Plan Details
Learn more about Critical Illness insurance for The Commonwealth of Pennsylvania employees.
While critical illnesses are often unexpected, they don’t have to be financially devastating.
Protect your family’s budget by enrolling for MetLife Critical Illness Insurance today. Here’s why:
- Comprehensive coverage
You and your eligible family members1 will be covered for over 20 critical illnesses, such as:- Certain cancers2
- Heart attack
- Stroke3
- Kidney failure
- Coronary artery bypass graft4
- Alzheimer’s Disease5
- Major organ transplant
- 22 listed conditions6 (see your Outline of Coverage for details)
- It’s your money.
Payment of either $10,000, $20,000 or $30,000, depending on your coverage selection, is made directly to you, not your doctor or hospital. You can spend the money on whatever you choose. - You won’t be denied coverage.
You and your eligible family members are guaranteed7 coverage, as long as you are actively at work. No medical exam and no hassle. - It’s less expensive than you think.
Take advantage of employee rates when applying for coverage through your employer.
Here's how it works:
Kathy’s daughter, Molly, plays soccer. During a recent game, Molly collided with an opposing player, was knocked unconscious and taken to the local emergency room (ER) by ambulance for treatment. The ER doctor diagnosed a concussion and a broken tooth. He also ordered a CT scan. After thorough evaluation, Molly was released to her primary care physician for follow-up treatment, and her dentist repaired her broken tooth with a crown. Luckily Kathy has accident insurance!
Coverages2 |
Benefit Amount3 |
|---|---|
Ambulance (ground) |
$300 |
Emergency Care |
$100 |
Medical Testing |
$200 |
Concussion |
$400 |
Physician Follow-Up ($75x 2) |
$150 |
BrokenTooth (repaired by crown) |
$200 |
Kathy would get a lump-sum payment totaling $1,350 with MetLife Accident Insurance |
|
This example is for illustrative purposes only.
Benefits paid by MetLife Accident Insurance High Plan
Plan Details
1 Eligible Family Members means all persons eligible for coverage as defined in the Certificate.
2 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 groups and NH residents, there is an initial benefit of $100 for All Other Cancer.
3 In certain states, the Covered Condition is Severe Stroke.
4 In NJ sitused cases, the Covered Condition is Coronary Artery Disease.
5 Please review the Outline of Coverage for specific information about Alzheimer’s disease.
6 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.
7 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.]
8 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.
9 MetLife Accident and Critical Illness Impact Study, October 2013.
10 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 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.