Critical Illness Insurance

Critical Illness Insurance  


Medical bills are reported to be the number one cause of bankruptcy in the U.S..1 Half of U.S. adults (48%) who live in a household where someone has a serious medical condition say problems paying medical bills had a “major impact” on them and their family.2 When critical illness affects your family, you’ll have the support you need when it matters most.


While experts recommend that families keep several months of living expenses set aside to help in an emergency, a general rule of thumb is to save enough to cover 3–6 months’ worth of essential expenses.3


Even if you have medical and disability insurance, there can be financial gaps in your coverage. Disability income may only cover a portion of your income, and medical insurance can possibly leave you with some extra expenses. You would have to cover deductibles, co-pays, extra costs for out-of-network care, and non-covered services such as alternative treatments. 


Add critical illness insurance to help offset expenses that may not be covered under your employer's existing medical insurance and disability plans.

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Critical illness insurance is coverage that can help safeguard your finances by providing you with a lump-sum payment — one payment all at once — when you or your family needs it most. The extra cash can help you focus on getting back on track — without worrying about finding the money to cover some of your expenses.


And best of all, the payment is made directly to you, and is in addition to any other insurance you may have. It’s yours to spend however you see fit, such as for household bills, medical insurance deductibles and copayments. Additional features include:

  • A lump sum benefit payment to use as you see fit
  • You pay a competitive employee group rate. Your premium is deducted from your paycheck
  • You’re guaranteed acceptance provided you enroll during the Enrollment Period and are actively at work4
  • Portable coverage so you can take it with you if you change jobs or retire5
  • Dependent coverage for a spouse or partner and children6
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How It Works


Answers about the plan, including eligibility, options, enrollment and customer service.
  • Who is the provider?

    With over 150 years of experience, MetLife is a recognized leader in protection planning and retirement & savings solutions.
  • How can this help me?

    MetLife Critical Illness Insurance can help give you the comfort to recover in confidence while helping to avoid the financial strain a serious illness can cause.

    MetLife Critical Illness insurance provides a lump-sum payment if you or a covered family member have a verified diagnosis of covered medical condition and meet the policy and certificate requirements.
  • Who can enroll?

    You, your spouse and eligible children qualify for this coverage.7 You and your eligible family members just need to enroll during your employer's enrollment period and be actively at work for your coverage to be effective.
  • When can I enroll?

    As a new hire, you can enroll during your new hire enrollment period. Outside of your new hire enrollment period, enrollment is limited to the annual enrollment period.
  • What if my employment status changes?

    When you leave or retire from your current employer, you can continue your coverage without interruption, subject to applicable law and the policies' terms and conditions. Although payroll deduction will no longer be available, you can opt for other payment methods such as direct bank account deduction, or home billing.

    Your coverage will only end if you stop paying your premium or if your employer offers you similar coverage with a different insurance carrier.5
  • What serious illness and diseases am I covered for?

    Critical illness insurance helps you manage expenses — so you can focus on getting well.

    As long as you or your loved one meets the policy and certificate requirements, Critical Illness Insurance provides a lump-sum payment for covered conditions such as heart attack8, cancer9 or stroke10.
  • How do I file a claim?

    Filing a claim is easy:

    1. Visit or download the MetLife Mobile app.

    2. Answer a few simple questions. Upload your medical documentation to support your claim.

    3. Once your claim is approved, you’ll receive a check made out to you. Start using these funds as needed.


For complete plan details, talk with your company’s benefits administrator or review your plan summary.


1Medical Bankruptcy and the Economy, Updated April 30, 2021. Accessed January 2022.
2(48% of those who have medical bills, 12% of adults). Kaiser Family Foundation Data Note: Americans' Challenges with Health Care Costs, December 21, 2021. Accessed January 2022.
3Bankrate, How much should you have in savings at each age? May 7, 2021. Accessed January 2022.
4Coverage 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. 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; and (2) dependents are not subject to medical restrictions as set forth on the enrollment form and in the Certificate.
5Eligibility 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.
7Eligible Family Members mean all persons eligible for coverage as defined in the Certificate. Dependent Child coverage varies by state. Please contact MetLife for more information.
8The 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.
9Please review the certificate for specific information about cancer benefits. In most states, not all types of cancer are covered.
10In certain states, the Covered Condition is Severe Stroke.

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 vary by state. There may be a preexisting condition exclusion. There may be a Benefit Reduction Due to Age provision. There may be a Benefit Suspension Period between recurrences of the same Covered Condition or occurrences of different Covered Conditions. MetLife offers CII on both an Attained Age basis, where rates will increase when a Covered Person reaches a new age band, and an Issue Age basis, where rates will not increase due to age. Rates are subject to change. MetLife reserves the right to raise premium rates for Issue Age CII on a class-wide basis. A more detailed description of the benefits, limitations, and exclusions applicable to MetLife’s CII product 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, GPNP19-CI or contact MetLife for more information. Please 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.




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Critical Illness Insurance Benefit In Action
Critical Illness Insurance Plan Summary
How to File a Claim Flyer
Mercer's Role & Compensation

Details of Mercer disclosure of the compensation.