Physician Disability Insurance for Foreign Nationals

For many foreign nationals, the ability to earn an income is not just a financial cornerstone but a necessity for maintaining their professional and immigration status. For physicians and other high-income professionals on work visas like J1, H1-B, or similar, an unexpected injury or illness could disrupt both their finances and their ability to remain in the United States.

A Foreign Medical Graduate’s Journey

Consider the story of a foreign medical graduate shared in The White Coat Investor Forum. This family—a physician and a software engineer with two young children—worked hard to achieve their professional and personal goals. After years of dedication and sacrifice, the physician finally secured a coveted residency position in internal medicine.

Their journey was far from easy. The family spent nearly all their savings on the process of obtaining a residency position. This included expensive USMLE exams, unpaid observerships in programs across the country, and applications to more than 200 residency programs. Each step brought financial and logistical challenges, requiring the couple to juggle parenting responsibilities, relocation costs, and the uncertainty of whether their efforts would pay off.

When the residency position was finally secured, it was a major victory. However, it also came with the realization that their financial security now depended heavily on the physician’s ability to continue working. As immigrants, they had built their lives and their future around this income. Any disruption to their earnings due to illness or injury could have devastating consequences. This is why income protection, regardless of citizenship status, should be one of the first things purchased as a foreign national physician.

But there are also things to consider.

Disability insurance plays a crucial role in securing financial stability for foreign nationals. Statistics show a physician has a 1 in 7 chance of experiencing a disability during working years that could prevent them from earning an income for a period of time. In addition, 90% of all long-term disability claims are due to illnesses and 10% are due to injury. While securing disability insurance is essential, foreign nationals face unique challenges and considerations when navigating their options.

Key Challenges for Foreign Nationals

Disability insurance policies for foreign nationals often come with specific restrictions due to concerns about:

• Residency status: Policies may require applicants to have permanent residency or meet specific visa requirements.
• Foreign travel: Many insurers impose limitations on benefits if the insured spends extended time outside the US.
• Claims administration: Managing claims internationally can pose logistical challenges for insurers.

Insurers generally address these risks in a few ways:

1. Limiting benefit periods to a specific duration (typically up to 12 months while outside the US).
2. Requiring the insured to live in the US for a certain period annually to maintain full benefits—sometimes at least six months every year if a claim is ever made.
3. Adding exclusion riders to policies issued to visa holders, restricting claims for incidents occurring abroad.

More information here:

Go Buy Disability Insurance!

Why Do Some Doctors Get Declined for Disability Insurance?

How the “Big 5” Disability Insurers Handle Disability Insurance for Foreign Nationals

Principal

Principal offers disability coverage to foreign nationals with the following considerations:

• Green card holders: Treated the same as US citizens after residing in the US for at least one year.
• Visa holders: Eligible on a case-by-case basis for individuals on H1B, L1, J1, O1, or TN visas, subject to a non-US citizen questionnaire.
• Foreign travel: Benefits may be limited if travel exceeds three months annually or involves high-risk locations.

Guardian Life

Guardian Life provides coverage under specific visa and residency conditions:

• Eligible visas: Coverage available for G1, H1B, J1, L1, O1, and TN visa holders.
• Student visas (F1): Eligible if intent to reside permanently in the US is documented.
• Travel exclusion: Policies generally include riders limiting benefits during foreign travel, except for Canadian citizens on temporary visas.

MassMutual

MassMutual evaluates foreign nationals based on stricter residency and lifestyle factors:

• Eligibility requirements: Applicants must:
  • Reside in the US for at least three years.
  • Own personal assets and have family ties in the US.
  • Avoid frequent foreign travel.
  • Be in specific occupational classes (e.g., 5A, 5P).

• Foreign travel: Applicants with extended travel plans may be ineligible.

Ameritas

Ameritas distinguishes applicants based on their length of US residency:

• Permanent residents: Green card holders residing in the US full-time for at least five years are treated as US citizens.
• Recent immigrants (1-5 years): Eligible on a case-by-case basis if they:
  • Intend to remain in the US permanently.
  • Hold an acceptable visa and are employed full-time.
  • Speak and understand English.
  • Only travel to their native country occasionally.

The Standard

The Standard considers applicants based on their visa status and residency history:

• Permanent residents: Green card holders residing in the US for five or more years are treated as US citizens.
• Temporary visa holders: Applicants with at least one year of residency in the US and the intent to remain permanently may be considered case-by-case.
• Foreign travel: Extended or frequent travel abroad may result in benefit limitations or ineligibility.

More information here:

Landing a Physician Job in the US While on a J-1 Visa

Investing in Tax-Advantaged Accounts for Non-US Citizens

Strategies for Foreign Nationals to Secure Coverage

The best approach depends on your residency status, visa type, and long-term plans:

Green Card Holders

Consider a policy that includes exclusion riders for foreign travel but avoids benefit period limitations in the base policy if possible. Once a green card is obtained, insurers are often willing to remove exclusion riders, leaving you with a more comprehensive policy.

No Green Card

Shop around by checking with one of the WCI-vetted insurance agents to get a quote and see what’s available. They’ll know what the best option would be in your situation. Focus on policies that provide some benefits even with limitations. If possible, try to find policies without exclusions for foreign travel, as they may leave you unprotected in the event of a disability.

The Value of Professional Guidance

Disability insurance for foreign nationals can be challenging, but you don’t have to navigate it alone. The White Coat Investor is here to help find the best, unbiased options available. Policies and provisions vary by company and state. Working with an experienced WCI insurance agent who specializes in serving foreign national physicians can help you evaluate your options and make informed decisions.

Have you had challenges obtaining disability insurance as a foreign national? What other experiences or questions do you have?