BasicMed, formally codified under 14 CFR Part 68, is one of the most significant regulatory changes in general aviation over the past decade. Enacted in 2017 as part of the FAA Reauthorization Act, it provides an alternative pathway for pilots who don't want to — or can't easily — maintain a traditional FAA medical certificate. But like most regulatory shortcuts, it comes with tradeoffs.
How BasicMed Works
Under the traditional system, pilots need a first-, second-, or third-class medical certificate issued by an FAA-designated Aviation Medical Examiner (AME). The third-class medical — required for private pilots exercising PPL privileges — must be renewed every 60 months (if under 40) or every 24 months (if 40 and older). This involves a specific FAA exam, and any medical conditions flagged during the process can trigger a lengthy Special Issuance process.
BasicMed replaces this with a two-step alternative:
Step 1: Physical Examination — Visit any state-licensed physician (not necessarily an AME). The physician completes the BasicMed Comprehensive Medical Examination Checklist (CMEC), a standardized form covering cardiovascular health, neurological function, mental health, vision, and general fitness. This exam must be completed every 48 months (4 years).
Step 2: Online Medical Course — Complete an FAA-approved aeromedical factors course through AOPA's online portal. The course covers topics like hypoxia, spatial disorientation, medication effects, and self-assessment of fitness to fly. This must be renewed every 24 months (2 years).
If both are current, you can exercise sport pilot or private pilot privileges without an FAA medical certificate.
Who Qualifies
The critical eligibility requirement is this: you must have held a valid FAA medical certificate issued after July 15, 2006. This means BasicMed isn't available to someone who has never held an FAA medical. The logic is that you needed to pass the FAA medical screening at least once to establish a baseline.
There are disqualifying conditions. If the FAA has ever revoked or suspended your most recent medical certificate — as opposed to it simply expiring — you may not use BasicMed. Certain conditions permanently disqualify you: these include heart valve replacement, cardiac pacemaker (unless approved under Special Issuance), epilepsy, and certain severe psychiatric conditions.
If you've had a Special Issuance medical in the past, you can still use BasicMed as long as the FAA didn't revoke or deny your last medical application.
The Operational Limitations
BasicMed is not a blanket replacement for the third-class medical. It comes with hard operational limits:
Aircraft: Maximum certificated takeoff weight of 6,000 lbs. This includes most single-engine piston aircraft and many light twins, but excludes popular models like the Beechcraft King Air, Cirrus Vision Jet, and anything in the turboprop or jet category.
Passengers: No more than 6 seats (including the pilot's seat), carrying no more than 5 passengers.
Altitude: Cannot operate above 18,000 feet MSL. This effectively means BasicMed pilots cannot fly in Class A airspace (which begins at FL180).
Speed: Cannot operate at indicated airspeeds exceeding 250 knots. This is rarely a limitation for aircraft under 6,000 lbs but is stated explicitly.
Operations: Part 91 only. No flying for compensation or hire. No Part 135, 121, or commercial operations of any kind. You also cannot act as a required pilot flight crewmember for operations requiring a second-in-command.
BasicMed vs. Third-Class Medical: The Decision Framework
The choice between BasicMed and a traditional third-class medical comes down to your specific situation:
Choose BasicMed if:
- You fly recreationally in aircraft under 6,000 lbs
- You have a stable medical condition that makes the AME process burdensome (common examples: well-controlled hypertension, history of depression treated with SSRIs, sleep apnea managed with CPAP)
- You want the convenience of using your regular doctor
- You don't plan to fly commercially or above 18,000 feet
Keep the traditional medical if:
- You plan to fly commercially at any point (you'll need at least a second-class)
- You fly or plan to fly aircraft over 6,000 lbs
- You want to fly internationally (BasicMed is not recognized by most foreign aviation authorities)
- You need to fly above FL180 for route planning purposes
- Your medical history is clean and the AME process is straightforward
The 2024 Expansion Proposals
Congress has considered expanding BasicMed several times. The most significant proposal — the General Aviation Pilot Protection Act amendments — would raise the weight limit from 6,000 lbs to 12,500 lbs, explicitly authorize IFR operations under BasicMed (currently allowed but sometimes questioned), and expand eligibility to include pilots who have never held an FAA medical (new entrants).
As of early 2026, these expansions have passed committee but await full floor votes. AOPA and EAA continue to lobby aggressively for passage. If enacted, BasicMed would become relevant to a much broader segment of the pilot population.
Practical Tips for Using BasicMed
1. Choose your physician carefully. While any state-licensed physician can perform the BasicMed exam, find one who understands aviation. Some physicians are overly cautious and may flag conditions that aren't actually disqualifying. Consider using a doctor who is also a pilot, or one recommended by your local EAA or AOPA chapter.
2. Complete the online course first. The AOPA medical course takes about 30–60 minutes. Completing it before your physical exam gives you a better understanding of what conditions matter and helps you have an informed conversation with your physician.
3. Keep your records. Maintain copies of your CMEC form, course completion certificates, and any medical records your physician references. The FAA can request these during a ramp check or investigation.
4. Understand the transition. If you currently hold a third-class medical, you don't need to "switch" to BasicMed at any specific time. You can let your medical expire and then begin using BasicMed. The two systems aren't mutually exclusive — you can hold a valid medical and also have BasicMed documentation on file.