M-F, 8:00 a.m. to 5:00 p.m. CT
Your application has been successfully submitted
Fill out the form below to enroll. Enrollment Deadline: June 30, 2023
You won’t be billed until and unless you are approved for coverage.
Based on the billing frequency which I selected above, I authorize AMA Insurance Agency, Inc. to make withdrawals against the account specified above or any other account subsequently named by me, and such bank to process these withdrawals as if I had signed them, for the purpose of collecting premium contributions due under each insurance plan indicated as AutoPay(EFT) in this Application Form. If I wish to discontinue this authorization, or my account number changes, I will notify the plan administrator in writing.
You won’t be billed until and unless you are approved for coverage. You will receive your bill in the mail with your certificate of insurance. If you choose a future effective date of coverage you will receive your bill 35 days prior to your chosen effective date of coverage.
Review legal notices and click Next to continue. Please review the statements below and acknowledge you understand and consent to each. Once you consent, you will continue to securely sign the application with DocuSign, our secure electronic signature process. You must click Next below to sign your application for it to be complete.
Read & Sign
FRAUD NOTICE — FOR RESIDENTS OF ALLSTATES EXCEPT THOSE LISTED BELOW: Any person who knowingly and with intent to defraud any insurance company or other person files an application for insurance or statement of claim containing any materially false information or conceals for the purpose of misleading, information concerning any fact material there to commits a fraudulent insurance act, which maybe a crime and may subject such person to criminal and civil penalties.
RESIDENTS OF CO: The following also applies: Any insurance company or agent who defrauds or attempts to defraud an insured shall be reported to the Colorado Division of Insurance within the Department of Regulatory Agencies.
RESIDENTS OF AL/AR/LA/RI: Any person who knowingly presents a false or fraudulent claim for payment of loss or benefit or knowingly presents false information in an application for insurance is guilty of a crime and may be subject to fines and confinement in prison.
RESIDENTS OF CA: For your protection California law requires the following to appear on this form. Any person who knowingly presents false or fraudulent information to obtain or amend insurance coverage or to make a claim for the payment of a loss is guilty of a crime and may be subject to fines and confinement in state prison.
FOR RESIDENTS OF D.C., WARNING: It is a crime to provide false or misleading information to an insurer for the purpose of defrauding the insurer or any other person. Penalties include imprisonment and/or fines. In addition, an insurer may deny insurance benefits if false information materially related to a claim was provided by the applicant.
RESIDENTS OF FL: Any person who knowingly and with intent to injure, defraud, or deceive any insurer files a statement of claim or an application containing any false, incomplete, or misleading information is guilty of a felony of the third degree.
RESIDENTS OF KS: Any person who knowingly presents a false or fraudulent claim for payment of a loss or benefit or knowingly presents false information in an application for insurance may be guilty of insurance fraud as determined by a court of law.
RESIDENTS OF ME: It is a crime to knowingly provide false, incomplete, or misleading information to an insurance company for the purpose of defrauding the company. Penalties may include imprisonment, fines or a denial of insurance benefits.
RESIDENTS OF MD: Any person who knowingly or willfully presents a false and fraudulent claim for payment of a loss or benefit or who knowingly or willfully presents false information in an application for insurance is guilty of a crime and may be subject to fines and confinement in prison.
RESIDENTS OF NJ: WARNING: Any person who includes any false or misleading information on an application for an insurance policy is subject to criminal and civil penalties.
RESIDENTS OF NY: Any person who knowingly and with intent to defraud any insurance company or any other person files an application for insurance or statement of claim containing any materially false information, or conceals for the purpose of misleading, information concerning any fact material thereto, commits a fraudulent insurance act, which is a crime, and shall also be subject to civil penalty not to exceed five thousand dollars and the stated value of the claim for each such violation.
RESIDENTS OF OK: WARNING: Any person who knowingly, and with intent to injure, defraud or deceive any insurer, makes any claim for the proceeds of an insurance policy containing any false, incomplete or misleading information is guilty of a felony.
