BasicMed, the Pilot's Bill of Rights Two, and the Third-Class Medical Alternative That Changed What It Means to Keep Flying

BasicMed is a formal FAA-approved medical qualification pathway that allows eligible pilots to exercise private, recreational, or student pilot privileges without holding a traditional FAA medical certificate. It took effect on May 1, 2017, following passage of the Pilot’s Bill of Rights 2 (PBOR2) in 2016. For thousands of pilots who struggled to obtain or maintain a third-class medical, it changed the practical reality of whether they could keep flying.

Why Did the Third-Class Medical Become a Barrier for General Aviation Pilots?

For decades, private pilots needed a third-class FAA medical certificate to fly. For most, the process was routine: see an Aviation Medical Examiner (AME), pass a physical, and repeat every five years (under age 40) or every two years (age 40 and older).

But for a growing number of pilots, that process triggered the special issuance pathway - a bureaucratic obstacle course involving specialist evaluations, paperwork submitted to the FAA’s Aeromedical Certification Division in Oklahoma City, and waits that could stretch months or longer, sometimes costing thousands of dollars. Conditions that triggered special issuance included depression (even resolved cases), controlled high blood pressure, past cardiac procedures, type 2 diabetes, and certain medications - regardless of whether the underlying condition had any real bearing on flight safety.

Some pilots gave up flying entirely. Others shifted to light sport aircraft, where a valid driver’s license can substitute for a medical - but that workaround excluded the vast majority of general aviation aircraft. A Cessna 172, a Piper Cherokee, a Beechcraft Bonanza: none qualify as light sport.

AOPA and EAA brought data to Congress showing the third-class medical was not meaningfully contributing to safety in Part 91 private operations. The accident record simply didn’t support the regulatory burden. Congress listened.

What Is the Pilot’s Bill of Rights 2 and How Did It Create BasicMed?

The Pilot’s Bill of Rights 2 (PBOR2) was signed into law in 2016, directing the FAA to create a third-class medical alternative for general aviation. The FAA spent the following year developing the specific rules - with substantial input from AOPA and EAA - and BasicMed officially took effect on May 1, 2017.

BasicMed is not a loophole or workaround. It is a formally structured regulatory pathway under FAR 61.23 with its own eligibility requirements, operational limits, and compliance obligations.

Who Qualifies for BasicMed?

To use BasicMed, you must have held a valid FAA medical certificate at some point on or after July 15, 2006. That is the regulatory anchor date. The certificate doesn’t need to be current - it may have expired years ago - but it must have been valid at some point after that date.

A denial is not the same as holding a certificate. If your most recent FAA medical application was denied, or if a certificate was revoked rather than simply allowed to expire, your BasicMed eligibility may be affected. That is a situation that warrants a conversation with an aviation attorney before you fly.

How Does the BasicMed Process Work?

The entire process has three components - and none of them involve sending paperwork to Oklahoma City.

1. Personal physician visit every four years. You see your own doctor - not an AME - and complete the Comprehensive Medical Examination Checklist, a specific FAA-provided form. Your physician examines you, you both sign the checklist, and you each keep a copy.

2. Online aeromedical course every two years. Both AOPA and EAA offer FAA-approved versions of this course. Content covers hypoxia, spatial disorientation, medication effects on cognition, and fatigue. It takes a couple of hours to complete, and you receive a certificate to keep in your records.

3. Driver’s license in lieu of a medical certificate. When flying under BasicMed, you carry your pilot certificate and your driver’s license. There is no separate medical certificate, because you don’t hold one under this pathway.

What Are the Operational Limitations Under BasicMed?

These limits are not optional - they define the boundary of legal BasicMed operations.

• Aircraft maximum certificated takeoff weight: 6,000 pounds or less. This covers most general aviation aircraft, including the Cessna 172, Piper Arrow, Beechcraft Bonanza, and Cirrus SR22. Heavier piston twins and turboprops can approach or exceed this figure. If you’re unsure, verify in the type certificate data sheet.
• Maximum passengers: 5 (6 people total, including the pilot).
• Maximum altitude: 18,000 feet MSL. Class A airspace begins at 18,000 feet MSL and is off-limits under BasicMed.
• Maximum airspeed: 250 knots indicated airspeed.
• No compensation or hire. BasicMed covers private, noncommercial operations only.
• No automatic international recognition. BasicMed does not travel with you. Some countries accept it; many do not. If you’re flying to Canada, the Bahamas, or anywhere outside U.S. airspace, verify with that country’s civil aviation authority before you depart.

What Medical Conditions Are Disqualifying Under BasicMed?

Your physician is not certifying that you are fit to fly. They are certifying that you do not present any condition listed on the Comprehensive Medical Examination Checklist as specifically disqualifying. That list is shorter than the third-class medical standard, but it is real and enforceable.

Disqualifying conditions include psychotic disorders, personality disorders that have manifested in overt acts, bipolar disorder, and substance dependence. If your physician identifies one of these conditions during your visit, they are required not to sign the checklist.

The ongoing self-certification responsibility rests with the pilot. FAR 61.23 requires you to ground yourself any time you know you have a medical deficiency that would prevent you from meeting BasicMed requirements. This is the same obligation that governs all medical certification in general aviation - BasicMed changed the administrative structure, not the underlying safety standard.

Why Is a Personal Physician a Valid Alternative to an Aviation Medical Examiner?

When BasicMed was being developed, some assumed moving away from AMEs meant reduced oversight. EAA made the opposite case to the FAA during rulemaking: a personal physician who has your complete medical history and sees you regularly has more complete information about your health than an AME who examines you for 15–20 minutes every few years.

What BasicMed eliminated was not oversight - it eliminated the documentation burden and bureaucratic overhead for pilots with stable, well-managed conditions that had no meaningful impact on flight safety. The oversight shifted to a more informed source.

What Records Do You Need to Maintain Under BasicMed?

Keep three documents current and accessible at all times:

1. Signed Comprehensive Medical Examination Checklist - completed with your physician within the last four years
2. Online course completion certificate - from within the last two years
3. Valid driver’s license - carried when flying, as your identification and authorization in place of a medical certificate

Disorganized record-keeping under BasicMed is a genuine compliance problem. Know when each document expires and renew before it lapses.

Who Benefits Most from BasicMed?

BasicMed was built for pilots whose medical histories created disproportionate obstacles under the traditional system. That includes pilots over 50 or 60 managing normal age-related conditions, pilots with controlled high blood pressure, pilots with controlled type 2 diabetes (previously subject to an extensive special issuance process for even a third-class medical), pilots with a history of cardiac procedures who are stable and asymptomatic years later, and pilots treated for depression or anxiety who are doing well.

If you currently hold a valid third-class medical, nothing requires you to switch. BasicMed is an option, not a mandate. For the pilots who couldn’t obtain or sustain a third-class medical, it’s the option that let them keep flying.

Key Takeaways

• BasicMed took effect May 1, 2017, allowing eligible pilots to exercise private, recreational, or student pilot privileges without an FAA medical certificate.
• Eligibility requires having held a valid FAA medical on or after July 15, 2006; a prior denial or revocation may affect eligibility - consult an aviation attorney if applicable.
• The process requires a personal physician visit every four years (using the Comprehensive Medical Examination Checklist) and an FAA-approved online course every two years.
• Operational limits include aircraft at or below 6,000 lbs MTOW, a ceiling of 18,000 feet MSL, a max of 5 passengers, 250 KIAS, no compensation or hire, and no automatic international recognition.
• The underlying safety standard did not change - FAR 61.23 still requires pilots to self-ground for any disqualifying medical deficiency.