Learn about Disease and Disability Health Insurance Coverage in Virginia

Disability income insurance policies provide replacement income for a specific period if you suffer a disability and cannot continue to work. The disability may involve sickness, injury, or a combination of the two.

Employers may offer short-term and/or long-term disability coverage. Social Security also provides disability protection, but only for those that are severely disabled and unable to work. Most disability income policies coordinate with Social Security benefits and workers' compensation to eliminate duplication of coverage.

When buying a disability income policy, you should find out the company's definition of a disability and the requirements that must be met. An insurance company paying for a disability claim may require the policyholder to provide a written doctor's report. The frequency of this requirement depends on the particular policy.

Examine your disability income policy carefully:

• Benefits are usually a percentage of your income at the time of purchase, but cost-of-living adjustments may be available.
• Know how your policy defines "disability." Eligibility for benefits is based on this definition. Is eligibility based on the premise that you are unable to perform the substantial or major duties of your regular occupation? Or, is eligibility based on your inability to engage in any occupation or employment for which you are qualified because of your education, training, or experience? Or, is there a dual definition?
• Review the benefit as it relates to the cause of the disability. You want to be insured if disability is caused by accident, illness or injury.
• Please be aware that disability income insurance policies include an elimination period (the length of time you must wait after the onset of disability, before benefit payments begin.) Benefit payments may actually begin several months or more after the onset of the disability.
• Consider disability income insurance that pays benefits to at least age 65. Disability income benefits are designed to replace earned income. A lengthy disability can threaten financial security.

Specified disease insurance policies provide benefits for medical expenses associated with specific diseases named in the policy. For example, cancer policies pay benefits for expenses incurred in connection with treatment of cancer. Benefits are usually limited in amount. Some policies may limit coverage to the first occurrence of the disease. These policies often pay the insured directly for the benefits available under the policy regardless of payments for medical care under other plans.

Short-term or temporary health insurance policies provide coverage that lasts only for a specified period of time. For example, you might purchase a one-month policy with major medical coverage for a brief period of unemployment.

Limited Benefit Health Policies: Minimum standards were established in Virginia to insure that individual accident and sickness policies provide a minimum of basic benefits needed for health care. A company may market an individual accident and sickness policy that does not meet these minimum standards, as long as it discloses that the benefits are limited and describes, in detail, the limitations. Contact your agent regarding your policy and minimum standards.

- - - - - - - - - - - - - - - - -

There are many consumer guides that explain other types or aspects of health insurance and its benefits available from the Bureau of Insurance at no charge. Please call, write or visit our website to make your request.