During a well woman exam, your doctor will review all of your current medical issues and determine if there is anything missing from care, says Dr. Marchand. It is important to note that medicine is constantly changing, so treatment that is recommended can vary a lot in just one year, he adds. The doctor should examine you from head to toe, check your vital signs, and assess if you are due for any vaccines. The visit generally includes the following:
Upon arrival, you will undergo a routine physical test that includes taking your weight, pulse and blood pressure. A urine demo may be requested to test for sexually transmitted diseases (STDs) and rule out urinary tract infections, says Dr. Alagia. “You will be asked to change into a gown after being left alone in the examination room. Once your health care professional enters the room, they should take a few moments to review the test they are planning to perform and explain the reason for the specific exam,” he says.
You’ll have time before, after and during the test to ask and answer any questions you and your health care provider might have. It’s useful to prepare a list of questions in advance.
The questions that your doctor asks will be tailored to your age and medical history, says Dr. Swarup. For example, they may ask if you smoke, use drugs or alcohol, have any allergies or infections and whether you’ve had any surgeries, he says––all of these factors can affect your reproductive health.
Your doctor may ask the following questions, according to Dr. Swarup:
It’s important to be completely honest in your answers because the questions are to benefit your health, says Dr. Marchand. “Remember that a doctor can never share any personal information about your visit (doing so could easily lead to medical board discipline or loss of licensure),” he says. Doctors can share your information with other members of their health team if it is necessary to provide your care or coordinate your care. Doctors can also share your information with your permission. Doctors can also share your information with law enforcement to prevent or lessen a serious and imminent threat to the health or safety of an individual or the public. Dr. Alagia adds that having an honest dialogue with your health care professional helps them recommend guideline-based care such as STD screening, cancer screenings and other services.
You should also expect questions about your diet, life stressors and exercise habits, says Dr. Marchand. “Since screening for depression and anxiety is very important for all patients, you should be ready for questions about how you’re feeling,” he says.
Starting at the age of 20, a breast test may be conducted every one to three years to identify any irregularities or lumps, says Dr. Swarup, but recommendations vary. For example, the ACOG advises that clinical breast examinations may be offered every one to three years in women ages 25 to 39, and once a year in women over the age of 40.
The American Cancer Society does not recommend clinical breast exams nor self breast exams at all due to lack of evidence that it contributes very little to early breast cancer detection when mammography is available. Currently, mammograms (x-ray images of the breast) are recommended annually in women over the age of 45 and once every two years in women over the age of 55.
The ACOG that women between the ages of 25 and 39 be offered a clinical breast test every one to three years, and that women over the age of 40 be offered them annually. In either case, the ACOG recommends women make the decision that’s best for them.
If your practitioner conducts a clinical breast exam, you will be asked to lift one arm behind your head, explains Dr. Alagia. This allows your doctor to better examine each breast, applying gentle pressure in circular movements. “They will look for abnormal lumps or cysts. If any lumps are discovered, a biopsy will be ordered to determine if they are cancerous or not,” says Dr. Alagia.
A pelvic, or internal exam, is performed to check the vulva, vagina, cervix, fallopian tubes, ovaries and rectum for abnormalities. Adolescents don’t need a pelvic test unless they are experiencing abnormal bleeding, discharge, or pelvic pain. It’s unlikely that you’ll have a pelvic test before the age of 21 unless such symptoms are present. Although the test may be uncomfortable, it should not be painful. Keeping your body relaxed will help minimize discomfort.
During a pelvic exam, your doctor will also examine your vulva and rectum for irritation, redness or other signs of anything concerning, says Dr. Swarup. A lubricated speculum is placed into the vagina to look inside it, allowing the cervix to be evaluated for signs of disease. After removing the speculum, your doctor will gently insert one or two fingers (using a lubricated glove) into your vaginal canal while placing gentle pressure on the lower abdomen, explains Dr. Alagia. This allows them to check for abnormalities in the size, shape, and position of the uterus and ovaries.
