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Fact-Finding Questions for Long-Term Care Planning at the Annual Review

Adult daughter and her aging mother sharing a warm moment while discussing long-term care planning

The annual review is the easiest place to raise long-term care, because it’s already a conversation about what changed this year. A few targeted questions can uncover exactly the life events that make LTC planning timely.

Key takeaways

  • Life changes such as caring for a parent, becoming an empty nester, or nearing retirement are natural LTC triggers.
  • Six simple questions at the annual review can surface them.
  • A “yes” to any of them is a reason to talk about a long-term care plan.

Long-term care isn’t about getting old or nursing homes. It’s about getting the care you want, when you need it.

Six questions to ask

  1. Have you had added expenses because a family member or friend needed care?
  2. Have you had to adjust your work schedule to help someone with daily activities or supervision?
  3. Have you recently moved a parent or loved one into assisted living or a nursing home?
  4. Have you recently become an empty nester?
  5. Are you preparing for retirement?
  6. Are you concerned about whether government programs will cover long-term care?

What a yes means

Each of these signals either firsthand experience with care or a planning milestone. They’re openings to talk about what the client would want for themselves, and how to pay for it without depending on unpaid family care or spending down assets for Medicaid.

Follow-up

After the fact-find, move to the client’s most important reason for coverage; see needs analysis before choosing an LTC product. For the underwriting side of fact-finding, see six things to uncover before you submit.

Frequently asked questions

When should advisors bring up long-term care?

The annual review is ideal, especially after life changes like caring for a parent, becoming an empty nester, or nearing retirement.

What questions uncover a long-term care need?

Questions about caregiving experiences, work disruptions, parents’ care, empty nesting, retirement plans, and concerns about government programs.

Is long-term care only for the elderly?

No. Illness or injury can require care at any age, though most care needs occur later in life.

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Reviewed by Tim Fuller on 2026-09-25

Tim Fuller, President of SRS Inc.

Tim Fuller

President, SRS Inc.

Tim leads SRS Inc., a full-service IMO (Independent Marketing Organization) and BGA (Brokerage General Agency), connecting independent financial professionals with life, annuity, disability income, and long-term care solutions from 60+ carrier partners.

Connect on LinkedIn →

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Disability Statistics Advisors Should Know (Updated)

Professional working confidently at her desk, representing disability income protection

Clients insure their cars, phones, and homes. The income that pays for all of them often goes unprotected. These facts help start that conversation.

Key takeaways

  • Social Security estimates just over 1 in 4 of today’s 20-year-olds will become disabled before full retirement age.
  • The average Social Security disability benefit for a disabled worker is about $1,630 a month in 2026.
  • Group disability plans typically replace 60% of salary, with taxable benefits and a cap, and most disabilities aren’t work-related.

The average SSDI check for a disabled worker is about $1,630 a month in 2026 — far short of what most families need.

The odds

  • Just over 1 in 4 of today’s 20-year-olds will become disabled before reaching full retirement age (Social Security Administration).
  • More than 1 in 4 U.S. adults report some type of disability (CDC).

Social Security isn’t enough

  • The average monthly benefit for a disabled worker on SSDI is about $1,630 in 2026, after the 2.8% cost-of-living adjustment.
  • SSDI uses a strict definition of disability and has a five-month waiting period, and many initial applications are denied.

Employer plans have limits

  • Group LTD typically replaces 60% of salary, often taxable and capped. See the 58% pay cut.
  • Group benefits are usually reduced by SSDI; see group LTD offsets.
  • The vast majority of disabilities aren’t caused by on-the-job accidents, so workers’ compensation rarely applies.

Using statistics well

Statistics support the conversation, but they rarely close it. Pair them with personal questions and stories; see three questions that lead to the sale.

Frequently asked questions

What is the average SSDI payment in 2026?

About $1,630 a month for a disabled worker, after the 2.8% cost-of-living adjustment.

What are the chances of becoming disabled before retirement?

Social Security estimates just over 1 in 4 of today’s 20-year-olds will become disabled before full retirement age.

How much does group disability insurance replace?

Typically 60% of base salary, often taxable and subject to a monthly cap.

