FAA Medical Certificate Classes: First, Second, Third And BasicMed

The FAA issues three classes of medical certificate — first, second and third — and the class you need depends on the privileges you are exercising at the moment you fly, not on the certificate in your wallet. A third class medical covers every student, recreational and private pilot operation. A second class is required to exercise commercial privileges. A first class is required to act as pilot in command under an airline transport pilot certificate. BasicMed is a fourth route, and it is not a medical certificate at all.

This page is the national reference for all four: who needs which, exactly how long each one lasts, what the examination covers, and what happens when the answer is not a straightforward yes. If you want the Los Angeles picture instead — how to find an examiner near Van Nuys and where the medical sits in a training timeline here — read our guide to the FAA medical certificate in Los Angeles. For the full first-year paperwork sequence, start at student pilot resources.

You Do Not Need A Medical To Start Flying

This is the single most useful thing on the page, and it is the thing most people get wrong. Under 14 CFR 61.23(b), a medical certificate is not required to receive flight training when an authorized instructor is acting as pilot in command. A discovery flight is exactly that. You can fly the airplane from the left seat, log the hour as dual instruction, and decide whether any of this is for you, without having filled in a single medical form.

The medical becomes mandatory at a specific, later point: before you fly solo. A student pilot must hold a third class medical certificate, or meet the sport pilot alternative, before an instructor can endorse them to fly alone. That is usually somewhere between hour ten and hour twenty-five. So the medical is a step to take early — early enough that a problem is discoverable before you have spent real money — but it is not a gate on your first lesson.

Which Class Do You Need

Work from the operation backwards. The FAA does not ask what you intend to do one day; it asks what you are doing today.

Two consequences fall out of this table and they surprise people. First, a flight instructor who is teaching from the right seat while the student is a certificated pilot acting as pilot in command does not need a medical for that flight, because the instructor is not the pilot in command and not a required crewmember. Second, holding a first class medical does not mean you must exercise ATP privileges; the certificate is a ceiling, not an obligation.

What Each Class Authorizes

Third Class

The third class medical is the one almost every new pilot meets first. It authorizes student, recreational and private pilot operations, flight instruction where you are the pilot in command, and practical tests. It is the least demanding of the three examinations, and the most forgiving on vision: distant visual acuity of 20/40 or better in each eye separately, with or without corrective lenses, under 14 CFR 67.303. Our full guide to the third class medical certificate covers requirements, cost and validity in detail.

Second Class

A second class medical is what a working pilot holds. It is required to exercise commercial pilot privileges — flying for compensation or hire within the limits of 14 CFR 61.133 — and to act as second in command under ATP privileges outside flag and supplemental operations. The examination is the same in structure as a third class, with a tighter vision standard: 20/20 or better in each eye separately, corrected or uncorrected, under 14 CFR 67.203. See our second class medical certificate guide for the detail.

First Class

A first class medical is required to act as pilot in command under an airline transport pilot certificate, and for the Part 121 operations listed in 61.23(a)(1). The vision standard matches the second class at 20/20 corrected in each eye under 14 CFR 67.103, and the examination adds an electrocardiogram at a defined age and then at intervals after that. If the airlines are the plan, read our first class medical certificate guide before you spend anything on training, for reasons the next section explains.

How Long Each Class Lasts

This is where the regulation is genuinely counter-intuitive, and where most of the confusion online comes from. A medical certificate does not have one expiry date. It has several, one for each level of privilege, and they run in parallel from the same examination. 14 CFR 61.23(d) sets them out.

The Calendar-Month Rule

Every duration in that table is expressed in calendar months from the month of the examination, and it runs to the last day of the month it lands on. An examination on 3 March therefore produces a certificate that is good through 31 March of the relevant year, not 3 March. You gain the remainder of the month at both ends. It is a small thing that becomes a large thing when a checkride is scheduled for the 28th.

If you would rather not count months on your fingers, our FAA medical expiry calculator does it for you and shows every privilege level from a single examination date.

Why A First Class Medical Does Not Simply Expire

Read the table again and notice that a first class medical appears on four rows. That is the mechanism people call the medical descending or stepping down. A 32-year-old who takes a first class examination in June holds first class privileges through the following June, commercial privileges through the same date, and private privileges for a full five years. Nothing is reissued and nothing is renewed; the same piece of paper simply authorizes less as time passes.

The practical use of this is real. A commercial pilot between jobs does not need to keep paying for first class examinations to stay flying privately. A student who takes a first class medical at the start of training — which is what we advise anyone aiming at an airline to do — is covered for private and student operations for years even if the airline plan changes.

Age Is Fixed At The Examination, Not At The Expiry

The age that decides which row applies is your age on the date of the examination. A pilot who is 39 when examined gets the full 60 calendar months of private privileges, even though they will be 44 when it runs out. A pilot examined three weeks after their 40th birthday gets 24. There is a genuine and entirely legal advantage in scheduling a third class examination before a 40th birthday, and we mention it to every student who is close.

