Critical Illness Insurance

Critical Illness Insurance helps you focus on recovery & not on your finances.

What is Critical Illness insurance?

MetLife Critical Illness Insurance provides a lump-sum payment if you or a covered family member1 is diagnosed with a serious illness. Critical illness insurance works to complement your medical coverage—and pays in addition to what your medical plan may or may not cover. It’s coverage that provides financial support when you or a loved one becomes seriously ill. Upon diagnosis, it provides you with a lump-sum payment of $15,000 or $30,000 in initial benefits. The payment you receive is yours to spend however you like.

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

It’s your money.
Payment of your benefit is made directly to you, not your doctor or hospital. You can spend the money on whatever you choose.

You wouldn’t be denied coverage.
You and your eligible family members are guaranteed9 & coverage, as long as you are actively at work. No medical exam and no hassle.

Less expensive than you think.
Take advantage of employee rates when applying for coverage through your employer.

What is covered?

A critically important decision - Even with good medical coverage, the cost of a critical illness, such as cancer, heart attack and stroke, can really add up. Some families spend as much as $14,444 or more during a time of a critical illness and recovery.5

While critical illnesses are always unexpected, they don’t have to be financially devastating. Protect your family’s budget by enrolling for MetLife Critical Illness Insurance today.

Your Initial Benefit provides a lump-sum payment upon the first diagnosis of a Covered Condition. Your plan pays a Recurrence Benefit2 for the following Covered Conditions: Full Benefit Cancer, Partial Benefit Cancer, Heart Attack, Stroke, and Coronary Artery Bypass Graft. A Recurrence Benefit is only available if an Initial Benefit has been paid for the Covered Condition. 

Please refer to the table below for the percentage benefit amount for each Covered Condition. 

Covered Conditions

Initial Benefit Recurrence Benefit
Full Benefit Cancer3 100% of Initial Benefit 50% of Initial Benefit
Partial Benefit Cancer3 25% of Initial Benefit 12.5% of Initial Benefit
Heart Attack 100% of Initial Benefit 50% of Initial Benefit
Stroke4 100% of Initial Benefit 50% of Initial Benefit
Coronary Artery Bypass Graft 100% of Initial Benefit 50% of Initial Benefit
Kidney Failure 100% of Initial Benefit Not applicable
Major Organ Transplant Benefit 100% of Initial Benefit Not applicable
Alzheimer’s Disease5 100% of Initial Benefit Not applicable
22 Listed Conditions 25% of Initial Benefit Refer to Certificate

22 Listed Conditions6
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 for a Listed Condition in his/her lifetime. Refer to your Certificate or Outline of Coverage for additional details. 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.

View more Plan Details

Benefit Payment Example

The example below illustrates an employee who elected an Initial Benefit of $15,000.
Illness – Covered Condition Payment
Heart Attack – first diagnosis Initial Benefit payment of $15,000 or 100%

Heart Attack – second diagnosis, two years later

Recurrence Benefit payment of $7,500 or 50%

Kidney Failure – first diagnosis, three years later

Initial Benefit payment of $15,000 or 100%
Total Benefit Amount (initial and recurrence) $37,500
Most Common FAQ's
How do I enroll? Collapsed Expanded

Enroll for coverage at State of Alaska enrollment website.

Who is eligible to enroll? Collapsed Expanded

Regular active full-time employees who are actively at work along with their spouse/domestic partner and dependent children can enroll for MetLife Critical Illness Insurance coverage.3

Why should I enroll? Collapsed Expanded
  • Competitive group rates
  • Your acceptance is guaranteed providing you are actively at work8
  • Rates will not increase due to age9
  • Convenient payroll deduction
  • Portable coverage enables you to take it with you if your employment status changes9
I have a good medical plan at work. Why do I need critical illness insurance? Collapsed Expanded

Even quality medical and disability income plans don’t always cover all of your expenses. For example, your medical coverage may have deductibles and copays and may not cover out-of-network treatments. And if you’re out on disability, only a portion of your income may be covered. With the average family spending thousands of dollars during a time of critical illness and recovery,10 most people will need the means to cover extra medical and daily living expenses. Such costs can include deductibles, groceries, housing expenses, car payments and more.

Can I enroll for this coverage without having to take a medical exam? Collapsed Expanded

Yes. Your critical illness coverage is guaranteed issue, which means your acceptance is guaranteed, regardless of your health. You just need to be actively at work for your coverage to be effective. There are no medical exams to take and no health questions to answer.8

How do I pay for coverage? Collapsed Expanded

Coverage is paid through convenient payroll deduction.

What is the coverage effective date? Collapsed Expanded

The coverage effective date is 01/01/2019.

How do I file a claim? Collapsed Expanded

File a claim online or with a form by following these steps:

Visit or download the MetLife Mobile App to view your certificate of insurance and initiate your claim, or call 866-625-3705 to obtain a claim form.

  1. Answer some questions about your claim and upload medical documentation and a physician statement to support your claim
  2. Visit MyBenefits or your MetLife Mobile App frequently to check claim status, letters and benefit payments.

A MetLife claims specialist will review your information, request any additional medical (if necessary) and notify you in writing of a claim decision.

Are payments made directly to me or to my health care provider? Collapsed Expanded

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
  • Child care
  • Mortgage and car payments
  • Or any other way you want; the choice is yours
What happens if I have a recurrence? Collapsed Expanded

Your plan pays a Recurrence Benefit for the following covered conditions: Heart Attack, Stroke, Coronary Artery Bypass Graft, Full Benefit Cancer, and Partial Benefit 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.2

If I Leave the Company, Can I Keep My Coverage? Collapsed Expanded

Under certain circumstances, you can take your coverage with you if you leave. You must make a request in writing within a specified period after you leave your employer. You must also continue to pay premiums to keep the coverage in force.

Who do I call for assistance? Collapsed Expanded

Contact a MetLife Customer Service Representative at 1 800- GET-MET8 (1-800-438-6388), Monday through Friday from 8:00 a.m. to 8:00 p.m., EST.

Covered Family Member mean all persons eligible for coverage as defined in the Certificate.

3 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.

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

6 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.

7 In certain states, the covered condition is Severe Stroke.

8 Please review the Outline of Coverage for specific information about Alzheimer’s disease.

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

10 Eligibility for portability through the Continuation of Insurance with Premium Payment provision may be subject to certain eligibility requirements and limitations.

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. 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.