50+ Years in Business60+ Top-Rated Carriers★★★★★ Rated by Advisors

Reviewed by Tim Fuller on 2026-09-25

Tim Fuller, President of SRS Inc.

Tim Fuller

President, SRS Inc.

Tim leads SRS Inc., a full-service IMO (Independent Marketing Organization) and BGA (Brokerage General Agency), connecting independent financial professionals with life, annuity, disability income, and long-term care solutions from 60+ carrier partners.

Connect on LinkedIn →

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Life Insurance, Annuities and the FAFSA: Protecting Financial Aid Eligibility

Happy family of four laughing together on the couch, representing life insurance protection

Families who saved responsibly are often the ones hit hardest by financial aid formulas. Because the FAFSA does not count the cash value of life insurance as a reportable investment, repositioning some savings can help certain families present a more favorable picture.

Key takeaways

  • The FAFSA’s asset calculation excludes the value of life insurance and retirement plans, including retirement annuities.
  • Middle-income families with sizable savings in taxable accounts or CDs are the strongest candidates for review.
  • Surrender charges, MEC rules, the CSS Profile and each school’s policies must be weighed before recommending any move.

The FAFSA instructions state that reportable investments do not include the value of life insurance.

Why middle-income savers get squeezed

The FAFSA uses income and net worth to calculate how much a family is expected to contribute toward college. Lower-income families often qualify for aid. High-net-worth families can pay regardless. The families in between, who saved and invested for retirement, can find that their responsible habits disqualify them from assistance.

What counts as an asset on the FAFSA

Net worth for FAFSA purposes is the current value of reportable assets minus debt on those assets. A commercial building worth $300,000 with a $100,000 mortgage, for example, adds $200,000. However, the instructions exclude several items from reportable investments, including the value of life insurance, the family home and retirement plans such as 401(k)s, IRAs and pensions.

Non-qualified annuities are a gray area. Some families and schools treat them as retirement assets and others do not, so confirm how a specific annuity will be handled before relying on it.

Repositioning savings with permanent life insurance

For a family holding large balances in CDs or taxable accounts, moving part of that money into a properly designed cash value policy may reduce reportable assets while adding protection the family may already need. Points to cover:

  • Funding design. Heavy funding can cause the policy to become a modified endowment contract, which changes how withdrawals and loans are taxed.
  • Surrender charges and access. Cash value is not fully liquid in the early years. Money the family will need for tuition should not be tied up in the policy.
  • Underwriting. Large premiums still need financial justification. See our article on financial underwriting.
  • Timing. Assets are reported as of the date the FAFSA is filed, so planning should begin well before the first application.

Know the limits before you recommend it

  • Many private colleges use the CSS Profile in addition to the FAFSA, and it may ask about insurance and annuity values.
  • Individual schools can adjust aid awards based on professional judgment.
  • Aid rules change periodically, so families should confirm current treatment with the school’s financial aid office and their tax advisor.

Positioned honestly, this is a planning conversation about protection and long-term savings, with financial aid as one consideration, not a guarantee.

Frequently asked questions

Does the FAFSA count life insurance cash value?

No. The FAFSA instructions exclude the value of life insurance from reportable investments. Other forms, such as the CSS Profile used by some private colleges, may treat it differently.

Are annuities excluded from the FAFSA?

Retirement plans, including retirement annuities, are excluded. Treatment of non-qualified annuities can vary, so families should confirm with the school’s financial aid office before relying on the exclusion.

Is overfunding a policy for financial aid purposes a good idea?

Only when the family also has a real need for the coverage and can leave the money in place long enough to avoid surrender charges. Aid savings alone should not drive the decision.

50+ Years in Business60+ Top-Rated Carriers★★★★★ Rated by Advisors

Reviewed by Tim Fuller on 2026-09-26

Tim Fuller, President of SRS Inc.

Tim Fuller

President, SRS Inc.

Tim leads SRS Inc., a full-service IMO (Independent Marketing Organization) and BGA (Brokerage General Agency), connecting independent financial professionals with life, annuity, disability income, and long-term care solutions from 60+ carrier partners.

