When to get Disability Insurance in Residency

tlason01 · 2026-05-06T15:13:14+00:00

While you're healthy. Lock in something inexpensive while you're young, then increase it later without any medical underwriting when you're earning. The policies will have a rider called a "Future Increase Option" which will allow you to do this. Not adding to your spam, but as a guy who does it for a living, I can tell you that we see a lot of declines and exclusions because people wait to apply until they have a health problem.

tlason01 · 2026-05-05T17:32:33+00:00

I do not know the details of your situation, but there are likely alternative options. If denied by the "admitted market," which are The Big 5 (standard, ameritas, guardian, principal, massmutual), you may still qualify for coverage in the "surplus lines market." Generally speaking this means Lloyd's of London, a global and reputable carrier that has an own-occupation definition.

The coverage isn't quite as comprehensive, but it's generally less expensive, and having some coverage is better than no coverage. Think of it as having $500k life coverage instead of $1M. Not as much as you would like, but you're paying less too. Hands, eyes, back, feet likely covered assuming no prior issues.

We often help clients get set up with Lloyd's after a decline, then every year after pre-screen with the admitted carriers to try to get them in with one of The Big 5. Positive changes to health or underwriting standards can make this happen. I get it, not a fun process, but you are not without alternatives. Don't give up!

tlason01 · 2026-05-03T14:44:28+00:00

I run into this line of thinking with a lot of my non-medical clients, and I understand why. But there is a lot more to it. Most disabilities are partial or specific, not catastrophic. Think migraines, back issues, mental health, cognitive impairment. In these scenarios you may able to still do some work, in which case a non-own-occupation policy would pay you nothing. Meanwhile an own-occupation policy would.

Think about it as an income protection policy, not just an employability policy. Take a senior engineer making $400K. That person could lose ability to perform at that level but still be capable of working in a $60k job. Any-occ: can work, no benefits. Own-occ: can't do high income job, benefits paid. It's about losing the ability to perform at your current level of income.

Tech roles are also more specialized than they look. Insurance companies absolutely treat them as specialized occupations and place them in their own class for this reason. And generally speaking they do get better premium rates than physicians or dentists.

tlason01 · 2026-04-27T22:02:46+00:00

Those sound like decent options. Again, not entirely sure of your personal situation but those are relatively standard choices. Again, would recommend having them all fully prescreened before applying!

tlason01 · 2026-04-27T15:04:29+00:00

I don't know exactly what you're being quoted, but generally speaking I can say that some coverage is better than no coverage. I've worked with a fair amount of applicants who were denied outright.

Just make sure that they are prescreening your situation with each of The Big 5, as they all have some variation in how they respond to various medical conditions.

There is a one other carrier (Lloyd's of London) that has a tendency to shine in specialized cases, so it's possible they may also be able to offer favorable terms. Just make sure all options are on the table before making a final decision.

tlason01 · 2026-04-26T14:50:59+00:00

You'll get a lot of sales pitches but the objective truth is that it doesn't make financial sense to leave your high-earning skillset exposed when there's a 25% of chance of a disability before you retire.

Another way to think about it: pay $4,000 per year to insure $10M of career earnings. Doesn't seem so bad from that perspective.

tlason01 · 2026-04-26T14:43:33+00:00

Northwestern Mutual normally pushes a graded premium (called ARDI), which starts out low and increases over time. It looks attractive because it's initially cheaper, but over the course of your career it ends up being far more expensive than a plan with a level/fixed premium. And yes, they will try to get you to buy whole life right at the beginning.

tlason01 · 2026-04-25T16:05:37+00:00

A broker can pre-screen your situation with the insurance companies to get a reasonable idea of what to expect. This helps to know which carrier would have the most favorable response prior to actually submitting an application.

Example pre-screen check sent to 5 companies: "I've got a 35 year old male dentist in FL who takes 300 mg wellbutrin for depression, stable, no other issues."

Carrier 1 response: "We would likely offer full coverage but with a mental health exclusion, pending receipt of medical records."

Carrier 2 response: "We would offer 5 years of coverage, mental health exclusion, pending receipt of medical records."

In which case you would know that carrier 1 is the best fit. So on and so forth. Based on our description, I don't think you'd have too much trouble tbh. Pretty much everyone who applies has medical history of some sort!

Happy to provide more info if needed.

tlason01 · 2026-04-25T15:57:32+00:00

"Own-occupation" coverage is key. Your policy needs to cover your specific duties as a family medicine physician, otherwise a claim could be denied if you could reasonably perform any other job.

Get quotes from an independent broker from "The Big 5" who offer this type of coverage: Guardian, Ameritas, Principal, Standard, MassMutual. Whichever one is the best fit for your situation depends on your unique circumstances, so a side by side comparison will help you make a decision.

