Aviation Medical Certificate: Class 1, 2, or 3?

Every pilot needs a medical certificate, but which class you need depends entirely on what kind of flying you’re doing. I’ve held all three classes at various points in my flying career, and the differences matter more than you might think. Let me break down what each actually requires and when you need it.

The short version: Class 1 for airline pilots, valid 12 months under 40. Class 2 for commercial operations, also 12 months for commercial privileges. Class 3 for private flying, good for 60 months if you’re under 40. BasicMed offers an alternative using your driver’s license medical standard with certain restrictions. The higher the class, the stricter the requirements.

Class 1: The Airline Standard

If you’re flying for an airline – actually operating under Part 121 as a required crewmember – you need a Class 1 medical. The exam is comprehensive in ways that can surprise first-time applicants.

The cardiovascular requirements include an EKG at age 35, then annually after 40. Vision must correct to 20/20 in each eye. Hearing tests use audiometry at specific frequencies. Blood pressure can’t exceed 155/95. The Aviation Medical Examiner will dig through your entire medical history, and any prescription medications get scrutinized.

Mental health conditions require special issuance consideration – not an automatic disqualification, but extra paperwork and review. Previous surgeries need documentation. The exam runs $150-$300 depending on location, and straightforward cases clear in days. Deferrals to Oklahoma City can take months.

Class 2: Commercial Operations

Commercial pilots – flight instructors, charter pilots, anyone getting paid to fly – need at least a Class 2. The standards are less stringent than Class 1 but still serious.

Vision requirements allow 20/40 uncorrected as long as you can correct to 20/20. Hearing tests are slightly more lenient, allowing up to 30 dB loss at lower frequencies. No EKG required unless the examiner spots something concerning. Blood pressure max remains 155/95.

Probably should have led with this, honestly: the Class 2 remains valid for commercial operations for 12 months. After that, it automatically downgrades to Class 3 privileges – you can still fly, just not commercially. Many career pilots get a Class 1 even if they only need Class 2, since the exam is similar and the duration matches.

Class 3: Private Pilot Territory

Weekend warriors, hobby pilots, people flying for personal transportation – Class 3 is your baseline. The requirements are the most relaxed of the three classes.

Vision needs to be 20/40 correctable in each eye. Color vision testing confirms you can distinguish aviation signal colors – those colored light signals from the tower matter. Hearing tests are simplified – conversational voice at six feet. Blood pressure max is still 155/95.

Here’s where it gets better: under age 40, a Class 3 is valid for 60 months. That’s five years without visiting an AME. Over 40, validity drops to 24 months. Most AMEs can issue Class 3 certificates immediately without FAA review unless you have conditions requiring special issuance.

BasicMed: The Alternative Path

BasicMed exists for pilots who can’t easily get FAA medical certification but can safely operate under less demanding conditions. The requirements: a valid state driver’s license, plus having held any FAA medical certificate issued after July 14, 2006.

The limitations are real: aircraft under 6,000 pounds maximum takeoff weight, no more than 6 occupants, operations below 18,000 feet and 250 knots, no flying for compensation. In exchange, you complete an online medical education course every 24 months and get a physical from any state-licensed physician every 48 months. That physician doesn’t need AME certification.

Cost savings are significant – often under $100 for the doctor visit versus $100-$300 for an AME exam.

When Things Get Complicated

Certain conditions require special issuance authorization from the FAA. Diabetes requiring medication, cardiovascular disease, mental health treatment, neurological conditions – these trigger deferral to the Aerospace Medical Certification Division.

Processing takes 60-90 days typically, longer for complex cases. The FAA requests additional records and specialist evaluations. Once approved, some special issuance certificates require annual renewal with updated documentation; others become permanent after demonstrating stability.

Working with a senior AME who has experience with difficult cases significantly improves your odds of success. They know what documentation to submit upfront and can prevent common mistakes that delay approvals.

The Smart Approach

Get the highest class you might ever need, even if you don’t need it today. A Class 1 includes all Class 2 and Class 3 privileges. If you’re a student pilot even considering commercial flying someday, get a Class 2 now. This identifies potential medical issues before you’ve invested heavily in training.

That’s what makes early medical certification important to career aviation – discovering a disqualifying condition after accumulating $50,000 in training costs is heartbreaking. Better to know upfront what you’re working with.