individual disability insurance?

Started by skydust03
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skydust03

skydust03

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Hey all,

As I just signed a contract, now I'm looking into everything else that comes into play.

I wanted to know if anyone had recommendations regarding disability insurance?

We had a financial guy stop by saying make sure you get your own individual insurance before you start working. Do you agree/disagree?

Appreciate your help!
 
skydust03 said:
Hey all,

As I just signed a contract, now I'm looking into everything else that comes into play.

I wanted to know if anyone had recommendations regarding disability insurance?

We had a financial guy stop by saying make sure you get your own individual insurance before you start working. Do you agree/disagree?

Appreciate your help!
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Well, you want to buy these things before you have anything in your medical record that would make it hard for you to get it. So in that sense, sooner is generally better. It seems like there's a push to get medical students to sign up for their own disability insurance when they start medical school.
 
There's two ways to look at this and life insurance.
This is more of a financial risk question.

I never really bought into these things until I had kids. The idea of my kids possibly not being able to go to college or even have basic needs provided for is something I will not allow to happen. While I know it's extremely unlikely that I'd die before they reached college age I'm not taking that risk.

Mathematically there's different takes on disability and life insurance.
There's the plan where you pay each year based on your risk. So if you're young, healthy, yada yada yada, you don't pay that much, possibly even less than $100 a month. Problem with these plans is that as you get older and sicker you got to pay a heck of a lot more, possibly even thousands a month.

Then there's the other plan where you lock in a rate based on your current health, and that rate stays the same even if the very next month your cholesterol skyrockets to over 400 (yeah I know that'll likely not happen but you get the point). Your rate stays locked in. These plans are more expensive than the above plan while young and healthy, but when you get older they stay at the same rate despite your health changes and inflation. Expect to pay about a few hundred a month for these. A drawback is they expire usually around late retirement age. so if you live till say 80, never got a dime of benefit bu you ended up paying about $50K to the insurance company by the time it expired.

IMHO I'd play it like this (and you don't have to do so). If you plan on never having kids, or already have tons of money, the first option sounds better to me. The second option is better if you have kids but don't have enough money to make sure they'll be okay enough to keep their same standard of living without you.

A financial planner could help you chart through this.
 
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Some employers have disability insurance that is a good deal for employees. I think at our level of income it's a good idea, and I have both life and disability insurance, although I'm healthy. Also - med school debt has to be paid even if you get disabled.
 
wolfvgang22 said:
Some employers have disability insurance that is a good deal for employees. I think at our level of income it's a good idea, and I have both life and disability insurance, although I'm healthy. Also - med school debt has to be paid even if you get disabled.
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If all your loans are federal, I believe you can get them discharged if you're permanently disabled, although the process is complicated. I filled out paperwork for one of my patients for this.
 
You need "own occupation" disability insurance. As in, if you are disabled for your own occupation, but can do something else.

General disability insurance policies only protect you if you can't do any job. Great if you stock shelves at a grocery store. Bad if you a high income professional.

Own occupation disability insurance will cover you if you suffer a massive stroke or something. There gets to be some limits around 200k.

The trick is determining if you want to write it off on your taxes. If you do, it can be a deduction. But, if you deduct it then your disability payments are taxed. If you don't deduct it, then your disability payments are tax free.
 
I'll be finishing up fellowship here in June, and a financial guy recommended getting your own individual disability before signing up with the company's.
Does that actually matter, or can you add on an individual disability plan at any time?
Is it that you just risk developing medical issues during that time? Or is there actually some limitation?
 
Oh, also, any company that you guys recommend?

I'm looking into Ameritas at this time, but have heard lots recommend Guardian
 
skydust03 said:
Does that actually matter, or can you add on an individual disability plan at any time?
Is it that you just risk developing medical issues during that time? Or is there actually some limitation?
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You can add it at any time, but the older you are, the higher the monthly cost. Every illness you get could put limitations on the policy. Discounts are available for residents/fellows.
 
I have long term disability insurance (starts 6 mos after incident), but not short term (starts 30 days after incident and lasts 6 mos). It pays about half of my current income. I opted out of short term as I keep about 6 months expenses liquid and have lots of paid time off I can use.

Better to be prepared and not need it.
 
As a gimp, I highly recommend you get it now before you get sick. It's somewhere between difficult and impossible once you have a major medical issue on you record. Get your own policy. Easier to continue between positions. No issues with change in health status between jobs as well.
 
