Critical Illness Insurance

A serious illness can be very costly, even if you have medical insurance. Critical Illness Insurance can help relieve financial stress so you can focus on getting better.

Highlights

Critical Illness (CI) insurance, issued by The Prudential Insurance Company of America, covers serious conditions like heart attacks and cancer. Benefits are paid directly to you as a lump sum based on your elected coverage amount, so in addition to helping with medical costs not covered by your Health insurance, you can use the money to help cover things like lost income and expenses for care.

CI insurance:

  • offers cash benefits for 13 serious, but common conditions
  • pays you directly, so you decide how benefits are spent
  • can help cover out-of-pocket costs like copays, deductibles, and more
  • is guaranteed up to $10,000 (up to $50,000 is available with limited underwriting)

CI insurance is designed to be used with—but not as a replacement for—your major medical insurance. You must have ACA-compliant health insurance to enroll.

IMPORTANT: This is a fixed indemnity policy,

NOT health insurance

This fixed indemnity policy may pay you a limited dollar amount if you’re sick or

hospitalized. You’re still responsible for paying the cost of your care.

  • The payment you get isn’t based on the size of your medical bill.

  • There might be a limit on how much this policy will pay each year.

  • This policy isn’t a substitute for comprehensive health insurance.

  • Since this policy isn’t health insurance, it doesn’t have to include most Federal consumer protections that apply to health insurance.

Looking for comprehensive health insurance?

  • Visit HealthCare.gov or call 1-800-318-2596 (TTY: 1-855-889-4325) to find health coverage options.

  • To find out if you can get health insurance through your job, or a family member’s job, contact the employer.

Questions about this policy?

  • For questions or complaints about this policy, contact your State Department of Insurance. Find their number on the National Association of Insurance Commissioners’ website (org) under “Insurance Departments.”

  • If you have this policy through your job, or a family member’s job, contact the employer.

Frequently Asked Questions

Why Critical Illness insurance?

CI insurance is for people who already have health insurance, especially those with high deductible plans. It can help pay for out-of-pocket medical and non-medical expenses that accompany a serious illness.

What conditions are covered?

Covered at 100%:  Includes: Invasive Cancer, Heart Attack, Major Organ Failure, Stroke, Renal Failure, Alzheimer’s Disease.

Covered at 25%: Includes: Cancer in Situ, Severe Coronary Artery Disease, Severe Heart Valve Malfunction, Coma, Parkinson’s Disease, Motor Neuron Disease (ALS), and Multiple Sclerosis

A critical illness is not covered if it is caused by or results from a pre-existing condition for which you’ve received medical consultation, care, or treatment or taken prescribed medication in the past 12 months and the critical illness begins within 12 months of your coverage effective date.

For more details and examples, read the Critical Illness Plan Highlights and How This Plan Works.

How much insurance is offered?

Minimum: $10,000 (guaranteed issue)

Maximum: $50,000 (in $10,000 increments; amounts above $10,000 require limited underwriting)

 

Minor children: $5,000-$15,000 (in $5,000 increments)

(Child coverage may not exceed Member amount)

Who is eligible?

You must be under age 65 when you enroll, and dependent children must be under age 27. Coverage can continue to age 80.

What are the monthly premiums?

See Critical Illness Insurance Plan Highlights for monthly premiums.

How do I receive my benefits?

Cash benefits are paid directly to you upon first diagnosis after your effective date of coverage. You’ll receive a lump sum based on your elected coverage amount at the time your claim is approved.

Resources

Critical Illness Insurance Plan Highlights

VISIT

Critical Illness Insurance: How This Plan Works

VISIT

Carrier

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Claims

If you need to file a claim, please call us at 973-774-7221.

This site may contain marketing language, on products issued by The Prudential Insurance Company of America, that has not yet been approved in all states.

The products issued by The Prudential Insurance Company of America may not be available in all states.

Not for residents of New Mexico
Not for use in New Mexico

This coverage is not health insurance coverage (often referred to as “Major Medical Coverage”).

THIS IS AN EXCEPTED BENEFITS POLICY. IT PROVIDES COVERAGE ONLY FOR THE LIMITED BENEFITS OR SERVICES SPECIFIED IN THE POLICY.

Group Critical Illness Insurance coverage is a limited benefit policy issued by The Prudential Insurance Company of America, a Prudential Financial company, Newark, NJ. Prudential’s Critical Illness Insurance is not a substitute for medical coverage that provides benefits for medical treatment, including hospital, surgical, and medical expenses, and it does not provide reimbursement for such expenses. The Booklet-Certificate contains all details, including any policy exclusions, limitations, and restrictions, which may apply. If there is a discrepancy between this document and the Booklet-Certificate/Group Contract issued by The Prudential Insurance Company of America, the Group Contract will govern. A more detailed description of the benefits, limitations, and exclusions applicable are contained in the Outline of Coverage provided at time of enrollment. Please contact Prudential for more information. Contract provisions may vary by state. Contract Series: 114774.

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