--- title: When a High-Deductible Health Plan Meets Critical Illness description: When a serious diagnosis introduces expenses beyond traditional health insurance, including a high deductible, supplemental income support matters. image: https://www.tmait.org/hubfs/February%202026/February%202026%20Week%201%20-%20Critical%20Illness.png --- - [800-880-8181](tel:800-880-8181) - [CONTACT US](https://www.tmait.org/contact) - [SELF-SERVICE PORTAL](https://tmait.aebsys.com/#/) [![](https://www.tmait.org/hs-fs/hubfs/TMA%20Insurance%20March%202019/Image/logo.png?width=197&name=logo.png)](https://www.tmait.org/) Topics All Accident Insurance Accidental Death and Dismemberment Auto & Home Insurance Auto Insurance Business of Medicine Business Overhead Expense Insurance Comparing Insurance Providers COVID-19 FAQs Critical Illness Insurance Dental Insurance Disability Insurance Employed Physicians Family Featured Financial Advice Group Benefits Group Coverage Health Insurance Homeowners Insurance HSA Independent Contractor Independent Physician Individual Coverage Insurance For Good Insurance for Women Insurance Review Key Person Insurance Life Events Life Insurance Locum Tenens Medevac Insurance Medical Insurance Medical Practice Medicare Medicare Part D Medicare Supplement Medigap Nearing Retirement Office Overhead Expense Insurance Open Enrollment Personal Umbrella Insurance Pet Insurance Practice Management Practice Managers Practice Owners Prescription Drug Coverage Renters Insurance Residents Retired Physicians Retirement Short Term Disability Short-Term Medical Insurance Supplemental Hospital Indemnity Insurance Term Life Insurance Travel Insurance Vision Insurance Women Physicians Young Physicans Young Physicians ![Doctor with his back turned looking down at his phone](https://www.tmait.org/hubfs/February%202026/February%202026%20Week%201%20-%20Critical%20Illness.png) [Residents](https://www.tmait.org/blog/topic/residents) # When a High-Deductible Health Plan Meets Critical Illness 7 February 2026 When a High-Deductible Health Plan Meets Critical Illness 5:04 When a serious diagnosis introduces expenses beyond traditional health insurance, including a high deductible, supplemental income support matters. The TMA Member Critical Illness Insurance plan, **issued by the Prudential Insurance Company of America,** is intended for situations like these. The following scenario* shows how this critical coverage can play out in practice. ## Critical Illness Insurance in Action Beginning in 2026, many health insurance premiums across Texas experienced double-digit rate increases.1 In response, like many physicians, Dr. Smith selected a high-deductible health plan during Open Enrollment to manage rising costs. Months later, a heart attack abruptly altered his daily routine. Returning to work was not immediate. Nearly two months passed before it felt realistic. During that time, short-term disability replaced only a portion of his income, while regular household expenses continued. His health plan deductible came due, and additional assistance at home became necessary. This created costs that his health insurance did not fully cover. Before his heart attack, Dr. Smith had enrolled in** TMA Member Critical Illness Insurance **through TMA Insurance Trust. As a TMA member under age 65, acceptance was guaranteed for $20,000 in coverage, with no medical exams, health questions, or underwriting required. Following his covered diagnosis, the lump-sum benefit was paid directly to him. By the time Dr. Smith returned to work, the impact of time away was significant. During recovery, the benefit provided flexibility by supplementing his reduced income, offsetting the high deductible, and helping cover medical and non-medical expenses. Having coverage in place helped reduce financial strain, allowing him to avoid relying on long-term savings or returning to work before he was ready. [![We're here to help - CLICK HERE or call today](https://no-cache.hubspot.com/cta/default/400074/f1028049-dc7a-4f66-bc55-4d7e534d3cd2.png)](https://cta-redirect.hubspot.com/cta/redirect/400074/f1028049-dc7a-4f66-bc55-4d7e534d3cd2)***[800-880-8181](tel:800-880-8181) 8:00 – 5:00 CST Monday – Friday*** ## Why This Scenario Is Not Unusual Recovery timelines like this are common. According to the Texas Heart Institute, returning to work after a myocardial infarction can take anywhere from a few weeks to two or three months.2 Serious illness is also more prevalent than many expect. The American Heart Association reports that someone in the United States experiences a myocardial infarction approximately every 40 seconds.3 The American Cancer Society estimates about two million new cancer diagnoses nationwide in 2024,4 including nearly 148,000 in Texas.5 Treatment and recovery can also involve additional expenses. Research published through the National Institutes of Health shows that about 40% of cancer patients use complementary or alternative medications during treatment,6 costs that may fall outside traditional health insurance coverage. Together, these realities help explain why some physicians look for an insurance plan beyond medical coverage alone. Having quick access to funds can provide the added flexibility needed when income is disrupted and expenses arrive from multiple directions. ### Key Features of the TMA Member Critical Illness Insurance Plan The following features highlight how this coverage helps provide financial support when it is needed most. - **Guaranteed acceptance for TMA members.