Disability Insurance

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Do you all have any recommendations on which disability insurance carrier to go with for young ophthalmologists?

Also, what access do disability insurance carriers have re: your health history? Do they independent access to all the meds you've ever been prescribed, all ER visits, doctors visits, etc? Basically can they contact your health insurance company and ask them to provide these details? Does HIPPA play any role in this?

Thanks for the info.

Originally Posted by Dusn

Do you all have any recommendations on which disability insurance carrier to go with for your ophthalmologists?

Also, what access do disability insurance carriers have re: your health history? Do they independent access to all the meds you've ever been prescribed, all ER visits, doctors visits, etc? Basically can they contact your health insurance company and ask them to provide these details? Does HIPPA play any role in this?

Thanks for the info.

The process for applying for disability insurance is very similar to the process for applying for life insurance.

They sit down with you, and fill out a long health questionnaire. They ask which meds you're currently on, if you have any chronic conditions, if you've ever been to the ER, if you've ever had surgery, if you've ever had a positive HIV test, if you've ever had to take time off of work/school because of a medical condition, what your family history is, etc.

I also had to undergo routine blood and urine tests - BMP, Fasting Lipid Panel, UA, etc.

My insurance agent did mention that they may call your old doctors and request records. He sort of mentioned this in passing, so I don't remember exactly what he said about that.

Agree with above. Also, be sure you get a policy that is "own occupation." That means if you cannot perform your duties as an ophthalmologist, you are considered disabled. A straight disability policy will only pay if you cannot work at all. You could end up disabled as an ophthalmologist, but still be employable as a Wal-Mart greeter.

You can often get a small policy as a resident with a rider that will allow you to expand coverage without another medical exam. Usually results in a lower premium, as the rate will increase with age and any personal (or immediate relative's) medical conditions.

Usually the premiums are lower if you have a longer waiting time before policy implementation.

Definitely go for own occupation. Some have COLA adjustments. Some have varying deals on mental health--24 months seems to be typical.

I worked with a guy named Matt at Physicians Disability whom I really liked. Was great in helping find a good life insurance policy while still a fellow as well as disability.

I started with Mass Mutual when I was a resident. Usually the earlier you start, the quicker you can increase your monthly benefit amount when you get your first job (most will want to see a 1040 or some other official income document to verify your increase to a higher monthly benefit level. As others said, get own occupation and non-cancellable.

A word of warning: whenever you get your disability policy, the salesman (often posing as a "financial advisor") may also try to sell you a cash value life insurance policy like whole life. Make sure you do not buy such an insurance policy until you have thoroughly researched it. For most of us, a cash value life insurance policy is a complete waste of money.

Originally Posted by 90 diopter

A word of warning: whenever you get your disability policy, the salesman (often posing as a "financial advisor") may also try to sell you a cash value life insurance policy like whole life. Make sure you do not buy such an insurance policy until you have thoroughly researched it. For most of us, a cash value life insurance policy is a complete waste of money.

Very true. Whole life, in this day and age, is not worth the premiums. Term is dirt cheap, and you can get term life that will last until you are retired (or have enough saved for retirement). You can likely invest your money better.

Also make sure your "own occupation" works if you can only partly do your job, ie if you can still do clinic but can't operate then it should pay partly. I bought my own as a fellow and can increase when I am done. They access everything about your history just like life insurance. Go with a good company with a long track record. I have mine through Principal.

Don't get whole life as others have said.

Thank you all for the advice!

Late addition. The premiums for an Ophthalmologist are going to be fairly similar with most of the major carriers. Focus on the quality of the policy, and don't give up benefits for things like mental/nervous conditions. Your specialty is one that should not have to sacrifice these things in order to find competitive pricing. If you are in the earlier years of residency you may want to consider a graded premium too.

For women there may be some opportunity to save considerably on the cost, if you are willing to accept limited mental/nervous benefits, but for men, you should not have to.

