Chronic Medication - Disability Insurance Quotes Not Great - Should I Still Get

[jezza]

I have gone with an independent agent for DI and he has provided me with bad news: given a chronic immunosuppresive medication that I am on, no insurance company will give me coverage for more than 5 years payout. He's telling me I should still go with insurance and try to appeal after 1-2 years assuming good health.

I'm a PGY-1 in a surgical subspecialty. Should I not go with DI at all, or try his strategy?

[VagabondMD]

Five years is better than nothing! Check in with one of the WCI-endorsed disability experts, as a second opinion.

[Scott at MD Financial Services]

Yes you should go that route, better to be trying to improve an existing contract rather than get one when you don't have one....

[shantster]

Does your residency program have a good group policy? Do they have any availability for purchasing a guaranteed standard insurance (GSI) towards end of residency?

If so, would forgo the policy now and purchase the GSI when you can. Ours would not allow the individual to be purchased under that program until the second to last year of training completion (not sure why). Got a really nice policy from Guardian without any medical underwriting.

[Dreamgiver]

Based on the little information provided, it seems to me that your best bet is coverage under a good group policy. While that is not usually the case, some group policies are indeed pretty good.

[adventure]

Scott @ MD Financial Services wrote:

Yes you should go that route, better to be trying to improve an existing contract rather than get one when you don’t have one….

Click to expand...

I'd imagine having a policy is better than nothing... but at a PGY1 in a surgical subspecialty, the OP will still be in training for the next 5+ years. Does the OP need the policy now (during training)?

[Scott at MD Financial Services]

If you have it in place/force then you know this is the worst case possible for coverage, the carrier can never come back in and reduce benefits or downgrade design ques.  If the issues which caused a modification to the policy continues to be stable or improves often times over the following 12-30 months the carrier will reduce or eliminate the exclusion or rate up on the policy.

Do they need a contract?  Probably not but if they do end up needing the contract then they probably can't get one at that point which would cover them for the issue they now have.  I would say that in my 24 years in this business I would estimate that about 15-20% of physicians I deal with that are between age 27-34 already have something they are dealing with from chronic illness, weight, depression, injury, or avocations which will cause them difficulty in obtaining a policy without restrictions or premium rate increases.  Now that does not mean they can't get a policy or that if they get a restricted policy then lose that weight, rehab that injury, get off the depression meds, get that A1C down to 5.7 or below, stop doing those hazardous activities that we can't then re-work their contract language to be restriction free.  Keep in mind however, it also means there are those that don't improve, I can't tell you how many people I talk to that say "well let's wait a year, I will quit using tobacco, lose weight, eat better" etc, same thing you hear as a physician speaking to your patients about their health.  Often they don't end up improving their health and thus the offer from the carrier gets worse since they postponed their purchase.

I am of the belief that if you think you need or want coverage than you should get it.  If it has exclusions or rate ups then you  can work on the area that needs improvement in order to have the policy modified or restrictions removed in the future.  If for some reason you don't get those areas improved then at least your disability policy is locked down.

[DMFA]

I am in a very similar boat.  I have an mild yet incurable chronic condition for which I'm p much uninsurable for good individual policies on health and disability now, and the premiums for term life aren't awesome, either (even though life expectancy for the condition is not lower).  The actual likelihood of my becoming disabled is still very low, the disability premiums are very high, and the benefits suck.  Based on that, a lot of my future insurance is going to depend either on group policies of my employer, should I choose primarily to be W-2 employed (which I might end up doing), or I could p much knock the three of those out and complete a 20-year term in the military and retire (eight more than I have to in order to make up my service commitment), which would give me guaranteed income (about $60,000/yr were I at 20 today) and health insurance (Tricare, not perfect but I live in a city with large military facilities); I'm not really sure what the survivor benefits are.

I had Larry Keller put together the best policy he could for me and I didn't think the benefit was worth the premium, so I declined.  Your situation and your opinon may vary, and that is fine.  All the same, you will likely find your group LTD policy may address some of your need, and your individual LTD policy can fill those gaps.  No one can make this decision but you; if you can afford the premium and think that it's worth the benefit, sure, go for it.  This is all the more reason to have a good-sized nest egg.

[Veiled]

jezza, I'm in your situation exactly except PGY3. They wouldn't give me more than 7 years and wanted to revisit things at that time. I compared costs with all the WCI-recommended companies and with the non-independent agent selling to our institution's residencies at a discount. (I learned that those discounts are only for the average perfectly healthy resident.)

I got the best, though still limited, policy. As others have said, it will never be easier to get and you'll never get a better offer. (Not only because you'll never be younger, but residency takes its toll and you'll never be a fall PGY1 again.) I'm hoping that I remain asymptomatic and that I can revisit the terms of my policy.

[nachos31]

It's worth getting a 2nd or 3rd opinion and seeing what kind of offer can be put together as DMFA did. It'd also be a good idea to see if there is a GSI policy offered by your program. If not, you have a few years to perhaps petition that they get one! Good luck!

[The White Coat Investor]

For sure look for group policies from employers and medical associations. But if you can't get anything, I'd probably still buy something that would give a five year payout.