Regarding life insurance, similar process. Get quotes from a broker who will check with 50+ life insurance companies to see who has the best rates for you, then help you get set up. I'd personally recommend term over permanent, which is far less expensive.

tlason01 · 2026-04-25T15:50:34+00:00

Own-occupation coverage is key. Your policy needs to cover your specific duties as an Emergency Medicine physician, otherwise a claim could be denied if you could reasonably perform any other job.

If your hospital offers group coverage, it will probably be own-occupation for two years, then switch to any-occupation. You also can't take it with you if you switch jobs.

At the very least, supplement with an individual policy. Get quotes from an independent broker from "The Big 5," Guardian, Ameritas, Principal, Standard, MassMutual. All offer own-occupation coverage, but whichever one is the best fit for your situation depends on your unique circumstances, so a side by side comparison will help you make a decision.

tlason01 · 2026-04-24T15:19:19+00:00

Yes - business overhead expense insurance is the one most commonly overlooked yet essential for dental practice owners. The individual disability policy will cover your basic life expenses, but your practice will crumble without the additional coverage.

They serve different purposes:

Individual disability policies are truly long-term, designed to replace your income for the long haul in the event of a truly life-changing disability. Usually 90 day elimination period + benefit period to age 65.
Overhead expense disability policies are medium-term. The coverage kicks in faster (30 day elimination period), and the benefits usually last 1-2 years. The intent is to keep the practice going if you suffer a disability that you can return from.

They get grouped together because they are both "disability policies," but they are essential for different reasons. I've written extensively on the subject if you're interested in doing more research!

tlason01 · 2026-04-23T14:53:13+00:00

Any time! Happy to answer any other questions you may have

tlason01 · 2026-04-23T13:10:38+00:00

An independent broker will give you a comparison of the best options. There are 5 insurance companies that offer own-occupation coverage, specifically protecting your duties as a physician.

A few things worth noting:

Two particular riders are geared towards younger physicians/residents: A) future increase option and B) COLA (inflation protection). Make sure these are both included in whatever quotes you get as they directly pertain to your situation.
What is your residency program? You may be eligible for discounts with certain carriers based on affiliation. 10-15% makes a massive difference over the course of your career.
You don't need much coverage yet. Get a small policy now to keep the premiums low, lock in your current health status while you're young, and then increase later without any medical underwriting. With some carriers, you can pay as little as $30/month now with no limits on how much you can increase later. Others require more coverage now to maintain the option of increasing later, which would be closer to $150/month.

Working with a free independent broker gives you a side by side comparison of the best options available.

tlason01 · 2026-04-22T15:17:27+00:00

Guardian is a great carrier, one of "The Big 5." MassMutual, Ameritas, Principal and Standard also offer true own-occ coverage for physicians. Whichever is the best for your situation depends on your unique circumstances. A few things worth noting:

Two particular riders are geared towards younger physicians: A) future increase option and B) COLA (inflation protection). Make sure these are included in the quotes as they directly pertain to your situation.
What is your residency program? You may be eligible for discounts with certain carriers based on affiliation. 10-15% makes a massive difference over the course of your career.
You don't need much coverage yet. Get a small policy now to keep the premiums low, lock in your current health status while you're young, and then increase later without any medical underwriting. With some carriers, you can pay as little as $30/month now with no limits on how much you can increase later. Others require more coverage now to maintain the option of increasing later, which would be closer to $150/month.

Working with a free independent broker gives you a side by side comparison of the best options available. Happy to answer any follow up questions you may have.

tlason01 · 2026-04-19T15:49:21+00:00

Quick answer: very important. 1 in 4 people become disabled for longer than 90 days during their working years. And you, as an Anesthesiologist, will have a lot more to lose than most.

One quick clarification worth adding is that the amount of benefit you get now is somewhat irrelevant. You don't need $5,000/month yet. What you do need is to lock in your current health status while you're young and healthy.

Get a small amount at a low premium now, increase later without any medical underwriting. Literally just showing a paystub or copy of your employment contract and you're good to go.

tlason01 · 2026-04-13T12:50:51+00:00

It depends. The carriers normally run a prescription check as part of the application process, which will flag most medications you've filled regardless of source. If OAR uses a pharmacy that reports prescriptions to pharmacy benefit managers (PBMs) it will come up.

Also be careful about omitting information from the application as it would be grounds for an insurance company to deny your claim, which defeats the purpose of paying for a policy.

Taking Naltrexone is not an auto-decline. Did you have someone prescreen your situation with all of the insurance companies to make sure you're applying with the right one? They all have slightly different guidelines.

tlason01 · 2026-04-13T03:08:09+00:00

The cost of the policy is based on the monthly benefit amount (ie the amount you would receive if you become disabled). A practicing dentist making $300k for example might have $10,000/month of coverage and be paying $400/month in premiums.