Originally Posted by Visionary

Very true. Whole life, in this day and age, is not worth the premiums. Term is dirt cheap, and you can get term life that will last until you are retired (or have enough saved for retirement). You can likely invest your money better.

You should talk with a trusted financial planner about that before making that decision.

It is true that for 95% of the population, whole or variable life policies are not worth it but it is also true that they can have some tax value to people who earn a very high income and most ophthalmologists would certainly fall into that group.

Originally Posted by KHE

You should talk with a trusted financial planner about that before making that decision.

It is true that for 95% of the population, whole or variable life policies are not worth it but it is also true that they can have some tax value to people who earn a very high income and most ophthalmologists would certainly fall into that group.

While what you say is true, there are also far better investments/tax shelters than whole life.

The tax benefits and investment opportunities of whole life are generally when you have maxed out everything else.

Originally Posted by MR Insurance

Late addition. The premiums for an Ophthalmologist are going to be fairly similar with most of the major carriers. Focus on the quality of the policy, and don't give up benefits for things like mental/nervous conditions. Your specialty is one that should not have to sacrifice these things in order to find competitive pricing. If you are in the earlier years of residency you may want to consider a graded premium too.

For women there may be some opportunity to save considerably on the cost, if you are willing to accept limited mental/nervous benefits, but for men, you should not have to.

I'm starting to look into this insurance thing after finally finishing school. What do you mean with regards to this specialty not having to sacrifice mental/nervous conditions in order to find competitive pricing? How is it different for men vs. women?

Originally Posted by KHE

You should talk with a trusted financial planner about that before making that decision.

It is true that for 95% of the population, whole or variable life policies are not worth it but it is also true that they can have some tax value to people who earn a very high income and most ophthalmologists would certainly fall into that group.

No it's not. A very small portion of ophthalmologists and doctors in general would benefit from bogus policies like these. They're sold by insurance salesmen because the commission is anywhere between 6 to 12 months of your premiums; money that is not being invested and going directly into the pocket of the salesman.

If you absolutely need a permanent death benefit (I certainly do not) and plan on leaving over 5 million dollars to your heirs when you die, then maybe there's some utility to a whole life policy. But most ophthalmologists will never accumulate this kind of money. And if I was one of the lucky ones that did save up such a large stash, I would retire well before I approached this amount and live comfortably off of my savings and investments.

As far as finding a "trusted" financial planner, the only type I would ever trust is one who charges a flat fee, regardless of the size of one's nest egg, and doesn't sell any products of any kind. As you can imagine, these people are not easy to find. There's not a single financial planner anywhere near where I live who has this sort of fee structure.

Good discussion here:
http://www.bogleheads.org/forum/view...p?f=10&t=88689

Originally Posted by dantt

I'm starting to look into this insurance thing after finally finishing school. What do you mean with regards to this specialty not having to sacrifice mental/nervous conditions in order to find competitive pricing? How is it different for men vs. women?

Many policies have limits on the number of years you can receive benefits if you become disabled due to mental disorder. Women are statistically more likely to become disabled and unable to work for this reason, so the insurance companies likely charge a higher premium for no limits on mental/nervous.

Ideally, you'd like a policy that treats mental/nervous the same as a physical disability.

I'm looking at disability insurance, myself.

First of all, definitely don't falsify anything they ask you. Down the road if you file a claim, they can terminate your policy because you weren't truthful with them about something and not pay you a dime.

They do request records from your medical providers. This information will be stored in the Medical Informaiton Bureau and should you apply for other types of insurance later in time, those companies will have access to all the information stored in the MIB.

Picking the right company is a matter of reading the fine print. Guardinan offers no mental-nervous exclusions unless you're in ER, pain management, anesthesia, or a few other professions. Met-Life and Standard Protector Platinum offer no mental health exclusions. Certain subsets of Principal offer no mental health exclusion.

So you go with the above? Maybe. MetLife has, IMHO, a weaker residual recovery benefit than the others. Guardian costs a lot--in my case a lot more. Other verbiage may be out there that concerns you.

