How long is a DOT physical good for?
Up to 2 years — if nothing needs watching. Here's every card length, why examiners shorten them, and how to keep getting the full 24 months.
Quick answer: a DOT physical (medical examiner's certificate) is good for a maximum of 24 months. Examiners issue 1-year, 6-month or 3-month cards when a condition needs monitoring.
DOT medical card length by condition
| Your situation | Longest card | Notes |
|---|---|---|
| Healthy, nothing to monitor | 2 years | The federal maximum |
| BP 140/90 or lower, not on BP treatment | 2 years | |
| Being treated for high blood pressure | 1 year | At least annual, even when controlled |
| BP 140–159 / 90–99 (stage 1) | 1 year | BP chart |
| BP 160–179 / 100–109 (stage 2) | 3 months, one time | Under 140/90 in time = 1 year from original exam |
| BP 180/110 or higher (stage 3) | Disqualified | Then 6-month cards once under 140/90 |
| Insulin-treated diabetes | 1 year | Form MCSA-5870 from your clinician, exam within 45 days |
| Sleep apnea on CPAP | Examiner decides | Commonly 1 year with a CPAP compliance report |
| Other conditions being monitored | Examiner decides | Can be any length up to 2 years |
Based on 49 CFR 391.45–391.46 and FMCSA hypertension guidance. Your examiner sets the final length.
What happens when your medical card expires
There's no grace period. Without a valid medical certificate you can't legally drive a commercial vehicle in interstate commerce. CDL holders also have to keep a current certificate on file with their state, and if it lapses the state can downgrade your CDL — which means extra paperwork and time off the road to get it back.
Since 2025, examiners send exam results to FMCSA electronically, and FMCSA passes them to state licensing agencies. Some states are still finishing that switch, so keep a copy of your certificate and check that your state shows it.
How to renew without losing a day
- Book 3–4 weeks before expiration. Your new card starts on the exam date, so going a little early costs you nothing.
- Use a National Registry examiner. Search FMCSA's National Registry of Certified Medical Examiners — not every clinic qualifies.
- Bring your paperwork: a list of medications, glasses or hearing aids, your CPAP compliance report if you have sleep apnea, and form MCSA-5870 if you use insulin.
- Know your blood pressure before you walk in. A pharmacy cuff or home monitor tells you if you need to see a doctor first.
How to keep getting 2-year cards
Most short cards come from two things: blood pressure and blood sugar that nobody has been treating. Both are cheap to manage with a regular doctor and generic prescriptions, which is what a health plan pays for. The DOT physical itself usually costs $50–$150 out of pocket (does insurance cover it?), but doctor visits, BP and diabetes meds, sleep studies and CPAP generally are covered.
Owner-operators: ACA subsidies are based on net income after business expenses. See owner-operator health insurance, the truck driver cost calculator, or open enrollment dates for truckers (Nov 1 – Jan 15).
Related: DOT physical requirements · DOT blood pressure limits · sleep apnea and your CDL · truck driver health insurance
General information, not medical or legal advice. Your certified medical examiner and state licensing agency make the final decisions.
DOT medical card questions
How long is a DOT physical good for?
Up to 2 years (24 months). That's the maximum. The certified medical examiner can issue a shorter card — 1 year, 6 months or 3 months — when a condition like high blood pressure or diabetes needs monitoring.
Why did I only get a 1-year DOT card?
The most common reasons are blood pressure between 140/90 and 159/99, being on treatment for high blood pressure, insulin-treated diabetes, or a condition such as sleep apnea that the examiner wants to recheck. The examiner decides the length based on what needs monitoring.
How long is a DOT physical good for with diabetes?
If you use insulin, up to 12 months. Your treating clinician completes the Insulin-Treated Diabetes Mellitus Assessment Form (MCSA-5870), and the exam has to happen within 45 days of the clinician signing it. Drivers whose diabetes is managed without insulin can receive up to 2 years if it's well controlled, at the examiner's discretion.
Is there a grace period when a DOT medical card expires?
No. You need a valid medical certificate to drive a commercial vehicle. If it expires, you can't legally drive a CMV until you pass a new exam, and CDL holders whose certificate lapses with their state can have their CDL privileges downgraded. Schedule your renewal a few weeks early.
Can any doctor do my DOT physical?
No. The exam has to be done by a medical examiner listed on FMCSA's National Registry of Certified Medical Examiners. Since 2025, examiners send results electronically to FMCSA, which passes them to state licensing agencies, but keep a copy of your certificate.
Does health insurance pay for the DOT physical?
Usually not, because it's a work-required exam rather than medical treatment. A typical exam costs about $50 to $150. What insurance does cover is the care that keeps your card at 2 years: doctor visits, blood pressure and diabetes medications, sleep studies and CPAP.
A doctor between physicals keeps your card long
Free quotes on plans with nationwide networks for drivers. Licensed advisors, no obligation.
Get my quoteText us