Health Insurance for Spouse and Kids?

JustAdocInBox · Nov 4, 2007

Does anyone know of any MSTPs that give health insurance to your spouse and kids if you have a family? So far, neither Wash U or Baylor (schools I have interviewed at) offered it. I plan on getting married and starting a family during my training and I am finding this lack of health insurance to be extremely worrisome.

OncDoc19 · Nov 4, 2007

revaldo29 said:
Does anyone know of any MSTPs that give health insurance to your spouse and kids if you have a family? So far, neither Wash U or Baylor (schools I have interviewed at) offered it. I plan on getting married and starting a family during my training and I am finding this lack of health insurance to be extremely worrisome.

I second this question. Thanks for bringing this up - something I definitely need to start asking about. I am startled that all schools don't offer this. The kids thing is more worrisome to me though. Won't your spouse be working though and therefore have their own insurance? I would think it would be pretty tough to start a family on an MSTP stipend alone.

JustAdocInBox · Nov 4, 2007

Well the plan is that my spouse would work for 1-2 years and save up money to last us until I get to residency while she stays home to raise the baby (babies?). I am also planning on taking out some subsidized stafford loans. It seems that most schools offer a rate of about $2,000 a year for each family member. This is quite a chip off the stipend.

OncDoc19 · Nov 4, 2007

revaldo29 said:
Well the plan is that my spouse would work for 1-2 years and save up money to last us until I get to residency while she stays home to raise the baby (babies?). I am also planning on taking out some subsidized stafford loans. It seems that most schools offer a rate of about $2,000 a year for each family member. This is quite a chip off the stipend.

So you can get the insurance but it's 4000 a year (assuming wife plus on child)? This is a lot. It seems to me that perhaps she should consider working until you enter residency. Even working 1-2 years it is unlikely (although I don't know her profession) that you could save up enough to last for that long. Plus if she does make that much perhaps she could work just enough to get the insurance at her job (like 60% time). I assume culturally (no offense meant here, I saw on your MD Apps that you are Arab) you and your spouse would prefer not to send the children to daycare but perhaps some sacrifices must be made now or alternatively wait to have children until you enter residency. I am dealing with similar things as my boyfriend is an Indian Muslim and his mother stayed at home. Unfortuantely it is prohibitively expensive to raise children in most places in the US on only one salary, especially if that one is that of a graduate student.

solitude · Nov 5, 2007

OncDoc19 said:
So you can get the insurance but it's 4000 a year (assuming wife plus on child)? This is a lot. It seems to me that perhaps she should consider working until you enter residency. Even working 1-2 years it is unlikely (although I don't know her profession) that you could save up enough to last for that long. Plus if she does make that much perhaps she could work just enough to get the insurance at her job (like 60% time). I assume culturally (no offense meant here, I saw on your MD Apps that you are Arab) you and your spouse would prefer not to send the children to daycare but perhaps some sacrifices must be made now or alternatively wait to have children until you enter residency. I am dealing with similar things as my boyfriend is an Indian Muslim and his mother stayed at home. Unfortuantely it is prohibitively expensive to raise children in most places in the US on only one salary, especially if that one is that of a graduate student.

Well you CAN take out loans if need be. I know a few MD/PhD's that started a family, the spouse stays home, and the couple has taken out loans. It sucks, but if you're planning to be more of a PHYSICIAN-scientist then you'll be able to pay them off. If you're planning to be a physician-SCIENTIST, and your spouse is not going to work, it's going to be hard to comfortably support a family at all, even without loans.

Fencer · Nov 5, 2007

It depends on how supportive is your spouse. 20 yrs ago, I did it with only a $8500/yr stipend. It is very hard, but my wife and I look back at those years as increadible ones. The situation really pulled us very close -together. We managed to do a lot of free stuff (i.e.: walks by park, travel to little adjancent town/parks, etc.) She quit her Master's to raised our family. We did get family insurance coverage, but premiums were lower than now. My daughter is now in a private college pre-med program and my son is sophomore in HS. I am only 44 while she is 42. I still have fun doing science and clinical work. Currently at Soc. for Neuroscience annual meeting.

Neuronix · Nov 5, 2007

solitude said:
Well you CAN take out loans if need be.

Taking out government subsidized loans such as Stafford loans is program dependent. Some programs will allow it, others will not. How much you can get and when you can get it is a school dependent question as well. If this is important, you need to ASK ASK ASK and make sure you ask financial aid. The MD/PhD program officials are often very clueless on questions like this.

