Do Physicians Need Disability Insurance If Their Spouse Also Works at a High Income Job?
- Nisha Mehta, MD
- Aug 7
- 9 min read
As a physician, your earnings potential is one of your most valuable assets. Disability insurance protects this asset you’ve spent literally over a decade to secure, and as such, we feel strongly that almost all physicians need it until they have enough in savings that losing their ability to earn income won’t impact their lifestyle. We often see doctors on our online physician community wondering if their personal situation is an exception. We’ve previously covered reasons physicians mistakenly think they don’t need disability coverage, but wanted to dig deeper into the specific question of whether doctors should get disability insurance if their spouse is also a high income earner, as it is one of the most common situations in which doctors decide to pass on getting disability insurance, and one that can be devastating. Below, we cover considerations and questions to ask to help you determine if you need disability insurance for dual income situations. TL;DR: you both usually do.
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What is disability insurance, and where do I get it?
Chances are if you’re reading this article, you already know about disability insurance, but if not, read our guide to disability insurance. The long and short of it is that in the event that you are unable to work as a physician secondary to a disabling condition, disability insurance will kick in to provide monthly income up to the benefit that you signed up for.
If you need to secure a policy, contact our recommended insurance brokers for physicians.
If my spouse works and can support our family, why do I need disability insurance?
Many physicians make the mistake of assuming that they can always live on one salary if something were to happen to their ability to earn. While that could end up being the case, if there’s anything that we know as physicians, it’s that tomorrow is never guaranteed, and a lot can happen between when you make the decision to purchase or not purchase disability insurance and if/when you become disabled.
You could get divorced in the interim, your spouse could pass away, or your spouse could lose their job or become simultaneously disabled
Unfortunately, as much as we don’t like to think about it, death, divorce, and other bad things happen. What would your plan be for your own financial security if you passed up on disability insurance assuming that somebody else could pay for your expenses, and for whatever reason they couldn’t? As a physician, you’re capable of standing on your own two feet financially, and you shouldn’t give that up.
Your lifestyle could change in the interim, and one income may not be able to support it
Chances are, as a physician, your income makes up a significant portion of your household's income. Dual-income households typically account for both income streams when making life and financial choices.
A reduction in income could impact:
Your debt-to-income ratio and your ability to comfortably manage your mortgage payment every month
Your ability to manage your real estate investment properties and their management, maintenance, and mortgages
How frequently your family travels, and the types of trips/opportunities you can afford to take
Your ability to pay for private school tuition for your children’s education, or to cover childcare expenses
Losing one income may affect the other person’s career choices or put a lot of pressure on one spouse to earn money
One of the most reassuring things about having two incomes is that you have a backup plan that allows for some financial flexibility. If that is gone, a lot of pressure then falls on the earning spouse to have a ‘safe’ income stream, which may preclude them from taking risks or opportunities that could be great for their careers and your life, or cutting back on hours or taking more vacation to alleviate burnout or spend more time with family.
In a worst case scenario, they may have to delay retirement or actually increase their working hours, potentially at a time where you need them more due to your disability or illness.
Disability insurance protects your long-term earnings and savings, not just lost income
It’s not just about meeting your expenses. You’ve spent years training for a job that allows you the financial security to be able to live and save comfortably. This includes:
Saving for a comfortable retirement - and ideally a fun retirement!
Potentially paying for your kids’ education or providing them with an inheritance
Should you unfortunately face a long-term or permanent disability, your disability coverage can help ensure you can still meet your long-term investing and retirement goals, without having to sacrifice your goals.
For example, if you’re a vascular surgeon who ends up with a disability at the age of forty that prevents you from operating in the future, this could severely restrict your income for the rest of your life. Your $625,000 annual income might drop to $150,000, or to no income at all. Over the next two decades of a career, this could mean not only $9,500,000 to $12,500,000 in income lost, but all the potential compounded growth of any portion of that you were able to invest for retirement. A $10,000,000 swing can have huge implications for your family's future, regardless of how much your spouse makes at their job.
Questions to consider include:
Would you still be able to fund your retirement savings if you lost your income?
How much will the long-term salary losses impact future planning and goals?
Will the additional loss of employer retirement benefits (pensions, defined benefit plans, 401k match, etc.) impact your overall retirement savings plan?
Do you have a large enough net worth and are your assets liquid enough to access without impacting your overall financial security?
