What is a GSI disability insurance policy?

Two ways to get a policy

Most residents and fellows can get disability insurance two ways: by answering health questions, or by not answering them. Which one gives you the widest coverage depends on what is or isn't in your medical records.

With a medically underwritten policy, the insurance company looks at your health history, medical records, prescription database, insurance billing codes and family history. That can take a few weeks, or a few months if records are slow to arrive, and the outcome is uncertain.

With a GSI policy, the insurance company is essentially saying: we're going to give you a policy and we're not going to ask you any questions. If the GSI comes from a company with a strong policy, it's comprehensive, and you can have it in a few days.

Where GSI policies come from

Guardian has the widest reach, offering GSI policies to residents and fellows at roughly 200 teaching hospitals. The next closest company has give or take 50, and the one after that around 15. Not all GSIs are created equal: some are robust and some are scaled back, so having one available doesn't automatically mean it's a strong offering.

GSI policies usually aren't endorsed or sponsored by your GME. You won't check a box on your benefits package to get one. You have to reach out to an insurance professional who can offer it.

The Guardian GSI policy

The Guardian GSI covers you for your medical specialty (the highest level of own-occupation), asks no health questions, and has no pre-existing conditions clauses, unlike some other GSI policies. There are no price increases or surcharges for going the GSI route, and the policy is individual and portable.