You can expect to feel pressure, says Dr. Alagia, adding that it’s important to communicate any feelings of pain, heaviness, bloating or tenderness––this helps your doctor understand potential causes for concern.
Depending on your age, you may undergo cervical cancer screening via a Pap smear and/or human papillomavirus (HPV) test during your pelvic exam. A Pap smear looks for cellular changes in the cervix that may turn into cervical cancer, and an HPV test checks for the presence of the human papillomavirus, the virus responsible for causing these changes.
Current U.S. Preventive Services Task Force guidelines advise that women between the ages of 21 and 29 be screened every three years with a Pap smear alone; women ages 30 to 65 may be screened every three years with a Pap test only, every five years with HPV testing only or every five years with both.
For both HPV and Pap tests, your health care practitioner will insert a lubricated speculum into your vaginal canal to view your vagina and cervix, explains Dr. Alagia. “They will swipe your cervix with a swab and send it to a lab to ensure there are no signs of cervical cancer and ensure your cervix is healthy,” he says.
Even if you think you are not at risk, you should discuss STD screening with your doctor, says Dr. Alagia. Currently, the Centers for Disease Control and Prevention (CDC) recommends the following testing schedule for STDS:
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Obtaining a CPC, CCA, or CBCS certification implies that an individual has met competencies in the field of medical billing and coding. Certification is invaluable to the student's career goals. Students have an opportunity to make confident, informed decisions about the national certification they prefer.
The Certified Professional Coder (CPC) test is offered by the American Academy of Professional Coders (AAPC). It is the gold standard entry-level coding certification for physician, or professional fee, coders.
The Certified Coding Associate (CCA) is offered by the American Health Information Management Association (AHIMA). It is an entry-level medical coding certification across all settings--physician practices and inpatient hospital.
The Certified Billing and Coding Specialist (CBCS) is offered by the National Healthcareer Association (NHA) and is currently an entry-level medical billing certification for physician practices. In the summer of 2021, the test will transition to an entry-level billing and coding certification, with the inclusion of ICD-10-CM, CPT, and HCPCS Level II testing.
Month-long testing windows offer candidates the ability to take the test on the day and time that is most convenient during a 30-day period.
Test Sites are located across the United States. At the time of scheduling the exam, candidates can select a site based on their zip code.
The normal hours of operation at Test Sites are 8 a.m. to 5 p.m., but times can vary. When registering, confirm the hours with the site you wish to select.
Candidates are required to bring one (1) form of valid (non-expired), government issued, photo ID to the test site. Additionally, candidates must bring a copy of their Confirmation Notice which is emailed to them at the time of registration.
If you wish to reschedule or cancel a testing appointment within the same test window, you must contact Meazure Learning (formerly Scantron) at least 2 business days before the scheduled appointment. Canceling or rescheduling a testing appointment more than 2 business days in advance is subject to a $50 fee. Canceling or rescheduling less than 2 business days in advance of an appointment is not permitted.
Please review the procedures and fee schedule on the Certification test Change Policy page. All change and cancellation requests must be made by submitting the Exam Window Change/Cancellation Form.
ABA will consider waiving fees in case of a medical emergency. Requests will be reviewed on a case-by-case basis.
Based on the certification, the test time is either 3 hours or 4 hours:
3-Hour test (150 questions) - CAFP, CFMP, CISP
4-Hour test (200 questions) - CERP, CRCM, CTFA
Yes. Questions can be marked and returned to at a later point in the exam, if time permits. Be sure to answer all questions, as only answered questions are scored. To help you navigate the test, please click on one of the links below to preview the test system prior to your test date:
Yes. Questions can be marked for review and answers changed, if time permits.
Yes. All testing centers are fully accessible and compliant with the Americans with Disabilities Act (ADA). In addition, accommodations can be made for LRP test candidates. You must submit your request for reasonable accommodations, along with supporting documentation with your test application.