BasicMed: The Fourth Route

BasicMed is not a class of medical certificate. It is an alternative set of conditions in 14 CFR 61.113(i) and 14 CFR Part 68 under which a private pilot may fly without holding a current medical certificate at all. To use it you must have held an FAA medical certificate at some point after 14 July 2006, hold a valid US driver's license, complete an approved medical education course within the preceding 24 calendar months, and have been examined by a state-licensed physician against the FAA's checklist within the preceding 48 calendar months.

In exchange, you accept aircraft and operating limits. Following the expansion that took effect with the FAA's 2025 rulemaking, 61.113(i) permits an aircraft authorized to carry not more than 7 occupants with a maximum certificated takeoff weight of not more than 12,500 pounds, flown with no more than five passengers aboard, not above 18,000 feet MSL, and not faster than 250 knots indicated. Most of the internet still quotes the original six-seat, 6,000-pound figures. They are out of date. Our BasicMed guide works through who qualifies, what the limits mean in practice, and where BasicMed is and is not better than a third class.

One hard constraint governs the whole thing: BasicMed requires that you have held a medical certificate after July 2006. If you have never been issued one, BasicMed is closed to you until you obtain one. And if your most recent application was denied, or your most recent certificate was suspended or revoked, or a special issuance authorization was withdrawn, BasicMed is closed too.

What The Examination Actually Involves

An FAA medical is performed by an Aviation Medical Examiner, a physician designated by the FAA for that purpose. It is not a physical in the sense of an annual health check with your own doctor. It is a defined examination against the standards in 14 CFR Part 67, and the examiner is working through a list.

• Eyes. Distant acuity in each eye separately, near vision at 16 inches, intermediate vision at 32 inches for applicants aged 50 and over on first and second class examinations, color vision, and normal fields of vision. Corrective lenses are permitted; they produce a limitation on the certificate, not a refusal. Our page on flying with glasses covers the numbers, and color vision has its own route through.
• Ears, nose, throat and equilibrium. A conversational-voice hearing test at six feet is the usual method, with audiometry as an alternative. Middle-ear function, balance and the absence of disease that could interfere with flight.
• Mental. A defined list of disqualifying diagnoses under 67.107, 67.207 and 67.307 — a severe personality disorder manifested by overt acts, a psychosis, a bipolar disorder, and substance dependence — plus a judgment clause covering other conditions. ADHD, anxiety and depression are not on the disqualifying list, and our page on flying with ADHD, anxiety or depression explains the pathways that exist.
• Neurologic. Epilepsy, a disturbance of consciousness without satisfactory medical explanation, and transient loss of control of nervous system function without satisfactory explanation.
• Cardiovascular. Blood pressure, pulse, and a history review. First class examinations add an electrocardiogram on a schedule tied to age.
• General. Height, weight, urinalysis for sugar and protein, and a review of everything you declared on the application form.

The whole thing takes about thirty to forty-five minutes for a straightforward third class. Most of the time is spent on the paperwork you should already have completed, which brings us to the form.

MedXPress Comes Before The Appointment

You do not fill in the application in the examiner's office. You complete FAA Form 8500-8 online through the FAA's MedXPress system first, and you bring the confirmation number to the appointment so the examiner can pull it up. The examiner cannot begin without it.

The form is where applications succeed or fail, because it is a legal declaration of your entire medical history — every diagnosis, every medication, every visit to a health professional in the preceding three years. Answering it carelessly is the most common way a simple medical turns into a six-month correspondence with Oklahoma City. Our step-by-step FAA MedXPress guide walks through the fields, the disclosure rules and the mistakes we see most often.

Issued, Deferred Or Denied

Three outcomes are possible at the end of the appointment, and the middle one is the one nobody explains.

Issued. The examiner prints and signs the certificate and you walk out with it. This is what happens in the large majority of cases.

Deferred. The examiner is not permitted to issue on the spot for something in your history, so the file goes to the FAA's Aerospace Medical Certification Division for a decision. A deferral is not a refusal. It is an administrative step that means the examiner lacks the authority to decide, and it frequently ends in issuance once the requested records arrive. It does, however, take time — often measured in months rather than weeks — and the way to shorten it is to walk in with the supporting documentation already gathered.

Denied. The FAA declines to issue. This is rare, and it matters more than it looks, because a denial closes the two alternative routes: you cannot then fly under BasicMed, and you cannot use the sport pilot driver's-license provision in 61.23(c). This is the reason we tell anyone with a complicated history to consult an examiner informally, or an aviation medical consultant, before submitting an application.

Special Issuance

Between deferral and denial sits the Authorization for Special Issuance of a Medical Certificate under 14 CFR 67.401. It is a time-limited authorization granted to an applicant who does not meet the standard but who the Federal Air Surgeon is satisfied can fly safely, usually subject to periodic reporting. Diabetes on insulin, a coronary history, a treated mental health condition and many other cases are certificated this way every year. The pilot flies; the paperwork recurs. For the broader picture of what genuinely ends a flying plan and what merely complicates it, see what disqualifies you from being a pilot.

