AC 68-1A

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U.S. Department of Transportation Federal Aviation Administration Advisory Circular

Subject: BasicMed Date: 5/3/17 AC No: 68-1A

Initiated by: AFS-800 Change:

This advisory circular (AC) describes how pilots can exercise student, recreational, and private pilot privileges in certain small aircraft without holding a current medical certificate. It outlines the required medical education course, medical requirements, and aircraft and operating restrictions that pilots must meet to act as pilot in command (PIC) for most Title 14 of the Code of Federal Regulations (14 CFR) part 91 operations. This AC is intended to be used as a resource for pilots operating under BasicMed. It is also intended to be a resource for State-licensed physicians who will be providing the required medical examination to those pilots. John Barbagallo Deputy Director, Flight Standards Service

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5/3/17 AC 68-1A ii CONTENTS Paragraph Page Chapter 1. General ...................................................................................................................... 1-1 1.1 Purpose .......................................................................................................................... 1-1 1.2 Audience ....................................................................................................................... 1-1 1.3 Where You Can Find This AC ...................................................................................... 1-1 1.4 Cancellation .................................................................................................................. 1-1 1.5 Background ................................................................................................................... 1-1 1.6 AC Feedback Form ....................................................................................................... 1-2 Chapter 2. References ................................................................................................................. 2-1 2.1 Related Title 14 of the Code of Federal Regulations (14 CFR) Parts........................... 2-1 2.2 Related Reference Material ........................................................................................... 2-1 2.3 Definitions ..................................................................................................................... 2-2 2.4 Abbreviations/Acronyms Used in This AC .................................................................. 2-2 Chapter 3. Summary of BasicMed Requirements....................................................................... 3-1 3.1 What Do I Need to Fly Under BasicMed? .................................................................... 3-1 3.2 What Are My BasicMed Privileges? ............................................................................ 3-1 3.3 What Do I Need to Maintain My BasicMed Privileges? .............................................. 3-1 Chapter 4. Pilot Requirements .................................................................................................... 4-1 4.1 Applicability.................................................................................................................. 4-1 4.2 Valid Driver’s License .................................................................................................. 4-1 4.3 Medical Certificate Issued by the FAA......................................................................... 4-2 4.4 Completion of Medical Education Course .................................................................... 4-4 4.5 Care and Treatment by a Physician............................................................................... 4-4 4.6 Receipt of Medical Exam During the Previous 48 Months .......................................... 4-4 Chapter 5. Covered Aircraft and Operating Requirements ......................................................... 5-1 5.1 Covered Aircraft Requirements .................................................................................... 5-1 5.2 Operating Requirements ............................................................................................... 5-1

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5/3/17 AC 68-1A iii Chapter 6. Medical Education Course Requirements ................................................................. 6-1 6.1 Availability of the Medical Education Course .............................................................. 6-1 6.2 Course Requirements .................................................................................................... 6-1 6.3 Documents the Course Must Provide to the Individual and Transmit to the FAA ....... 6-1 Chapter 7. Comprehensive Medical Examination Requirements ............................................... 7-1 7.1 General .......................................................................................................................... 7-1 7.2 Comprehensive Medical Examination Checklist (CMEC) ........................................... 7-1 7.3 Physician Qualifications ............................................................................................... 7-4 Chapter 8. Special Basicmed Requirements for Certain Medical Conditions ............................ 8-1 8.1 General .......................................................................................................................... 8-1 8.2 Special Issuance Medical Certificates Required ........................................................... 8-1 8.3 BasicMed Prohibitions for Persons with Mental Health Conditions ............................ 8-2 8.4 BasicMed Prohibitions for Persons with Neurological Health Conditions................... 8-2 Appendix A. Comprehensive Medical Examination Checklist ................................................. A-1

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5/3/17 AC 68-1A 1-1 CHAPTER 1. GENERAL 1.1 Purpose. This advisory circular (AC) provides information to pilots and other stakeholders about complying with the medical certificate relief described in section 2307 of the Federal Aviation Administration (FAA) Extension, Safety, and Security Act of 2016 (Public Law (PL) 114-190) (FESSA), enacted by Congress on July 15, 2016. That relief is referred to as BasicMed.

1.2 Audience. This AC is intended to provide information to pilots who wish to operate under BasicMed. It is also intended to provide information for nonprofit and not-for-profit general aviation stakeholder groups who wish to offer the required medical course. Lastly, this information may be used by State-licensed physicians who are providing a medical examination to a pilot intending to operate under BasicMed. 1.3 Where You Can Find This AC. You can find this AC on the FAA’s website at http://www.faa.gov/regulations_policies/advisory_circulars. 1.4 Cancellation. AC 68-1, Alternative Pilot Physical Examination and Education Requirements, dated January 9, 2017, is canceled.

1.5 Background. The FAA Extension, Safety, and Security Act of 2016 (PL 114-190) (FESSA) was enacted on July 15, 2016. Section 2307 of FESSA, Medical Certification of Certain Small Aircraft Pilots, directed the FAA to “issue or revise regulations to ensure that an individual may operate as pilot in command of a covered aircraft” without having to undergo the medical certification process under Title 14 of the Code of Federal Regulations (14 CFR) part 67 if the pilot and aircraft meet certain prescribed conditions as outlined in FESSA.

