Does disability insurance pay medical bills? This question was posed to Mark Webb, Executive Vice President, Governmental Relations, of Employers Direct Insurance Company. "Disability insurance is insurance...
This question was posed to Mark Webb, Executive Vice President, Governmental Relations, of Employers Direct Insurance Company. "Disability insurance is insurance that pays you for lost income arising from an injury," Webb explains. "State benefit systems (workers' compensation) will compensate you for lost income up to a set amount and will also pay for the medical costs that you incur as you recover from your injury. In order to access workers' compensation benefits, your injury or illness must arise out of and in the course of employment. In the vast majority of states, medical benefits are provided without any deductibles or co-payments. The employer at the time of your injury or illness is responsible for all of the medical payments necessary to cure or relieve the effects of the injury or illness regardless of when those expenses are incurred and regardless of whether you are even still working for the same employer."
"Social Security disability (SSDI) will also allow you to participate in the Medicare program," Webb continues. "For most disabling conditions, Medicare eligibility is after a 24 month waiting period. Under such circumstances, even if this is a condition that causes you to leave the workforce, you should seriously consider continuing the health care benefits that your prior employer is required to offer if you had health care insurance while working. While expensive," Webb points out, "these benefits will help bridge the gap that may occur if you apply for and receive SSDI payments. SSDI is not available if you are not expected to be totally disabled. That means that a temporary disability or a permanent partial disability will likely not qualify for SSDI benefits."
Webb goes on to explain that, "Private disability plans, either purchased by you or through a group coverage provided by your employer, do not make payments to providers of medical services. Policies such as hospital indemnity plans or specific illness plans will make payments to you, which may assist in paying medical bills but are not limited to that use. When considering a hospital indemnity plan, be certain that you understand all the terms, conditions, and restrictions of the policy. Policies will not generally cover a condition that you have been diagnosed as having during the 12 months preceding the date that the policy becomes effective. Certain types of hospitalizations, such as for pregnancy or cosmetic surgery, may also not be covered. In addition, if both you and your spouse are employed and are receiving benefits from both employers, there may be an issue regarding coordination of benefits (COB). As is always the case with insurance coverage, it is important to know what policies cover what conditions before you start buying additional insurance products."
"In addition to these plans, in certain circumstances where you are injured as the result of a negligent or intentional act by another, such as an automobile accident, you may have indemnification rights against that person. In such circumstances, insurance companies that have paid benefits to you may also have the right of subrogation against the insurance company of the party at fault to recover sums paid to doctors or hospitals on your behalf. When you are facing large medical bills and the potential of significant time off of work, it is important to understand all the insurance options that are available to you. Before it happens, contact your employer's benefit professional, an insurance professional, or look online at the many insurers who offer disability insurance products."