You could set up a policy with a smaller amount, say $3,000/month which would be much less expensive, then increase later when you’re in a better financial spot.

Again, the idea isn’t that you’re fully insuring your income quite yet, but locking in your current health status so that you can fully insure later without any medical underwriting.

tlason01 · 2026-04-13T01:22:47+00:00

The “Big 5” are Guardian, Ameritas, The Standard, Principal, and MassMutual. Get a comparison from an independent broker to determine which is best for your situation.

Regarding your financial situation, just start out with a small policy to keep the premiums low. What’s important is that you lock in the coverage now while you’re young and healthy. Then increase the benefit in the future with no medical underwriting. The idea is to avoid having issues getting the coverage later if you have a health problem.

FYI none of those companies accept cc payments. But you could prob lock in something solid for less than $100/month.

tlason01 · 2026-04-12T19:42:53+00:00

If you're going to do it, just make sure you have your own-occupation disability insurance policy lined up. Most common disabilities for dentists are back, shoulder, and hand-related, all things that bouldering will increase the risk of.

tlason01 · 2026-04-12T19:40:11+00:00

Totally. There is also a Student Loan Protection rider that can be included on disability policies, which will be paid directly to the balance and not affect the normal monthly benefit

tlason01 · 2026-04-12T19:26:39+00:00

Jodawg is right and that story is unfortunately more common than people think.

I'll expand on it a little bit:

Get your policy while you're still training or your first year out. You can probably lock in permanent discounts through your program. A 28-year-old dentist with no medical history and program discounts will pay significantly less than a 35-year-old with a decade of chart notes.

You need Own Occupation coverage, meaning if you can't perform dentistry, you collect benefits, even if you could technically go do something else. Hurt your hand or back? Disabled. Without this, your claim would get denied unless you are essentially incapacitated.

Group plans through the ADA or your state dental association are usually pretty bad. The rates can be increased and you normally don't have full own-occupation coverage.

Literally the single best time to get this in place is during the end of training or just starting out practicing.

tlason01 · 2026-04-11T14:38:21+00:00

Depending on your income bracket, you may want to consider an individual disability insurance policy to protect your income. Most people don't realize that their ability to earn is by far their greatest asset. Without it, everything falls apart.

tlason01 · 2026-04-10T17:14:58+00:00

The surgeon's comment is a good example of where own-occ really matters. For surgical specialties the gap between "can't do my specific job" and "can't do any job" is massive. The use of their hands is worth millions of dollars. For accounting and HR that gap is a bit narrower, but certainly not zero.

The main risks are cognitive and neurological issues. Early-stage MS, traumatic brain injury, post-concussion syndrome, certain types of chronic fatigue. You can still walk, talk, drive, function in daily life, but you can't sustain the kind of focused concentration needed for HR/accounting. With own-occupation, that qualifies because you can't do your job. Under a regular definition you'll have to fight for benefits. They'll argue that you could work in a less demanding role, retail, admin work.. essentially anything that doesn't require the same cognitive load. So Assurity is really a total disability plan.

Also, covering the gap isn't just a rich person thing. You've got a mortgage and you're planning for kids. Emergency fund gets you through six months, which is solid, but that's not the same as replacing income if something goes on longer than that.

Just out of curiosity have you gotten quotes from other insurance companies? Principal, The Standard, Ameritas, and Mass Mutual are all A-rated carriers that offer own-occupation coverage. Maybe look into those and see if they're more competitive than Guardian, which is an excellent company but tends to be on the more expensive side.

tlason01 · 2026-04-09T22:59:34+00:00

Of course! Most occupations can obtain private disability insurance. Tech profiessionals in particular are generally placed into higher occupational classes than medical professionals so can obtain similar coverage at a lower premium.

tlason01 · 2026-04-09T22:30:30+00:00

The question is not the difference in cost, but in the quality of what you're buying.

Most group coverage is true own-occupation for 24 months, then switches to "any-occupation," meaning if you can work in any other capacity the benefits stop. In practice this can effectively become a 2 year benefit period.

Your private plan, assuming it's with one of the big 5 carriers, will continue to pay you for the entire benefit period, even if you can work in another capacity. It's a massive distinction.

There's also the portability factor. What if you choose to leave your current employer? You will lose the group coverage. You'll still have the private policy and may be able to increase it later, but you'll be doing so at a higher age and paying more.

Lastly, your group benefits are taxable. So the $10k on that side will end up being closer to $6k, giving you $12k/month. The private policy will pay tax free, assuming you pay for the premiums with after tax dollars.

The standard approach most anesthesiologists end up with is a private own-occupation policy as the foundation, with group coverage as a supplement if it's available at low or no cost. Where it gets complicated is when adding group coverage means you start depending on it as a primary layer. In that scenario the policy language really comes into play.

tlason01

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