Something I've been telling medical students and residents is to watch your health cause it could lend to about 10 more years of professional life. In psychiatry this isn't as much of a big deal except perhaps correctional or inpatient where a patient is more likely to attack you. But in surgery, ER, and IM, being on your feet for hours a day having to duck a patient trying to punch you, well if you're in your 60s but still can go to a gym, never smoked, are in good health, you can still do that. If you were obese for 30 years you likely might not.
 
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whopper said:
Something I've been telling medical students and residents is to watch your health cause it could lend to about 10 more years of professional life. In psychiatry this isn't as much of a big deal except perhaps correctional or inpatient where a patient is more likely to attack you. But in surgery, ER, and IM, being on your feet for hours a day having to duck a patient trying to punch you, well if you're in your 60s but still can go to a gym, never smoked, are in good health, you can still do that. If you were obese for 30 years you likely might not.
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I thought inpatient, an attack is less likely because of guards. That's one of the reasons I prefer in-patient, you have a lot of ancillary staff available to prevent that from happening. In outpatient, you never know. Or maybe I'm wrong.

But at any rate, thanks for the tip about the disability and life insurance, I definitely want to make sure my kids are taken care of should anything ever happen to me.
 
It's good to have, you never know the cards you are dealt....Buy what you need...not just what you can. The reason I say that is some reps will suggest you buy as much as you can but I think buying the amount you need and then have options for future needs or lifestyle changes is what makes the most sense.
 
whopper said:
A lot depends on the individual unit. I've seen some places where the general knowledge was expect to get punched at least once in your a career. Sometimes it was more often than that.
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I guess that makes sense.

my program is offering a disability insurance program which I'm seriously considering taking.
 
psych72 said:
I guess that makes sense.

my program is offering a disability insurance program which I'm seriously considering taking.
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If your program offers it, take it, even if it costs a few dollars a month.
You're always one little bike accident away from having no career.

(If you don't believe me now, wait until you've taken care of a physician with a TBI next year.)
 
We were required to have disability insurance in medical school, and the company we bought it through is now offering one of the "pay this rate until age 65" type plans if you sign up before the current plan expires. I've been waffling on whether I should do it or not, but based on what you're saying this seems like a pretty decent deal. The premium is <$100/month and doesn't require any kind of health clearance. They also assume a $100k income for the purposes of benefit payouts should you become disabled during residency, with future payouts based on your current income. Not sure about the "own occupation" vs. any occupation point.

Anyway, thanks for the discussion. It's good to hear the thoughts of those more wise.
 
NickNaylor said:
We were required to have disability insurance in medical school, and the company we bought it through is now offering one of the "pay this rate until age 65" type plans if you sign up before the current plan expires. I've been waffling on whether I should do it or not, but based on what you're saying this seems like a pretty decent deal. The premium is <$100/month and doesn't require any kind of health clearance. They also assume a $100k income for the purposes of benefit payouts should you become disabled during residency, with future payouts based on your current income. Not sure about the "own occupation" vs. any occupation point.

Anyway, thanks for the discussion. It's good to hear the thoughts of those more wise.
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$100K income, during residency though?

My income is going to be $45K, I think we have a disability insurance that's rolled in through our tuition. Or perhaps we don't because I was never asked for it. Maybe its rolled in through the same way that our malpractice is. Do mos med schools require it?

I'm a bit alarmed by these attacks during in patient months, I've rotated at a quite a few psych hospitals and they were so well guarded, I felt completely safe.

One has to wonder though, can you bring a bottle of pepper spray or a tazer just in case you're at a place that's understaffed and does not have adequate security? At the end of the day, you have to protect yourself.
 
psych72 said:
$100K income, during residency though?

My income is going to be $45K, I think we have a disability insurance that's rolled in through our tuition. Or perhaps we don't because I was never asked for it. Maybe its rolled in through the same way that our malpractice is. Do mos med schools require it?

I'm a bit alarmed by these attacks during in patient months, I've rotated at a quite a few psych hospitals and they were so well guarded, I felt completely safe.

One has to wonder though, can you bring a bottle of pepper spray or a tazer just in case you're at a place that's understaffed and does not have adequate security? At the end of the day, you have to protect yourself.
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Obviously you aren't making $100k as a resident. For the purposes of the policy and any benefits that might be paid out, though, you are. I.e., you will receive a larger benefit compared to what you would receive with an actual resident's salary.
 
