BasicMed vs an FAA Medical Certificate

The short answer

BasicMed and an FAA medical certificate are different ways to satisfy medical qualification rules for certain flights. BasicMed is an alternative for eligible pilots making limited, non-compensated operations under 14 CFR 61.113(i); it is not a medical certificate. It requires a qualifying medical history, a U.S. driver's license, a medical course every 24 calendar months, and a physician examination every 48 calendar months. An FAA medical certificate is required when the intended operation falls outside BasicMed's authority.

BasicMed vs a medical certificate at a glance

The practical distinction is scope. A first-, second-, or third-class FAA medical certificate is issued through the FAA aeromedical process and supports the operations allowed by that class while it remains effective for them. BasicMed uses a valid U.S. driver's license plus the requirements in 14 CFR 61.23(c)(3), Part 68, and 61.113(i).

BasicMed can suit an eligible private pilot whose aircraft, passengers, speed, altitude, location, and purpose all remain inside its limits. A medical certificate is the relevant path when a pilot needs privileges that require one, including airline transport pilot privileges or most commercial-pilot operations. It may also be the necessary starting point for someone who has never held an FAA medical certificate.

Neither route is a judgment that a person is safe to fly in every circumstance. A pilot may not act as pilot in command or required flightcrew while knowing, or having reason to know, of a condition that would make the operation unsafe. Personal questions about a diagnosis, medication, application history, or medical eligibility belong with an Aviation Medical Examiner and the treating clinician.

Who may use BasicMed?

14 CFR 61.23(c)(3) sets the threshold conditions. A person using BasicMed must hold a valid U.S. driver's license and comply with its medical requirements or restrictions. The person must have held a medical certificate issued under Part 67 at some point after July 14, 2006.

The status of the latest FAA medical records matters. The most recently issued medical certificate may be expired and may have included a special-issuance authorization, but it cannot have been suspended or revoked. The most recent special-issuance authorization cannot have been withdrawn. The most recent FAA medical application cannot have been completed and denied.

Those conditions make BasicMed unavailable as a shortcut around an unresolved or adverse FAA application. They also mean a first-time applicant who has never held the required medical certificate cannot simply choose BasicMed instead. An AME can explain which certification process applies to the record; a flight school or recruiter cannot determine medical eligibility.

Some medical histories require completion of a special-issuance process before BasicMed may be used. 14 CFR 68.9 lists the limited mental-health, neurological, and cardiovascular diagnoses subject to that rule. Do not decide from a summary that a particular diagnosis is or is not covered. Take the actual history to an AME and continue care with the treating clinician.

What does BasicMed require on a continuing basis?

BasicMed has two recurring intervals. Under 14 CFR 61.23(c)(3), the pilot must complete an approved medical education course during the 24 calendar months before acting as pilot in command or serving as required flightcrew. The pilot must also receive a comprehensive medical examination from a state-licensed physician during the preceding 48 calendar months.

Before that examination, the pilot completes the individual section of FAA Form 8700-2, the Comprehensive Medical Examination Checklist. 14 CFR Part 68 requires the physician to conduct the checklist examination, address listed medical conditions and reported medications as medically appropriate, and complete and sign the physician section.

The FAA's BasicMed page tells pilots to retain the signed checklist and course-completion certificate in their logbook. Section 61.113(i) likewise requires those records to be available in the pilot's logbook. Completing one task does not extend the other: the 24-calendar-month course and 48-calendar-month examination are separate clocks.

If a pilot has a diagnosed condition that may affect the ability to fly, section 61.23(c)(3) requires the pilot to be under the care and treatment of a state-licensed physician when operating under BasicMed. This article cannot classify a condition or medication. Do not stop treatment, change a dose, or delay care to preserve a flying plan.

What flying does BasicMed permit?

Current 14 CFR 61.113(i) allows an eligible pilot to act as pilot in command or as a required flightcrew member without a Part 67 medical certificate, subject to every stated condition. The aircraft must be authorized for no more than seven occupants and have a maximum takeoff weight of no more than 12,500 pounds. No more than six passengers may be aboard.

The flight may not be conducted above 18,000 feet mean sea level or at an indicated airspeed exceeding 250 knots. It may not be conducted outside the United States unless the country where it occurs authorizes the operation. The FAA's BasicMed summary also specifies that the flight is not operated for compensation or hire.