I absolutely agree that the lack of family options is disturbing. Why can't there be daycare for employees/grad students for example? Very few schools offer this. The idea that you're "in school" begins to get less and less relevant when you're in school until you're 30. There are frequent lectures at my school, usually only for women, but sometimes they let us men in, that talk about trying to balance family and career. Is it all talk? The last talk I went to was entirely about helping women as new faculty have family and career. I won't be faculty until I'm 37, should I put off having a family until then? The sad thing is that that residency salary isn't much better and gets taxed more. You may even have to start repaying those loans, so it's not much of an improvement over your graduate stipend and most residencies still don't provide any consideration for families. All you ever hear is how much burden your family is on the residency program. The whole system is really screwy IMO.

In any case, after inflation, Fencer's $8,500 stipend 20 years ago would be $15,600 today (http://data.bls.gov/cgi-bin/cpicalc.pl). If you take off the $4,000 for health insurance you're easily at today's stipend levels (~$19,500 is on the low end). So it's still incredibly hard.

solitude · Nov 5, 2007

Neuronix said:
Taking out government subsidized loans such as Stafford loans is program dependent. Some programs will allow it, others will not. How much you can get and when you can get it is a school dependent question as well. If this is important, you need to ASK ASK ASK and make sure you ask financial aid. The MD/PhD program officials are often very clueless on questions like this.

Weird, I figured every school would let mudphuds take out government-subsidized loans because MD-only students do it everywhere (I think?). Regardless, if you really need money that neither your kind institution nor government will provide, you shouldn't have trouble finding loans somewhere, albeit expensive ones. At that point it may be cost-effective to just hold off on the kids until you graduate though.

Fencer · Nov 6, 2007

Keep in mind that there is the NIH loan repayment program. Every year, they have trouble finding enough people to qualify. It was difficult, but with 10 yrs of being faculty, I have no loans, over 400K in IRA, net worth over 1M, while I have been doing SCIENCE/Clinical work. Certainly, I could be making much more money just doing Clinical private practice. You make your choices on what you need. I only drive a Suzuki, but my wife has a MDX.

It is a privilege to do what I do, get paid well, and continue being funded by NIH and VA. Nevertheless, this is an area where benefits need some improvements.

dazlindz · Nov 7, 2007

Fencer said:
Keep in mind that there is the NIH loan repayment program. Every year, they have trouble finding enough people to qualify. It was difficult, but with 10 yrs of being faculty, I have no loans, over 400K in IRA, net worth over 1M, while I have been doing SCIENCE/Clinical work. Certainly, I could be making much more money just doing Clinical private practice. You make your choices on what you need. I only drive a Suzuki, but my wife has a MDX.

It is a privilege to do what I do, get paid well, and continue being funded by NIH and VA. Nevertheless, this is an area where benefits need some improvements.

you make me so hopeful about being able to live/have a family has a physician scientist. =)

Neuronix · Nov 7, 2007

Fencer said:
Every year, they have trouble finding enough people to qualify.

Maybe they should expand it beyond its very limited scope? It doesn't even sound like it's focused towards basic science hardly at all. The following quotes are from a NIH announcement for the LRP:

NIH will repay up to $35,000 annually of qualified educational debt for health professionals pursuing careers in one of the five LRPs: Clinical, Pediatric, Health Disparities, Contraception and Infertility, and Clinical Research for Individuals from Disadvantaged Background. The programs also provide coverage for Federal and state tax liabilities.

I don't know that they have "trouble finding enough people to qualify". A 40% funding rate isn't competitive compared to say a R01, but is no guaranatee.

NIH annually awards loan repayment contracts to approximately 1,600 health professionals. Approximately 40% of new and 70% of renewal applicants are funded each year.

There's also so many stipulations on the money it makes my head spin. First:

New applicants must also have outstanding educational loan debt equal to at least 20% of their institutional base salary and be a U.S. citizen or permanent resident.

Second:

NIH will repay up to $35,000 annually of qualified educational debt

The up to is based on a rather complicated algorithm. The maximum is $140,000, as opposed to my medical school's 4 year budget is >$240,000.

That being said it is an excellent point. Borrow your ass off now and hopefully you can get it repaid later. This is a bit of a gamble (who knows if this will still be there when you're eligible) and comes with many caveats that must be considered (i.e. it doesn't fund many types of investigators).

PS: Solitude, it's true, not all schools allow MD/PhDs to take loans on top of their stipends. If you want to PM me sometime I can explain why this is, but I don't want to go into detail here because I don't want more schools to stop offering loans to MD/PhDs. I have no idea which schools do or do not allow MD/PhD student loans. My school does allow it but I have been warned that could change any year.

