Critical Illness

Critical Illness Plan Through MetLife

Being diagnosed with a critical illness can be devastating, both personally and financially. Breathe easier knowing Critical Illness Insurance can help you pay your out-of-pocket expenses and allow you to focus on your health.

Critical Illness Insurance provides a benefit payment upon the diagnosis of an illness or condition shown below. Benefits are payable at 100% of the Critical Illness benefit amount unless otherwise stated. For a complete description of benefits, exclusions and limitations, refer to your certificate of insurance.

Benefits payable for a new diagnosis of:

• Heart Attack / Stroke
• End-Stage Renal Failure
• Major Organ Failure
• Coma
• Permanent Paralysis Due to a Covered Accident
• Severe Burns

Please refer to the carrier Certificate of Voluntary Critical Illness Coverage for complete details, limitations, and exclusions OR click here for a MetLife Benefit summary. Click here to view a full Certificate of Critical Illness Coverage.

Critical Illness Plan Weekly Rates

Premium rates are based on the amount of coverage you elect, your age, your tobacco use status, and who you have elected to cover and will be displayed in Dayforce.

Download a Critical Illness & Cancer Claim Form.

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Download a Critical Illness Beneficiary Form.

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For Critical Illness & Cancer:

Please return completed and signed form by fax, mail or on-line. Complete Section 1 on the Physician’s Statement. Your physician must complete the remainder of the Physician’s Statement (all of Section 2) and return the completed form to MetLife.

• If this is an Initial Claim for an illness, please complete each section in its entirety. (An illness is not considered reported to us until a claim form is received).
• If this is an additional claim for an illness previously reported (i.e. – initial claim previously submitted and additional services were incurred), no claim form is required. Please provide supporting documentation from the healthcare provider related to the critical illness for which a claim is being made.
• Include your claim number and/or certificate number on all pages of your submission.
• Please provide us with supporting documentation from the healthcare provider(s) related to the Critical Illness for which a claim is being made. The supporting documents MUST include 1) the diagnosis, 2) the date(s) of diagnosis, and 3) pathology reports, surgical notes, UB 04 forms, lab results, or medical records that support the diagnosis of the covered condition.

Please return completed and signed form in one of the following ways:

• Mail: Cancer/Critical Illness Insurance Products, P.O. Box 80826 Lincoln, NE 68501-0826
• Fax: 1-855-306-7350 (If faxing, please remember to fax both front and back sides of the signed claim form. Allow two (2) hours for documents to be received)
• Online: https://mybenefits.metlife.com

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Download: Critical Illness & Cancer Claim Form

Download Now

Download: Critical Illness Beneficiary Form

Download Now

Download: Critical Illness & Cancer Physician's Statement Form