NickNaylor said:
Obviously you aren't making $100k as a resident. For the purposes of the policy and any benefits that might be paid out, though, you are. I.e., you will receive a larger benefit compared to what you would receive with an actual resident's salary.
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Oh cool that sounds nice. Thanks for clarifying. what plan is this under?
 
By the way, for those of you guys with therapy dogs in the units, have any of them ever attacked you? On one of my interviews, I was a bit startled when I saw some of the breeds they had.

Also, have any of you ever had an incident where the officers brought someone into the ER and not take all weapons out? Once I heard about a social worker getting attacked with a machette from a county ER admit into the unit when she was doing intake. She wasn't physically harmed, but the patient threatened her with it.

That idea of having a tazor handy is sounding a lot more tempting especially if my program ain't gonna provide protection for me.
 
psych72 said:
Oh cool that sounds nice. Thanks for clarifying. what plan is this under?
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I forget the provider - I think it's something like RB Financial - but it's offered through our school. As mentioned earlier, we were required to carry disability insurance and I just got the default plan offered by the school. The plan I'm talking about above is available only if you renew prior to the current plan expiring next month.
 
I know for my residency program they provide group disability insurance and life insurance ( I think)...are you guys getting additional on top of that?

Also, my income is a bit on the lower side, but are you guys with higher incomes during your residency years getting any type of retirement fund set up through your residency?

All of this financial stuff is completely new to me so pardon the errors in the above. Thanks
 
serimeri said:
I know for my residency program they provide group disability insurance and life insurance ( I think)...are you guys getting additional on top of that?

Also, my income is a bit on the lower side, but are you guys with higher incomes during your residency years getting any type of retirement fund set up through your residency?
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My program provides incredibly cheap disability insurance. It only covers mental health for 2 years, and only pays for complete disability from all occupations. If I become schizophrenic and can't work, I'd only get money for 2 years. If I get in a car accident and sustain a brain injury, I could become unable to safely practice medicine, but I could still technically work simple manual labor jobs. This cheap DI policy will not pay if I can do any job. No offense to anyone in those occupations, but I did not do college, med school, residency, and fellowship while accumulating huge debt to collect shopping carts. I purchased a quality own-occupation policy that pays for mental illness equally, partial disability, and with an option to increase the amount without a medical exam when my income raises.

I have young children that I want to provide for if I die. The residency life policy was not high enough, and term life insurance for 20-30 year olds is cheap.

My program matched 8% of our salary to a 403b retirement account.
 
TexasPhysician said:
My program provides incredibly cheap disability insurance. It only covers mental health for 2 years, and only pays for complete disability from all occupations. If I become schizophrenic and can't work, I'd only get money for 2 years. If I get in a car accident and sustain a brain injury, I could become unable to safely practice medicine, but I could still technically work simple manual labor jobs. This cheap DI policy will not pay if I can do any job. No offense to anyone in those occupations, but I did not do college, med school, residency, and fellowship while accumulating huge debt to collect shopping carts. I purchased a quality own-occupation policy that pays for mental illness equally, partial disability, and with an option to increase the amount without a medical exam when my income raises.

I have young children that I want to provide for if I die. The residency life policy was not high enough, and term life insurance for 20-30 year olds is cheap.

My program matched 8% of our salary to a 403b retirement account.
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Wow your program was solid. Lots of nice perks.

What policy did you purchase?
 
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skydust03 said:
Oh, also, any company that you guys recommend?

I'm looking into Ameritas at this time, but have heard lots recommend Guardian
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This changes from time-to-time, but you might want to be sure that you've checked with Principal and Metlife. They put psychiatrists in their lowest risk categories of physicians, whereas Standard, Guardian, Ameritas, and Mass Mutual physicians in the middle category. I know that for me, Principal was hundreds of dollars less than the others. Some of this will vary by state or if you are male v. female. I also used transitional own occupational from Principal, which allowed me to get rid of the mental/nervous 2-year exclusionary period. I find it hard to envision myself working a job that pays me more than I make in psychiatry if I was disabled enough to be unable to be a psychiatrist, and hence transitional over pure own-occ.
 
Just signed the check on my plan. Went with Standard.

psych72 said:
By the way, for those of you guys with therapy dogs in the units, have any of them ever attacked you? On one of my interviews, I was a bit startled when I saw some of the breeds they had.
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I had a family member get bit by a dog while on a home nursing visit a number of years back. no disability or anything, but enough to say "f-ck it" to doing that job.
 
