Critical Illness Insurance | Aetna

Critical Illness Insurance | Aetna

Critical Illness Insurance

Helps you alleviate the expenses that come with a covered critical illness diagnosis.

Here's what you need to know

Aetna Critical Illness Insurance helps provide financial support if you’re diagnosed with a covered critical illness.

 

If you’re diagnosed with a critical illness like a heart attack or stroke, your life can change quickly. In addition to the emotional and physical toll, there may be strain on your personal finances. That’s because while a major medical plan may pay for some of the costs associated with treatment, out-of-pocket expenses like co-pays and deductibles can still put a strain on your savings. 

 

However, once you’re enrolled in Critical Illness Insurance, you’ll have additional financial protection if you are diagnosed with a covered critical illness. With this policy, you receive cash benefits paid directly to you to use however you choose.

 

Critical Illness Insurance:

  • Pays a lump-sum cash benefit if you’re diagnosed with a covered serious illness
  • Helps cover out-of-pocket medical expenses associated with a serious diagnosis
  • Pays benefits directly to you, letting you decide how to use the money 

 

This payment is in addition to your employer’s major medical plan – and in addition to any other type of medical coverage, disability insurance, or other benefits you may be eligible for or collect. However, it is NOT a substitute for these coverages and does not meet minimum essential coverage as defined by federal law. 

Dealing with a critical illness can be costly to you in two ways:

 

  • Medical Bills. It’s not unusual for a critical illness to result in out-of-pocket expenses. It starts with the usual deductibles and copays, but it doesn’t always end there. You might decide to go to a doctor or facility that’s out-of-network. You might decide to get a second opinion or type of treatment that isn’t covered at all. When your health is at stake, it's important to feel like you have control and choices. 
  • Lost Income. Treatment and recovery may require extra time away from work. That can impact the paycheck your family relies on. Or you might discover you have added expenses because you need more help around the house, extra childcare, or additional lodging near treatment. These costs can drain your savings quickly. 

 

The advantage of this plan is simple: you can use your critical illness benefit any way you choose. You can use it to help pay for medical expenses like deductibles and copays, as well as any non-medical expenses. You can also use this money to help pay daily living expenses such as grocery bills, mortgage payments, childcare, and transportation – all of which can be an added worry if you lose income while you’re out of work.

 

Access to this benefit provides you with more control over your finances and ultimately your health care options, too. Less stress about money and added peace of mind are both great ways to support your recovery.

These are the periods when you can enroll in critical illness insurance:

 

  1. Within your new hire enrollment period
  2. If you have a qualifying life event (you get married, have a baby, etc.)
  3. During annual enrollment

 

Check with your human resources/benefits team for specifics about these timeframes.

 

Keep in mind: If you enroll during these timeframes, you have what is called "guaranteed issue," which means you may qualify for Critical Illness Insurance without answering health questions. You must have insurance in place before a covered critical illness occurs in order to be eligible to collect the benefit when you need it.

These form(s) are in Adobe Acrobat Reader (PDF) format and are available for downloading and printing.

 

Benefit Summary

 

After you become a member, you’ll enjoy an Aetna Simplified Claims Experience™ on  MyAetnaSupplemental.com or on the My Aetna Supplemental app.

 

You can also view your coverage documents and sign up for direct deposit.

 

If you have questions or need a paper claim form call Aetna Member Services at 1-800-607-3366 (TTY: 711), Monday through Friday, 8 AM to 6 PM.

How It Works

Number One Enroll Now Icon

You enroll in Critical Illness Insurance

Number Two Doctor Checkup Icon

After the plan is in effect, you receive a diagnosis of a covered critical illness 

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Receive a cash benefit

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Use your money however you want

Doctor's test results indicate a heart attack diagnosis.

That’s when Critical Illness Insurance comes in.

Because you have Critical Illness Insurance, your diagnosis means you’re eligible to receive a payment you can use any way you choose.

Frequently Asked Questions

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  • Who is the provider?

    Aetna

    With over 150 years of experience, Aetna is a leading innovator and a recognized leader in protection planning and retirement & savings solutions.

     

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  • When is a benefit paid under the policy?

    Once your plan is effective, you’ll receive benefits when you’re diagnosed with a covered critical illness. These benefits may have other limitations and exclusions that may affect what’s payable. See your plan summaries or certificates for a list of exclusions and limitations that apply.
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  • Who in my family is eligible for this insurance?

    Members of your family who are considered eligible to enroll for plan include:

    • You – if you are an active employee working 16+ hours per week
    • Your spouse – age 16 and older
    • Your child(ren) – under age 26
    • Family

     

    You must be enrolled in Critical Illness Insurance for members of your family to also enroll. 

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  • How much does this insurance cost?

    This is a group plan offered at rates based on the employee’s age, tobacco usage, and the chosen plan. Refer to the policy documents for complete details. 
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  • Do I have to answer health questions or take a medical exam?

    No, you don’t. Your Critical Illness Insurance is "guaranteed issue," which means you may qualify for insurance without answering health questions.
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  • What if my employment status changes?

    Good news! If you leave or retire from your current employer, you can continue your Critical Illness Insurance without interruption (subject to applicable law and the policy’s terms and conditions). Although payroll deduction will no longer be available, you can opt for other payment methods such as credit card billing or home billing. 
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  • When would my coverage start?

    Coverage becomes effective for new members on the coverage effective date. Check with your HR team to determine when coverage begins for new hires and for qualifying life events.
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  • Am I really free to use the payment any way I choose?

    Yes, you are! There are no restrictions or requirements about how you can use your critical illness cash benefit. When you’re facing a critical illness, you want to be able to focus your time and energy on treatment and recovery. This policy can help you do just that. You’re free to use your benefit on medical expenses and/or non-medical expenses. Having that kind of flexibility can help you feel more in control over your care and your finances at a very stressful time.

Are you ready To Enroll?

Act now to put the Critical Illness Insurance in place to help offset expenses that may not be covered by other plans.

Do You Need Help?

Our team is ready

M-F 9a-6p ET

Phone Number: 1-866-795-4268