What do critical illness insurance policies cover?
Policies cover a range of critical illnesses. Here are the top illnesses that may be covered.
- Heart Attack
- End Stage Renal Failure
- Major Organ Transplant
- Benign Brain Tumor
- Blindness or Deafness
- Skin Cancer (often limited)
- Permanent Paralysis
- Severe Burns
- Bone Marrow Transplant (Stem Cell Transplant)
Policies cover cancer; Full Benefit means at 100%.
Cancer is the greatest risk you face. Because of the risk, you want a policy that covers malignant tumors. Specifically look for language that says tumors characterized by uncontrolled growth of malignant cells and invasion of normal tissue.
Policies that cover at 100% means the policy will pay full amount of the policy limits. Sometimes a policy will limit or offer a partial benefit. Read the policy carefully for details.
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Policies cover cancer; Partial Benefit means at less than 100%.
Many policies cover cancers at different rates. A partial benefit means the policy pays less than 100%. Generally the policy will pay at 25% for certain cancer diagnosis.
Specifically, these tend to be less common or less serious forms of cancer. However, it is important that you read your policy when it is delivered to you. It will contain complete definitions for what cancers are covered by the partial benefit amount.
Policies cover heart attacks.
Critical illness insurance policies cover heart attacks. They are one of the ‘Big 3’ critical illnesses.
Policies often define heart attacks as the death of heart muscle due to inadequate blood supply. Generally you will find language like the following.
Read the policy language to see what requirements must be satisfied.
Policies cover strokes.
Strokes are the third of the Big 3 critical illnesses. Therefore they are covered by all good critical illness insurance policies.
Refer to the policy for definitions. Strokes are often defined as the death of brain tissue that appears on imaging.
Look for any policy exclusions.
Policies cover other things like major organ transplants.
Good critical illness insurance policies cover things like major organ transplants.
Specifically, the policy will define which organs are covered. Generally it means a human to human organ transplant.
Chiefly an entire heart, lung, pancreas, a total or partial liver transplant. It may also cover a bone marrow or stem cell transplant.
Policies cover blindness and deafness.
Because these conditions happen, it’s good to look for a policy that can pay benefits.
Firstly, blindness which generally means permanent and irreversible reduction of sight in both eyes as a result of sickness or injury.
Secondly, see what is required. For example will you need the diagnosis of blindness to be made by a Board Certified ophthalmologist.
Deafness may be covered. You may see it defined as permanent and irreversible loss of hearing in both ears.
Again read the policy language. The policy may specifically call for an auditory threshold of ‘x’ decibels or greater within the speech threshold of 500 to 3,000 hertz.
Finally, again you should expect that the policy will require the diagnosis must be made by a Board Certified Otolaryngologist (ear, nose, and throat).
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A message for consumers
Critical illness insurance products can vary significantly. Firstly, the price can differ. Additionally available options can also vary. That is why we so passionately believe in the importance of comparing.
Additional Resources for Insurance Quotes
Here are links to our other insurance industry organizations.
For long-term care insurance quotes visit the American Association for Long-Term Care Insurance.
To find Medicare Insurance agents use the Medicare Insurance Agent directory offered by the American Association for Medicare Supplement Insurance.
Tips for finding the best critical illness insurance policy
Obviously, compare costs and benefits.
If you are in your 40’s significantly consider a cancer-only policy. Likewise, if you are in your 50’s, compare a comprehensive CI policy.
If you do not use tobacco products it is equally important to find a policy that offers non-smoker rates. Rates shown online may not be accurate because rates vary by state.
If you have health conditions, certainly compare a policy that is guaranteed issue.
If you have no health issues conversely compare a plan that asks health questions. It may save you money which unquestionably can be desirable.
Finally, always read your policy when it arrives. It explicitly contains all the information you need to know. Indeed that is the smartest move you can make.
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