Critical Illness Insurance

If you’re lucky, you’ve probably never had to use critical illness insurance (sometimes called Catastrophic Illness Insurance). Perhaps you’ve never even heard of it. But in the event of a big health emergency, such as Cancer, a Heart Attack, or a Stroke, Critical Illness Insurance could be the only thing standing between you and financial ruin. Many people assume they’re fully protected with a standard health insurance plan, but the exorbitant costs of treating life-threatening illnesses are usually more than any plan will cover. Read on to learn more about Critical Illness Insurance and whether it’s something you and your family should consider.

KEY TAKEAWAYS

  • Critical Illness Insurance provides additional coverage for medical emergencies like Heart Attacks, Strokes or Cancer.
  • Because these emergencies or illnesses often incur greater-than-average medical costs, Critical Illness Insurance policies pay out cash to help cover those overruns when traditional health insurance may fall short.
  • These policies come at a relatively low cost. However, the instances that they will cover are generally limited to a few illnesses or emergencies.

 

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Critical Illness Insurance 101

As the average life expectancy in the United States continues to increase, insurance brokers are finding ways to make sure Americans can afford the privilege of getting older. Critical illness insurance was developed in 1996, as people realized that surviving a Heart Attack or Stroke could leave a patient with insurmountable medical bills.

“Even with excellent medical insurance, just one critical illness can be a tremendous financial burden,” says certified financial planner Jeff Rossi, director of talent development at Santander Bank in New York. Critical illness insurance provides a benefit if you experience one or more of the following medical emergencies:

  • Heart attack
  • Stroke
  • Organ transplants
  • Cancer
  • Coronary bypass

Because these illnesses require extensive medical care and treatment, their costs can outstrip a family’s medical insurance policy quickly. If you don’t have an emergency fund or health savings account (HSA), you’ll have an even harder time paying those bills out of pocket.

Many people are now choosing high-deductible health plans, which can be something of a double-edged sword: Consumers benefit from relatively affordable monthly premiums but can find themselves in a real pinch if a serious illness strikes.

Critical illness Insurance can pay for costs not covered by traditional insurance. The money can also be used for non-medical costs related to the illness, including transportation, child care and so on. Typically, the insured will receive a lump sum to cover those costs. Coverage limits vary depending on your policy. Policy pricing is impacted by a number of factors, including the amount and extent of coverage, the sex, age and health of the insured and family medical history.

 

There are exceptions to Critical Illness Insurance coverage. Some types of Cancer may not be covered, while chronic illnesses are also frequently exempted. You may not be able to receive a pay out if a disease comes back or if you suffer a second Stroke or Heart Attack. Some coverage might end when the insured reaches a certain age. So, like any form of insurance, make sure to read the policy carefully. The last thing you want to worry about is your emergency plan.

Why It May Be Important

A big draw of Critical Illness Insurance is that the money can be spent on a variety of things, such as:

  • To pay for critical medical services that might otherwise be unavailable
  • To pay for treatments not covered by a traditional policy
  • To pay for daily living expenses, enabling the critically ill to focus their time and energy on getting well instead of working to pay their bills
  • Transportation expenses, such as getting to and from treatment centers, retrofitting vehicles to carry scooters or wheelchairs and installing lifts in homes for critically ill patients who can no longer navigate staircases
  • Terminally ill patients or those simply in need of a restful place to recuperate, can use the funds to take a vacation with friends or family

Like all insurance policies, critical illness policies are also subject to a host of stipulations. Not only do they cover only the conditions listed in the policy, but they cover them only under the specific circumstances noted in the policy. A diagnosis of cancer, for example, may not be enough to trigger payment of the policy if the cancer has not spread beyond the initial point of discovery or is not life-threatening. A diagnosis of a stroke may not trigger a payment unless the neurological damage persists for more than 30 days. Other restrictions may include a specific number of days for which the policyholder must be ill or must survive after diagnosis.

The Bottom Line

Because medical bills are a common cause of bankruptcy in the United States, this type of policy may be worth taking the time to research, especially if you have a family history of any of the aforementioned illnesses. Critical Illness Insurance can alleviate some of the financial worry in the event that you become too sick to work. It provides some flexibility in that you can use the money paid out as you wish to cover a wide variety of potential needs.

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Marsha Johnson
Marsha Johnson