Connect on LinkedIn →

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Annuity Maximization: Repositioning Deferred Annuities to Fund Life Insurance

Retired couple relaxing on a porch at sunset, representing guaranteed annuity income

Many clients own deferred annuities they no longer need for retirement income and simply plan to leave them to the kids. Annuities are excellent accumulation tools, but they are an inefficient way to transfer wealth. Annuity maximization repositions that money into a tax-free life insurance death benefit.

Key takeaways

  • Heirs pay ordinary income tax on the gain in an inherited deferred annuity, and larger estates may also owe estate tax on its value.
  • Annuity maximization converts the deferred annuity to income, then uses that income to pay premiums on life insurance, often owned by an ILIT.
  • The strategy fits clients who are insurable and do not need the annuity for their own retirement income.

A deferred annuity is a great way to accumulate for retirement but an inefficient way to pass wealth to the next generation.

The problem with leaving a deferred annuity to heirs

At death, the gain in a deferred annuity is income in respect of a decedent. Beneficiaries pay ordinary income tax on it at their own rates, with no step-up in basis. For clients whose estates exceed the federal exemption, the annuity’s value can also be subject to estate tax at 40%. Our article on the $15 million estate tax exemption explains who is still exposed.

How annuity maximization works

  1. The deferred annuity is exchanged or annuitized into a single premium immediate annuity (SPIA) that pays income over a chosen period.
  2. The client uses the after-tax income to pay premiums on a life insurance policy, or gifts it to an irrevocable life insurance trust (ILIT) that owns the policy.
  3. The policy is sized to replace or exceed the annuity’s value.
  4. At death, heirs receive an income-tax-free death benefit instead of a taxable annuity.

Who is a good candidate

  • Clients who do not expect to need the annuity for income
  • Clients who are insurable at reasonable rates
  • Those who want a larger, more predictable legacy
  • Clients comfortable using annual exclusion gifts to fund an ILIT

Clients who want to keep more control might pair this with a grantor trust design. Their attorney should confirm the right structure.

Points to review before recommending it

  • Surrender charges on the existing annuity
  • The tax cost of the SPIA income, which includes a portion of gain
  • Any living benefit or death benefit riders being given up
  • Underwriting results, which should be known before the annuity is changed

Our case design team can run side-by-side comparisons of keeping the annuity versus repositioning it.

Frequently asked questions

How are inherited non-qualified annuities taxed?

The gain above the owner’s cost basis is taxed as ordinary income to the beneficiary. There is no step-up in basis at death, unlike many other assets.

Does the client need to use an ILIT?

Not always. For estates well below the federal exemption, the client may own the policy directly. An ILIT is useful when estate tax exposure or control over distributions is a concern.

Should the annuity be changed before the life policy is issued?

No. Complete underwriting and have the life policy approved first so the client is never left with the tax cost of the change and no coverage.

50+ Years in Business60+ Top-Rated Carriers★★★★★ Rated by Advisors

Reviewed by Tim Fuller on 2026-09-26

Tim Fuller, President of SRS Inc.

Tim Fuller

President, SRS Inc.

Tim leads SRS Inc., a full-service IMO (Independent Marketing Organization) and BGA (Brokerage General Agency), connecting independent financial professionals with life, annuity, disability income, and long-term care solutions from 60+ carrier partners.

Connect on LinkedIn →

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Long-Term Care Planning for Couples With No Children

Adult daughter and her aging mother sharing a warm moment while discussing long-term care planning

Parents often assume a child will step in if they need care. Couples without children don’t have that default, which changes how they should think about long-term care.

Key takeaways

  • Couples without children face the same risk of needing care, but have no built-in family caregiver.
  • They’re more likely to need paid professional care and to rely heavily on each other.
  • Planning early protects both spouses’ quality of life and assets.

No child on call means the healthy spouse becomes the caregiver — or the care has to be paid for.

The same risk, a different situation

The need for long-term care doesn’t depend on income, marital status, or family size. But clients without children can’t count on an adult child to coordinate or provide care, so their plan has to be deliberate.

The challenges they face

  • More need for professional care: without a child on call, paid help is likely to fill the gap sooner.
  • A heavier load on the spouse: the healthy partner often carries more of the caregiving, which can affect their own health and finances.
  • Who manages the care: someone needs to coordinate providers and decisions, especially if both spouses need help.