RESIDENTS OF TN/WA: It is a crime to knowingly provide false, incomplete, or misleading information to an insurance company for the purpose of defrauding the company. Penalties include imprisonment, fines, and denial of insurance benefits.
RESIDENTS OF VA: Any person who, with the intent to defraud or knowing that he is facilitating a fraud against an insurer, submits an application or files a claim containing false or deceptive statements may have violated state law.
NEW YORK LIFE INSURANCE COMPANY Customer Electronic Consent and Disclosure (the “Consent”) IMPORTANT NOTICE – PLEASE READ CAREFULLY
What is the purpose of this Consent?
You are applying for insurance coverage from New York Life Insurance Company (“New York Life”) and have expressed your desire to electronically sign the Application Forms for the insurance certificate (the “Insurance Certificate”) and electronically receive communications related to the application for the Insurance Certificate. To conduct this business electronically, you must provide New York Life and its authorized designees with your consent. By clicking the “Submit” button below, and applying your electronic signature, you will be providing New York Life and its authorized designees, with your consent:
If you do not want to have the Required Documents delivered to you electronically, if you do not want to execute via electronic means the Application Forms, and/or if you do not agree with all of the terms and conditions of this Consent, you may not conduct business electronically with New York Life, and you must not click the submit link below. In this event you may contact the Administrator below to request a paper application.
What does the Consent cover once I click “Sign” and apply my electronic signature?
The Consent covers your agreement to all of the terms and conditions of the Consent, including your agreement to:
Even though you have provided New York Life with the Consent, New York Life may, at its option, deliver the Required Documents to you on paper.
May I obtain paper copies of the Required Documents and the Consent?
Yes. You may obtain paper copies of any of the Required Documents and/or the Consent at any time and without charge by contacting New York Life at GMAD_DocumentRequest@newyorklife.com or (914) 846-3017.
Should I maintain copies of the Required Documents received by electronic means?
Yes. You agree to print or save the Required Documents and to keep printed or electronic copies of them for your records. If you have any trouble with printing or saving, you should contact New York Life at GMAD_DocumentRequest@newyorklife.com or (914) 846-3017.
In what form will I receive Required Documents by electronic means?
Required Documents will be provided in Portable Document Format (PDF). I agree that I must have Adobe® Acrobat® viewer software installed on my personal computer in order to view these Required Documents. I agree that if I do not have the ability to access and retain PDF documents, I should not click the “Submit” button. By clicking the “Submit” button, I acknowledge that I can access the Required Documents on my personal computer in PDF Form.
How will I receive Required Documents by electronic means?
There are links to the notices and documents on this website and in this notice. Click on the linked text to open the document. Upon selecting the link, you will be able to view, download, and/or print all the Required Documents pertaining to your application. For reference, these required documents are:
(each below should be linked) Important Notice
How long will this Consent remain in effect?
This Consent shall become effective once you click the “Submit” button below and shall remain in effect until you withdraw your consent (as described in the next section) or the Insurance Certificate is issued.
What if I change my mind?
You may only withdraw your consent to do business electronically before the Insurance Certificate is issued. If you would like to do so, you must provide New York Life with a written withdrawal of your consent to do business electronically. This will terminate the Consent and your Insurance Certificate application as of the date you sign your withdrawal, subject to any action New York Life took before recording the withdrawal. If we issue the Insurance Certificate before we record your withdrawal, and you wish to cancel this Insurance Certificate thereafter, you must exercise your right to surrender the Insurance Certificate according to its terms. There is no charge to withdraw your consent.
What if my contact information changes?
You must keep New York Life informed of any changes to your e-mail address. You may inform New York Life of any such changes by contacting New York Life at GMAD_DocumentRequest@newyorklife.com or (914) 846-3017.
Are there any hardware or software requirements to do business electronically with New York Life?
