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Critical Illness Insurance

Basics

Critical illness insurance provides you with a lump-sum payment that can help offset expenses that may not be covered under your employer's existing medical insurance and disability plans.

While most medical plans provide coverage for hospital and medical expenses, they don’t typically cover costs like daily living expenses, childcare, or copays. A critical illness insurance policy can help close the gap.

Critical Illness insurance through your employer may include:

  • A lump-sum benefit payment to use as you see fit
  • Dependent coverage for your spouse or partner and children1
  • No obligation to submit expense receipts
  • Portable coverage should you leave your employer2
  • For complete plan details, talk to your company’s benefits administrator.

Frequently Asked Questions

Yes, you can use your payment as you see fit. Use it to help cover your household bills, medical insurance deductibles, copayments and more.

Payments will be paid directly to you, not to the doctors, hospitals or other health care providers. You will receive a check, payable to you, for maximum convenience.

Critical illnesses can happen when you least expect them – and they can be costly. Even quality medical plans can leave you with extra expenses to pay. Costs like plan deductibles, copays for doctor visits and extra costs for out-of-network care can add up fast. Having the financial support you may need when the time comes means less worry for you and your family.

Yes. If your employer offers critical illness insurance, your acceptance is guaranteed, regardless of your health. You just need to be actively at work for your coverage to be effective.3 There are no medical exams to take and no health questions to answer.

No. This supplemental Insurance will be effective on the date of your coverage as long as you are actively at work. There are no waiting periods to satisfy.

Yes. Once all required information is received, claims are generally processed within 10 business days. Only one claim form is needed per accident and every claim is reviewed by a claims professional.

1 Coverage for Domestic Partners, civil union partners and reciprocal beneficiaries varies by state. Dependent child coverage varies by state. Please contact MetLife for more information. 

2 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.

3 Coverage is guaranteed provided (1) the employee is actively at work and (2) dependents to be covered 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 the employee's job at the employer's place of business or at an alternate place approved by the employer (2) dependents are not subject to medical restrictions as set forth on the enrollment form and in the Certificate.

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.   In most states, after a covered condition occurs, there is a benefit suspension period during which most plans do not pay recurrence benefits.  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 that increase’s 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. In New York, 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.