Starting the conversation

Ask how they want to live: where, how independently, and who they’d want involved. Couples without children often have more freedom and resources, and a planning mindset that makes them strong candidates. Policies with care coordination services can be especially valuable. See what modern LTC policies cover beyond nursing homes.

Frequently asked questions

Do couples without children need long-term care insurance?

Often more than others, since they don’t have an adult child to provide or coordinate care.

Who takes care of you if you have no children?

Usually a spouse first, then paid professionals. Long-term care insurance helps pay for professional care and coordination.

What LTC policy features help couples without children?

Care coordination services, home care benefits, and shared or joint benefit options can be especially valuable.

50+ Years in Business60+ Top-Rated Carriers★★★★★ Rated by Advisors

Reviewed by Tim Fuller on 2026-09-25

Tim Fuller, President of SRS Inc.

Tim Fuller

President, SRS Inc.

Tim leads SRS Inc., a full-service IMO (Independent Marketing Organization) and BGA (Brokerage General Agency), connecting independent financial professionals with life, annuity, disability income, and long-term care solutions from 60+ carrier partners.

Connect on LinkedIn →

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Family Care Benefit: Disability Coverage When Clients Care for a Loved One

Professional working confidently at her desk, representing disability income protection

Disability insurance protects against income lost to the insured’s own illness or injury. But what if a client has to cut back at work to care for a seriously ill child, spouse, or parent? Some policies now cover that too.

Key takeaways

  • More than 60 million U.S. adults provide care to a loved one, often while working.
  • A compassionate family care benefit, included at no extra cost on some individual DI policies, helps replace lost income.
  • One carrier uses a 20/20 guideline: benefits are payable when the client works 20% fewer hours and loses 20% or more of income.

The 20/20 guideline: work 20% fewer hours to care for a family member, lose 20% or more of income, and the benefit can pay.

The caregiving reality

Tens of millions of working adults care for a family member. Many have to cut hours or take time off, losing income just when expenses rise. Traditional disability insurance doesn’t address that, because the insured isn’t the one who is sick.

How the family care benefit works

At one carrier, the benefit is included with an individual DI policy at no extra cost. After a benefit waiting period, it pays if the insured works 20% fewer hours and loses 20% or more of income because they’re caring for a family member with a serious health condition.

Who and what qualifies

  • Family members: parent, spouse, domestic partner, or child (including adopted and stepchildren).
  • Serious health condition: the family member is receiving inpatient hospital, hospice, or residential medical care; needs substantial supervision due to severe cognitive impairment; can’t perform two or more activities of daily living; or is terminally ill with life expectancy of 12 months or less.
  • The condition must begin after the policy’s effective date, and documentation of income and the family member’s condition is required.

Terms vary by carrier and state.

Why it matters in the sale

It’s a feature most clients have never heard of, and one that resonates with anyone who has cared for a parent or child. It also pairs naturally with long-term care planning conversations.

Frequently asked questions

Does disability insurance pay if I care for a sick family member?

Some individual DI policies include a family care benefit that pays when you lose income caring for a seriously ill family member.

What is the 20/20 rule for the family care benefit?

At one carrier, benefits are payable when the insured works 20% fewer hours and loses at least 20% of income due to caregiving.

Which family members qualify for the family care benefit?

Typically a parent, spouse, domestic partner, or child, including adopted and stepchildren.

50+ Years in Business60+ Top-Rated Carriers★★★★★ Rated by Advisors

Reviewed by Tim Fuller on 2026-09-25

Tim Fuller, President of SRS Inc.

Tim Fuller

President, SRS Inc.

Tim leads SRS Inc., a full-service IMO (Independent Marketing Organization) and BGA (Brokerage General Agency), connecting independent financial professionals with life, annuity, disability income, and long-term care solutions from 60+ carrier partners.

Connect on LinkedIn →

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Grantor Trusts: How Clients Can “Have It Both Ways” on Estate and Income Taxes

Advisor and client reviewing an advanced markets estate planning strategy in a private office

“You can’t have your cake and eat it too” is usually good advice. Grantor trusts are the exception: properly structured, they let a client move assets out of their taxable estate while still being treated as the owner for income tax purposes, and that combination works in the family’s favor.