Yes. To do business electronically with New York Life and to access and retain the Required Documents sent or made available to you electronically by New York Life requires that you have a personal computer or mobile device with appropriate browser software, such as Microsoft Internet Explorer®, Mozilla® Firefox®, or equivalent, and email software as well as communications access to the Internet. You must ensure that the mobile device that you are using to view or electronically sign the Application Forms allows you to access all associated content. This access may incur charges from Internet Service Providers and telephone or cable companies. These costs are your responsibility. In order to view certain Required Documents in the Portable Document Format (PDF), you must have Adobe® Acrobat® viewer software. This software is available for download, free of charge, from the Adobe Web site (www.adobe.com). You must have the ability to save the Required Documents to a storage device for later reference or have a connection between your computer or mobile device and a printer so you can print out the Required Documents.
Call us at 888-627-5902 Monday to Friday, 8:00 a.m. to 5:00 p.m. CT
Specialty-specific coverage to help protect one of your most valuable assets – your ability to earn an income over your working life.
You have invested years of your life, hundreds of thousands of dollars on your medical education, and have a potential income stream that could be significant. That all needs to be protected. While you may have employer coverage, it’s likely not covering you at an adequate benefit level or offering the own-specialty protection you need. Here’s your chance to fill in those gaps in coverage with guaranteed issue supplemental disability income insurance protection.
Graduating Medical Students in participating medical schools under age 40 may enroll for $1,000 in monthly benefits for total disability. Benefits are payable regardless of whether your covered total disability is caused by injury, an illness, or organ donation.
In year two and three of residency, insureds have the option to purchase an additional $500 of coverage annually, up to a $2,000 maximum monthly benefit, on a guaranteed issue basis. Upon Finishing Residency, the insured physician has the option to increase coverage to a $5,000 monthly benefit on a guaranteed issue basis and consider taking advantage of a one-time offer to convert their coverage to a new physician disability income insurance that offers level rates and a “True Own-Specialty” Definition of Disability. In year two as a Practicing Physician coverage can be increased up to a $10,000 monthly benefit through a simplified application process. And, in year four as a Practicing Physician coverage can be increased up to a $17,000 monthly benefit through a simplified application process.
All insured physicians receive a 10% rate reduction for at least the first year of coverage. Members of the American Medical Association receive a 35% reduction. Rate reductions are reviewed annually and although not promised or guaranteed, premium credits have lowered the cost of this insurance since 2006. Rates may vary by state of residence.
If you convert your student coverage you will receive a 5% premium credit.
This coverage includes an “Own-Specialty” definition of disability, which means, benefits are payable if you are unable, as the result of a covered an illness, injury, or organ donation to perform the duties of your own medical specialty and are not gainfully employed; even if you have the ability to work in another field of medicine.
If you are disabled by injury, illness, or organ donation before age 62, benefits under this policy are payable up to age 67. If you are disabled at age 62, benefits are payable for up to 60 months. At age 63 and each year thereafter, the benefit period is reduced by six months depending on your age at disability. From age 70 to 75, benefits are payable up to 12 months.
If you are disabled due to mental, nervous or emotional disorders before age 69, benefits under this policy are limited to 24 months. At age 69 and 70, benefits are limited to 18 and 12 months, respectively.
This benefit is available to physicians insured prior to age 40. This benefit could pay up to $200,000 of eligible student loans if you are totally and permanently disabled before age 45. This benefit is paid in addition to your monthly disability benefit and it’s included in your coverage at no additional charge.
Residents who take advantage of the finishing residents coverage increase option will also have the opportunity to secure the Catastrophic Disability Rider, without medical underwriting. This rider increases your base monthly benefit by 30% if you become Totally Disabled and unable to perform two of six activities of daily living-bathing, dressing, toileting, transferring, eating, or continence. You will also be eligible for this benefit if your disability results in a Cognitive Impairment: the deterioration or irreversible loss of intellectual capacity. Benefit is available for 10% additional premium under age 60 (or 20% additional premium if age 60 and above). You must have a minimum of $3,000 in base benefits to elect the rider.
