Critical Illness

Why is having critical illness insurance so important?

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 $15,000 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 $45,000 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.

Your family’s expenses will continue if and when a critical illness occurs.  Studies show that some families spend as much as $14,444 or more during a time of critical illness and recovery.1 And while financial experts recommend having 3–9 months of living expenses set aside to help in an emergency situation2 like undergoing a serious illness, with today’s economy, most families don’t have that kind of money in reserve.  Help protect yourself, your family, and your budget from the financial impact of a critical illness. 

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

Critical Illness Insurance

How can having MetLife Critical Illness Insurance benefit you and your loved ones?

MetLife Critical Illness Insurance provides a lump-sum payment if you or a covered family member4 is diagnosed with one of the following medical conditions and meets the policy and certificate requirements:

Full Benefit Cancer,5 Partial Benefit Cancer,5 All Other 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 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.10

Why should I enroll now?

  • Competitive group rates
  • Your acceptance is guaranteed providing you are actively at work.11
  • Spouse/Domestic Partner Benefit Amount: 50% of employee's Initial Benefit
  • Child Benefit Amount: 50% of employee's Initial Benefit
  • Convenient payroll deduction
  • Portable coverage enables you to take it with you if your employment status changes.12
Outline of Coverage
Rate Chart

Critical Illness Insurance FAQs

Yes, you can enroll both yourself and your eligible family members.1 All you need to do is enroll during the enrollment period and be actively at work.

One of the hardest parts of managing illnesses like Cancer, Heart Attack, or Stroke is providing the support and comfort your family needs beyond the cost of care.

Even the best medical and disability income plans can leave you with extra expenses to pay or services that just aren’t covered. Things like medical plan deductibles and copays, or extra costs for out-of-network care. And if you’re out of work because of a disability, it might be that only some of your income is protected. Many people aren’t prepared to handle these extra costs, so having this extra financial support when the time comes may mean less worry for you and your family.

Yes. Your critical illness coverage is guaranteed,2 regardless of your health. You just need to be actively at work to be covered. There are no medical exams to take and no health questions to answer, so the whole process might be easier than you first thought.

Your plan pays an additional benefit (Recurrence Benefit) if a medical condition reoccurs for: a Heart Attack, Stroke, Coronary Artery Bypass Graft, Full Benefit Cancer, and Partial Benefit Cancer. A recurrence benefit is only available if the initial benefit has already been paid for the covered condition. And there is a benefit suspension period (or waiting period) between recurrences.3

Benefits will be paid directly to you, not to the doctors, hospitals or any other health care providers. There’s no need to work it around any other insurance you may have. Benefits are paid no matter what your other insurance plans may cover.

Yes. This coverage is portable, meaning you can take it wherever you go. 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

Help protect your health and your finances

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

1. Please review the Disclosure Statement or Outline of Coverage/Disclosure Document for specific information about cancer benefits. Not alltypes of cancer are covered. Some cancers are covered at less than the Initial Benefit Amount. For NH-sitused cases and NH residents, thereis 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 ListedConditions. 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); cerebralpalsy; 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 RecurrenceBenefit for either a Full Benefit Cancer or a Partial Benefit Cancer unless the Covered Person has not had symptoms of or been treated for theFull 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 onthe enrollment form and in the Certificate. Some states require the insured to have medical coverage. Additional restrictions apply todependents serving in the armed forces or living overseas. [For CA-sitused cases, coverage is guaranteed provided (1) the employee isperforming all of the usual and customary duties of your job at the employer’s place of business or at an alternate place approved by youremployer (2) dependents are not subject to medical restrictions as set forth on the enrollment form and in the Certificate.]

10. The Health Screening Benefit is not available in all states. See your certificate for any applicable waiting periods. There is a separate mammogram benefit for MT residents and for cases sitused in CA and MT.

11. 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’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 most plans do not pay recurrence benefits. Attained Age rates are based on 5-year age bands and will increase when a Covered Person reaches a new age band. A more detailed description of the benefits, limitations, and exclusions applicable 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 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 expenses.