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Critical Illness

Critical Illness Insurance

Many people are not adequately prepared financially when faced with a serious illness, despite having good medical coverage.

Group Voluntary Critical Illness Insurance is a smart way help bridge the gap between traditional medical coverage and disability income coverage as well as address the financial consequences of certain Covered Conditions. It can help lessen the burden of increased out-of-pocket expenses so employees can focus on recovery instead of expenses.

  • Provides a lump sum benefit payment to be used as the employee chooses
  • Offers guaranteed coverage provided the employee is actively at work and any dependents to be covered are not under medical restriction as described in the Certificate; some states require the insured to have medical coverage
  • Complements medical and disability income coverage

The Right Solutions

Covered conditions:

  • Certain Cancers1
  • Coronary Artery Bypass Graft2
  • Stroke3
  • Kidney Failure
  • Heart Attack
  • Alzheimer's Disease4
  • 22 Listed Conditions5
  • Major Organ Transplant6

An Occupational HIV benefit is available to qualified employers with a risk of exposure to HIV in the workplace. The benefit is not available in all states. Please review the Disclosure Statement or Outline of Coverage/Disclosure Document for specific information about the Occupational HIV benefit. Please speak with your MetLife Representative for more information.

Key features:

  • Issue age and attained age rates
  • Recurrence benefit7
  • Guaranteed issue coverage8
  • No waiting periods, benefit reductions or age restrictions9
  • No limitations between filing claims for covered conditions
  • No pre-existing condition for heart attack or stroke
  • Industry leading 3/6 pre-existing condition limitation10
  • Portable (continuation of coverage)
  • Health screening benefit11

Please review the exclusions and limitations for the state of Arizona

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.

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

3 In some states, the Covered Condition is Severe Stroke.

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 for each of the 22 additional conditions listed in the group certificate 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.

6 MetLife offers several different product variations. For certain products, the Major Organ Transplant Benefit is included within the Total Benefit Amount. With others, the benefit is payable in addition to the Total Benefit Amount. Please contact MetLife for additional information.

7 There 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.

8 Coverage is guaranteed provided (a) the employee is actively at work and (b) 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.

9 Children are covered to age 26. In some states, there may be benefit reductions that begin at age 65.

10 Does not apply to heart attack and stroke.

11 In most states there is a 30 day waiting period for the Health Screening Benefit. The Health Screening Benefit is not available in certain states. In some states, there is a separate mammogram benefit. Please review your Disclosure Statement or Outline of Coverage/Disclosure Document for specific state variations and exclusions around this benefit.

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 vary by state. There is a preexisting condition exclusion. There is a Benefit Suspension Period between Recurrences. MetLife offers CII on both an attained age and an issue age basis. MetLife's Issue Age CII product is guaranteed renewable, and may be subject to benefit reductions that begin at age 65. MetLife reserves the right to raise premium rates for 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. Please contact MetLife for more information. Benefits are underwritten by Metropolitan Life Insurance Company, New York, New York. In certain states, 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.

ADF# CII698.14


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