Residents who take advantage of the finishing residents coverage increase option will also have the opportunity to secure the Cost of Living Adjustment Rider, without medical underwriting. For just 15% additional premium you may add the COLA option. With it, the monthly benefit payable for a covered total disability may be adjusted annually to reflect changes in the cost of living based on the CPI-U.* Years are measured from the start of the waiting period. In the first year, no adjustment will be made. Adjustments may be made to the monthly benefit paid in the second and each succeeding year. Note: If you choose this option in addition to the Catastrophic Disability Rider above, the cost of the COLA option will be an additional 1.5% in premium for a total of 16.5% (or an additional 3% in premium for a total of 18% if age 60 and above).*’CPI-U’ means the Consumer Price Index for All Urban Consumers, All items, as published by the Bureau of Labor Statistics. If the CPI-U, in New York Life’s opinion, is no longer a valid index for the purpose of this Option, or is no longer published by the Bureau of Labor Statistics, they will use a new index.
To help you recover, you may also qualify for rehabilitation benefits in addition to your monthly disability benefit if you participate in an approved accredited occupational rehabilitation program while you are disabled.
Collect partial benefits, if you return to work part time in your specialty (true own-specialty definition) or collect partial benefits, if you return to work part time in your specialty or any other occupation (own specialty definition), provided you first qualify for a covered Total Disability and provided your monthly income is reduced by at least 20%. Benefits will be based on a percentage of your total monthly benefit.
If you contract a Communicable Disease* before age 67, you may qualify for benefits without the requirement that you suffer a covered total disability. You’ll be eligible for this benefit if the illness causes you to earn less than 75% of your average monthly income for the period before your practice was limited and/or condition was disclosed as a result of contracting the disease.*Communicable Disease means any of the following conditions, but only if: (a) the medical profession recommends; or (b) an appropriate governmental agency requires; the disclosure of the diagnosis of the Communicable Disease and/or a limitation of his or her practice due to contracting the Communicable Disease: Acute Viral Hepatitis of a non A type, Human Immunodeficiency Virus (HIV), Acquired Immune Deficiency Syndrome (AIDS) or tuberculosis.
This coverage will pay up to one basic monthly benefit to you to care for a close family member with a Serious Health Condition.* Your spouse or domestic partner; child, including a step-child, adopted child or child of your domestic partner; or your parents, are considered ‘close family members.’ The health condition must be certified by the family members’ licensed attending physician.
You must be working at least 20% fewer hours and have a loss of 20% or more of your average monthly income, due to the time off to qualify. The monthly benefit is the amount payable in proportion to the loss of monthly income up to a maximum of one basic monthly benefit.
0%-19%: No benefit
20%-25%: 25% of the Basic Monthly Benefit is payable
26%-50%: 50% of the Basic Monthly Benefit is payable
51%-75%: 75% of the Basic Monthly Benefit is payable
76%-100%: 100% of the Basic Monthly Benefit is payable
*Serious Health Condition is a condition that causes the family member: to be unable to complete, without substantial supervision, two of six ‘activities of daily living’ including bathing, dressing, toileting, transferring, (e.g., in and out of bed), eating and continence; to require substantial supervision due to severe cognitive impairment; to be hospitalized; or to become terminally ill with a condition that is reasonably expected to result in death within 12 months.
Your insurance can continue beyond the end date of the coverage if you cease to be employed full-time due to layoff, leave of absence, or a leave of absence required by state law or by the Family and Medical Leave Act of 1993 (FMLA). Your coverage will continue for up to 90 days during a temporary layoff or a leave of absence other than state mandated leave or FMLA; or the greater of the period required by state law or by FMLA provided the leave authorization is in writing and required premium is paid. The insurance will then end on the earliest of 90 days after the temporary lay-off or leave of absence (other than state mandated leave of FMLA) began; the date the layoff becomes permanent; the date the state mandated leave or FMLA leave ends; or the date insurance would otherwise end.