Originally Posted by dantt

I'm starting to look into this insurance thing after finally finishing school. What do you mean with regards to this specialty not having to sacrifice mental/nervous conditions in order to find competitive pricing? How is it different for men vs. women?

For Ophthalmologists, there are a number of carriers that will offer fairly competitive pricing without limiting the benefits for mental/nervous conditions. As someone mentioned above, Guardian, MetLife and Standard are the first that come to mind. Principal can be included, but only if you opt for their Transitional Own Occ definition of total disability.

As someone mentioned above. Women are statistically more likely to go on claim, which makes the cost of insurance greater.
*There are ways of creating an even playing field so that men and women are the same price. This is very product specific though and I prefer not to write it publicly so feel free to PM me if you'd like more info. This coverage would not be the “best” out there, but still very good with a well known insurance carrier and the price is too good not to seriously consider it.

It's strange that the AAO does not seem to have disability insurance like many of the other medical specialty organizations. Has anyone tried going through the AMA for disability insurance? If so, how was your experience? Which company do they contract with?

Originally Posted by 90 diopter

As far as finding a "trusted" financial planner, the only type I would ever trust is one who charges a flat fee, regardless of the size of one's nest egg, and doesn't sell any products of any kind. As you can imagine, these people are not easy to find. There's not a single financial planner anywhere near where I live who has this sort of fee structure.

I can’t help but disagree with this. A true fee-only planner may be unbiased and have less conflict of interest, but you will be paying a decent chunk of money and will likely be told the exact same thing as a non fee-only planner who has good morals, principles and industry experience along with some advanced education (like a CFP).

Additionally, there are so-called “fee-only” planners who charge you a fee for managing assets, but do not sell any products. At first thought, this seems unbiased and free of any conflicts of interest. BUT, how can someone whose earnings are based on the amount of money you invest, act without a conflict of interest?

True fee-only planners charge flat fees completely unrelated to assets or insurance, but many individuals fall for the “fee-only planner” that charges based on assets under management, which is not conflict free.

IMHO, you just need to speak with multiple people and find one who is right for you, and whose process aligns with your goals and principles. Don’t just go with the first person that you meet with (even if you end up with them), and if they start bringing up specific products within the first ten minutes, run. Make sure that everything makes sense and be sure to ask a lot of questions. If they cannot backup their position and recommendations with strong and logical reasoning, move on.

I am in the financial services profession and I am capable/licensed to do fee-based, assets under management fee-based, and commission-based work. If a young physician needs disability insurance, the fee-only planner will tell him the same thing as the insurance agent and the asset based fee planner (hopefully). The difference is that you will pay your fee-only planner (let’s say $5,000) for that advice, along with other advice obviously. The way that I see it, if I know that I will make a $3,000 commission by selling disability insurance, I will not need to also charge a $5,000 fee to help you with additional planning. At the least, I can reduce it to $2,000 which still gets me the $5,000 I wanted to make, but saves you $3,000. I’ve done this multiple times and am pretty confident that those clients are very appreciative.

IMHO, you could be paying out of pocket for something that you can get for free. If I know that you will implement recommendations through me, then I don’t have to charge a huge financial planning fee because the banks and insurance companies will already be paying me plenty.

The hard part is finding someone who you can trust – I just don’t think it has to be a fee-only planner.

Originally Posted by Dusn

It's strange that the AAO does not seem to have disability insurance like many of the other medical specialty organizations. Has anyone tried going through the AMA for disability insurance? If so, how was your experience? Which company do they contract with?

The United States Life Insurance Company underwrites the AMA policy.
I've spoken with multiple docs who decided in favor of AMA based on pricing alone, but its not usually my recommendation (for multiple reasons). If you are looking for the lowest price - might be a good option. If you want a quality policy than you should do your research before buying. This goes with any association (group) policies.

