The Aetna Critical Illness Plan helps provide financial support if you’re diagnosed with a covered critical illness.

If you’re diagnosed with a critical illness like a heart attack or stroke, your life can change quickly. In addition to the emotional and physical toll, there may be strain on your personal finances. That’s because while a major medical plan may pay for some of the costs associated with treatment, out-of-pocket expenses like co-pays and deductibles can still put a strain on your savings. 

However, once you’re enrolled in the Critical Illness Plan, you’ll have additional financial protection if you are diagnosed with a covered critical illness. With this policy, you receive cash benefits paid directly to you to use however you choose.

The Critical Illness Plan:

• Pays a lump-sum cash benefit if you’re diagnosed with a covered serious illness on or after your coverage effective date
• Helps cover out-of-pocket medical expenses associated with a serious diagnosis
• Pays benefits directly to you, letting you decide how to use the money 

This payment is in addition to your employer’s major medical plan – and in addition to any other type of medical coverage, disability insurance, or other benefits you may be eligible for or collect. However, it is NOT a substitute for these coverages and does not meet minimum essential coverage as defined by federal law. Limits may apply to the number of times benefits are paid. Please review your plan documents for a complete list of benefits, details, exclusions, and limitations that apply.

Dealing with a critical illness can be costly to you in 2 ways:

• Medical Bills. It’s not unusual for a critical illness to result in out-of-pocket expenses. It starts with the usual, deductibles and copays, but it doesn’t end there. You might decide to go to a doctor or facility that’s “out of network.” You might decide to get a second opinion or type of treatment that isn’t covered at all. When your health is at stake, it's important to feel like you have control and choices. 
• Lost Income. Treatment and focus on recovery may require extra time away from work. That can impact the paycheck your family may rely on to keep everything on track. Or you might discover you have added expenses because you need more help around the house, extra childcare, or additional lodging near treatment. These costs can subtract from your wages or savings. 

The advantage of this plan is simple: you can use your critical illness benefit any way you choose. You can use it to help pay for medical expenses like deductibles and copays, as well as any non-medical expenses. You can also use this money to help pay daily living expenses such as grocery bills, mortgage payments, childcare, and transportation – all of which can be an added worry if you lose income while you’re out of work.

Access to this benefit provides you with more control over your finances and ultimately your health care options, too. Less stress about money and added peace of mind are both great ways to support your recovery.

These are the periods when you are eligible to enroll in the Critical Illness Plan:

1. Within your new hire enrollment period
2. If you have a qualifying life event (you get married, have a baby, etc.)
3. During your employer’s annual enrollment 

Check with your employer’s human resources/benefits team for specifics about these timeframes.

Keep in mind: If you enroll during these timeframes, you have what is called "guaranteed issue," which means you may qualify for Critical Illness Plan without answering health questions. You must have insurance in place before a covered critical illness occurs in order to be eligible to collect the benefit when you need it.

These form(s) are in Adobe Acrobat Reader (PDF) format and are available for downloading and printing.

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After you become a member, you’ll enjoy an Aetna Simplified Claims Experience™ on  MyAetnaSupplemental.com or on the My Aetna Supplemental app.

You can also view your coverage documents and sign up for direct deposit.

If you have questions or need a paper claim form call Aetna Member Services at 1-800-607-3366 (TTY: 711), Monday through Friday, 8 AM to 6 PM.