Select a waiting period of 2, 3, 6, or 12 months. The waiting period is defined as the period of time from the start of a covered total disability during which no benefits are payable. Benefits are not payable if you work in any occupation during the waiting period. (Note: for organ donation, the waiting period is waived as long as insurance has been in effect for at least six months.)
Once claim payments begin, any premium becoming due will be waived; no further premiums will be due while you remain disabled.
Subject to U.S. government regulations on restricted countries. You’ll have 24-hour/7-day a week protection, whether you are at home, at work, or on vacation anywhere in the world. U.S. residency is required to maintain coverage.
You’re eligible to enroll for this group coverage if you’re a medical student graduating from a participating medical school, residing in the U.S, under age 50, and will be actively engaged full-time in the duties of your profession as a resident physician.
Membership in the American Medical Association is not required.
Your coverage will be effective on 7/1, 8/1, or 9/1. Coverage will be in force from the effective date provided you are eligible, actively at work, and premiums are paid when due.
Coverage terminates at age 75.
As long as you are a physician actively at work, a resident of the United States, under the age of 75 (not retired), pay your premiums when due, the group policy remains in force, and the AMA continues to sponsor this policy and you have not received the maximum benefits payable under the policy, your coverage can be renewed. Coverage will be terminated upon the suspension or revocation, or voluntary surrender in any state, of your license to practice medicine as a result of a criminal act, ethical violation or gross malpractice.
Premiums increase on the renewal date on or immediately after the date you reach a higher age bracket. You also cannot be singled out for a rate increase, regardless of how many claims you have made or the changing status of your health. However, rates may be adjusted on a class-wide basis. For example, a “class” may be a group of insureds of the same age group.
No monthly benefit will be paid for Disability due to:
Benefits will not be paid, or accrued, for any period of time while you are incarcerated.
Benefits will be paid either for Injury or for Sickness, but not for both, during any concurrent period of Disability.
Yes, for a few reasons:
First, the monthly benefit amount paid through employer-sponsored disability insurance is likely to be taxable, reducing the true amount of protection the coverage provides. In contrast, the benefits of this policy could be free of income tax when you pay the premiums with your own after-tax dollars. Consult your tax advisor.
Second, the level of protection you now carry may not be enough to help cover the living expenses that would continue should you become disabled. Using this policy to increase your total coverage can help you avoid having to deplete savings and investments intended for other purposes.
Third, this is a one-time special offer of guaranteed coverage with opportunities to increase your coverage at pivotal times in your career. If you decide not to convert your coverage at this time, you can still apply for AMA-sponsored Disability Income Insurance, but you will have to go through underwriting and you will not be eligible for guaranteed future increases of your coverage.
Finally, unlike many employer-provided plans, this coverage is yours to keep without interruption, even if you change jobs or become self-employed. This policy adds an extra layer of protection that you control, and it can move with you throughout your career.
Some disability insurance limit their definition of ‘total disability’ to the inability to work in any occupation. This means you might not be eligible for benefits if you are sick or injured but still able to work in another profession.
Other policies may include an ‘own occupation’ definition of disability, meaning that you might not be eligible for benefits if you were able to perform any physician job in the field of medicine, even though you were no longer able to carry out the duties and responsibilities of your medical specialty.
This coverage contains a preferred definition of disability, called ‘own specialty’, that is so important for physicians. It means you are eligible to receive benefits if you’re unable to perform the duties of your own medical specialty- not just any job or some other job in the medical profession.
In addition, you will have the opportunity in the future to enhance the protection of this coverage by choosing the ‘True Own-Specialty’ definition of disability to allow you to collect full benefits if you choose to return to work in another occupation, regardless of the income you earn. Additional cost applies.
You will be considered totally disabled, after the waiting period, if you are unable to perform the material and substantial duties of your medical specialty as a result of a covered illness, injury or organ donation. House or hospital confinement is not required to be eligible for benefits, but you must be under the care of a physician. During the waiting period, you will be considered totally disabled if you are not working in any occupation.