The FAA refers to the implementation of section 2307 as alternative pilot physical examination and education requirements (BasicMed). This AC provides guidance regarding the regulations the FAA has enacted to conform to this legislation. This AC does not provide, nor is it intended to provide, a legal interpretation of the regulations. 1.5.1 Acceptable Means of Compliance (AMC). This AC uses mandatory terms, such as “must,” only in the sense of ensuring applicability of these particular methods of compliance when using the AMC described herein. This AC is not mandatory and does not constitute a regulation.

This AC does not change, add to, or delete regulatory requirements or authorize deviations from regulatory requirements. It does describe a new qualification for people exercising certain pilot privileges. Pilots may elect to continue to meet the medical certification requirements that existed before BasicMed, or, if eligible, may use the BasicMed qualifications.

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5/3/17 AC 68-1A 1-2 1.5.2 Part 68 Provisions. This AC is not intended to cover every provision of 14 CFR parts 61, 68, or 91. Rather, this AC is intended to provide guidance on those provisions of the regulations where additional information may be helpful. The FAA emphasizes, however, that persons subject to those regulations are responsible for complying with every applicable provision, regardless of whether the provision is discussed in this AC. 1.6 AC Feedback Form. For your convenience, the AC Feedback Form is the last page of this AC. Note any deficiencies found, clarifications needed, or suggested improvements regarding the contents of this AC on the Feedback Form.

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5/3/17 AC 68-1A 2-1 CHAPTER 2. REFERENCES 2.1 Related Title 14 of the Code of Federal Regulations (14 CFR) Parts. The following regulations and parts can be found at http://www.faa.gov/regulations_policies/faa_regulations/. • Part 1, Definitions and Abbreviations.

• Part 61, Certification: Pilots, Flight Instructors, and Ground Instructors. • Part 67, Medical Standards and Certification.

• Part 68, Requirements for Operating Certain Small Aircraft Without a Medical Certificate.

• Part 91, General Operating and Flight Rules.

2.2 Related Reference Material. The following listed reference materials contain additional information necessary to meet FAA medical certification standards. Interested airmen may consider seeking additional publications to supplement the lists below. 2.2.1 FAA ACs, Notices, and Orders (current editions). You can find the following publications on the FAA websites:

http://www.faa.gov/regulations_policies/advisory_circulars/ and http://www.faa.gov/regulations_policies/orders_notices/.

• AC 68-1, BasicMed.

• FAA Order 8900.1, Flight Standards Information Management System (FSIMS). 2.2.2 Additional FAA Online Sources.

• BasicMed website: http://www.faa.gov/go/basicmed.

• FAA website: http://www.faa.gov/licenses_certificates/medical_certification/. 2.2.3 FAA Handbooks, Manuals, and Other Publications. You can find the following handbooks, manuals, and other publications on the FAA website at http://www.faa.gov/regulations_policies/handbooks_manuals/. • The FAA Guide for Aviation Medical Examiners (AME Guide): http://www.faa.gov/go/ameguide.

• The FAA Pharmaceuticals (Therapeutic Medications) Do Not Issue - Do Not Fly List: http://www.faa.gov/go/dni.

• The FAA’s Aeronautical Information Manual (AIM), Chapter 8, paragraph 8-1-1, which addresses medical facts for pilots: http://www.faa.gov/air_traffic/publications/.

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5/3/17 AC 68-1A 2-2 2.3 Definitions. The following defined terms are used throughout this AC: 1. Calendar Months. Known also as “unit months,” is defined as beginning on the first of the month and ending on the last day of the month. For example, a certificate issued on July 15, 2016 with a 24 calendar-month duration does not expire until July 31, 2018.

2. Corrective Lenses. Spectacles or contact lenses. 2.4 Abbreviations/Acronyms Used in This AC.

1. AC Advisory Circular.

2. AME Aviation Medical Examiner.

3. CMEC Comprehensive Medical Examination Checklist 4. ICAO International Civil Aviation Organization. 5. FAA Federal Aviation Administration.

6. FESSA FAA Extension, Safety, and Security Act of 2016 (Public Law (PL) 114-190) 7. MSL Mean Sea Level.

8. NDR National Driver Register.

9. PIC Pilot in Command.

10. U.S.C. United States Code.

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5/3/17 AC 68-1A 3-1 CHAPTER 3. SUMMARY OF BASICMED REQUIREMENTS 3.1 What Do I Need to Fly Under BasicMed?

1. Hold a current and valid U.S. driver’s license.

2. Hold or have held a medical certificate issued by the FAA at any point after July 14, 2006.

3. Answer the health questions on the Comprehensive Medical Examination Checklist (CMEC).

4. Get your physical examination by any State-licensed physician, and have that physician complete the CMEC (be sure to keep the CMEC). 5. Take the BasicMed online medical education course. Keep the course completion document issued to you by the course provider. 3.2 What Are My BasicMed Privileges? You can conduct any operation that you would otherwise be able to conduct using your pilot certificate and a third-class medical certificate, except you are limited to:

1. Fly with no more than five passengers.

2. Fly an aircraft with a maximum certificated takeoff weight of no more than 6,000 lbs.

3. Fly an aircraft that is authorized to carry no more than 6 occupants. 4. Flights within the United States, at an indicated airspeed of 250 knots or less, and at an altitude at or below 18,000 feet mean sea level (MSL). 5. You may not fly for compensation or hire.