The test is scored on a "Pass/Fail" system using a predetermined cut off score based on advisory board analysis of the degree of difficulty for each question. Exams are scored based on your personal performance and are not graded on a curve.
All ABA Professional Certification exams use scaled scoring. Scaled scores are recommended by the Standards for Educational and Psychological Testing. Many testing programs, including the ACT® and SAT®, use scaled scores.
Exam scores are based on the total number of items answered correctly. The total number of items correct is then converted to a scaled score for reporting purposes. Scaled scores are a mathematical conversion of the number of items that a candidate correctly answers so that there is a consistent scale used across all versions of a test.
All ABA Professional Certification exams are scored on a scale ranging from 200 to 800, with the passing score set at 500.
Each test contains a small number of randomly embedded questions that are included for statistical research purposes. These questions do not count against candidate scores. This form of piloting questions before they are scored is part of ABA's efforts in continuous quality improvement.
Score results are confidential. You must sign an Exam Score Release Form if you want to authorize a third party to receive your score results.
An instant pass/fail outcome is provided for most computer-based exams at the testing sites. Official score results are delivered via email within 6 weeks after the close of the test window.
On occasion, ABA holds scores to conduct statistical analysis. This means that for some exams, instant outcomes will NOT be provided at the test sites and all outcomes and score results will be emailed within 6 weeks after the close of the test window.
All test fees are listed on each certification's webpage.
All of the companies on this list represent good options for getting life insurance without a medical exam. All are A+ rated or better for financial strength and have received fewer complaints than expected when averaged over a three-year period. If you don’t need more than $3 million in coverage and are 50 or younger, any company on this list could be a good fit. But if you’re over 50 and looking for a death benefit of more than $1 million, you can rule out Nationwide. If you’re over 60, your only option for high-coverage no-medical-exam life insurance is Penn Mutual. And regardless of your age, Penn Mutual is your only option if you need a death benefit greater than $5 million and don’t want to take an exam.
If you’re looking for term coverage, try Penn Mutual or Pacific Life; for dividends, Penn Mutual or Guardian. If you want free living benefits, look to Nationwide. And if you’d like a wellness plan with your life insurance, John Hancock delivers.
Term life insurance is designed to last for a specific number of years, such as 30, and then expire. Permanent life insurance is designed to last your entire lifetime, and is therefore more expensive than term. You may also want to combine term and permanent policies to have a higher-coverage term policy during your working years or while you’re raising a family, and then a lower-coverage permanent policy that will kick in once the term coverage expires.
Term policies let you choose the length of the term (a 40-year term is the longest we’ve seen), and often provide the option to convert your term coverage to permanent. Permanent policies have a cash value, which may be accessed via withdrawals and loans.
Once you’ve figured out your budget and the general type of coverage you need, you should begin to get quotes from financially stable companies with track records of good customer satisfaction.
If you want a no-exam life insurance policy, it may be helpful to know that most of the 91 companies we reviewed offer some sort of policy that doesn’t require an exam. You’re best off first finding a good company (or a few you like), and then seeing what kind of policy you can get without an exam. This list and our rankings of the best life insurance companies are both good places to start. And be sure to compare multiple quotes for no-exam life insurance because some policies are cheaper than others (depending on the type of no-exam underwriting used).
A number of companies offer life insurance policies without requiring a medical exam, but you’ll generally be eligible for the lowest premiums with those that ask thorough health questions on the application.
Most any type of policy is eligible for no-exam underwriting. It used to be that if you wanted to skip the exam, only low-coverage insurance policies were available to you. These are still available and sold as burial or funeral insurance, or guaranteed-issue policies. But now, insurers have a number of sophisticated means by which to collect health and other information, so they don’t need to rely on your exam. Plus, it costs them money to administer it and time to receive and review the results. No-exam underwriting allows insurance carriers to issue life policies faster, which is often good for both the customer and the insurer.