** Members under age 65 are guaranteed acceptance for $20,000 in coverage with no medical exams, health questions, or underwriting required. - **Guaranteed acceptance for spouses.** Once you enroll, guaranteed acceptance for $10,000 extends to a spouse or domestic partner under age 65. - **Direct benefit payments.** Benefits are paid directly to you upon diagnosis of a covered illness and may be used for medical and non-medical expenses. - **Coverage that works alongside other insurance.** Benefits are paid regardless of other insurance and are not subject to deductibles, co-pays, or coinsurance. - **Options to tailor coverage.** You may apply for additional coverage up to $250,000, with options for spouse and family coverage. - **Coverage that stays with you.** Coverage remains in place as long as you are a TMA member, regardless of changes in employment or practice structure. **Enrollment is simple and can be completed online (click below) or with guidance from a TMA Insurance Trust advisor.** Members have 30 days to review their coverage. A full refund is available if canceled during that time. For questions or assistance, TMA Insurance Trust is available at 800-880-8181, Monday through Friday, from 8:00 AM to 5:00 PM CST. [![START MY COVERAGE](https://no-cache.hubspot.com/cta/default/400074/26aa10cd-c7df-46be-b638-858a87eeb06e.png)](https://cta-redirect.hubspot.com/cta/redirect/400074/26aa10cd-c7df-46be-b638-858a87eeb06e)[![New Call-to-action](https://no-cache.hubspot.com/cta/default/400074/9bd4d602-5a80-4525-8e30-bf1985283605.png)](https://cta-redirect.hubspot.com/cta/redirect/400074/9bd4d602-5a80-4525-8e30-bf1985283605)   * This is a fictional scenario created for illustrative purposes 1. Marketplace Average Benchmark Premiums, KFF - December 2025 2. Recovering From a Heart Attack, The Texas Heart Institute, Baylor College of Medicine - December 2025 3. 2024 Heart Disease and Stroke Statistics Update Fact Sheet, American Heart Association - December 2025 4. Cancer Facts & Figures 2024, American Cancer Society - December 2025 5. Cancer Statistics Center, American Cancer Society - December 2025 6. Over 40% of cancer patients use complementary and alternative medications while receiving anticancer treatment, PMC - December 2025   **This coverage is not health insurance coverage (often referred to as “major medical coverage”)**.   Group Critical Illness Insurance coverage is a limited benefit policy issued by The Prudential Insurance Company of America, a Prudential Financial company, Newark, NJ.**Prudential’s Critical Illness Insurance is not a substitute for medical coverage that provides benefits for medical treatment, including hospital, surgical, and medical expenses, and it does not provide reimbursement for such expenses.** The Booklet-Certificate contains all details, including any policy exclusions, limitations, and restrictions, which may apply. If there is a discrepancy between this document and the Booklet-Certificate/Group Contract issued by The Prudential Insurance Company of America, the Group Contract will govern. A more detailed description of the benefits, limitations, and exclusions applicable are contained in the Outline of Coverage provided at time of enrollment. Please contact Prudential for more information. Contract provisions may vary by state. Contract Series: 114774. 1089891-00001-00 ** [ Residents ](https://www.tmait.org/blog/topic/residents) [, Individual Coverage ](https://www.tmait.org/blog/topic/individual-coverage) [, Critical Illness Insurance ](https://www.tmait.org/blog/topic/critical-illness-insurance) [, Family ](https://www.tmait.org/blog/topic/family) [, Independent Physician ](https://www.tmait.org/blog/topic/independent-physician) [, Employed Physicians ](https://www.tmait.org/blog/topic/employed-physicians) [, Practice Owners ](https://www.tmait.org/blog/topic/practice-owners) [, Practice Managers ](https://www.tmait.org/blog/topic/practice-managers) [, Locum Tenens ](https://www.tmait.org/blog/topic/locum-tenens) [, Independent Contractor ](https://www.tmait.org/blog/topic/independent-contractor) [, Insurance for Women ](https://www.tmait.org/blog/topic/insurance-for-women) [, Women Physicians ](https://www.tmait.org/blog/topic/women-physicians) [, Young Physicians ](https://www.tmait.org/blog/topic/young-physicians) [, Insurance For Good ](https://www.tmait.org/blog/topic/insurance-for-good) ** [Medical Practice](https://www.tmait.org/blog/topic/medical-practice) [**Previous Entries](https://www.tmait.org/blog/confident-smiles-begin-with-dental-insurance) [Next Entries**](https://www.tmait.org/blog/dont-leave-yourself-exposed-why-you-need-personal-umbrella-liability-insurance) ## 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