TMA Insurance Insights | Blogs, Tools & Resources for Texas Physicians

Do You Really Know the Cost of Being Seriously Ill?

Written by TMA Insurance Trust Team | Feb 22, 2020 1:00:00 PM

As a physician, you understand how important it is to carry comprehensive health insurance. But when you are faced with a critical illness, your health insurance - though important - could still leave you with coverage gaps that may leave you financially vulnerable.

The Cost of Being Critically Ill

There are many expenses associated with being seriously ill. These, of course, include your deductibles and copays. But when your recovery becomes the most important thing in your life, there are other medical and non-medical costs that can pile up. These include lost wages from work; costs for child care, transportation, hotel stays, and so much more. Take a closer look at some common expenses associated with a critical illness and how quickly they can add up:

Pursuing Out-of-Network Treatments

When illness or injury isn’t serious, it’s easy to stay within the parameters of your health insurance network. There are plenty of qualified physicians from which to choose who can treat pneumonia, set a broken wrist, or perform an appendectomy. But when your life is truly on the line, you may want to pursue experimental treatments or consult with a highly qualified specialist who is not in your network. This is where costs for medical treatment can really skyrocket.

According to one major insurer, a single visit to an out-of-network physician instead of one that is in your network could take your out-of-pocket medical costs from $140 to $645.¹ And that is just for the visit - this doesn’t include testing or treatment. What about diagnostic imaging? The American College of Radiology states that the average copayment for out-of-network advanced imaging is $630.²

Prescription Costs Add Up

When a patient is faced with an illness like invasive cancer, to say that treatment is “expensive” is a gross understatement. According to the National Cancer Institute, prices higher than $10,000 per month for individual drugs and biologic agents are common.³ These oral cancer drug-based treatments are frequently covered under patient pharmacy benefits’ speciality tier, which requires high coinsurance that patients pay out-of-pocket.³ In 2017, 88% of prescription plans were multi-tiered, in which specialty drugs had the highest cost sharing.³

Sustained Costs After Recovery

After a serious illness like cancer, increased costs often continue for years. The National Cancer Institute states that cancer survivors (1) have higher out-of-pocket medical costs for years, (2) are more likely to be unable to work because of their health, and (3) have more missed work days because of poor health.³

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How Critical Illness Insurance Can Help

TMA Member Critical Illness insurance offers a full benefit for: 

  • heart attack,
  • invasive cancer,
  • stroke,
  • Alzheimer’s disease,
  • kidney and all major organ failure. 

Benefits can also be paid for a diagnosis of:

  • non-invasive cancer (other than skin cancer),
  • multiple sclerosis,
  • occupational HIV infection,
  • Parkinson’s disease,
  • severe coronary artery disease, and
  • terminal illness.

If you are afflicted with a serious illness, the benefit is paid directly to you, upon diagnosis. You can use the funds as you see fit: offset your high deductibles, copays, and any out-of-pocket medical costs once your insurance reaches the maximum limits. You can even use the benefits to help with non-medical expenses like hotel stays near specialized medical facilities, airfare, and replacing lost wages.

Features of TMA Member Critical Illness Insurance

  • Get $20,000 of coverage with guaranteed acceptance if you’re a TMA member under age 65, as well as $10,000 coverage for your spouse or partner under age 65.
  • No physical exam or questions to answer. You cannot be turned down.
  • This insurance pays a lump sum benefit directly to you when diagnosed with a covered illness, regardless of any other insurance you may have.
  • As a TMA member, you can apply for a total of $250,000 of coverage.

Right Now, You Can’t Be Turned Down

Until March 31, TMA Insurance Trust is offering members guaranteed acceptance for $20,000 coverage of the TMA Member Critical Illness Insurance issued by The Prudential Insurance Company of America. If you are a TMA member under age 65, you can take advantage of this guaranteed acceptance offer.

When you enroll, you won’t be asked medical questions, and there is no underwriting. You’ll get coverage quickly that helps fill a gap that your health insurance leaves.

So act now. Getting coverage has never been easier. Click the button below to get a quote and enroll.

 

For over 60 years, TMA Insurance Trust advisors have been serving Texas physicians, their families and staff. TMA Insurance Trust prides itself on offering unbiased information and strategies to members, along with exclusive group rates on a range of the highest-rated plans in the industry.