Total disability is presumed, and the waiting period waived, if you experience total and irrecoverable loss of speech, hearing in both ears, sight of both eyes, loss of use of both hands or feet or one hand and foot.
No. Membership in the AMA is not required to apply, although members pay less.
Since 1988, AMA Insurance has offered high-quality, attractive coverage designed to meet the unique needs of physicians nationwide. We can take advantage of the buying power available to large groups to secure attractive rates and physician-focused coverage you won’t find anywhere else. This policy has provided physician-exclusive rates to help keep the cost flexible, even for significant amounts of coverage. AMA-sponsored disability insurance has been protecting physicians for more than five decades with solid, dependable coverage at attractive pricing.
A medical student, under age 50, graduating from a participating medical school can enroll for $1,000 in monthly benefits regardless of their current salary, debt, or other insurance. There is no underwriting, medical exams, or health questions.
In year two and three of residency, you have the option to purchase an additional $500 of coverage annually, up to a $2,000 maximum monthly benefit, on a guaranteed issue basis. Upon Finishing Residency, you will the option to increase coverage to a $5,000 monthly benefit on a guaranteed issue basis and take advantage of a one-time offer to convert your coverage to a new physician disability income plan that offers level rates and a “True Own-Specialty” Definition of Disability. In year two as a Practicing Physician your coverage can be increased up to a $10,000 monthly benefit through a simplified application process. And, in year four as a Practicing Physician your coverage can be increased up to a $17,000 monthly benefit through a simplified application process.
The waiting period is defined as the period of time from the start of total disability during which no benefits are payable. You have your choice of waiting periods. You may have to rely on your personal savings and other financial assets as you wait for benefits to be payable. The waiting period is only satisfied if you are not working in any occupation.
No. This insurance is designed to help replace your income while you’re unable to work; the money is sent directly to you, and you may use it any way you wish.
That depends on your age at the time the disability begins. If you are disabled before age 62, benefits under this coverage are payable up to age 67. If you are disabled at age 62, benefits are payable for up to 60 months. From age 63 to 69, the benefit period is reduced in six-month increments, depending upon your age at the time the disability begins. From age 70 to 75, benefits are payable up to 12 months.
If you are disabled due to mental, nervous, or emotional disorders before age 69, benefits under this coverage are limited to 24 months. At age 69 and 70, benefits are limited to 18 and 12 months, respectively. This limitation does not apply to any period you are institutionalized in any treatment facility.
No. You can never be singled out for a rate increase or have your coverage cancelled due to your health. You are also assured that your rates will never increase as a result of the number of claims you’ve made. Rate increases occur as you move from one age bracket to the next. Additionally, the insurance company can only change premium rates for the group.
Once you enroll and coverage is issued, you’ll receive a Certificate of Insurance. Then you’ll have 30 days to decide if you’re completely satisfied with your coverage. If you decide this coverage isn’t right for you, return your Certificate within that 30-day period. Your coverage will be invalidated, and you will be sent a full refund. You will be under no further obligation.
No. You don’t need to send any money until you’ve reviewed your Certificate of Insurance and confirmed that it meets your needs. Your first premium notice will be enclosed with your Certificate of Insurance.
AMA Members :
Current 2023 Monthly Rates
Current 2023 Monthly Rates
No results. Select a different state.
As you take this next step in your medical training, it’s best to start out on the right foot. Check out this guide to help you prepare for your residency and the future.
Check out this infographic to help you understand the decisions before you—convert your coverage now or wait? See the benefits and risks here.
AMA-Sponsored Disability Income Insurance is underwritten by New York Life Insurance Company, 51 Madison Ave, New York, New York 10010, under group policy NO. G-30639-0 on policy forms GMR-FACE/G-30639-0. Coverage may not be available in all states and product features may vary by state. For more information on features, costs, eligibility, renewability, limitations, and exclusions, please visit the Coverage Details section of this page.
AR Insurance Producer License #100105975 and CA Insurance License #0754707
AMA Insurance Agency, Inc., is a subsidiary of the American Medical Association.