Key takeaways

  • Assets in a properly drafted grantor trust are outside the grantor’s taxable estate, including all future growth.
  • The grantor pays the trust’s income tax, which lets trust assets grow untouched and is effectively an additional tax-free gift.
  • Grantor trusts also offer creditor protection and, through a spouse’s interest, indirect access to trust property.

Every dollar of income tax the grantor pays on the trust’s behalf is, in effect, an extra gift to the heirs — with no gift tax.

The estate tax side

Property in the trust isn’t included in the grantor’s taxable estate, so both the original gift and all appreciation after the transfer escape estate tax. For clients above the $15 million exemption, that growth can be worth far more than the original gift.

The income tax side

For income tax purposes, the trust’s income, gains, and losses flow through to the grantor’s personal return. That has two advantages: the grantor can manage the tax using their own tax position, and trust assets aren’t depleted to pay taxes. Paying the trust’s tax is effectively a gift to the beneficiaries that doesn’t use any annual exclusion or lifetime exemption.

Other benefits

  • Trust assets are protected from the grantor’s creditors.
  • A married grantor can keep indirect access to trust property by giving the spouse a lifetime interest.
  • Grantor trusts are well suited to owning life insurance and to sales of appreciated assets. See how sales to grantor trusts work with life insurance.

The catch: no step-up in basis

The IRS confirmed in 2023 (Revenue Ruling 2023-2) that assets in a grantor trust that aren’t included in the grantor’s estate don’t receive a step-up in basis at death. Heirs inherit the original basis, so highly appreciated assets may carry a built-in capital gain. Some trusts include a power to swap assets back to address this, which should be planned with the client’s attorney.

Frequently asked questions

What is a grantor trust?

A trust in which the creator is treated as the owner for income tax purposes, while the assets can still be outside their taxable estate if properly structured.

Why would a grantor want to pay the trust’s income taxes?

Paying the tax lets trust assets grow untouched and is effectively an extra gift to beneficiaries that isn’t subject to gift tax.

Do grantor trust assets get a step-up in basis at death?

Not if they’re excluded from the grantor’s estate. The IRS confirmed this in Revenue Ruling 2023-2.

50+ Years in Business60+ Top-Rated Carriers★★★★★ Rated by Advisors

Reviewed by Tim Fuller on 2026-09-25

Tim Fuller, President of SRS Inc.

Tim Fuller

President, SRS Inc.

Tim leads SRS Inc., a full-service IMO (Independent Marketing Organization) and BGA (Brokerage General Agency), connecting independent financial professionals with life, annuity, disability income, and long-term care solutions from 60+ carrier partners.

Connect on LinkedIn →

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Charitable Giving With Life Insurance: Leveraging a Gift to Charity

Happy family of four laughing together on the couch, representing life insurance protection

Gifts to universities, hospitals, faith-based organizations and other nonprofits are a meaningful way for clients to use accumulated wealth. A large direct gift can substantially reduce what passes to family. Funding a life insurance policy owned by the charity lets clients make a larger future gift at a fraction of the current cost.

Key takeaways

  • Instead of giving a large sum today, the client donates premium dollars and the charity owns and is beneficiary of a policy on the client’s life.
  • The client’s net worth is reduced only by the premiums, which may be deductible for clients who itemize, subject to limits.
  • The charity must be willing to own the policy, and premiums must be paid in full and on time to protect the death benefit.

Donating premium dollars rather than a lump sum can turn a modest annual gift into a much larger legacy for a cause the client cares about.

The trade-off with direct gifts

A direct gift reduces the client’s net worth dollar for dollar. For clients who also want to leave a meaningful inheritance, that trade-off can limit how much they are willing to give. Life insurance separates the size of the gift from the size of today’s outlay.

How charity-owned life insurance works

  1. The client donates cash each year equal to the premium.
  2. The charity applies for, owns and is the beneficiary of a policy on the client’s life.
  3. The charity pays the premium with the donated funds.
  4. At death, the charity receives the full death benefit.