3.3 What Do I Need to Maintain My BasicMed Privileges? 1. Be sure you have a CMEC that shows that your most recent physical examination was within the past 48 months.

2. Be sure you are being treated by a physician for medical conditions that may affect the safety of flight.

3. Be sure you have a course completion certificate that was issued by a BasicMed medical training course provider within the past 24 calendar-months.

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5/3/17 AC 68-1A 4-1 CHAPTER 4. PILOT REQUIREMENTS 4.1 Applicability. The BasicMed privileges apply to persons exercising student, recreational, and private pilot privileges when acting as pilot in command (PIC). It also applies to persons exercising flight instructor privileges when acting as PIC. You cannot use BasicMed privileges to fly as a safety pilot, except when that pilot is acting as PIC.1 4.1.1 Pilots operating under BasicMed may act as PIC2 of an operation conducted under the conditions and limitations set forth in part 61, § 61.113 (i.e., charitable, nonprofit, or community event flights, search and location flights). Persons exercising privileges of a student pilot or recreational pilot certificate must comply with the limitations in §§ 61.89 and 61.101, as applicable, when those limitations conflict with § 61.113(i). 4.1.2 BasicMed does not apply to persons exercising privileges of a Commercial Pilot Certificate or an Airline Transport Pilot (ATP) Certificate. Persons exercising the privileges of a Commercial Pilot or ATP Certificate must hold a first or second-class medical certificate in accordance with § 61.23(a)(1) and (2).

4.1.3 BasicMed does not apply to persons performing the duties as an examiner in an aircraft when administering a practical test or proficiency check for an airman certificate, rating, or authorization. Accordingly, persons performing such duties must hold at least a third-class medical certificate in accordance with § 61.23(a)(3)(iv).

4.1.4 Persons exercising pilot privileges in a balloon or glider can operate without any medical certification. Similarly, persons exercising sport pilot privileges can operate by merely holding a driver’s license. While the FAA encourages pilots to obtain qualifications and certificates above those necessary for their operation, sport pilots and pilots operating balloons or gliders may not operate under BasicMed. However, the BasicMed online course can be used by any airman for educational purposes.

4.2 Valid Driver’s License. In accordance with §§ 61.23(c)(3) and 61.113(i), pilots operating under BasicMed must hold a current and valid U.S. driver’s license and comply with all medical requirements or restrictions associated with that license. Each State determines what, if any, medical requirements or restrictions are necessary and associated with each driver’s license issued. While an official passport may serve as a valid form of photo identification under § 61.3(a)(2), it may not be used in lieu of a driver’s license as required in § 61.23(c)(3) to operate under BasicMed. An international driver’s license or any driver’s license issued by a country or territory other than the United States does not suffice to meet this requirement.

Individuals who hold or have held a medical certificate issued by the FAA that was valid at any point after July 14, 2006 but whose driver’s license has been revoked or rescinded for any reason are not eligible to use BasicMed unless and until the driver’s license is reinstated. Any restrictions on a driver’s license (e.g., corrective lenses, prosthetic aids 1 The plain language of the requirements described in FESSA explicitly apply only to the PIC (“…the FAA shall issue or revise regulations to ensure that an individual may operate as pilot in command of a covered aircraft…”). 2 §§ 61.3 and 61.23

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5/3/17 AC 68-1A 4-2 required, daylight driving only, etc.) also apply under BasicMed. Similar to the pilot certificate, when using a driver’s license in lieu of a medical certificate, the driver’s license needs to be in the pilot’s personal possession when they are operating under BasicMed.

4.3 Medical Certificate Issued by the FAA.

4.3.1 General Requirements. In accordance with § 61.23(c)(3)(i)(B), persons operating under BasicMed must hold or have held a valid medical certificate issued under part 67 at any point after July 14, 2006. This medical may have been a first, second, or third-class medical certificate, including any FAA medical certificate issued under an authorization for special issuance (“special issuance medical certificate”).

4.3.1.1 A person who has not held a medical certificate at any point after July 14, 2006 must obtain a medical certificate issued under part 67. The person may choose to use BasicMed even while holding an unexpired medical certificate. After that medical certificate expires, that pilot may use or continue to use BasicMed, provided that person meets the other conditions and limitations.

Note: An FAA medical examination associated with an application for an FAA medical certificate may not be used in lieu of the CMEC requirements of BasicMed.

4.3.1.2 A person should use the expiration date of his or her most recent medical certificate to determine whether it meets the after July 14, 2006 requirement. Special issuance medical certificates are always time-limited and will explicitly state the date when the certificate expires or is no longer valid. Therefore, any special issuance medical certificate with an expiration date after July 14, 2006 would meet the 10-year period preceding the date of enactment of FESSA.

4.3.1.3 Unrestricted (“regular issuance”) medical certificates do not list a specific expiration date. Therefore, persons with an unrestricted FAA medical certificate should refer to the “Date of Examination” displayed on the certificate, and then use the table3 below to determine if you meet the requirements. The expiration date is based on a pilot’s age on the date of the examination as calculated from his or her date of birth (i.e., “under age 40” vs. “age 40 and over”). For example, a person born on January 2, 1963 would be “under age 40” if the date of examination was January 1, 2003, but would be 3 The duration of FAA medical certificates was changed in a final rule issued on July 24, 2008. This rule extended the duration of a third-class medical certificate from 36 calendar-months to 60 calendar-months for persons under age 40. This table reflects the duration of third-class medical certificates prior to those changes. See “Modification of Certain Medical Standards and Procedures and Duration of Certain Medical Certificates” (73 FR 43059 July 24, 2008)

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5/3/17 AC 68-1A 4-3 “age 40 and over” if the examination occurred one day later on January 2, 2003.