Information Underload said:
This changes from time-to-time, but you might want to be sure that you've checked with Principal and Metlife. They put psychiatrists in their lowest risk categories of physicians, whereas Standard, Guardian, Ameritas, and Mass Mutual physicians in the middle category. I know that for me, Principal was hundreds of dollars less than the others. Some of this will vary by state or if you are male v. female. I also used transitional own occupational from Principal, which allowed me to get rid of the mental/nervous 2-year exclusionary period. I find it hard to envision myself working a job that pays me more than I make in psychiatry if I was disabled enough to be unable to be a psychiatrist, and hence transitional over pure own-occ.
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Wise move on the transitional, heck I might even suggest you think about the not engaged definition (another 10% savings)....as you know if you can do your specialty you will have to so think about "if I am so disabled as a psychiatrist that I can't do that job, what job can I do"? I think own occupation contracts and specialty definitions are great but one needs to think about what their specialty is and if I can't do that what else can I do while still not able to do my medical occupation.
 
TexasPhysician said:
My program provides incredibly cheap disability insurance. It only covers mental health for 2 years, and only pays for complete disability from all occupations. If I become schizophrenic and can't work, I'd only get money for 2 years. If I get in a car accident and sustain a brain injury, I could become unable to safely practice medicine, but I could still technically work simple manual labor jobs. This cheap DI policy will not pay if I can do any job. No offense to anyone in those occupations, but I did not do college, med school, residency, and fellowship while accumulating huge debt to collect shopping carts. I purchased a quality own-occupation policy that pays for mental illness equally, partial disability, and with an option to increase the amount without a medical exam when my income raises.

I have young children that I want to provide for if I die. The residency life policy was not high enough, and term life insurance for 20-30 year olds is cheap.

My program matched 8% of our salary to a 403b retirement account.
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Congrats on getting a quality contract, language matters and knowing the way a contract will behave at claim time allows you to decide" is this how I want the contract to perform when I can't do the job I spend tons of money on and years of your time?" Always remember there are no loopholes just facts on how an insurance carrier has to react based on the terms of the policy.
 
bumping this, as I'm having the individual disability insurance debate currently.

Pardon any potential egregious naivety, but how disabled must one be to not perform the duties of a psychiatrist? Outside of physical barriers (e.g., hospitalization, surgery, recovery) or reduced cognitive function, what possibilities are there? Just trying to make a sound decision!
 
Truthfully you have to be pretty disabled. In your specialty the ability to have cognitive skills, hearing, speaking are about it but certainly the other 'normal health issues (heart attacks, stroke, organ issues) would be a potential claim too.....assuming they affected your ability to do your job. In your specialty please keep in mind the idea that you need a true own specialty definition is not really there because in my opinion if your so beat up you can't do your specialty then what else can you do? Finally keep in mind the insurance companies are aware of this and thus those that are statistically harder to become disabled they also have a lower cost per dollar of coverage than lets say a surgeon. I would suggest that you get look at a long waiting period and what is called a Not Engaged definition since if the proverbial bus runs over you then you will want some coverage to keep the lights on, food on the table and a roof over your head.
 
wolfvgang22 said:
I worry however that the difficulty of Psychiatry is being grossly underestimated here, though. There is no way I could be an effective full time psychiatrist if I was suffering from chronic severe back pain resistent to treatment or had treatment resistant Crohn's disease.
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Certainly something like that if the illness or injury prevented you from doing your occupation specialty then benefits would be paid. My comment was more around something very specific like if you lost the use of your dominate hand index finger you may not write well so you would certainly be doing verbal dictation for medical records but it does not put you out of job like surgeon.
 
PsyYaYaYaYai said:
bumping this, as I'm having the individual disability insurance debate currently.

Pardon any potential egregious naivety, but how disabled must one be to not perform the duties of a psychiatrist? Outside of physical barriers (e.g., hospitalization, surgery, recovery) or reduced cognitive function, what possibilities are there? Just trying to make a sound decision!
Click to expand...

I made sure to get a policy that would include psychiatric disability without a limit. While I don't expect to suffer from chronic depression, I do find it insulting that some firms will place a 2 year limit on psychiatric disability claims.

I would expect some forms of cognitive error to disable me from psychiatry but not manual labor.
 
TexasPhysician said:
I made sure to get a policy that would include psychiatric disability without a limit. While I don't expect to suffer from chronic depression, I do find it insulting that some firms will place a 2 year limit on psychiatric disability claims.

I would expect some forms of cognitive error to disable me from psychiatry but not manual labor.
Click to expand...

Some states have the 2 year mental health limit, and this has nothing to do with the insurance company. But I do agree that it's insulting.
 
