Critical Illness Insurance
Critical Illness Insurance overview
Our Critical Illness Insurance, provided by MetLife, provides a lump sum payment in the event of a critical illness diagnosis, including COVID-19. And, by participating in one of the eligible screening/prevention measures each year, you’ll get a $75 benefit each year!
Coverage is guaranteed — there is no need to answer any medical questions.
Critical Illness Insurance complements your medical plan and Life & Long-Term Disability Insurance. It provides you or a covered family member with a lump sum payment in the event that you or a covered family member experiences one of over 35 critical illnesses – including cancer, heart attack, stroke, kidney failure, and COVID-19 (you must be hospitalized for 5 or more days).
You can choose between:
- $10,000; and
- $20,000
The lump sum is paid directly to you regardless of any other insurance you may have. To receive the lump sum, the individual must meet all group policy and certificate requirements.
You can use the lump sum as you see fit, including to cover your deductible, copays/coinsurances, household expenses – like your mortgage, groceries or childcare, and experimental treatments. Having extra financial support in such circumstances means less worry for everyone involved.
Coverage also includes a “recurrence benefit” of 100% of the initial benefit. So, if you received an initial benefit with a diagnosis of one of the covered conditions and the condition returns, you may be entitled to this recurrence benefit. A recurrence benefit is available for a number of conditions, including heart attack or stroke, as well as full and partial-benefit cancer.
How to make a claim
If you experience a covered critical illness, there are three simple steps to claim your lump sum:
- Opening a claim
- Call 1-800-GET-MET8 to get a claim form via email, fax or mail.
- Submit a fully completed claim form, including the physician statement, to MetLife by fax or online via the MyBenefits website.
- Processing the claim
- A claims acknowledgment letter will be sent to you within 3 days after receipt of a fully completed claims form (including the physician statement) to confirm that MetLife has received your claim and are working to review and process it.
- MetLife may call you to collect any missing information.
- Payment
- A claim is generally processed and payment issued within 10 business days after receipt of all required information
MetLife Customer Service Representatives will be available to answer questions at any time throughout the claims process.
How much does this benefit cost?
The cost will vary based on the amount selected ($10,000 or $20,000), your age at the time of enrollment, and who you choose to cover. Your per pay cost will show in Workday when you elect this benefit.
How to make the most of this benefit
- This benefit complements the Health Savings Account (HSA), as you can use it to pay for covered out-of-pocket expenses before using your HSA.
- Add dependent coverage — your spouse and any children through the month they turn age 26 are eligible.
- MetLife provides an annual benefit of $75 per calendar year for taking one of the eligible screening/prevention measures.
- If you need emotional support or counseling following a critical illness diagnosis, the Employee Assistance Program is available to you 24/7.
- Change your coverage at any time during the year if you have a relevant and qualified change in family status (e.g. you get married and want to add your spouse) – update your elections in Workday.