Fencer · Nov 7, 2007

NIH is not the only loan repayment program. Yes, there are stipulations for each and every program. A director of a NIH institute made that statement in a program where I and other faculty were mentoring young investigators. There are other ways of getting a portion of your loans repaid.

Today, I looked at median academic salaries ('05-'06) in Neurology (all types of Institutions).

Instructor - 98K
Assistant Professor - 130K
Associate Professor - 160K
Professor - 195K
Chair - a lot more

It takes time to get up in the ladder, but in the end you are reasonably well paid.

Jorje286 · Nov 7, 2007

Fencer said:
NIH is not the only loan repayment program. Yes, there are stipulations for each and every program. A director of a NIH institute made that statement in a program where I and other faculty were mentoring young investigators. There are other ways of getting a portion of your loans repaid.

Today, I looked at median academic salaries ('05-'06) in Neurology (all types of Institutions).

Instructor - 98K
Assistant Professor - 130K
Associate Professor - 160K
Professor - 195K
Chair - a lot more

It takes time to get up in the ladder, but in the end you are reasonably well paid.

That's more than I expected. I guess these numbers are higher than those for academic basic scientists.

Fencer · Nov 7, 2007

These are Medical School numbers for Neurology. Private and Public institutions; all faculty: full time clinicians and 50/50 clinician scientist included. Keep in mind that as a faculty member doing NIH funded science, your salary progressively will be approaching NIH max. As NIH reviewer (>4 yrs), these salaries were not different that those in R01 grants that I reviewed. Successful clinician scientist do make nice money, even higher than median described above.

Neuronix · Nov 7, 2007

Jorje286 said:
That's more than I expected. I guess these numbers are higher than those for academic basic scientists.

For a mostly basic science faculty member at the big name institutions with which I'm most familiar, take roughly 30-40% off of those numbers for all the salaries listed except "instructor".

solitude · Nov 7, 2007

Neuronix said:
PS: Solitude, it's true, not all schools allow MD/PhDs to take loans on top of their stipends. If you want to PM me sometime I can explain why this is, but I don't want to go into detail here because I don't want more schools to stop offering loans to MD/PhDs. I have no idea which schools do or do not allow MD/PhD student loans. My school does allow it but I have been warned that could change any year.

Weird. I will PM me you sometime but do publicly keep it under wraps if it will avoid scaring more programs off!

Fencer · Nov 7, 2007

Neuronix said:
For a mostly basic science faculty member at the big name institutions with which I'm most familiar, take roughly 30-40% off of those numbers for all the salaries listed except "instructor".

Sorry, but that is the price "of being Ivy". NIH reviewers do not care whether you are at Penn or in Texas. My first job was at U. Colorado. They were roughly offering me 50% more than the offer I had at Duke. I didn't need the extra prestige of the Ivy type institution. On the other hand, it is easier to find collaborators and technicians of high caliber at those Ivy type institutions.

mudphudwannabe · Nov 12, 2007

I don't know anything about this loan on top of stipend business, but to answer the original question, University of Wisconsin does offer health insurance coverage for spouses/children. I pay about $30/month for the "family" plan for me and my husband, and it would be the same cost if we had children. The plan I chose includes dental, no copay for office visits or urgent care, and small copays for most prescriptions ($5). Certainly beats my husband paying $150/month for health insurance (he's self employed), which didn't include dental or prescription drug coverage.

As far as managing finances for a family while you're in school - well, it does seem a bit tricky. What does your wife do? Is there any way she could work from home part time after you have children?

JustAdocInBox · Nov 13, 2007

yes working from home will probably be an option.
the University of Michigan offers family health insurance at no additional cost. Unfortunately, the programs I am finding the most enticing in terms of research interests seem to offer the least benefits.

Jacarei · Dec 4, 2007

As far as having a family while in an MSTP, it's doable. I'm in my 2nd year, get 25k a year, have 2 kids, and my wife is able to be a stay-at-home-mom. We have a little savings from college, but my stipend is able to cover everything we need. We've even been able to save a little bit since we anticipate the stipend not stretching as far when I'm in the later years of the program. And with two kids and a low-paying job, my federal tax return last year was 3.5k more than what I paid in taxes.

We originally paid for insurance for my wife and kids, but premiums went up 50%. My state offers health insurance for kids if the parents earn less than some insanely high amount (something like 70k), so I don't feel bad to have my kids in CHIP. I'm sure I'll pay the government back in a few years.

There's one guy in my program, in his last year, who has 5 kids and he makes it work.

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