This insurance pays a benefit for medical conditions in three distinct categories (Cancer, Heart, Other). It may pay a full benefit or a partial benefit depending on the severity of the condition, such as heart attack, cancer, and/or major organ transplant. Rates are based on age.
MetLife (Critical Illness) Contact Information
Billing & Eligibility Inquiries: (866) 232-1518
9 a.m. - 6 p.m. (EST), Mondays - Fridays
Claims Inquiries: (800) 438-6388
8 a.m. - 6 p.m. (EST), Mondays - Fridays
Mail Claims to:
Attn: Critical Illness Insurance Dept.
P.O. Box 6120
Scranton, PA 18505-9972
- Plan Highlights for 2015
- Plan Highlights (2014)
- Certificates of Coverage - MetLife
- HIPAA Privacy Notice
Critical Illness Forms
Frequently Asked Questions
What is Critical Illness Insurance?
A form of supplemental health insurance, Critical Illness Insurance is a standalone, lump-sum product whose benefit payment helps to offset expenses not reimbursed by other types of insurance when a covered person is diagnosed with one of the covered conditions and meets the requirements of the certificate. Critical Illness Insurance is not medical insurance.
Does this insurance take the place of medical insurance?
No, Critical Illness Insurance does not take the place of major medical insurance.
How does MetLife Critical Illness Insurance Work?
MetLife Critical Illness works like this. If you enroll and you experience one of the covered conditions within any category and meet all the group policy and certificate requirements, you will receive a lump-sum benefit payment to use as you see fit. This payment can help keep your family finances on track if you experience a covered condition.
Who is eligible for this benefit?
Eligibility is dependent on the terms set by the State of North Carolina. Any state agency, university, or select community college employee working 20 or more hours per week in a permanent, probationary, or time-limited position.
What are the covered conditions?
MetLife Critical Illness Insurance covers the following medical conditions and groups them into three distinct categories (as defined by the group certificate):
- Category 1 incorporates certain cancer-related conditions: Full Benefit Cancer, Partial Benefit Cancer, and Bone Marrow Transplant
- Category 2 incorporates certain heart-related conditions: Heart Attack, Stroke, Coronary Artery Bypass Graft and Heart Transplant
- Category 3 incorporates certain other conditions: Major Organ Transplant (other than bone marrow and heart) and Kidney Failure
What do you mean by a “lump-sum benefit?”
As a certificate holder, if you receive a lump-sum benefit – you receive a single payment to use as you see fit.
How can I use this lump-sum benefit payment?
You can use the lump-sum benefit payment in any way you choose – co-pays, deductibles, out-of-network treatments, childcare, travel to treatment centers, or utility payments. It’s up to you.