Because the charity owns the policy, the client may be able to deduct the premium gifts as charitable contributions.

Design and tax points to confirm

  • Deductions. Income tax deductions apply only to gifts to qualified charities, require itemizing and may be subject to percentage limits and phase-outs. The client’s tax advisor should confirm the benefit.
  • Short-pay designs. A limited-pay premium schedule reduces the risk of the gift falling short if the client stops giving.
  • Consistent funding. Each premium must be paid in full. Smaller donations can reduce the death benefit or cause the policy to lapse.
  • Charity policies. Some organizations will not own life insurance or have specific requirements, so confirm early.
  • Insurable interest. State rules on charitable insurable interest vary, and carriers will review them at application.

Balancing charity and family

Many clients want to support a cause and still leave a meaningful inheritance. Combining charity-owned coverage with a family gifting strategy can serve both goals. Contact our team to compare designs for the charitable portion of a plan.

Frequently asked questions

Can a client deduct premiums on a policy owned by a charity?

Generally, cash given to a qualified charity that owns the policy can be deductible if the client itemizes, subject to IRS limits. The client’s tax advisor should confirm the treatment.

What happens if the client stops donating?

The charity may not have the money to pay premiums, and the policy could shrink or lapse. Short-pay designs reduce this risk.

Can the client name the charity as beneficiary of a policy they own instead?

Yes. That keeps flexibility but generally does not provide a current income tax deduction for premiums. The death benefit is still removed from the taxable estate through the estate tax charitable deduction.

50+ Years in Business60+ Top-Rated Carriers★★★★★ Rated by Advisors

Reviewed by Tim Fuller on 2026-09-26

Tim Fuller, President of SRS Inc.

Tim Fuller

President, SRS Inc.

Tim leads SRS Inc., a full-service IMO (Independent Marketing Organization) and BGA (Brokerage General Agency), connecting independent financial professionals with life, annuity, disability income, and long-term care solutions from 60+ carrier partners.

Connect on LinkedIn →

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Why Referrals Are Your Best Source of New Clients

Advisor presenting a client outreach marketing plan on a whiteboard to a colleague

Everyone agrees referrals are a strong way to find new clients, yet many advisors hesitate to ask. Reframed correctly, asking for a referral is a compliment to your client, and it is one of the most efficient ways to fill your calendar with qualified prospects.

Key takeaways

  • Asking for referrals acknowledges that your client made a smart decision and invites them to share it.
  • Referred prospects come with built-in credibility and are easier to reach than cold leads.
  • The best time to ask is right after you have delivered value, with a specific description of who you help.

For every appointment you earn through hours of cold calling, you should be able to get several referred leads from a single good client meeting.

Why asking feels hard, and why it shouldn’t

Many advisors worry that asking for names will seem pushy. Consider it from the client’s side. You are telling them they made a sound decision and asking whether people they care about might benefit from the same conversation. Most clients are glad to help when the request is framed that way.

Five reasons referrals outperform other leads

  1. You start on favorable terms. A shared connection makes it far more likely a prospect will take your call and book a meeting.
  2. You borrow credibility. Your client valued your work enough to recommend you, which establishes trust before you speak.
  3. Your confidence goes up. Calling a referred prospect is much easier than a cold call.
  4. You spend more time advising. Less time prospecting means more time in front of people who are ready to talk.
  5. Prospects can be qualified in advance. Your client can tell you about the person’s situation so you are prepared for the first call.

A simple script you can adapt

Here is a version for long-term care conversations:

“I’m interested in meeting people much like you, people who are concerned about protecting their retirement savings, not becoming a burden to their children and staying in their own homes. I’d really appreciate the chance to share with your friends and relatives some of what we went over today. Who do you think we could help?”

Adjust the concerns to the product you just placed: income protection for a disability client, family security for a life client and so on.

Making referrals a habit

  • Ask at the moment of greatest value, such as policy delivery or a completed review.
  • Describe your ideal client specifically so names come to mind.
  • Ask for a little background on each person and permission to mention your client’s name.
  • Follow up with a thank-you, whether or not the referral buys.

