Critical Illness

What Is Critical Illness Insurance?

Critical Illness insurance helps cover out-of-pocket expenses associated with a serious illness. You may have medical insurance. But that doesn't mean you're covered for all of the expenses resulting from a serious illness that you probably haven't budgeted for — things like co-pays, deductibles, loss of income, childcare and travel expenses. Group Critical Illness insurance helps fill the gap caused by these out-of-pocket costs, creating a financial safety net for you and your family.

How Does Critical Illness Insurance Work?

Critical Illness insurance provides an extra layer of protection that can make a big difference in your ability to pay out-of-pocket expenses associated with a serious illness. It pays a lump-sum benefit directly to you upon diagnosis of a covered illness, regardless of your treatment costs or what’s covered by your medical insurance.

 

 

Key Benefits
Helps pay expenses not covered by medical insurance
Covers over 20 serious illnesses, plus 21 childhood illnesses (7 serious illnesses in New York)
Pays lump sum directly to you, not medical providers
Benefit Examples

Cancer
Cancer
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Shayna beat cancer, but there were many costs she didn't expect. Beyond her medical plan’s coinsurance for chemotherapy treatments and copays for doctor appointments, she purchased hair prosthetics, had to pay for travel to specialists, and underwent alternative treatments that she felt helped her. What's more, her husband missed work to help care for her. Fortunately, she had Critical Illness insurance coverage, which helped provide an essential buffer for her family's finances while she was being treated.

Shayna used her insurance benefit to help pay for:

  • Medical insurance deductible
  • Out-of-pocket expenses for six months
  • Alternative treatments and diets not covered by her medical plan
  • Transportation to medical appointments and treatments
  • Lodging near treatment facility
  • Husband's lost wages

 

*Example is for illustrative purposes. Eligibility for benefits and amounts shown in this example may vary from any policy your employer may offer and may vary based upon your individual circumstances, policy definitions, waiting periods, exclusions and limitations.

Heart attack
Heart Attack
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Meghan's husband suffered a heart attack that not only required hospitalization, but made it impossible for him to work for months. Fortunately, Meghan signed up for Critical Illness insurance for her spouse. The benefits not only helped her pay for their medical insurance deductible, copays and other out-of-pocket expenses, but they also helped provide a much-needed buffer for their regular monthly expenses while he recovered. They even used a portion of the benefit for specialists who helped her husband improve his health and manage his stress.

Meghan used the benefit to help pay for:

  • Medical insurance deductible
  • Prescription copays and coinsurance
  • Sessions with wellness specialist
  • Lost wages

 

*Example is for illustrative purposes. Eligibility for benefits and amounts shown in this example may vary from any policy your employer may offer and may vary based upon your individual circumstances, policy definitions, waiting periods, exclusions and limitations.

Congenital disease
Congenital Illness
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The birth of Mateo’s new baby took a surprising turn when he found that their baby had a developmental defect called spina bifida. While not life threatening, this condition meant his son required specialist visits, surgeries and assistive devices to promote his development. Fortunately, Mateo's Critical Illness coverage paid a benefit equal to 25 percent of the coverage amount he chose for himself. This benefit helped his family cover much of the unexpected costs of taking special care of his son.

Mateo used the benefit to help pay for:

  • Medical insurance deductible
  • Specialist copays (six visits)
  • Coinsurance for two surgeries
  • Assistive devices

 

*Example is for illustrative purposes. Eligibility for benefits and amounts shown in this example may vary from any policy your employer may offer and may vary based upon your individual circumstances, policy definitions, waiting periods, exclusions and limitations.

Alzheimers
Advanced Alzheimer's Disease
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When Steven's spouse was in the early stages of Alzheimer’s disease, she could still function independently despite a few memory lapses. But recently, her condition has progressed to an advanced stage, and caring for her condition was becoming very expensive. There were constant copays because of ongoing doctors’ visits and medication, and expensive therapies not covered by medical insurance. Eventually, he needed to hire in-home help. Fortunately, Steven's Critical Illness benefit helped cover those expenses as their lives adjusted to meet her needs.

Steven used his benefit to help pay for:

  • Doctor visit copays
  • Prescription copays
  • Safety-related home modifications
  • In-home caregiver (20 hours per week)

 

*Example is for illustrative purposes. Eligibility for benefits and amounts shown in this example may vary from any policy your employer may offer and may vary based upon your individual circumstances, policy definitions, waiting periods, exclusions and limitations.

Help Ensure Your Financial Plans Stay Healthy Even When You're Not

Critical Illness insurance is an affordable way to make up the difference between what your health insurance covers and what you'd owe out of pocket if you or a family member were diagnosed with a covered serious illness.

Interested in this coverage? Talk to the benefits administrator where you work.