4.3.1.4 Persons age 40 or older on the date of their examination would meet the 10-year period described in the Act if their examination was on or after July 1, 2004. Pilots under age 40 on the date of their examination would meet the 10-year period described in the Act if their examination was on or after July 1, 2003.

Determining if your Unrestricted Medical Certificate Meets the July 14, 2006 Requirement 1. Determine certificate date of issuance.

2. Determine your age on date of issuance.

3. Determine validity: If you were under age 40 on the date of issuance and your medical certificate was issued after June 30, 2003, you are eligible; if you were age 40 or older on the date of issuance and your medical certificate was issued after June 30, 2004, you are eligible for BasicMed.

4.3.2 Medical Certificate Requirements. There are a few requirements in § 61.23(c)(3) that apply to the medical certificate the individual is using to meet BasicMed. The most recently issued medical certificate may have been a special issuance medical certificate and could be expired. However, it may not have been suspended or revoked, or in the case of a special issuance medical certificate, it may not have been withdrawn. Medical certificates can be suspended or revoked if the certificate holder does not meet the medical standards of part 67, or as the result of noncompliance with other regulatory requirements. The FAA may also suspend or revoke a medical certificate on the basis of a reexamination of that certificate under Title 49 of the United States Code (49 U.S.C.) § 44709.

4.3.2.1 If a person’s last medical certificate was under suspension at any point in time, that medical certificate does not qualify for BasicMed. Further, if the pilot’s medical certificate expired while under suspension, the pilot must apply for and be issued a new medical certificate to qualify for BasicMed. Under § 61.23(c)(3)(iv), the most recent application for an airman medical certificate submitted to the FAA by the individual cannot have been completed and denied. The FAA considers the application to be in process once the AME accesses the individual’s application in FAA MedXPress. If the individual’s application is completed and denied, the FAA considers the applicant to no longer hold a valid medical certificate, even if the applicant is appealing the denial. In this circumstance, the applicant is unable to use BasicMed.

4.3.2.2 If a person held a medical certificate that was valid after July 14, 2006, but subsequently applied for a new medical certificate, that pilot could not revert to the previous medical certificate if his or her application for a new medical

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5/3/17 AC 68-1A 4-4 certificate was completed and denied. That pilot would need to obtain a new medical certificate to qualify for BasicMed.

4.3.2.3 People operating under BasicMed do not need to maintain or provide documentation that proves their compliance with this medical certificate requirement.

4.4 Completion of Medical Education Course. Pilots flying as PIC under BasicMed must complete a medical education course during the 24 calendar-months4 before acting as PIC of a covered aircraft. The medical education course requirements are listed in part 68, § 68.3 and discussed in Chapter 6.

4.5 Care and Treatment by a Physician. Pilots flying as PIC under BasicMed must be under the care and treatment of a physician5 if the pilot has been diagnosed with any medical condition that may impact their ability to fly. 4.6 Receipt of Medical Exam During the Previous 48 Months. Pilots flying as PIC under BasicMed must undergo a comprehensive medical examination6 from a State-licensed physician during the previous 48 months. The requirements of the exam are listed in § 68.7 and discussed in Chapter 7.

4 § 61.23(c)(3)(i)(C) 5 § 61.23(c)(3)(i)(E) 6 § 61.23(c)(3)(i)(D

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5/3/17 AC 68-1A 5-1 CHAPTER 5. COVERED AIRCRAFT AND OPERATING REQUIREMENTS 5.1 Covered Aircraft Requirements.

5.1.1 General. The aircraft must be authorized by the FAA to carry not more than six occupants7. Additionally, the maximum certificated takeoff weight, which is determined as part of the certification process, must be no more than 6,000 pounds. While a person may operate an aircraft that meets the requirements of § 61.113(i)(1), the FAA notes that this provision does not relieve an aircraft from the requirement to be operated in accordance with its operating limitations. If an aircraft being operated under BasicMed has any operating limitations that conflict with § 61.113(i)(1), that aircraft must comply with its operating limitations.

5.1.2 Type Certificated Aircraft. For type certificated aircraft, the aircraft’s design approval would authorize the number of occupants the aircraft may carry and would contain the maximum certificated takeoff weight. The aircraft’s design approval may be a type certificate (TC), a supplemental type certificate (STC), or an amended TC (ATC). The FAA recognizes that changes could be made to an aircraft’s type design. For example, an aircraft type certificated to carry more than six occupants may be altered to carry six or fewer occupants. In order to make such a change, that aircraft would have to obtain a new design approval, such as an STC or an ATC. So long as an aircraft’s design approval (i.e., TC, STC, or ATC) authorizes the aircraft to carry no more than six occupants, that aircraft would meet the requirements of § 61.113(i)(1). Additionally, if an aircraft with a maximum certificated takeoff weight of more than 6,000 pounds is altered to have a maximum certificated takeoff weight of less than 6,000 pounds, then that aircraft would likewise meet the requirements of § 61.113(i)(1).