These are cumulative limits, not a menu. An aircraft that satisfies the weight limit but exceeds the occupant authorization does not qualify. A pilot who meets the personal requirements still cannot use BasicMed for a flight that exceeds the operating limits. Aircraft certification records and the planned operation should be checked independently before the flight.

BasicMed does not create pilot privileges. The pilot must still hold the required pilot certificate, ratings, endorsements, currency, and authorizations. For the broader sequence, see the private pilot certificate guide and the guide to becoming a pilot.

When is an FAA medical certificate the clearer path?

An FAA medical certificate is required when 14 CFR 61.23 assigns one to the privileges being exercised and no exception applies. The rule requires a first-class certificate for specified airline transport pilot operations, at least a second-class certificate for specified commercial privileges, and at least a third-class certificate for specified private, recreational, student, instructor, and examiner operations unless an applicable exception or BasicMed condition is met.

The certificate class and its effective duration depend on the operation, the class held, and age at the examination. A higher class can remain effective for a lower-class operation after its higher-class period ends, according to the duration table in section 61.23(d). Avoid treating a printed expiration shortcut as universal; determine the operation being conducted and read the applicable row.

The FAA medical-certificate route begins with a MedXPress application and an examination by an FAA-designated AME. The FAA's medical application guide says the AME exam must be completed within 60 days of submitting the application. The AME may issue a certificate when authorized, defer the application to the FAA for review, or deny it in limited circumstances.

A person considering BasicMed after previously using an FAA medical should examine the application history before filing anything new. Because a completed denial of the most recent application affects BasicMed eligibility, submitting an application is not a casual administrative experiment. Discuss the facts with an AME before submission when the history, medication list, or documentation is uncertain.

How do the documents differ?

Under BasicMed, the pilot keeps the signed Comprehensive Medical Examination Checklist and course-completion certificate available in the logbook. The physician conducts the Part 68 examination but does not issue an FAA medical certificate. The education-course completion information is transmitted as Part 68 specifies.

Under the FAA medical route, the applicant submits MedXPress information and attends an examination with an AME. If issued, the FAA medical certificate states its class and any limitations. Additional FAA correspondence or a special-issuance authorization may also govern the certificate.

Keep both processes distinct in personal records. A BasicMed checklist is not an FAA medical certificate, and an ordinary primary-care visit without the completed BasicMed checklist does not satisfy the Part 68 examination requirement. Conversely, holding BasicMed documents does not replace a medical certificate for an operation that requires one.

How should a pilot choose between them?

Start with the intended operation, not with which examination sounds easier. Write down:

• the pilot privileges that will be exercised;
• whether any compensation or hire is involved;
• the aircraft's authorized occupants and maximum takeoff weight;
• planned passenger count, altitude, indicated airspeed, and country;
• whether a valid U.S. driver's license and qualifying prior medical history exist;
• the status of the most recent certificate, special issuance, and application;
• the dates of any BasicMed course and checklist examination; and
• whether future training or work is expected to require a medical certificate.

Then compare those facts with the current regulations. A private owner-pilot flying qualifying domestic trips may find BasicMed fits the operation. A student who has never held an FAA medical, a pilot planning operations outside BasicMed's limits, or someone pursuing privileges that require a medical certificate needs the corresponding FAA path.

International acceptance is a separate checkpoint. Section 61.113(i) permits flight outside the United States only when the country where the flight occurs authorizes it. Verify the current foreign authority's rules for the exact destination and operation; do not infer permission from U.S. eligibility.

Training organizations, insurers, aircraft owners, and employers may impose requirements beyond the minimum regulation. Verify their written terms directly. Neither BasicMed nor an FAA medical certificate guarantees admission, insurance, employment, or work authorization.

What belongs with an AME?

Ask an AME about the effect of a prior application, denial, suspension, revocation, special issuance, diagnosis, or medication on the available FAA pathway. Ask the treating clinician about diagnosis, treatment, medication changes, and health. When both roles are relevant, let the clinicians coordinate through accurate records rather than asking a school to translate medical facts.

If symptoms, a new diagnosis, or medication effects raise a fitness-to-fly concern, do not fly until the issue has been addressed by qualified professionals. The regulatory minimum does not override the pilot's continuing duty to avoid operating during a medical deficiency.

Sources

• FAA — BasicMed
• eCFR — 14 CFR 61.23, medical requirements and duration
• eCFR — 14 CFR 61.113, private pilot privileges and BasicMed operating limits
• eCFR — 14 CFR Part 68, BasicMed education and examination requirements
• FAA — Get a Medical Certificate and What to Expect