Critical Illness Insurance

Critical Illness Insurance provides a lump sum payment to provide financial support if you are diagnosed with a serious illness.

Critical Illness Insurance

Don’t choose between

Financial benefits that could prove to be a lifesaver

You can never be fully prepared for a major illness. But with critical illness insurance, you can be financially prepared.

Critical Illness Insurance

Lump sum payment provides support when your family needs it most

Emotionally managing illnesses like cancer, a heart attack or stroke is hard enough. Financially managing the costs on top of this is often overwhelming. Critical illness insurance provides a lump sum payment to ensure you and your family have financial support in a difficult time. So, you’ll be able to spend less time worrying about money and more time focusing on healing.

  • You’ll receive a lump sum payment to use as you see fit
  • Use it for prescriptions, deductibles, co-payments, experiential/non-traditional treatments and even non-medical expenses like everyday bills
  • Pays out in addition to what your medical insurance covers
  • Payments may be paid directly to you, not to the doctors, hospitals or healthcare providers

FAQs

This is coverage that can help cover the extra expenses associated with a serious illness. 

When a serious illness happens to you or a loved one, this coverage provides you with a lump-sum benefit of your choice of either $10,000, $20,000 or $30,000 in Initial Benefits upon diagnosis. The Total Benefit Amount available to you is 3 times the Initial Benefit Amount you select, either $30,000, $60,000 or $90,000, in the event that you suffer more than one Covered Condition. Payment(s) you receive will be made in addition to any other insurance you may have and may be spent as you see fit.

If you meet the group policy and certificate requirements, critical illness insurance provides you with a lump-sum benefit upon diagnosis of the following conditions:

• Full Benefit Cancer1 • Stroke2 • Alzheimer’s Disease4
• Partial Benefit Cancer1 • Kidney Failure • Major Organ Transplant
• All Other Cancer1 • Coronary Artery Bypass Graft[3] • 22 Listed Conditions5 (see your outline of coverage for details)
• Heart Attack    

Your plan pays a Recurrence Benefit for the following covered conditions: Heart Attack, Stroke, Coronary Artery Bypass Graft, Full Benefit Cancer, Partial Benefit Cancer and All Other 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.6

You and your eligible family members.7 You just need to enroll during your open enrollment.

Even quality medical and disability income plans don’t always cover all of your expenses. 

For example, your medical coverage may have deductibles and copays and may not cover out-of-network treatments. And if you’re out on disability, only a portion of your income may be covered. With the average family spending thousands of dollars during a time of critical illness and recovery,8 most people will need the means to cover extra medical and daily living expenses. Such costs can include deductibles, groceries, housing expenses, car payments, and more. 

Yes. Provided you are actively at work, your enrollment is guaranteed.9

Yes. This plan provides a $50 annual benefit per calendar year for eligible health screenings/prevention measures. This benefit amount is above and beyond the Total Benefit Amount.10

This coverage may be less expensive than you think. You can put this coverage in place as a way to supplement your medical and disability income plans. Your initial rate is based on your age at the time your coverage becomes effective and your rates will not increase due to age.11 Exact rates can be found in the materials provided by your employer.

Premiums will be conveniently paid through payroll deduction, so you never have to worry about writing a check or missing a payment.

Payments will be made directly to you, not to the doctors, hospitals or other health care providers. You will receive a check, mailed directly to your home.

Yes. This coverage is “portable,” meaning you can take it with you if your employment status changes.12

1. Please review the Disclosure Statement or 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.

2. In certain states, the Covered Condition is Severe Stroke.

 3. In NJ sitused cases, the Covered Condition is Coronary Artery Disease.

4. Please review the Outline of Coverage for specific information about Alzheimer’s disease.

5. MetLife Critical Illness Insurance will pay 25% of the Initial Benefit Amount when a covered person is diagnosed with one of the 22 Listed Conditions. A Covered Person may only receive one benefit payment of a 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.

6. 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.

7. Eligible Family Members means all persons eligible for coverage as defined in the Certificate. 

8. MetLife Accident and Critical Illness Impact Study, October 2013.

 9. Coverage is guaranteed provided (1) the employee is actively at work and (2) dependents are not subject to medical restrictions as set forth on the enrollment form and 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.

10. The Health Screening Benefit is not available in all states. See your certificate for any applicable waiting periods. 

11. The plan is guaranteed renewable, and may not be canceled due to an increase in your age or a change in your health. Premium rates can only be raised as the result of a rate change made on a class-wide basis. Benefit reduces to 25% by age 65 and 50% at age 70. Coverage is guaranteed renewable provided: (1) premiums are paid as required under the Certificate; and (2) in a situation where the Group Policy ends, it is not replaced by a substantially similar critical illness policy as described in the Certificate.

12. 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.

Helpful Resources


Helpful Resources

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Use 9212420 for certificate #

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Use 9212429 for certificate #

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Eligible Family Members means all persons eligible for coverage as defined in the Certificate.

MetLife Accident and Critical Illness Impact Study, October 2013.

Coverage is guaranteed provided (1) the employee is actively at work and (2) dependents are not subject to medical restrictions as set forth on the enrollment form and 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.]

4There is a Benefit Suspension Period between Recurrences. 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.

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.

METLIFE 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 pre-existing condition exclusion. After a covered condition occurs, there is a benefit suspension period during which most plans do not pay recurrence benefits, except in the case of insureds covered under a New York certificate. MetLife offers CII on both an Attained Age and an Issue Age basis. Attained Age rates are based on 5-year age bands and will increase when a Covered Person reaches a new age band. MetLife’s Issue Age CII 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 the initial coverage 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 applicable to both Attained Age and Issue Age CII 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, GPNP09-CI or GPNP14-CI, or contact MetLife for more information. Benefits are underwritten by Metropolitan Life Insurance Company, New York, New York. 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 expense.