5.1.3 Experimental Aircraft. For experimental aircraft, which are not type certificated but instead issued Special Airworthiness Certificates, the operating limitations prescribed by the FAA would authorize the maximum takeoff weight (MTOW). Prior to issuing a Special Airworthiness Certificate, the FAA checks the current Weight and Balance (W&B) information for an aircraft, which includes the maximum gross weight established by the operator. The maximum number of occupants in an experimental aircraft operated by a pilot under BasicMed is addressed in § 91.319(j). This section prohibits a person from operating an experimental aircraft under BasicMed carrying more than six occupants.

5.2 Operating Requirements. Section 61.113(i)(1) requires that the individual operate in accordance with the following operating requirements:

5.2.1 Aircraft Occupancy Limitations. A covered aircraft may be authorized to carry up to six occupants (including any required flightcrew members) and may be operated with up to five passengers on board. For example, a person may operate an aircraft type certificated for one pilot flightcrew member under BasicMed with up to five additional occupants on board. An aircraft type certificated for two pilot flightcrew members may 7 § 61.113(i)(1)

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5/3/17 AC 68-1A 5-2 be operated under BasicMed with up to four additional occupants on board. An occupant in the aircraft (other than the PIC operating under BasicMed) may be a passenger, a required pilot flightcrew member (if the aircraft is type certificated for more than one pilot or if the regulations require more than one pilot), or a flight instructor (if the flight is a training operation).

5.2.2 Status of Required Flightcrew Members.

5.2.2.1 If a pilot operating an aircraft under BasicMed carries another pilot on board who is not a required pilot flightcrew member and who is not a flight instructor providing flight instruction, that additional pilot would be considered a passenger under the FAA’s regulations. A pilot acting as a safety pilot per part 91, § 91.109(c), however, would be a required pilot flightcrew member by regulation rather than a passenger. Section 91.109(c) provides that no person may operate a civil aircraft in simulated instrument flight unless the other control seat is occupied by a safety pilot who possesses at least a private pilot certificate with category and class ratings appropriate to the aircraft being flown. Because a safety pilot is a required pilot flightcrew member, the safety pilot is required to hold a valid and appropriate medical certificate in accordance with § 61.3(a). BasicMed privileges can only be exercised by a person acting as safety pilot when that person is also acting as PIC. BasicMed privileges do not extend to anyone other than the person acting as PIC. 5.2.2.2 Operations under BasicMed include flight training. A person may receive flight instruction from an FAA-authorized flight instructor while that person is operating under BasicMed. A person receiving flight training may receive flight instruction from a flight instructor while the flight instructor is operating under BasicMed, when the flight instructor is acting as PIC. While flight instruction for compensation is considered “other commercial flying” for flight and duty requirements under 14 CFR parts 121 and 135, “a certificated flight instructor who is acting as PIC or as a required flightcrew member and is receiving compensation for his or her flight instruction is only exercising the privileges of a private pilot.”8 5.2.3 Operating Under VFR or IFR. Pilots may fly under BasicMed in visual flight rules (VFR) or instrument flight rules (IFR). There is no prohibition against flying in instrument meteorological conditions (IMC)9, but BasicMed doesn’t change the requirement to hold an instrument rating and be instrument current to act as PIC under IFR. Furthermore, BasicMed does not relieve an aircraft from the requirement to be approved for IFR operations in order to be operated under IFR.

5.2.4 Flight Limitations. Section 61.113(i)(2) contains the following limitations: 8 Pilot, Flight Instructor, Ground Instructor, and Pilot School Certification Rules, 62 FR 16220, 16242 (April 4, 1997).

9 Section 2307(a)(8)(B) of FESSA.

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5/3/17 AC 68-1A 5-3 5.2.4.1 Section 61.113(i)(2)(i) requires that the flight, including each portion of that flight, is not carried out for compensation or hire, including that no passenger or property on the flight is being carried for compensation or hire. In general, pilots exercising private pilot privileges may not operate for compensation or hire. The FAA has long held that operations carrying people or property for compensation or hire require a higher level of safety, such as additional maintenance standards (such as aircraft inspections) and higher airman certificate requirements (at least a Commercial Pilot Certificate and a second-class medical certificate) to support that level of safety. The general prohibition against private pilots operating for compensation or hire is in § 61.113(a).

Section 61.113(b) through (h) contains exceptions from the general prohibition for certain operations from which a pilot may receive some form of compensation. These include operations such as flying in furtherance of a business, sharing flight expenses with passengers, demonstrating an airplane for sale, and conducting search and location operations. These exceptions apply to people operating under BasicMed just as they would apply to a person exercising private pilot privileges under a part 67 medical certificate. 5.2.4.2 Section 61.113(i)(2)(ii) requires that the flight, including each portion of that flight, is not carried out at an altitude that is more than 18,000 feet above MSL.

The aircraft must operate at or below 18,000 feet MSL during the entire flight. For pilots operating aircraft capable of flight above 18,000 feet MSL, the pilot’s preflight planning must accommodate the altitude limitation. For instance, if weather phenomena like icing or thunderstorms are forecast (or is within reasonable possibility) within the pilot’s route of flight that would necessitate climbing above 18,000 feet MSL, the FAA considers initiating such a flight to be contrary to BasicMed.

5.2.4.3 Section 61.113(i)(2)(iii) requires that the flight, including each portion of that flight, is not carried out outside the United States, unless authorized by the country in which the flight is conducted. Title 14 CFR part 1, § 1.1 defines the United States as the States, the District of Columbia, Puerto Rico, and the possessions, including the territorial waters, and the airspace of those areas. Thus, a pilot operating in the United States, as defined in § 1.1, may elect to use BasicMed.

