Updated September 2026 to reflect the expanded BasicMed aircraft and operating limits now in 14 CFR 61.113(i).
BasicMed lets you fly without holding an FAA medical certificate, as long as you meet a set of medical, education, and operating requirements. Congress created it in the FAA Extension, Safety, and Security Act of 2016, and the FAA published its BasicMed rules in January 2017. Congress expanded BasicMed in the FAA Reauthorization Act of 2024, and the FAA has since updated its regulations to match. If you read about BasicMed a few years ago, some of the numbers have changed.
A traditional medical certificate is issued under 14 CFR Part 67 after an exam with an Aviation Medical Examiner (AME). There are three classes. You need a first-class medical to act as pilot in command under an airline transport pilot certificate. You need at least a second-class medical to exercise commercial pilot privileges in most aircraft. You need at least a third-class medical to exercise private, recreational, or student pilot privileges, or to act as pilot in command as a flight instructor, unless you fly under BasicMed.
How long a traditional medical lasts depends on the class, your age on the exam date, and the kind of flying you do. Under 14 CFR 61.23(d), a medical used for private pilot privileges lasts until the end of the 60th month after the month of your exam if you were under 40, or the 24th month if you were 40 or older. For commercial pilot privileges, a first- or second-class medical lasts until the end of the 12th month. For airline transport pilot-in-command privileges, a first-class medical lasts 12 months if you were under 40 and 6 months if you were 40 or older.
Who can use BasicMed? You must hold a valid U.S. driver's license and follow any medical restrictions on it. A foreign or international driver's license does not count. You must have held an FAA medical certificate at some point after July 14, 2006. That certificate can be expired, and it can include a Special Issuance authorization. However, your most recently issued medical certificate cannot have been suspended or revoked, your most recent Special Issuance authorization cannot have been withdrawn, and your most recent application for a medical certificate cannot have been denied.
BasicMed covers more than private pilots. Under the current rules and the FAA's BasicMed page, you can use it when acting as pilot in command with student, recreational, or private pilot privileges, when serving as a required flight crewmember such as a safety pilot, when acting as pilot in command as a flight instructor, and when serving as an examiner, as long as the flight stays within the BasicMed limits.
The first medical requirement is a comprehensive medical examination with any state-licensed physician, using FAA Form 8700-2, the Comprehensive Medical Examination Checklist (CMEC). Before the exam, you fill out your section of the checklist, which uses the health history questions from FAA Form 8500-8 (the medical application form behind MedXPress), and bring it to the physician. The physician examines each item on the checklist, from vision and hearing to heart, lungs, and neurological function, discusses every prescription and over-the-counter medication you take, and decides whether any tests are needed. The physician then signs a statement that they are not aware of any medical condition that, as presently treated, could interfere with your ability to fly safely.
The second requirement is a free online BasicMed medical education course. The FAA lists two options: AOPA's BasicMed Medical Self-Assessment: A Pilot's Guide to Flying Healthy, and the Mayo Clinic BasicMed Online Training Course. When you finish, you receive a course completion certificate. As part of the course, you also give information that is sent to the FAA: your name, address, and pilot certificate number; your physician's name, contact information, and state medical license number; the date of your exam; a certification that the physician followed and signed the checklist; a release that lets the FAA check your driving record through the National Driver Register; and a statement that you understand you cannot fly if you know or have reason to know of a medical condition that makes you unsafe.
Both requirements run on calendar months. To fly under BasicMed, your comprehensive medical exam must be within the previous 48 calendar months, and your course must be within the previous 24 calendar months. A calendar month ends on the last day of the month, so an exam on January 5, 2024 is good through January 31, 2028, and a course completed on July 15, 2024 is good through July 31, 2026. Both must be current at the same time.
Keep the signed checklist and your course completion certificate with your logbook. The regulations require you to have both available in your logbook when you fly under BasicMed, and the course certificate must be made available on request.
You also have ongoing responsibilities. If you have been diagnosed with any medical condition that may affect your ability to fly, you must be under the care and treatment of a state-licensed physician for it. And as with any pilot, you cannot act as pilot in command or as a required crewmember if you know or have reason to know of a medical condition that would make you unable to fly safely. The FAA can also ask you for more information if it receives credible information, such as from the National Driver Register, that raises questions about your ability to fly safely.
Some conditions require you to go through the Special Issuance process once before you can use BasicMed. These are not permanent bars. Under 14 CFR 68.9, they are: a personality disorder severe enough to have repeatedly shown itself through overt acts; psychosis; bipolar disorder; substance dependence within the previous 2 years; epilepsy; a disturbance of consciousness or a transient loss of control of nervous system functions without a satisfactory medical explanation; a myocardial infarction (heart attack); coronary heart disease that has required treatment; cardiac valve replacement; and heart replacement.
For the heart conditions, you need only one Special Issuance for each diagnosis, and the process is satisfied by an appropriate clinical evaluation without a mandatory waiting period. For a clinically diagnosed mental health or neurological condition, there are two more rules. You cannot use BasicMed if your state-licensed medical specialist judges that the condition makes you unable, or may reasonably be expected to make you unable, to fly safely, or if your driver's license has been revoked because of the condition. And every 2 years, along with your course, you must certify that you are under the care of a state-licensed medical specialist for that condition.
Now the operating limits, as amended in 2024 and 2025. Under BasicMed, the aircraft must be authorized to carry no more than 7 occupants and have a maximum takeoff weight of no more than 12,500 pounds, and it cannot be a transport category rotorcraft. You can carry no more than 6 passengers. Every portion of the flight must be at or below 18,000 feet MSL and at an indicated airspeed of no more than 250 knots. You can fly VFR or IFR. The flight cannot be operated for compensation or hire. The aircraft's own operating limitations still apply.
You may also fly outside the United States under BasicMed only if the country where the flight takes place authorizes it. Check with that country's aviation authority before you plan an international trip.
If you are working from older material, be aware that two FAA documents have not caught up with these changes. Advisory Circular 68-1A, dated May 3, 2017, still lists the original limits of 6 occupants, 6,000 pounds, and 5 passengers. The FAA says Form 8700-2 is being updated for the same reason, and that you may keep using the current version while flying under the expanded privileges. The regulation in 14 CFR 61.113(i) and the FAA's BasicMed page reflect the current limits.
So which should you choose? BasicMed can work well if your flying fits within its limits and you meet the eligibility rules. You see a state-licensed physician of your choice instead of an AME.
A traditional medical certificate still makes sense in several situations. You need one to exercise commercial or airline transport pilot privileges. You need one if you fly an aircraft or operation outside the BasicMed limits, such as more than 6 passengers, more than 7 occupants, a maximum takeoff weight over 12,500 pounds, or flight above 18,000 feet MSL or faster than 250 knots indicated. You need one to fly in a country that has not authorized BasicMed flights. And if you are not eligible for BasicMed, for example because your most recent medical application was denied, the traditional route is your path back to flying.
Whichever path you choose, the most important check is the one you do yourself before every flight. Neither a medical certificate nor BasicMed replaces an honest assessment of whether you are fit to fly that day. If you are unsure which option fits your health history and your flying, talk with your physician or an AME before you decide.