicMed pathway substitutes for holding a current medical certificate for qualifying private operations.
• PLT443 — Regulations: pilot qualifications / privileges / responsibilities. Know that a pilot must hold the appropriate certificate and meet the medical requirement to act as pilot in command, and that BasicMed sets specific operating limits (aircraft size, altitude, speed, non-commercial purpose) the pilot is responsible for honoring.
• PLT447 — Regulations: privileges / limitations of medical certificates. Be able to compare the privileges and limitations of the medical certificate classes against the BasicMed limits, and recognize that BasicMed cannot be used for commercial flying or for aircraft outside the Part 68 envelope.

Frequently Asked Questions

A medical question should never be the thing that keeps a healthy pilot on the ground. BasicMed exists precisely because Congress and the FAA recognized that the everyday recreational flyer in a four-seat single does not need to repeat the full AME process forever. Understand the limits, keep your paperwork in order, and ground yourself honestly when you need to — that is the whole deal.

FROM CHRIS

The medical is just one piece of the bigger puzzle of staying legal and current as a pilot. Learn the regulations once, understand the why behind them, and the paperwork stops being something you fear and becomes something you simply manage — like a preflight checklist for your career.

Throttle On!

Chris Palmer

Founder & Chief CFI, Angle of Attack — Two-Time Master Aviation Educator and Gold Seal CFI