What does disability insurance cover?

If you couldn’t work for weeks or months, would you be able to pay your bills? When back-to-back surgeries in January and February of 2020 kept Isabel Restrepo out of work for an extended period, the disability income insurance her employer provided picked up where her paycheck left off.

“I was out for a total of 11 weeks, none of which was planned,” she said. “If I didn’t have coverage, I wouldn’t have been able to focus on my recovery. You never realize how important disability insurance is until you actually need it.”

For many workers, if their employer doesn’t provide coverage, seeking out individual disability insurance isn’t a consideration. But even if it’s provided, paid sick leave only lasts for so long, and with over half of Americans living paycheck to paycheck, that could be a mistake. Think of it as income protection insurance: if you get sick or injured and can’t work, disability income insurance replaces a portion of your paycheck to help make ends meet. That way you can worry about getting better, rather than bills.

It’s also easier on the budget than you might think, with monthly premiums starting at less than the cost of a couple streaming subscriptions. (Seriously. See for yourself with a 30-second disability insurance quote.)

Types of disability insurance

Short term disability insurance, like Haven Disability, helps you cover immediate needs if a medical condition prevents you from working. Depending on the options you choose, the elimination period can be as short as 14 days. That means you’d be eligible for disability benefits after missing just two weeks of work. You can also choose from short term disability benefit periods of three months, six months, or a year. With a one-year benefit period, you’d receive disability benefits for up to 12 months for each approved claim.

The amount of income short term disability replaces varies, but it’s generally around 60% of your income. If you get the coverage through work, any disability insurance benefits you receive will likely be taxed. Disability benefits from individual policies like Haven Disability are paid for with after-tax money, so they won’t be taxed further. A benefit of 60% means you’ll receive 60% of your gross income.

Long term disability insurance typically doesn’t kick in until you’ve missed 90 days of work or more, and replaces 40-60% of your income. But just like it sounds, long term disability insurance can pay a monthly benefit for a period of years, or even decades. The longer the benefit period, the more you can expect to pay.

If you’re wondering which type of disability insurance to get, it doesn’t have to be an either-or proposition. Short term and long term disability insurance complement each other well, since long term can pick up where short term leaves off. If having both isn’t an option, the right choice depends on your personal situation. If you don’t have the savings to get you through a rainy month or two, short term might be the priority. But if your emergency fund is large enough to last for several months, long term might be the right option.

The most common disability insurance claims

Many people seem to think of disability insurance as accident protection insurance. That’s certainly a benefit of disability coverage, but it’s far from the only one. The vast majority of claims for both short and long term disability insurance are from medical conditions like arthritis and cancer, rather than broken bones.

Since short and long term disability insurance kick in at different times and pay benefits for different periods, the most common reasons for claims are also a bit different, according to the Council for Disability Awareness.

Most common short term disability insurance claims

1. Pregnancies (25%)
2. Musculoskeletal disorders affecting the back and spine, knees, hips, shoulders, and other parts of the body (20%)
3. Digestive disorders, such as hernias and gastritis (7.8%)
4. Mental health issues including depression and anxiety (7.7%)
5. Injuries such as fractures, sprains, and strains of muscles and ligaments (7.5%)

Most common long term disability insurance claims

1. Musculoskeletal disorders (29%)
2. Cancer (15%)
3. Pregnancy (9.4%)
4. Mental health issues including depression and anxiety (9.1%)
5. Injuries such as fractures, sprains, and strains of muscles and ligaments (9%)

Which conditions are covered by disability insurance?

If you are wondering how to qualify for disability coverage, it depends on the specific disability policy that you choose, so we can’t give a one-size-fits-all answer. We can say with certainty what Haven Disability covers though. Since this is an important section, we’ll have to use the contract language. That means a bit of legalese is incoming. It can’t be avoided, but we’ll keep it brief.

You’ll be eligible for Haven Disability benefits if you suffer a total disability. That means…

• You have a condition caused by sickness or injury that prevents you from doing the important tasks, functions and operations generally required for your occupation that can’t be reasonably omitted or modified
• You’re under a doctor’s care
• The disability begins while the policy is in force
• We consider your occupation to be your regular profession(s) or business(es) at the start of a disability for which you receive or can receive remuneration.

If you’re curious, sickness includes contagious diseases like COVID-19 and other viruses. In terms of disability insurance coverage, Haven Disability can’t help with lost income due to business closures, but if a COVID diagnosis keeps you out of work beyond your elimination period, you’re covered.

What isn’t covered by Haven Disability?

Not every injury or illness that causes you to miss work will be eligible for coverage. Some of the conditions that aren’t typically covered include normal pregnancy (but pregnancy complications are), self-inflicted injuries, substance abuse, and most elective cosmetic surgeries.

The exact list of excluded conditions can vary, depending on where you live. If you’d like the specifics for your state and situation, our Customer Success team can give you the details. Reach out by email at disupport@havenlife.com, or give us a call at 1 (855) 950-1395 weekdays from 8:30am to 4:30pm Eastern. No hard sells, just helpful answers. Pinky promise.

Does disability insurance cover pre-existing conditions?

If you have a pre-existing medical condition, you can still purchase Haven Disability in most cases, but disabilities caused by that condition may not be covered. Or at least not right away. When you apply, we’ll ask about your history with certain medical conditions.

A disability caused by a condition we ask about during the application won’t be covered if it begins before the policy has been in force for 24 months. A disability caused by a pre-existing condition we don’t ask about in the application won’t be covered until the policy has been in force for 12 months. After those periods have elapsed, disabilities caused by pre-existing conditions won’t be excluded.

How is pre-existing condition defined?

Since this is another important term, we’ll need to use the contract language again. A pre-existing condition is one for which (whether disclosed in the application or not)…

• Symptoms existed that would reasonably cause an ordinarily prudent person to seek diagnosis, care, or treatment within the year before the policy issue date, or
• Medical advice, diagnostic testing, or treatment was recommended or received by a physician within the two years before the policy issue date, or
• A qualified health professional prescribed drugs or medication within the two years before the policy issue date.

How much does disability insurance cost?

If you’re wondering how much disability insurance costs, the examples below will give you an idea of the premiums for a few different ages and professions. They’re all based on healthy, non-smoking adults. Refer to important information about policy limitations and exclusions.

Want to know how much coverage will cost for you? Good news. It only takes 30 seconds to get a disability insurance estimate. Just 7 questions, and no contact information needed.