A third class medical certificate is an FAA-issued document that confirms you meet the minimum health standards required to fly as a private, recreational, or student pilot. It’s the least restrictive of the three FAA medical certificate classes (first, second, and third), and it’s the one most non-commercial pilots need. The exam covers your vision, hearing, heart health, neurological function, and mental health, and the certificate remains valid for two to five years depending on your age.
What It Lets You Do
A third class medical certificate covers the flying privileges most people pursuing aviation as a hobby or personal activity will need. It authorizes you to act as pilot in command under a private pilot certificate, recreational pilot certificate, or student pilot certificate. Flight instructors also need at least a third class medical when they’re acting as pilot in command or serving as a required crew member on powered aircraft (glider and balloon instructors are exempt). Sport pilots can use one too, though sport pilots also have the option of flying with just a valid U.S. driver’s license instead.
What it does not cover: any flying for compensation or hire, or operations that require a first or second class medical, such as airline transport or commercial pilot duties.
How Long It Lasts
Your age on the date of the exam determines how long the certificate stays valid. If you’re under 40, it’s good for 60 calendar months (five years) from the end of the month it was issued. If you’re 40 or older, that window shrinks to 24 calendar months (two years). In both cases, validity runs through the last day of the expiration month, so an exam on March 5 counts as issued in March and expires at the end of the corresponding month years later.
Vision and Hearing Standards
The vision bar for a third class medical is 20/40 or better in each eye for both distance and near vision (tested at 16 inches). Glasses and contact lenses count. If you need corrective lenses to hit 20/40, you’ll receive a limitation on your certificate requiring you to wear them whenever you fly. There’s no color vision requirement for basic certification, though failing a color vision test may result in operational restrictions like no night flying.
Hearing can be tested in one of three ways. The simplest is the conversational voice test: you stand six feet from the examiner with your back turned and demonstrate that you can hear an average speaking voice in a quiet room using both ears. Alternatively, you can pass an audiometric speech discrimination test with a score of at least 70 percent in one ear, or meet specific pure tone thresholds across frequencies from 500 to 3,000 Hz.
Blood Pressure and Heart Health
Your blood pressure must not exceed 155/95. If you’re within that range, haven’t used blood pressure medication for 30 days, and are otherwise healthy, the examiner can issue your certificate on the spot. Readings above that threshold, or current use of blood pressure medication, will require FAA review but don’t necessarily mean denial. Many pilots fly with treated hypertension under ongoing monitoring.
Certain cardiovascular conditions are specifically listed as disqualifying: coronary heart disease that has been treated or has caused symptoms, prior heart attack, cardiac valve replacement, heart transplant, permanent pacemaker, and angina. That said, “disqualifying” in FAA terms often doesn’t mean permanent denial. When a condition is well controlled, the FAA can grant a Special Issuance authorization, essentially a conditional medical certificate that requires periodic follow-up reports.
Mental Health and Neurological Conditions
The FAA encourages pilots to seek treatment for mental health conditions, and most treated conditions do not permanently ground you. Depression and anxiety, for example, can be compatible with medical certification. The FAA now allows pilots to fly while being treated with several common antidepressant medications, and it has reduced the frequency of cognitive testing required for pilots on those medications.
A few conditions are automatic disqualifiers unless cleared through Special Issuance: psychosis, bipolar disorder, substance dependence, and personality disorders severe enough to have manifested through repeated overt acts. Substance abuse is also disqualifying, though certification is possible after documented recovery.
Seizure history receives close scrutiny. A single seizure with a known cause (provoked) requires a one-year seizure-free period plus neurological evaluation, brain MRI, and EEG before the FAA will consider Special Issuance. An unprovoked seizure requires four years seizure-free, with at least two of those years off medication. A diagnosis of epilepsy requires ten years without a seizure and three years off medication before the FAA will review your case.
The Application and Exam Process
You start by creating an account on MedXPress, the FAA’s online medical application system. You’ll answer a series of health history questions and submit the form electronically. After submission, save or print your confirmation number, because your Aviation Medical Examiner (AME) will need it to pull up your application.
Your MedXPress application stays active for only 60 days, so schedule your AME appointment promptly. AMEs are physicians designated by the FAA to conduct aviation medical exams. You can search for one near you on the FAA’s website. The FAA does not set exam fees, so prices vary by location and practice. Expect to pay roughly what you’d pay for a thorough physical exam in your area, typically somewhere between $75 and $200, though this varies.
On exam day, bring your MedXPress confirmation number along with any relevant medical records. The examiner will check your vision, hearing, blood pressure, heart, lungs, abdomen, spine, and neurological function. If everything meets the standards and your medical history doesn’t flag any disqualifying conditions, the AME can issue your third class medical certificate right there in the office. If something needs further review, the AME will defer the decision to the FAA’s Aerospace Medical Certification Division, which may request additional records or testing before making a determination.
BasicMed as an Alternative
Since 2017, many private pilots have had the option of flying under BasicMed instead of holding a traditional third class medical. BasicMed lets you skip the AME exam and instead get a physical from any state-licensed physician using a standardized checklist. You also complete an online medical education course every four years. The tradeoff is a set of operating limitations: the aircraft can’t weigh more than 12,500 pounds or carry more than six passengers, you must fly at or below 18,000 feet and no faster than 250 knots, and you must stay within the United States.
To be eligible for BasicMed, you need to hold a valid U.S. driver’s license, and you must have held an FAA medical certificate at some point after July 14, 2006. If your most recent medical was denied or revoked, BasicMed may not be available to you. Pilots with a history of certain disqualifying conditions, including psychosis, bipolar disorder, epilepsy, heart attack, or substance dependence, must have received at least one Special Issuance medical certificate for that condition before they can operate under BasicMed.
For many private pilots, BasicMed is simpler and eliminates the need to deal with the AME system. But if you’re a student pilot just starting out, you’ll likely need to get a third class medical first, which also establishes the medical certificate history required for future BasicMed eligibility.