Accident & Health Insurance

Critical Illness Insurance: What Is It and How May It Help?

3 min read Feb 21, 2023

When you get sick, medical insurance often helps cover the costs to help you get better. Sometimes though, the expenses associated with illness go beyond standard medical bills. Taking the time you need to recover can put a strain on other aspects of your life, from getting groceries to earning enough income to cover your rent or mortgage.

Critical illness insurance is designed to help you and your family with these additional expenses. Read on for a closer look at what critical illness insurance is and how it may help you.

What is critical illness insurance?

Critical illness insurance typically provides a lump sum payment when you have a verified diagnosis of a covered illness.

Pay-outs can typically be used to cover:

  • Out-of-network treatment
  • Therapy and rehab
  • Transportation expenses
  • Childcare
  • Lost income
  • Other financial obligations (e.g., mortgage)

Exactly how much your critical illness plan pays out depends on your insurance provider and the type of plan you’ve selected.

What does critical illness insurance typically cover?

Critical illness plans are designed to provide coverage for illnesses and injuries that have a significant impact on your quality of life. The list of qualifying conditions may vary based on your insurance provider. Critical illness insurance often provides a lump-sum payment when you’re diagnosed with or require any of the following:

  • Heart attack
  • Stroke
  • Kidney failure
  • Cancer
  • Major organ transplant
  • Alzheimer’s disease
  • Coma
  • Severe burns
  • Paralysis
  • Coronary artery bypass graft
  • Sudden cardiac arrest
  • Benign brain tumors
  • Progressive diseases 
  • Infectious disease 
  • Childhood diseases 
  • Loss of the ability to speak, hear, and/or see

For conditions with a possibility of recurrence, such as cancer or stroke, some critical illness plans will provide an additional payout.

Why critical illness insurance?

Critical illnesses and injuries are more common than you might think. According to the Centers for Disease Control and Prevention (CDC), someone in the U.S. has a heart attack every 40 seconds.1 When surgery is involved, the average cost of emergency treatment is $100,000 or more, even with health insurance.2 And that’s for just one type of critical illness. Strokes, Alzheimer’s, and progressive diseases are becoming more prevalent as the average life expectancy continues to climb.

Critical illness insurance may help cover some of the unexpected cost that come from diagnoses. Plus, it’s typically pretty easy to sign up for. If your job provides employee critical illness insurance, you can sign up during open enrollment or when you first start your job. Premiums are typically handled via payroll, like employee health insurance, so you don’t have to worry about managing additional payments.

Curious about getting a critical illness plan through your employer? Ask your benefits representative if it’s an offering your employer provides.

Get information about MetLife Critical Illness Insurance

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1 “Heart Disease Facts,” CDC, 2022

2 “The Cost of a Heart Attack,” Preventative Diagnostic Center, 2021

This article is intended to provide general information about insurance. It does not describe any Metropolitan Life Insurance company product or feature.