Airmen certificated by the FAA are represented to the International Civil Aviation Organization (ICAO) as compliant with ICAO standards for private pilots, among other requirements. As BasicMed standards divert from ICAO requirements, flights must be geographically limited to operations within the United States, unless specifically authorized by the country in which the flight is conducted.

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5/3/17 AC 68-1A 5-4 5.2.4.4 Section 61.113(i)(2)(iv) requires that the flight, including each portion of that flight, is not carried out at an indicated air speed exceeding 250 knots. Recognizing that many aircraft have airspeed indicators that read in miles per hour (mph), 250 knots is equivalent to 288 mph. If the aircraft can be safely operated (that is, operated in a manner that is not careless or reckless) at a speed of 250 knots or less, then that aircraft may be operated under BasicMed. 5.2.5 Flight Limitation Applicability. A “flight, including each portion of the flight,” means that all of the flight limitations for the operation described above, set forth in § 61.113(i)(2)(i) (iv), apply to the entire flight. Accordingly, if BasicMed is being exercised in any flight, it must be applied for the entire flight (takeoff to full-stop landing) and all the operational restrictions apply for the entire flight. As such, on a flight in which two pilots are present, one holding a medical certificate and the other operating under BasicMed, if the pilot operating under BasicMed is acting as PIC, then no portion of the flight may go beyond the limitations set forth in this section even though the pilot holding the medical certificate may be able to act as PIC during the portion of the flight conducted outside the limitations.

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5/3/17 AC 68-1A 6-1 CHAPTER 6. MEDICAL EDUCATION COURSE REQUIREMENTS 6.1 Availability of the Medical Education Course. The FAA’s publicly-accessible website contains a list of each medical education course that the FAA has accepted for BasicMed purposes.

Note: Nonprofit or not-for-profit general aviation stakeholder groups interested in being a BasicMed course provider can contact the FAA at 9-AWA-AFS-basicmed@faa.gov.

6.2 Course Requirements. Each online medical course accepted by the FAA will include the following elements, in accordance with § 68.3:

1. Educate pilots on conducting medical self-assessments. 2. Advise pilots on identifying warning signs of potential serious medical conditions.

3. Identify risk mitigation strategies for medical conditions. 4. Increase awareness of the impacts of potentially impairing over-the-counter and prescription drug medications.

5. Encourage regular medical examinations and consultations with primary care physicians.

6. Inform pilots of the regulations pertaining to the prohibition on operations during medical deficiency and medically disqualifying conditions. 7. Provide the checklist developed by the FAA in accordance with § 68.7. 6.3 Documents the Course Must Provide to the Individual and Transmit to the FAA. In accordance with § 68.3(b), upon successful completion of the course, the medical education course must electronically provide to the individual and transmit to the FAA: 1. A certification of completion of the medical education course. 2. A release authorizing single access to the National Driver Register (NDR) through a designated State Department of Motor Vehicles to furnish to the FAA information pertaining to the individual’s driving record. 3. A certification by the individual that the individual is under the care and treatment of a physician if the individual has been diagnosed with any medical condition that may impact the ability of the individual to fly. 4. Information provided by the pilot about the physician and the comprehensive medical examination, including:

• The pilot’s name, address, telephone number, and airman certificate number; • The name, address, telephone number, and State medical license number of the physician performing the comprehensive medical examination;

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5/3/17 AC 68-1A 6-2 • The date of the comprehensive medical examination; and • A certification by the individual that the checklist described in § 68.7 was followed and signed by the physician in the comprehensive medical examination. 5. A statement certifying that the individual understands the existing prohibition on operations during medical deficiency. In accordance with § 68.3(b)(5), the person must attest that “I understand that I cannot act as pilot in command, or any other capacity as a required flightcrew member, if I know or have reason to know of any medical condition that would make me unable to operate the aircraft in a safe manner.” This statement shall be electronically provided to the individual and transmitted to the FAA upon successful completion of the course.

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5/3/17 AC 68-1A 7-1 CHAPTER 7. COMPREHENSIVE MEDICAL EXAMINATION REQUIREMENTS 7.1 General. In order for an individual to operate under BasicMed, he or she must receive a comprehensive medical examination from a State-licensed physician during the previous 48 months in accordance with § 61.23(c)(3)(i)(D). The physician does not need to be an FAA-designated AME, although AMEs are not prohibited from providing this examination. Section 68.5(a)(1) requires the individual to complete the individual’s section of the Comprehensive Medical Examination Checklist (CMEC) described in § 68.7(a) and to provide the completed checklist to the physician performing the examination.

Section 68.5(b) requires the physician to conduct the comprehensive medical examination in accordance with the checklist, check each item specified during the examination, and address, as medically appropriate, every medical condition listed and any medications the individual is taking.

7.2 Comprehensive Medical Examination Checklist (CMEC). The CMEC provides an outline of the elements that must be accomplished in order to meet the requirements of BasicMed. The CMEC is completed by the individual and then provided to the physician performing the comprehensive medical examination. The checklist, which can be found in Appendix A, Comprehensive Medical Examination Checklist, contains three sections: a section with instructions, a section for the airman to complete, and a section for the physician to complete.