So whether you’re looking for term or permanent coverage, a whole life policy or an indexed universal life policy, it’s available somewhere without a medical exam. But not all companies offer no-exam life insurance on all or even any of their policies, so you’ll need to do some research to find one that does. (The companies in the list above are an excellent start.) The one caveat is that not everyone is eligible for no-exam underwriting. If you have health issues that raise red flags for the insurance company, you may be required to undergo a medical screening to complete your application.
Yes, if it's a policy with a cash value. No-exam life insurance policies are just like regular life insurance policies. The only difference is that a medical screening is not required during the application process. Once approved, the policy functions just as it would had you taken an exam. So if you’ve purchased a permanent life insurance policy that builds a cash value, that cash value will be available to you, subject to any surrender period or other standard policy conditions.
Choosing the best life insurance policy for you depends on your life insurance needs. How much coverage do you need? (Ideally, you’ll get enough to pay off your debts and replace your income, at the very least.) How long do you need it for? Your needs may change once your kids are grown and your home is paid off, for instance. The next question to ask is, how much premium can you afford?
In order to compile our list of the best no-medical-exam life insurance companies, we developed a comprehensive life insurance methodology. We started off by researching what consumers want from life insurance companies, and for that, we looked to third-party consumer studies, including J.D. Power’s 2021 U.S. Life Insurance New Business Study and the 2021 Insurance Barometer Study, by Life Happens and LIMRA.
With those findings in mind, we gathered more than 50 data points on 91 life insurance companies, including ratings for financial strength, customer satisfaction, and customer complaints, as well as information about years in business, online tools, no-exam options, dividends, maximum issue ages, and available riders.
Our review process gave preference to companies with solid financials, few customer complaints, high no-exam coverage amounts available, high-issue ages for no-exam coverage, and a broad product portfolio. Companies received ratings boosts for online resources, including online quotes and live chat, and included living benefit riders. We ranked each company according to the following categories and weights.
To finalize our list, we compared individual offerings between top companies by considering ratings from third parties such as AM Best and J.D. Power, and delving deeper into product specifics—including cost and the availability of dividends. We used this research to determine the best no-medical-exam life insurance companies.
Hundreds of aspiring nurse aides can start taking their certification exams in Spanish and Chinese next year, the start of a multilingual policy that advocates and lawmakers say will tackle a major workforce shortage in nursing homes and other long-term care facilities.
The English-only test for certified nurse aides (CNAs) has prevented non-native speakers — including those with years of nursing experience in other countries — from accessing the entry level health care role here. The new language options were included in a policy section within the fiscal 2024 budget that Gov. Maura Healey signed into law last week, but lawmakers say it is only the first step in breaking down barriers for immigrant CNAs and improving care for nursing home residents who don't speak English.
"Just before the pandemic, we turned away probably three dozen applicants that wanted to become nurse aides because we knew they couldn't pass the test in English, so this is going to be a huge help for us, and I think it's going to benefit other populations, as well," said Bill Graves, president and CEO of the South Cove Manor, a nursing and rehabilitation facility in Quincy where the vast majority of residents are native Chinese speakers. "We could hire another dozen tomorrow and put them to work right away if they could pass the test."
An influx of new CNAs — who provide care for daily tasks like bathing, eating and dressing — would Strengthen staffing ratios and help staunch burnout among current staffers who must work overtime, Graves said.
Asani Furaha, a refugee from the Democratic Republic of the Congo and a former longtime nurse for Doctors Without Borders, said at a July committee hearing that she failed the written part of the CNA test three times due to language barriers. Yet she passed the clinical component on the first try, calling it "simple."
The policy to expand language offerings for the CNA written test made it to former Gov. Charlie Baker's desk last year as part of a broader economic development bill, and he returned it to lawmakers with an amendment asking for an implementation date and tacked on other initiatives for mental health exams for incarcerated people. The Legislature didn't take up Baker's proposed changes, though Sens. Jo Comerford and John Keenan and Rep. Tackey Chan revived the issue with similar legislation this session.