Your financial needs may increase during disability
Think of all the things that could change financially if you were significantly disabled. Could your spouse’s income also cover that?
Would you need to hire help to assist you if you were significantly disabled? This could cost thousands a month. Many disability insurance policies also have riders that would increase your benefit if you can’t perform your ADLs.
Would you need to hire help around the house to help with the things that you normally do, like laundry, cooking, etc.?
Would you need to hire more help for your children?
Relationship dynamics may change during disability, and you may not want to rely on someone else for your financial stability
We know we keep saying this, but you worked hard to become a physician, and you shouldn’t have to rely on someone else for money. A lot may change about your relationship if you have a significant disability, to the point where the marriage dynamic changes completely. The role of a caregiver isn’t for everyone. Sometimes, marriages don’t survive this, or even if they do, it could add significant strain.
If you’re not used to having to ask for money or be told how much you can spend, you may not want to rely on someone else giving you money and telling you how much you can have. We’re not saying your spouse would definitely do this, but you just don’t know how the stress of supporting both could change things.
Additionally, if the marriage turns out to no longer be a good fit (either because of the disability or otherwise), you don’t want money being the reason that you feel like you have to stay.
Do I need disability insurance if my spouse makes so much money that we don’t rely on my income at all, and they could easily cover any and all expenses, save for retirement, etc.?
To reiterate the points above, there are still situations there that leave you vulnerable.
Also, if this is the case, a few thousand dollars a year for your disability insurance policy probably won’t make a big difference to your family, but the peace of mind of knowing you are protected might. Therefore, unless you know that you have enough money in your own bank account that’s protected to support yourself independently of anybody else, you likely still want your own disability insurance policy until you can confidently say that.
Once you’ve achieved this point, you can always consider dropping or modifying your disability insurance coverage.
If we’re both doctors, should we both get disability insurance policies? Should we make any adjustments accordingly?
Yes, these arguments go both ways for each of you. Love each other enough to want both of you to be protected equally in the off chance that something would happen.
In terms of how much to get, this can get a little trickier in a dual income situation. In a world where money wasn’t an issue, getting the two biggest policies you each qualify for may seem like the obvious decision. However, we do understand adjusting how much you get for each once you map out potential scenarios to try and save a little on those disability premiums. For example, you may not both need $20,000 in disability insurance benefit a month. If you were to get divorced, there would likely still be some spousal support, and if somebody were to pass away, hopefully you’ll have life insurance as well.
If you need to work through these situations, you can discuss this with a financial advisor who’s used to working with physicians or high income families to walk through the various considerations. Of course, don’t buy your insurance policies from your financial advisor - that’s one of our red flags, as it may result in your financial advisor acting more as an insurance salesperson and introduces conflict of interest. Because of this, we always recommend working separately with an independent disability insurance broker that can run quotes across multiple companies to get you your best options.
Where to find a disability insurance policy
There are different types of disability insurance, with true own-occupation typically being the best fit for physicians. These policies offer the widest definition of what counts as a disability and generally provide the least reductions to benefits based on other income you may be able to make.
If you or your spouse don't have a disability insurance policy yet, or you need to replace or supplement your existing policy, we have partnered with a few insurance companies who have helped thousands of our community members find the right coverage.
Pattern: This convenient option will allow you to enter your information and immediately begin generating quotes from the major disability companies, as well as schedule a meeting with the Pattern team to discuss the options and figure out which plan is best for you. Many in the group have had a great experience with this process.
Moment Insurance: Complete your quote inquiry information in less than five minutes and easily schedule an appointment to speak with a dedicated, experienced disability insurance expert who will walk you through the process from start to finish and help you compare different options. Many in the group have worked with their experts previously and had a great experience!
Conclusion
Having a working spouse, even if they are also a physician or are a high-income earner, doesn’t replace the protections that a disability insurance policy provides. Fundamentally, insurance is always a balance of assessing risk, and having disability insurance to help cover you in the situations above and will give you the peace of mind you deserve after working so hard to get to a point where you can support yourself financially without leaning on someone else. can be an additional backup layer of protection. Additionally, it will take some of the burden off of your spouse at an already stressful time.
TLDR: Unless you’re financially independent or are retiring, we recommend securing a disability policy to protect your income. The sooner, the better, as policies typically become more expensive with age and you may run into a situation where you don’t qualify for coverage, either short term or permanently. If you need help securing a policy, reach out to one of our recommended insurance agents for doctors.
Additional disability insurance resources for physicians
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