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Critical Illness Insurance

Focus on recovery—not on your finances.
What is critical illness insurance?

MetLife Critical Illness Insurance provides a lump-sum payment if you or a covered family member1 is diagnosed with a serious illness.   Critical illness insurance works to complement your medical coverage—and pays in addition to what your medical plan may or may not cover. It’s coverage that provides financial support when you or a loved one becomes seriously ill. Upon diagnosis, it provides you with a lump-sum payment of $10,000, $25,000 or $50,000 in initial benefits. The payment you receive is yours to spend however you like.

Quality health and disability income insurance plans aren’t always enough. There may still be coverage gaps. Disability income plans cover a portion of your income while health insurance may leave you with some expenses to pay including:

  • Health plan deductibles
  • Out-of-network treatments
  • Prescription copays
  • Alternative treatments

Access to additional services.
Amazon offers Social Security Disability Advocacy and Advisory Services (DAS), provided through SSDC Services Corp (SSDC), as an added service that is included as part of Amazon’s employee-paid Personal Accident and Critical Illness insurance plans. Amazon’s employees enrolled in the Personal Accident and Critical Illness plans have access to the DAS benefit4, which can help you obtain Social Security Disability Income benefits if your accident or illness is serious enough for you to be permanently disabled for at least twelve months. To determine if your accident and disability qualify for Disability Advocacy Services through SSDC, call SSDC Services Corp. at 866-587-2853.4

What is covered?

Your Initial Benefit provides a lump-sum payment upon the first diagnosis of a Covered Condition. Your plan pays a Recurrence Benefit2 for the following Covered Conditions: Full Benefit Cancer, Partial Benefit Cancer, Heart Attack, Stroke, and Coronary Artery Bypass Graft. A Recurrence Benefit is only available if an Initial Benefit has been paid for the Covered Condition. 

Please refer to the table below for the percentage benefit amount for each Covered Condition.  

Covered Conditions Initial Benefit Recurrence Benefit
Full Benefit Cancer3 100% of Initial Benefit 100% of Initial Benefit
Partial Benefit Cancer3 100% of Initial Benefit 100% of Initial Benefit
Skin Cancer 25% of Initial Benefit 25% of Initial Benefit
Heart Attack 100% of Initial Benefit 100% of Initial Benefit
Stroke4 100% of Initial Benefit 100% of Initial Benefit
Coronary Artery Bypass Graft 100% of Initial Benefit 100% of Initial Benefit
Kidney Failure 100% of Initial Benefit Not applicable
Major Organ Transplant Benefit 100% of Initial Benefit Not applicable
Alzheimer’s Disease5 100% of Initial Benefit Not applicable
7 Listed Conditions  100% of Initial Benefit Not applicable
15 Listed Conditions 25% of Initial Benefit Refer to Certificate

 

7 Listed Conditions
MetLife Critical Illness Insurance will pay 100% of the Initial Benefit amount when a covered person is diagnosed with one of the 7 Listed Conditions.  A Covered Person may only receive one benefit payment for a listed condition in his/her lifetime.  The Listed Conditions are: Amyotrophic lateral sclerosis (Lou Gehrig’s disease); cerebral palsy; cystic fibrosis; multiple sclerosis (definitive diagnosis); muscular dystrophy; sickle cell anemia (excluding sickle cell trait); systemic lupus erythematosus (SLE).

15 Listed Conditions6
MetLife Critical Illness Insurance will pay 25% of the Initial Benefit Amount when a covered person is diagnosed with one of the 15 Listed Conditions. A Covered Person may only receive one benefit payment for a Listed Condition in his/her lifetime. Refer to your Certificate or Outline of Coverage for Listed Conditions with Recurrence Benefits. The Listed Conditions are: Addison’s disease (adrenal hypofunction); cerebrospinal meningitis (bacterial); diphtheria; encephalitis; Huntington’s disease (Huntington’s chorea); Legionnaire’s disease; malaria; myasthenia gravis; necrotizing fasciitis; osteomyelitis; poliomyelitis; rabies; systemic sclerosis (scleroderma); tetanus; and tuberculosis.

Benefit Payment Example

The example below illustrates an employee who elected an Initial Benefit of $10,000.
Illness – Covered Condition Payment
Heart Attack – first diagnosis Initial Benefit payment of $10,000 or 100%
Heart Attack – second diagnosis, two years later Recurrence Benefit payment of $10,000 or 100%
Kidney Failure – first diagnosis, three years later Initial Benefit payment of $10,000 or 100%
Total Benefit Amount (initial and recurrence) $30,000

 

All Benefit Levels include Social Security Disability Advocacy and Advisory Service (DAS), which can be initiated regardless of the outcome of a submitted Critical Illness claim filed with MetLife.7

 
Who is eligible to enroll for this coverage? Collapsed Expanded

If you are a regular full-time, part-time or reduced-time employee, you are eligible to enroll yourself and your eligible family members. You need to enroll during your Enrollment Period and be actively at work for your coverage to be effective.

Amazon’s employees enrolled in the Critical Illness plan have access to the DAS benefit. After contacting SSDC, they will advise and help determine your eligibility to receive Social Security Disability Income benefits.7

Why should I enroll? Collapsed Expanded
  • Competitive group rates
  • Your acceptance is guaranteed providing you are actively at work8
  • Rates will not increase due to age9
  • Convenient payroll deduction
  • Portable coverage enables you to take it with you if your employment status changes9
  • If your illness results in you being permanently disabled for at least twelve months, Disability Advocacy and Advisory Services (DAS) are included with your plan, which are provided through SSDC Services Corp (SSDC).7 These services include Social Security Disability Representation to assist you in obtaining Social Security Disability Income benefits.
I have a good medical plan at work. Why do I need critical illness insurance? Collapsed Expanded

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,10 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. 

Can I enroll for this coverage without having to take a medical exam? Collapsed Expanded

Yes. Your critical illness coverage is guaranteed issue, which means your acceptance is guaranteed, regardless of your health. You just need to be actively at work for your coverage to be effective. There are no medical exams to take and no health questions to answer.8

Are payments made directly to me or my health care provider? Collapsed Expanded

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. The payment you receive is yours to spend as you see fit and may be used to cover ongoing household bills like:

  • Groceries
  • Child care
  • Mortgage and car payments
  • Or any other way you want; the choice is yours
What happens if I have a recurrence? Collapsed Expanded

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 Skin 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.2

Additional recurrence benefits (Listed Conditions at 25%): cerebrospinal meningitis (bacterial), diphtheria, encephalitis, Huntington’s disease (Huntington’s chorea), Legionnaire’s disease, malaria, necrotizing fasciitis, tetanus and tuberculosis. Please refer to your Member Certificate or your Outline of Coverage for additional details.

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