There are also some discounts out there for AMA members with individual DI policies that are issued through alternate carriers such as MetLife and Union Central. Those are usually better quality and still discounted.

Honestly though, do your research - there are obviously good reasons why a lot of docs opt to go with higher quality coverage, regardless of the price.

Originally Posted by MR Insurance

The hard part is finding someone who you can trust – I just don’t think it has to be a fee-only planner.

After my experience with my prior "financial advisor," who is a CFP by the way, I will never again trust any other person with my money. Most of us are capable of managing our own investments, provided we educate ourselves with the correct resources and avoid getting greedy.

Does anyone have any experience with a company called Doctor Disability? Its a group I found that put together a bunch of quotes from different insurance companies. It was convenient to get the quotes, but I wonder if I use them to buy insurance, will I be paying more than I would if I just contacted whichever company directly.

Pricing is the same regardless of who you buy it through. Additionally, you will have to buy through a licensed agent, so you might as well give them the business if they put in the time to help you - assuming that they did actually help you.

The only way pricing will be different, is if there is a difference in the coverage design.

I just picked up a plan from MetLife. Plan looks like so:


Disability Occupational Class: 5S, which I was told is awesome since most of us don't get into this class for some reason that is above me.

Base Monthly Benefit: $5,000, 90 day elimination, maximum benefit period to age 65.

Residual Disabilty Rider
COLA 3% simple rider
Your Occupation Rider
Presumptive Total disabilty Rider
Guaranteed Insurability Rider (up to age 51, units of increase $1,000, Total available $9,000)
Catastrophic Disability Benefit: $5,000
Automatic increase benefit (5% each of the first five years not disabled)

I pay $130/mo. I was told this just came about in the previous few months and was at quite the discounted rate.

Originally Posted by freaker

I'm looking at disability insurance, myself.

First of all, definitely don't falsify anything they ask you. Down the road if you file a claim, they can terminate your policy because you weren't truthful with them about something and not pay you a dime.

They do request records from your medical providers. This information will be stored in the Medical Informaiton Bureau and should you apply for other types of insurance later in time, those companies will have access to all the information stored in the MIB.

.

How far back do they check, and what if you forget to mention a visit? I'm about to apply for insurance myself, and I don't have any medical conditions I'm trying to hide. I've just seen a few doctors over the past over the past 5-10 years-- ie a dermatologist for nevus excision, an allergist for allergies (duh), my knee had an MRI after an injury etc etc. -- None of my visits resulted in any long term treatment and I have no chronic issues, but what if I forget to put one of these visits down-- is that alone grounds for them to weasel out of paying if I become disabled?

I'm in the process of obtaining coverage myself. How common is it to be offered coverage but not denied future insurability without medical under writing? Unfortunately, I have an abnormal lab value of uncertain significance that's been extensively worked up in the past.

Originally Posted by odieoh

How far back do they check, and what if you forget to mention a visit? I'm about to apply for insurance myself, and I don't have any medical conditions I'm trying to hide. I've just seen a few doctors over the past over the past 5-10 years-- ie a dermatologist for nevus excision, an allergist for allergies (duh), my knee had an MRI after an injury etc etc. -- None of my visits resulted in any long term treatment and I have no chronic issues, but what if I forget to put one of these visits down-- is that alone grounds for them to weasel out of paying if I become disabled?

Mine asked about things within 5 years.

Originally Posted by dantt

I'm in the process of obtaining coverage myself. How common is it to be offered coverage but not denied future insurability without medical under writing? Unfortunately, I have an abnormal lab value of uncertain significance that's been extensively worked up in the past.

All depends on the situation, so unfortunately you cannot get an answer without someone reviewing your medical record.

Depending on your personal situation, the company may offer you coverage but exclude certain options such as the Future Increase Option that you mentioned. My opinion is to work with an experienced DI specialist as they are doing the highest volume of business, meaning they have the best relationships with companies and know how to position your case.
Goodluck, I hope that helps.