Critical Illness Insurance

Critical Illness insurance provides a lump sum payment to help provide you and your family financial support in a difficult time.

Critical Illness Insurance

Lump sum payment provides support when your family needs it most

Managing the emotional cost of illnesses like cancer, a heart attack or a stroke* is hard enough. Managing the financial cost as well can be overwhelming. Critical illness insurance provides a lump sum payment to ensure you and your family have financial support in a difficult time. So, you can spend less time worrying about money and more time focusing on healing.

  • You’ll receive a lump sum payment upon verified diagnosis to use as you see fit
  • Use it for prescriptions, deductibles, co-payments, experiential/non-traditional treatments and even non-medical expenses like everyday bills
  • Pays out regardless of what your medical insurance covers
  • Payments are paid directly to you, not to the doctors, to the hospitals or to the healthcare providers

Example of How Benefits are Paid

Illness – Covered Condition Payment
Heart Attack — first verified diagnosis Initial Benefit payment of $20,000 or 100%
Kidney Failure – first verified diagnosis, two years later Initial Benefit payment of $20,000 or 100%
Heart Attack — second verified diagnosis, four years later Recurrence Benefit payment of $20,000 or 100%

This example is for illustrative purposes only. The MetLife Group Policy and Certificate are the governing documents with respect to all matters of insurance, including coverage for specific illnesses. The specific facts of each claim must be evaluated in conjunction with the provisions of the applicable Policy and Certificate to determine coverage in each individual case.

Critical Illness Insurance FAQs

Yes, you can enroll both yourself and your eligible family members.1 All you need to do is enroll during the enrollment period and be actively at work.

One of the hardest parts of managing illnesses like Cancer, Heart Attack, or Stroke* is providing the support and comfort your family needs beyond the cost of care.

Even the best medical and disability income plans can leave you with extra expenses to pay or services that just aren’t covered. Things like medical plan deductibles and copays, or extra costs for out-of-network care. And if you’re out of work because of a disability, it might be that only some of your income is protected. Many people may not be prepared to handle these extra costs, so having this extra financial support when the time comes may mean less worry for you and your family.

Yes. Your critical illness coverage is guaranteed,2 regardless of your health. You just need to be actively at work to be covered. There are no medical exams to take and no health questions to answer, so the whole process might be easier than you first thought.

Your plan pays an additional benefit (Recurrence Benefit) if a medical condition reoccurs for: a Benign Brain Tumor, Invasive and Non-Invasive Cancer, Coronary Artery Bypass Graft, Coma, Heart Attack, Severe Burn and Stroke

Benefits will be paid directly to you, not to the doctors, hospitals or any other health care providers. There’s no need to work it around any other insurance you may have. Benefits are paid no matter what your other insurance plans may cover.

Yes. This coverage is portable, meaning you can take it wherever you go.4 Your coverage will only end if you stop paying your premium or if your employer offers you similar coverage with a different insurance carrier.4

Financial benefits that could prove to be a lifesaver

You can never be fully prepared for a major illness. But with critical illness insurance, you can help be financially prepared.

Eligible Family Members means all persons eligible for coverage as defined in the Certificate.

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.] Some states require the insured to have medical coverage. Additional restrictions apply to dependents serving in the armed forces or living overseas.

There is a Benefit Suspension Period between Recurrences. 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 Treatment Free Period. A Recurrence Benefit is available for the following conditions: Heart Attack, Stroke, Coronary Artery Bypass Graft, Full Benefit Cancer and Partial Benefit Cancer.

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.

* 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 cases and NH residents, there is an Initial Benefit of $100 for All Other Cancer. The Heart Attack Covered Condition pays a benefit for the occurrence of a myocardial infarction, subject to the terms of the certificate. A myocardial infarction does not include sudden cardiac arrest. Regarding strokes, in certain states, the Covered Condition is Severe Stroke. Regarding Coronary Artery Bypass Graft, in NJ sitused cases, the Covered Condition is Coronary Artery Disease.

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. The plan may include a pre-existing condition exclusion. After a covered condition occurs, there is a benefit suspension period during which benefits will not be paid for a recurrence, except in the case of individuals covered under a New York certificate. MetLife offers CII with either Attained Age or Issue Age rates. 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 include a Benefit Reduction Due to Age provision. 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 the initial coverage 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 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, GPNP10-CI, GPNP14-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.