7.2.1 Section for the Airman to Complete. In accordance with § 68.7(a)(1), the portion of the checklist for the individual to complete must include the same questions as boxes 3 through 13 and boxes 16 through 19 of the FAA Form 8500-8, Application for Airman Medical Certificate, dated 3-99. These questions include:

1. Name (Last name, First name, Middle name, Suffix).

2. Social Security Number (optional).

3. Street address (City, State, Zip Code, Country).

4. Telephone number.

5. Country of citizenship.

6. Date of birth (mm/dd/yyyy).

7. Hair color.

8. Eye color.

9. Sex (male/female).

10. Type of airman certificate held.

11. Occupation.

12. Employer.

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5/3/17 AC 68-1A 7-2 13. Has your FAA airman medical certificate ever been denied, suspended, or revoked? (Yes, No) If yes, give date (mm/dd/yyyy). 14. Date of last FAA medical application (mm/dd/yyyy). 15. Do you currently use any prescription or nonprescription medication? (Yes, No).

16. For each medication prescribed, provide medication name, dosage, dosage unit, frequency, and whether previously reported. 17. Do you ever use near vision contact lens(es) while flying? (Yes, No). 18. Medical History. Have you ever in your life been diagnosed with, had, or do you presently have any of the following? (Yes, No, Comment). a. Frequent or severe headaches.

b. Dizziness or fainting spell.

c. Unconsciousness for any reason.

d. Eye or vision trouble, except glasses.

e. Hay fever or allergy.

f. Asthma or lung disease.

g. Heart or vascular trouble.

h. High or low blood pressure.

i. Stomach, liver, or intestinal trouble.

j. Kidney stone or blood in urine.

k. Diabetes.

l. Neurological disorders: epilepsy, seizures, stroke, paralysis, etc. m. Mental disorders of any sort: depression, anxiety, etc. n. Substance dependence or failed a drug test ever; or substance abuse or use of illegal substance in the last 2 years.

o. Alcohol dependence or abuse.

p. Suicide attempt.

q. Motion sickness requiring medication.

r. Military medical discharge.

s. Medical rejection by military service.

t. Rejection for life or health insurance.

u. Admission to hospital.

v. History of (1) any conviction(s) involving driving while intoxicated by, while impaired by, or while under the influence of alcohol or a drug; or (2) history of any conviction(s) or administrative action(s)

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5/3/17 AC 68-1A 7-3 involving an offense(s) which resulted in the denial, suspension, cancellation, or revocation of driving privileges or which resulted in attendance at an educational or a rehabilitation program. w. History of nontraffic conviction(s) (misdemeanors or felonies). x. Other illness, disability, or surgery.

7.2.1.1 Section 68.7(a)(2) requires this section of the checklist to also contain a signature line for the individual to affirm that:

1. The answers provided by the individual on that checklist, including the individual’s answers regarding medical history, are true and complete;

2. The individual understands that he or she is prohibited under FAA regulations from acting as PIC, or any other capacity as a required flightcrew member, if he or she knows or has reason to know of any medical deficiency or medically disqualifying condition that would make the individual unable to operate the aircraft in a safe manner; and 3. The individual is aware of the regulations pertaining to the prohibition on operations during medical deficiency and has no medically disqualifying conditions in accordance with applicable law.

7.2.2 Section for the Physician to Complete. The third section of the checklist includes a portion for the physician to complete, and instructs the physician to perform a clinical examination10 of the following:

1. Head, face, neck, and scalp.

2. Nose, sinuses, mouth, and throat.

3. Ears, general (internal and external canals), and eardrums (perforation). 4. Eyes (general), ophthalmoscopic, pupils (equality and reaction), and ocular motility (associated parallel movement, nystagmus).

5. Lungs and chest (not including breast examination).

6. Heart (precordial activity, rhythm, sounds, and murmurs). 7. Vascular system (pulse, amplitude, and character, and arms, legs, and others). 8. Abdomen and viscera (including hernia).

9. Anus (not including digital examination).

10. Skin.

11. G–U system (not including pelvic examination).

10 § 68.7(c)

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5/3/17 AC 68-1A 7-4 12. Upper and lower extremities (strength and range of motion). 13. Spine and other musculoskeletal.

14. Identifying body marks, scars, and tattoos (size and location). 15. Lymphatics.

16. Neurologic (tendon reflexes, equilibrium, senses, cranial nerves, and coordination, etc.).

17. Psychiatric (appearance, behavior, mood, communication, and memory). 18. General systemic.

19. Hearing.

20. Vision (distant, near, and intermediate vision, field of vision, color vision, and ocular alignment).

21. Blood pressure and pulse.

22. Anything else the physician, in his or her medical judgment, considers necessary.

7.2.2.1 Section 68.7(c)(2) requires the physician:

• To exercise medical discretion to address, as medically appropriate, any medical conditions identified; and • To exercise medical discretion in determining whether any medical tests are warranted as part of the comprehensive medical examination. 7.2.2.2 Section 68.7(c)(3) requires the physician to discuss all prescription and nonprescription drugs the individual reports taking and their potential to interfere with the safe operation of an aircraft or motor vehicle. 7.2.2.3 Provided the physician is satisfied that the applicant does not present any medical evidence that the applicant is not safe for flight, the physician shall sign and date the checklist in accordance with § 68.7(c)(4). 7.3 Physician Qualifications. The FAA relies on the determination of each State (as well as each territory and possession of the United States) as to which persons it will license as physicians. If the person holds a license as a physician issued by any State, territory, or possession, then they meet the requirement as a state-licensed physician. The FAA notes that all States license medical doctors (M.D.) and doctors of osteopathic medicine (D.O.) as physicians; although Federal and some State laws may permit the licensure of other persons, such as doctors of dental surgery (D.D.S.), as physicians. While the FAA expects that these specialists (e.g., D.D.S., dentist, podiatrist, etc.) who do not also hold an M.D. or D.O. would not have the breadth of training for a BasicMed medical examination, the FAA will rely on each State-licensed physician to determine whether he or she is qualified to conduct the medical examination.

