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4 Key Roadblocks to Securing Disability Coverage

As an advocate for health care professional disability insurance education, I want to review some recurring roadblocks to securing complete policies that I’ve witnessed.

We can all learn a thing or two from our peers about how to make better choices or change bad behaviors, and the following are serious roadblocks to coverage that are easy to avoid or remedy.


1. Not Prioritizing Your Health

Part of what I do is to help create realistic expectations. As a doctor, I know that it’s uncomfortable enough to discuss things like weight and smoking habits with patients, let alone with the mirror. It’s important to understand that all these things can play an important role in determining policy costs.

We all know that with BMI, at opposite ends of the spectrum, there’s a chance you won’t get coverage. Be aware that your premium will go up if you’re overweight or underweight. Worse, you can actually “weigh out” of insurance. If you’re over or under a certain weight, you may be uninsurable by the traditional carriers.

Another example is that all insurance companies have “smoker rates” that can as much as double your cost of coverage. To remove that smoker rate, you need to prove through testing (urine and blood tests at your own cost) that you have been nicotine- and tobacco-free for 12 months.

At the end of the day, the most important thing you can do for your policy costs is to take care of yourself and your body. Please stay healthy!


2. Waiting Until Pregnancy or Post-pregnancy to Acquire Disability Insurance

Many carriers are quick to exclude coverage for “abnormal outcomes of pregnancy.” As an OB/GYN, I know just how many things can happen during pregnancy and while trying to get pregnant. It’s shocking what qualifies as an “abnormal outcome” such as infertility workups and recurrent miscarriages. These are just some reasons that carriers have excluded future pregnancy coverage.

Cesarean sections, in particular, are an issue I’ve taken up with insurance companies because historically they were seen as an abnormal outcome of pregnancy, and if you had one, there would be an automatic pregnancy exclusion written into your policy.

I had a C-section because my first child was breech, meaning he was coming out bottom first. In cases like this, it’s standard practice for doctors to perform a cesarean. So, I tried to tackle this issue with the six traditional carriers throughout my years in insurance. A few of them are willing to look at why people have C-sections, and I’ve since gotten women pregnancy coverage when they didn’t previously qualify.

That has taken a lot of effort, and in general, carriers tend to look for reasons not to cover future pregnancy disability claims.

So, I’m sorry to say it, but please think about securing a policy before your first attempt at trying to get pregnant!


3. Waiting Until After Residency/Fellowship to Acquire Disability Insurance

If you don’t know this, at PearsonRavitz we started out by specializing in helping physicians on their quest to secure the best possible disability and life insurance coverage.

If you’re a doctor, the timing of when you get your policy is critical. Many physicians wait until they become an attending to purchase disability insurance. I hear two common rationales: “I’m waiting until I make more money,” or “I can’t afford it during training.”

There are several problems here:

  • Waiting until you make more money will potentially cost you more money in the long run.
  • You may not qualify for the same benefit rates as an attending that you would have qualified for as a resident/fellow.
  • Once you finish with training, carriers take both your income and group benefits into account when determining your qualifying benefit.

In fact, that happened to me; I was that attending!

I got my first disability insurance policy after completing my residency training. I didn’t know better. Not only did I qualify for a lesser monthly benefit, but it ended up being more expensive. Once you cross the threshold of being an attending and attempt to secure disability insurance, many more factors are considered in producing your quote.

Most companies have calculators that take into account a range of things like your salary and any group long-term disability insurance benefits you receive from your employer. By contrast, when you’re still a resident, everyone qualifies for the same amount through a resident package, which all carriers provide.

Additionally, group benefits often have inferior or nebulous language (there’s no standard language in insurance as there is in medicine). Often, they are considered taxable income. Most are not portable should you switch jobs.

On the other hand, when you opt for private insurance, you don’t have to worry about paying taxes on the income and can keep your policy wherever you go. But that’s another topic (and luckily one I’ve already covered here).

What I really want you to take away is that you can afford a quality policy in training.

You don’t need to secure the maximum benefit to secure your future insurability, and in many ways, you may be eligible for discounts that are trainee-dependent. It’s best to explore options that suit your particular needs, and your budget is a big part of that. We can individually tailor policies to fit any budget. So single or married, children or none – whatever your situation – we can help you secure exactly what you need.

Locking in rates at a younger age will potentially save you thousands over the policy’s life. Please, do not wait!


4. Asking Colleagues to Write Scripts

I know that it may not seem like a big deal to ask a friend or colleague to write you a quick script or to get a hallway consult for a problem.

You’re busy, I get it. You don’t have time to see your own physician, or more problematic, you don’t have one.

The issue here arises during underwriting, and not to scare you, but it’s an incredibly intrusive process. You may have to give a urine sample, a blood sample, you definitely have to answer a million medical questions a million times, and there is a script check usually going back five to seven years.

I sometimes joke that there are no secrets from insurance companies. It’s amazing, really, how knowledgeable they can get with our histories.

Depending on your answers to the questions and the results of the prescription check, carriers can request medical records. When there are no records to support medications or treatments, it creates a big problem.

Some of the red flag drugs are antidepressants, anxiolytics, sleep agents, weight-loss drugs, and steroids. If these drugs pop up, there needs to be a paper trail. You do not want to look as if you’re hiding anything.


This Is Why I’m Here

In my time as an insurance advisor and advocate, I’ve worked with numerous physicians.

The part I love most is knowing that I am protecting health care professionals, often former colleagues, by offering them a disability policy that will support them and their families.

The hardest part, by far, is telling someone that they can’t get the insurance they deserve because of something easily preventable.

Please take care of yourself. Get insurance as soon as possible.

And if you have any questions about these topics or any other concerns about disability insurance, give me a call. That’s what I’m here for.