Hi, I'm Billy Gwaltney and this is the CYA podcast. This show is for the physician who understands the importance of protecting everything you've worked so hard to achieve. Each week I'll bring you tips and advice to help you cut through the clutter and misinformation and show you exactly what you need to preserve your income and way of life. If you're ready to achieve the peace of mind that only financial security can bring let's get started.
(00:28): Welcome to today's episode of the cover, your assets podcast. This is your host, Billy Watney, and as always, I'm excited to be with you today. Today, we're gonna cover explaining the emeritus non disabling injury benefit. I get this question a lot in working with physicians across the country with their specialty disability coverage, there are four current top tier contracts with four separate insurance companies. Ameritus is one of the companies, a E R I T a S.
(00:59): There are mutual company, excellent track, excellent company, and they have a perk that they give policy holders called a non disabling injury benefit. And I'm gonna read the definition and kind of talk a little bit about what this means and how it can impact you. So the definition reads as this non disabling injury benefit. If you suffer an injury requiring medical treatment prescribed by a physician or the repair to natural teeth prescribed by a dentist, we emeritus will pay the expense of such treatment not to exceed the lesser of 50% of the base benefit or $3,000. Now, this is available for policy holders who purchase in 40 of the 50 states, okay? The state departments of insurance approved these contracts, and there are four states that, that for whatever reason, it's not been approved, those states are Colorado, Connecticut, Maryland, or Massachusetts. Okay. Two C two M Colorado, Connecticut, Maryland, Massachusetts.
(02:01): If you're purchasing in any other state and you go with Ameritus, this non samely injury benefit would be included on your policy. Even if you didn't want it, they give it to everybody. You're not getting nickled in dime. You don't pay an extra fee for it. You can't take it out, even if you wanted it removed. Okay. But a lot of people pick Aerus because of this perk. And so what this means is that if, if you suffer any kind of minor injury, technically a non disabling injury, which would be a minor injury. In other words, you're not gonna miss work for 90 or 180 days or longer, and you get it medically treated that they're gonna pay the cost of that treatment up to the lesser of 50% of your policy benefit or $3,000. So if you have five, a month of coverage as a trainee, the non disabling injury benefit cap is 2,500 per occurrence.
(02:50): Okay? If you have 6,000 a month of benefit or higher, then the cap is $3,000 per occurrence. And what's important is that they pay this regardless of health insurance. Okay? So the injuries can be anything as long as it's not intentionally self-inflicted or occurring while committing a felony or as a part of being in a war or active duty or military. And so it doesn't have to be work related. You don't have to miss any work. You could miss work. It does whichever it is. If you go to urgent care, if you get an x-ray, if you get an MRI, whatever treatment you get, they're gonna pay you the cost of that treatment. Again, up to 50% of the benefit or $3,000. And they're gonna send you a check for that. They do deposited in your account regardless of health insurance. So I have a client a while back who sprained her ankle really bad, had an MRI that cost I'm gonna use round numbers.
(03:50): It was about $2,000 for this MRI. Now her health insurance was apparently really good. She only paid a couple hundred bucks outta pocket, and she submitted the medical invoice to emeritus and they deposited $2,000 into her checking account. Okay, now I'm using round numbers, but that's, that's what happened. And so she was concerned like, Hey, I, I thought it was a reimbursement that the default tends to be. It's a reimbursement for copays. That's not what it is. It's a payment for the medical expense. Even if your health insurance covers it, which means you can make a profit on your injury. So she made an $1,800 profit on her sprained ankle. Now, you know, the joke is that's a tough way to make a living. You wouldn't wanna do that a lot, but I do have clients that have collected multiple times. It's a per occurrence limit.
(04:37): There's not an annual limit. It's just a per event limit. And so this client who sprains her ankle, they can't raise her rate. They cannot exclude her ankle from future injuries or, or disabilities. There's no downside impact to her or her contract at all. And then if she sprained the other ankle a week later, there would be non injury benefit, pay for that. If she hurt her wrist, the next week, there would be one for that. If she hurt her other wrist the next week, there'd be another one for that. And so I just wanna kind of explain this because there's a lot of questions about it and it, and it's a very attractive benefit and it's usually much more attractive than people think it is initially, because if you're gonna have a policy over 30 years, hopefully you'll never be disabled, but it's a reasonable to assume that you, at some point you might hurt yourself, you know, working out or hiking or doing yard work or something. And if you do, then they're gonna pay you the medical cost of that treatment, even if your health insurance covers. So hope you found this helpful would be happy to discuss this offline with you in more detail, answer questions regarding your specific situation. Feel free to text me at 7 0 4 2 7 0 2 3 7 6 again, 7 0 4 2 7 0 2 3 7 6. And until we meet again, this is Billy GU me grateful to be with you. Thank you as always for your time.
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