I'm curious how many of you have disability insurance?
I went through the whole process to sign up for some with one company recommended to me by my University, but after a physical screening the company rep pulled a ghost on me and I never heard back despite an email to their office. Which is weird, as I have no health issues. I would have thought the company would want my money.
So obviously, I'm considering if I need disability insurance with a different company or not. Is it worth it?
 
wolfvgang22 said:
I worry however that the difficulty of Psychiatry is being grossly underestimated here, though. There is no way I could be an effective full time psychiatrist if I was suffering from chronic severe back pain resistent to treatment or had treatment resistant Crohn's disease.
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Agree with this. I have a spinal cord injury plus all sorts of other wonderful joint damage. Yes, I sit in a chair on day. Yes, it still takes a toll on my body. Yes, I unfortuantely do hvae to call in sick more than I probably would've if I were healthy. I'm young and single and can invest a ton of time and money in compensatory strategies but. it. is. a. struggle. I think that's what people don't understand who aren't chronically ill. Even if you can look ok, and fake ok, it can still take a LOT of effort. I'm doing absurdly well for my level of damage but I'm not sure how long that absurdity can continue.

Small update on the disability insurance front by the way. Some universities allow you to join their disability insurance while still in training. Some double down and allow you to stay on with their policy with your 'attending-level income' based support. Mine is letting me join the group policy with no underwriting for my gimpitude with guaranteed payout of 60% of median attending psychiatrist salary, for the same rate as everyone else. And stay on it for as long as I pay my premiums. Which is huge given that I'm currently uncoverable.
 
PistolPete said:
I did not know this, thanks! I thought it applied to any and all mental health conditions. Do you have updated ICD-10 codes that are limited?
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I was a meeting just a couple of weeks ago and asked the question "is there anything else you look at beside the diagnosis code for M/N claims", the answer was no all they look at are the ICD-9, 290-319, anything and everything else is paid with no limitation. Now that can always change but that is the same answer we have gotten for the last 15-20 years when carriers started implementing M/N limitations.
 
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MD Financial Services Scott said:
I was a meeting just a couple of weeks ago and asked the question "is there anything else you look at beside the diagnosis code for M/N claims", the answer was no all they look at are the ICD-9, 290-319, anything and everything else is paid with no limitation. Now that can always change but that is the same answer we have gotten for the last 15-20 years when carriers started implementing M/N limitations.
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I just looked this up. ICD9 290-319 is literally the entire "mental disorders" section... so that's not particularly encouraging if you have a mental disorder, as it will be excluded by the disability insurance company after 2 years.
 
wolfvgang22 said:
I'm curious how many of you have disability insurance?
I went through the whole process to sign up for some with one company recommended to me by my University, but after a physical screening the company rep pulled a ghost on me and I never heard back despite an email to their office. Which is weird, as I have no health issues. I would have thought the company would want my money.
So obviously, I'm considering if I need disability insurance with a different company or not. Is it worth it?
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I have it. Worth it. Never know what will happen.
 
wolfvgang22 said:
I'm curious how many of you have disability insurance?
I went through the whole process to sign up for some with one company recommended to me by my University, but after a physical screening the company rep pulled a ghost on me and I never heard back despite an email to their office. Which is weird, as I have no health issues. I would have thought the company would want my money.
So obviously, I'm considering if I need disability insurance with a different company or not. Is it worth it?
Click to expand...

My first ghosted me as well. I had to fill out a form to transfer my services. I would recommend my second -Lawrence Keller. He is a contributor to the White Coat Investor website.
 
Just to be clear there are several carriers that do not have any M/N limitation in the individual disability space there are zero that don't have the limitation in the group or association product space.

In addition here are a few examples of what is NOT going to fall under that 290-319 exclusion:

Alzheimer's Disease - ICD-9 code is 331.0
Parkinson's Disease - ICD-9 code is 332.
Fibromyalgia - ICD -9 code is 729.1

Certainly anyone that comes to me for disability insurance we certainly visit about the price point differences based on features and then the client makes up their mind on what they want to spend their money on. The reality is we work with all of the carriers that have a true own specialty definition of disability and some of those have a M/N limitation, some don't.
 
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I keep 6 mos emergency fund and have a long term disability insurance plans that kicks in after disabled 6 mos. It only pays 1/2 of what I currently make, so I hope I'll never need it. Our employer offers short term disability insurance at my expense that pays for 30 days to 6 months of disability (I declined).
 
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