Every 40 seconds, someone in the U.S. has a heart attack or stroke1 and someone is diagnosed with cancer every 3 minutes.2 If it happens to you, shouldn’t your primary focus be on getting well, and not worrying about how to pay for your treatment and care?
Critical Illness Insurance can help you by paying a lump sum cash benefit to help cover your out-of-pocket medical costs, including deductibles, copays, and cost-shares or pay daily living expenses such as grocery bills, mortgage payments, transportation costs, etc.
Answers about the plan, including eligibility, options, enrollment, customer service and more.
Who is the provider?
With over 145 years of experience, MetLife is a recognized leader in protection planning and retirement & savings solutions.
How can this help me?
Gives you the comfort to recover in confidence while avoiding the financial strain a serious illness can cause.
MetLife Critical Illness insurance provides a lump-sum payment if you or a covered family member are diagnosed with a covered medical condition and meet the policy and certificate requirements.
Who can enroll?
You, your spouse and eligible children qualify for this coverage. You and your eligible family members just need to enroll during your employer's enrollment period and be actively at work for your coverage to be effective.
When can I enroll?
As a new hire, you can enroll during your new hire enrollment period. Outside of your new hire enrollment period, enrollment is limited to the annual enrollment period, and within 30 days following a qualified life event.
What if my employment status changes?
When you leave or retire from your current employer, you can continue your coverage without interruption, subject to applicable law and the policies' terms and conditions. Although payroll deduction will no longer be available, you can opt for other payment methods such as direct bank account deduction, or home billing.
Your coverage will only end if you stop paying your premium or if your employer offers you similar coverage with a different insurance carrier.4
What serious illnesses and diseases am I covered for?
Once you’re enrolled in this coverage, you’ll collect a lump sum payment if you are diagnosed with one of the following medical conditions: Full Benefit Cancer,5 Partial Benefit Cancer,5 Heart Attack, Stroke,6 Coronary Artery Bypass Graft,7 Kidney Failure, Alzheimer’s Disease,8 Major Organ Transplant and the 22 Listed Conditions.9
What happens if I recover and then I’m diagnosed again?
This plan pays a Recurrence Benefit for the following Covered Conditions: Heart Attack, Stroke, Coronary Artery Bypass Graft, Full Benefit Cancer and Partial Benefit Cancer. A Recurrence Benefit is only available if an Initial Benefit has been paid for the Covered Condition. There is a Benefit Suspension Period between Recurrences.10
1American Heart Association/American Stroke Association, “Heart Disease and Stroke Statistics 2017,” http://www.heart.org/idc/groups/ahamah-public/@wcm/@sop/@smd/documents/downloadable/ucm_491265.pdf
2National Cancer Institute, National Institutes of Health, “Cancer Statistics,” viewed at https://www.cancer.gov/about-cancer/understanding/statistics. This is computed by their statistic: “In 2018, an estimated 1,735,350 new cases of cancer will be diagnosed in the United States,” divided by the number of minutes in a year, 525,600.
3Coverage is guaranteed provided (1) the employee is actively at work and (2) any dependents to be covered are not under medical restriction as described in the Certificate. Some states require the insured to have medical coverage. Additional restrictions apply to dependents serving in the armed forces or living overseas. For CA sitused cases, coverage is guaranteed provided (1) the employee is performing all of the usual and customary duties of your job at the employer's place of business or at an alternate place approved by your employer (2) dependents are not subject to medical restrictions as set forth on the enrollment form and in the Certificate.
4 Eligibility for portability through the Continuation of Insurance with Premium Payment provision may be subject to certain eligibility requirements and limitations. For more information, contact your MetLife representative.
5 Please review the Outline of Coverage/Disclosure Document for specific information about cancer benefits. Not all types of cancer are covered. Some cancers are covered at less than the Initial Benefit Amount. For NH-sitused cases and NH residents, there is an Initial Benefit of $100 for All Other Cancer.
6 In certain states, the Covered Condition is Severe Stroke.
7 In NJ sitused cases. the Covered Condition is Coronary Artery Disease.
8 Please review the Outline of Coverage for specific information about Alzheimer’s disease.
9 MetLife Critical Illness Insurance will pay 25% of the Initial Benefit Amount for each of the 22 Listed Conditions until the Total Benefit Amount is reached. A Covered Person may only receive one payment for each Listed Condition in his/her lifetime. The Listed Conditions are: Addison’s disease (adrenal hypofunction); amyotrophic lateral sclerosis (Lou Gehrig’s disease); cerebrospinal meningitis (bacterial); cerebral palsy; cystic fibrosis; diphtheria; encephalitis; Huntington’s disease (Huntington’s chorea); Legionnaire’s disease; malaria; multiple sclerosis (definitive diagnosis); muscular dystrophy; myasthenia gravis; necrotizing fasciitis; osteomyelitis; poliomyelitis; rabies; sickle cell anemia (excluding sickle cell trait); systemic lupus erythematosus (SLE); systemic sclerosis (scleroderma); tetanus; and tuberculosis.
10 There is a Benefit Suspension Period between Recurrences. Please review the Outline of Coverage/Disclosure Document for specific information about the Benefit Suspension Period. We will not pay a Recurrence Benefit for a Covered Condition that Recurs during a Benefit Suspension Period. We will not pay a Recurrence Benefit for either a Full Benefit Cancer or a Partial Benefit Cancer unless the Covered Person has not had symptoms of or been treated for the Full Benefit Cancer or Partial Benefit Cancer for which we paid an Initial Benefit during the Benefit Suspension Period. A Recurrence Benefit is available for the following conditions: Heart Attack, Stroke, Coronary Artery Bypass Graft, Full Benefit Cancer and Partial Benefit Cancer.
METLIFE’S CRITICAL ILLNESS INSURANCE (CII) IS A LIMITED BENEFIT GROUP INSURANCE POLICY. Like most group accident and health insurance policies, MetLife’s CII policies contain certain exclusions, limitations and terms for keeping them in force. Product features and availability may vary by state. In most plans, there is a preexisting condition exclusion. In most states, after a covered condition occurs there is a benefit suspension period during which benefits will not be paid for a recurrence. [Attained Age rates are based on 5-year age bands and will increase when a Covered Person reaches a new age band. OR MetLife’s Issue Age CII product is guaranteed renewable, and may be subject to benefit reductions that begin at age 65. Premium rates for MetLife’s Issue Age CII are based on age at the time of the initial coverage effective date and will not increase due to age; premium rates for increases in coverage, including the addition of dependents’ coverage, if applicable, will be based on the covered person’s age at the time of that increase’s effective date. Rates are subject to change for MetLife’s Issue Age CII on a class-wide basis.] A more detailed description of the benefits, limitations, and exclusions can be found in the applicable Disclosure Statement or Outline of Coverage/Disclosure Document available at time of enrollment. For complete details of coverage and availability, please refer to the group policy form [GPNP07-CI or GPNP09-CI OR GPNP14-CI] or contact MetLife for more information. Benefits are underwritten by Metropolitan Life Insurance Company, New York, New York. [In New York, availability of MetLife's Issue Age CII product is pending regulatory approval.]
MetLife's Critical Illness Insurance is not intended to be a substitute for Medical Coverage providing benefits for medical treatment, including hospital, surgical and medical expenses. MetLife's Critical Illness Insurance does not provide reimbursement for such expenses.