Educational material helps too. Sharing facts such as current long-term care costs gives clients something useful to pass along. Contact SRS for client-approved pieces you can use.

Frequently asked questions

When is the best time to ask a client for a referral?

Right after you have delivered clear value, such as at policy delivery, after a claim is paid or at the end of a helpful review meeting.

How many referrals should I ask for?

Rather than a number, ask who comes to mind that shares a specific concern. Describing the need helps clients think of the right people.

What if a client says they can’t think of anyone?

Thank them and let them know the door is open. Offer a short article or handout they can share if someone comes to mind later.

50+ Years in Business60+ Top-Rated Carriers★★★★★ Rated by Advisors

Reviewed by Tim Fuller on 2026-09-26

Tim Fuller, President of SRS Inc.

Tim Fuller

President, SRS Inc.

Tim leads SRS Inc., a full-service IMO (Independent Marketing Organization) and BGA (Brokerage General Agency), connecting independent financial professionals with life, annuity, disability income, and long-term care solutions from 60+ carrier partners.

Connect on LinkedIn →

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Disability Insurance Riders That Help Cover Clients’ Medical Bills

Advisor supporting a couple as they review living needs benefits paperwork together

Even clients with good health insurance can face medical bills well beyond their deductible after an illness or injury. Some individual disability income policies offer riders that add benefits aimed at those costs, often for a modest additional premium.

Key takeaways

  • Health insurance deductibles are only part of the cost; copays, out-of-network care and non-covered expenses add up.
  • Riders on some DI policies add benefits for loss of daily living activities, critical illness diagnoses and accident-related medical costs.
  • Rider availability, benefit amounts and state approval vary by carrier, so confirm current details before presenting.

The right riders can turn a basic disability policy into a more comprehensive plan for little additional premium.

The medical cost gap most clients overlook

Clients often budget to meet their annual health insurance deductible, but a serious illness or injury can bring copays, coinsurance, travel, equipment and other costs that health coverage does not pay. At the same time, a disability can cut off the income used to pay them. Our article on income protection covers the core need.

Three types of riders to know

One carrier’s income protection policy offers riders like these. Details differ between carriers and states.

  • Activities of daily living (ADL) or catastrophic benefit rider. Pays an additional monthly benefit on top of the base benefit if the insured cannot perform two or more activities of daily living without stand-by assistance, or is cognitively impaired.
  • Supplemental health or critical illness rider. Pays a lump sum, in one design equal to six times the monthly benefit, upon a covered stroke, cancer diagnosis or coronary bypass surgery.
  • Accident medical expense rider. Reimburses accident-related medical expenses up to a per-accident maximum, such as $5,000, with a lifetime maximum of up to ten times that amount. It can pay even when the injury does not result in a disability claim.

How to present the riders

  1. Start with the core recommendation: the right policy type and monthly benefit for the client’s income.
  2. Before the meeting, share educational material explaining how medical expense protection works alongside income protection.
  3. Show the added cost of each rider next to the benefit it provides so the client can decide what is worth including.
  4. Be clear about limitations, including exclusions and states where riders are not approved.

Where these riders fit

These riders are most compelling for clients with high-deductible health plans, limited emergency savings or physically demanding work. For clients whose employer coverage leaves gaps, see our article on the group disability insurance gap. Contact our disability team for current rider availability, state approvals and sample illustrations.

Frequently asked questions

Do DI medical expense riders replace health insurance?

No. They supplement health coverage by helping with out-of-pocket costs and adding cash benefits in certain situations. Clients still need primary medical coverage.

Does the accident medical expense rider require a disability claim?

In the design described here, no. It can reimburse accident-related medical costs even when the injury does not qualify as a disability. Confirm terms with the specific carrier.

Are these riders available in every state?

No. Availability varies by carrier and state, and features change over time. Our team can confirm what is currently approved for your client.

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Reviewed by Tim Fuller on 2026-09-26

Tim Fuller, President of SRS Inc.

Tim Fuller

President, SRS Inc.

Tim leads SRS Inc., a full-service IMO (Independent Marketing Organization) and BGA (Brokerage General Agency), connecting independent financial professionals with life, annuity, disability income, and long-term care solutions from 60+ carrier partners.

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