7.3.1 Physicians should refer to their State medical licensing authority for further guidance.

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5/3/17 AC 68-1A 8-1 CHAPTER 8. SPECIAL BASICMED REQUIREMENTS FOR CERTAIN MEDICAL CONDITIONS 8.1 General. BasicMed contains several provisions that require specific actions for individuals who have mental, cardiac, or neurological health conditions. 8.2 Special Issuance Medical Certificates Required. For certain conditions, a person wishing to operate under BasicMed must complete the process for obtaining an authorization for special issuance of a medical certificate in accordance with § 68.9. The person is required to obtain only one special issuance medical certificate for each condition, and may subsequently operate under BasicMed. Persons who have, or are newly diagnosed with, a cardiovascular, neurological, or mental health condition described in FESSA, may not use BasicMed until they have been found eligible for special issuance of a medical certificate. Once issued a medical certificate, the person may then use BasicMed if they meet all other requirements of FESSA. These conditions are listed below:

8.2.1 A mental health disorder, limited to an established medical history or clinical diagnosis of any of the following:

1. Personality disorder that is severe enough to have repeatedly manifested itself by overt acts.

2. Psychosis, defined as a case in which an individual:

• Has manifested delusions, hallucinations, grossly bizarre or disorganized behavior, or other commonly accepted symptoms of psychosis; or • May reasonably be expected to manifest delusions, hallucinations, grossly bizarre or disorganized behavior, or other commonly accepted symptoms of psychosis. 3. Bipolar disorder.

4. Substance dependence within the previous 2 years, as defined in part 67, § 67.307(a)(4).

8.2.2 A neurological disorder, limited to an established medical history or clinical diagnosis of any of the following:

1. Epilepsy.

2. Disturbance of consciousness without satisfactory medical explanation of the cause.

3. A transient loss of control of nervous system functions without satisfactory medical explanation of the cause.

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5/3/17 AC 68-1A 8-2 8.2.3 A cardiovascular condition, limited to a one-time special issuance for each diagnosis of the following:

1. Myocardial infarction.

2. Coronary heart disease that has required treatment.

3. Cardiac valve replacement.

4. Heart replacement.

8.3 BasicMed Prohibitions for Persons with Mental Health Conditions. 8.3.1 Section 68.9(c)(1)(i) prohibits an individual with a clinically diagnosed mental health condition from operating under BasicMed if, in the judgment of the individual’s State-licensed medical specialist, the condition:

1. Renders the individual unable to safely operate under BasicMed; or 2. May reasonably be expected to make the individual unable to operate under BasicMed.

8.3.2 Section 68.9(c)(1)(ii) prohibits a person from operating under BasicMed if the person’s driver’s license is revoked by the issuing agency as a result of a clinically diagnosed mental health condition.

8.4 BasicMed Prohibitions for Persons with Neurological Health Conditions. Under § 68.9(d)(1), an individual with a clinically diagnosed neurological condition may not operate under BasicMed if the individual’s driver’s license is revoked by the issuing agency as a result of a clinically diagnosed neurological condition, or if, in the judgment of the individual’s State-licensed medical specialist, the condition: 1. Renders the individual unable to safely operate under BasicMed; or 2. May reasonably be expected to make the individual unable to safely operate under BasicMed.

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5/3/17 AC 68-1A Appendix A A-1 APPENDIX A. COMPREHENSIVE MEDICAL EXAMINATION CHECKLIST

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5/3/17 AC 68-1A Appendix A A-2

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5/3/17 AC 68-1A Appendix A A-3

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5/3/17 AC 68-1A Appendix A A-4

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5/3/17 AC 68-1A Appendix A A-5

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5/3/17 AC 68-1A Appendix A A-6

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5/3/17 AC 68-1A Appendix A A-7

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5/3/17 AC 68-1A Appendix A A-8

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5/3/17 AC 68-1A Appendix A A-9

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Advisory Circular Feedback Form If you find an error in this AC, have recommendations for improving it, or have suggestions for new items/subjects to be added, you may let us know by contacting the General Aviation and Commercial Division (AFS-800) at 9-AFS-800-Correspondence@faa.gov or the Flight Standards Directives Management Officer at 9-AWA-AFS-140-Directives@faa.gov.

Subject: AC 68-1A, BasicMed

Date: _____________________

Please check all appropriate line items:

An error (procedural or typographical) has been noted in paragraph ____________ on page _______.

Recommend paragraph _____________ on page __________ be changed as follows: ______________________________________________________________________ ______________________________________________________________________ In a future change to this AC, please cover the following subject: (Briefly describe what you want added.)

______________________________________________________________________ ______________________________________________________________________ Other comments:

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Submitted by: Date: ______________________