Plan Benefits

Why is having Critical Illness insurance so important?

Your family’s expenses will continue if and when a critical illness occurs.

Studies show that the average family spends about $7,071 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 situation like undergoing a serious illness, with today's economy, fewer than 4 of 10 American adults have an emergency fund to fall back on.2

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
  • Prescription copays
  • Out-of-network treatments
  • Alternative treatments

Critical illnesses can happen at any age and more often than you may think.

The odds of you or a family member suffering a critical illness are actually quite surprising. Studies have shown:

  • The average age for onset of a critical illness is 43.3
  • In a typical year, more than 920,000 Americans will have a heart attack.4
  • 1 out of every 2 men will be diagnosed with cancer at some point in their lives.5
  • 1 out of every 3 women will be diagnosed with cancer at some point in their lives.5

Critical Illness insurance can help safeguard your finances when you or a covered family member experience a Covered Condition and meet policy and certificate requirements. This coverage provides you with an initial lump-sum payment of $15,000 when your family needs it most. The payment you receive is yours to spend as you see fit and in addition to any other insurance you may have.

Critical Illness insurance pays you a lump-sum payment for diagnosis of the following conditions:

  • Category 1 – Cancer-Related Conditions, including: Full Benefit Cancer,6 Partial Benefit Cancer,6,7 and Skin Cancer.8
  • Category 2 – Heart-Related Conditions, including: Heart Attack, Stroke,9 Coronary Artery Disease.7
  • Category 3 – Other Conditions, including: Kidney Failure, and Major Organ Transplant.10

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
  • Mortgage and car payments
  • Child care
  • Transportation or lodging
  • Or any other way you want; the choice is yours

1 MetLife Accident and Critical Illness Impact Study, October 2013.

3, How Does Critical Illness Insurance Work, 2012.

4 New York Times Health Guide, 2011.

5 American Cancer Society, Cancer Facts and Figures 2013.

6 Please review the Outline of Coverage/Disclosure Document for specific information about cancer benefits.

7 For some types of cancer and Coronary Artery Disease, the insured may be eligible to receive 25% of the Category Benefit Amount. In certain states, the Covered Condition is Coronary Artery Bypass Graft. Not all Cancers are covered.

8 There is a lump sum payment of $250 which is not available in all states. See your OOC/Disclosure Statement for details.

9 In certain states, the Covered Condition is Severe Stroke.

10 In certain states, Heart Transplant is a Category 2 heart-related Covered Condition and Bone Marrow Transplant is a Category 1 cancer-related Covered Condition.

11 Coverage is guaranteed provided (1) the employee is actively at work and (2) any dependents to be covered are not under medical restriction as explained within your enrollment form and in the Certificate. Medical coverage is required. Additional restrictions apply to dependents serving in the armed forces or living overseas.

12 Your coverage will only end if you stop paying your premium or if the Group Policy ends.

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. In some states there is a Benefit Suspension Period between Covered Conditions in different categories or a limit on the Total Benefit payments per calendar year. Attained Age rates are based on 5-year age bands and will increase when a Covered Person reaches a new age band. Rates are subject to change. A more detailed description of the benefits, limitations, and exclusions applicable to you can be found in the 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 contact MetLife for more information.

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# CI1646.17