Under the budget signed by Healey, the Department of Public Health must offer the CNA test in a language other than English by Oct. 1, 2024, though Keenan said he intends to urge officials to target a faster timeline. The CNA test used to be available in Chinese before the COVID-19 pandemic, when the state used a different test provider, Keenan and Chan said.
"The demand is immediate — it's now, and I think we have to respond as quickly as possible," Keenan, a Quincy Democrat, told the State House News Service. "It's long overdue. I can't imagine how isolating it must be when somebody is in a room and unable to communicate with a nurse, CNA or anyone that comes in."
At the committee hearing last month, Keenan lamented the disconnect between the CNA exams being offered in just English, compared to the learner's permit test in more than 30 languages.
Tara Gregorio, president of the Massachusetts Senior Care Association, also called on DPH to implement the policy "as soon as practical" to grow the volume of CNAs, who she said deliver the majority of direct care and provide "vital companionship" to residents at nursing facilities.
There are 3,240 vacant CNA positions, Gregorio said, citing a July 2023 workforce survey from the association. That translates into a 20% vacancy rate, she said.
"Quality of care and quality of life for individuals living in nursing facilities is directly dependent upon an adequate number of caregivers at a time when demand critically outpaces supply," Gregorio said in a statement to the News Service. "As demand for nursing home services continues to grow, it is critical that we continue to work together to adopt policies, like this new provision, that embraces our direct care workforce and aging population and allows nursing facilities to continue to recruit and retain a more stable and skilled workforce."
At South Cove Manor, Graves said CNAs who can only speak English sometimes need to ask a bilingual colleague for help translating on behalf of residents, who could be expressing that they're in pain or need another meal. Hiring CNAs who are fluent in Chinese would be a "huge benefit" for his facility, said Graves, the former chair of the Massachusetts Board of Registration of Nursing Home Administrators.
"For us to hire all English-speaking nursing aides doesn't make sense," Graves said.
The related Senate bill that's pending on Beacon Hill calls for the CNA test to be in a "language other than English, including but not limited to Portuguese, Haitian Creole, Spanish and Chinese." Meanwhile, the policy approved through the budget only invokes Spanish and Chinese, while likewise allowing DPH to determine which other languages are needed.
A DPH official told the State House News Service the department will make future decisions about providing additional choices without specifying what other languages could be under consideration.
DPH is working with the state's CNA testing provider to ensure test guides are developed, translated and made available to applicants, the official said. There will be a public comment period, as well as a public hearing, as DPH modifies nurse aide regulations, the official said.
The language policy in the budget falls short of the legislation that Comerford said she will still pursue "without question" this session — including "commonsense measures" aimed at making the CNA test more comprehensible to non-native speakers, who struggle with the phrasing of certain multiple choice questions.
Comerford said the budget leaves DPH with a "good deal of latitude" for crafting rules and regulations to implement the test policy.
"It's a wonderful first step honestly, and it's an acknowledgement of what it's going to really take to break down barriers to access for those who would like to become certified nurse aides," the Northampton Democrat said of the budget. "I have faith in DPH that they're going to want to make this test as accessible as possible within the limits of the law."
The current CNA test is not "straightforward," said Laurie Millman, executive director of the Northampton-based Center for New Americans, which offers training for students preparing for the CNA exam. Millman said immigrants view the CNA role as an opportunity to strengthen their English vocabulary before they continue their education and pursue other health care positions, such as medical assistants or phlebotomists, that allow them to save up for a house and car, among other expenses.
Yet due to the language barrier, only 60% of students who are learning English at the center pass the written exam, compared to 80% who pass the clinical exam, according to Millman. She said she regularly fields "frantic" calls from long-term care facilities who are searching to hire CNAs.
"We end up taking so much time decoding the test rather than measuring what students know," she said. "We are receiving a lot of immigrants; the smart money figures out who's highly qualified and removes the barriers. If you have the lens that says Americans are not the only people who are qualified — there are highly qualified people all over the world — figure out how to make these pathways more accessible."