What A Medical Costs

The FAA does not set the fee; the examiner does, and it varies by practice and by class. In the Los Angeles area a third class examination typically runs $120 to $200, with first and second class examinations usually at the upper end or above because of the additional items. An electrocardiogram on a first class examination may be billed separately. It is not usually covered by health insurance, because it is an aviation certification examination rather than treatment.

The Order To Do Things In

If you are starting from nothing, this sequence wastes the least money and the least time.

1. Fly first. Take a discovery flight. No medical, no paperwork, no commitment. You will know within the hour whether you want the rest of it.
2. Decide the ceiling. If there is any chance of a professional plan, take a first class medical rather than a third. It costs more once and it tells you immediately whether the airline route is open. Discovering an airline-level problem after paying for a career program is the expensive version of this discovery.
3. Check your history before you apply. If anything in your record gives you pause — a stimulant prescription, an antidepressant, a head injury, a DUI, a cardiac event — talk to an Aviation Medical Examiner informally first. An informal conversation is free of consequence. A submitted application is not.
4. Complete MedXPress. Carefully, honestly, and close to the appointment date rather than months ahead.
5. Get examined, then get the student pilot certificate. The student pilot certificate is applied for separately through IACRA and is issued by mail. See the IACRA student pilot certificate process.
6. Train. The medical needs to be in hand before solo, not before lesson one.

Related Reading

• Third class medical certificate — the one most pilots need, with cost and validity.
• First class medical certificate — what the airlines require and when to get it.
• BasicMed — who qualifies, the current limits and how it compares to a third class.
• FAA MedXPress guide — filling in Form 8500-8 without creating problems.
• Finding an aviation medical examiner in Los Angeles — how to choose one and what to expect.
• FAA medical certificate in Los Angeles — the local picture around Van Nuys.

FAA Medical Certificate FAQ

What Are The Three Classes Of FAA Medical Certificate?

First, second and third class. A third class covers student, recreational and private pilot operations and flight instructing where you are the pilot in command. A second class is required for commercial privileges. A first class is required to act as pilot in command under an airline transport pilot certificate.

How Long Does An FAA Medical Certificate Last?

It depends on the class, the privileges being exercised and your age at the examination, under 14 CFR 61.23(d). Third class privileges last 60 calendar months if you were under 40 at the examination and 24 calendar months if you were 40 or over. Commercial privileges last 12 calendar months. ATP pilot-in-command privileges last 12 calendar months under 40 and 6 calendar months at 40 and over.

Do I Need A Medical Certificate For A Discovery Flight?

No. Under 14 CFR 61.23(b) no medical certificate is required to receive flight training when an authorized instructor is the pilot in command. You need one before you fly solo, not before your first lesson.

Which Medical Class Should A Beginner Get?

A third class is enough for all private flying. If there is any realistic chance you will want a commercial certificate or an airline job, take a first class instead. It is examined against the strictest standard, so it answers the question of whether the professional route is open to you before you commit money to training.

Does A First Class Medical Become A Third Class When It Expires?

In effect, yes. A single first class certificate carries several parallel expiry dates under 61.23(d). Once the 12-month or 6-month first class window closes, the same certificate still authorizes commercial privileges for 12 calendar months and private privileges for 60 or 24 calendar months depending on your age at the examination.

What Is The Difference Between BasicMed And A Third Class Medical?

A third class is an FAA medical certificate issued by an Aviation Medical Examiner. BasicMed is an alternative under 14 CFR 61.113(i) and Part 68 that lets a private pilot fly without a current medical certificate, provided they held one after 14 July 2006, complete an online course every 24 calendar months and are examined by a state-licensed physician every 48 calendar months. BasicMed carries aircraft and operating limits that a third class does not.

How Much Does An FAA Medical Exam Cost?

The examiner sets the fee. Around Los Angeles a third class examination is typically $120 to $200, and first and second class examinations usually cost more because of the additional items. It is generally not covered by health insurance.

What Happens If My Medical Is Deferred?

Deferral means the examiner is not authorized to issue on the spot, so the file goes to the FAA for a decision. It is not a denial and it frequently ends in issuance. It does take time, so gather the supporting records your examiner asks for as quickly as you can.

Talk To Us Before You Spend Anything

If the medical is the thing standing between you and a decision, the cheapest way through it is a conversation. Book a free consultation and we will tell you honestly what your situation is likely to mean and in what order to do things. If you would rather just find out whether you enjoy flying, a discovery flight is $229 for 60 minutes, you fly it yourself from the left seat, and it needs no medical certificate at all. Call (818) 330-1318 any day between 9 AM and 9 PM. We are at 7900 Balboa Blvd, Van Nuys, CA 91406, on Van Nuys Airport.