The Centers for Disease Control reports that in a given year, about 805,000 people in the US have a heart attack – that's one every 33 seconds.1 Thousands more have strokes or are diagnosed with cancer and other critical illnesses. And when health issues like these strike, there are almost always unexpected expenses that arise. A critical illness insurance plan can help protect your financial well-being by directly paying you a lump-sum payment that can be used for any purpose.
What is critical illness insurance?
Critical illness insurance is a type of supplemental health insurance that provides financial support when you or a covered dependent is struck with a covered severe ailment. It pays a lump-sum benefit directly to you and you can use your benefit for things like paying your health insurance deductible or other out-of-pocket medical expenses. Like other types of supplemental health insurance plans, it's not a substitute for health insurance that covers your medical bills. But, the added benefit payments provided by critical illness insurance can help at a stressful time so that you can focus on recovery. And coverage may be available as a workplace benefit, giving you this protection at affordable group rates not typically given to individuals.
How does critical illness insurance work?
Plans vary, but coverage tends to be affordable, and once you sign up, the cost is conveniently deducted from your paycheck. The claims process tends to be simple. If you or a covered family member have a covered illness or health event, you contact the insurance company directly, provide a doctor or hospital bill, and soon after, the benefit payment will be sent to you. How much will you get? That depends on the policy and the specific health issue.
What’s covered – and not covered?
Some insurance carriers provide benefits for more health issues than others, so it's important to check what's covered before signing up. Subject to state restrictions and plan limitations, Guardian plans cover many illnesses, including certain chronic conditions such as multiple sclerosis (MS) and Parkinson's disease. Benefits may also be paid for certain measures taken to prevent a critical illness, such as a mastectomy.
What's not covered? Critical illness plans typically don't pay benefits for injuries like broken bones (which are usually covered by accident insurance), and policies may exclude a pre-existing condition. Also, many common chronic conditions, like asthma , aren't usually covered. Again, a plan's schedule of benefits should clearly define what is covered – and if a health condition isn’t listed, you can assume it isn’t covered.
Why so many employers2 offer Guardian critical illness insurance as part of their benefits package
Optional benefits like critical illness coverage help support employee financial well-being, but not all employees are the same. So, Guardian works with companies to tailor critical illness plans to their workers’ needs. Highlights and optional features may include:
More conditions covered
Guardian critical illness insurance now covers a greater number of diseases and conditions and is the first to offer coverage for preventive measures taken as a result of having the BRCA1 or BRCA2 genetic mutation.Family planning benefits
Provides support for employees during infertility treatments, or if there are pregnancy or delivery complications.Mental well-being benefits
A mental health assessment is available, as well as diagnostic testing for conditions such as severe depression, postpartum, or PTSD.Easy sign up
Coverage is “guaranteed issue,” which means no health or family history questions and no medical exams are required, making it easier to get.** Coverage is also available for spouses and dependent children.
Combine with other supplemental health benefits for extra financial support
Every health and medical issue is unique and can impact household finances. That’s why your employer may offer different types of supplemental health insurance – including hospital indemnity insurance, cancer insurance, and accident insurance. These benefits can help ensure that you don’t have to choose between taking care of your health and taking care of everyday expenses.
Critical illness insurance cost
Premium costs vary depending on the specifics of the critical illness insurance policy your company offers. Plans with higher benefit levels will cost somewhat more than more basic plans. In any case, because you're purchasing benefits through your employer at group rates, the cost is typically lower than if you purchased a comparable plan on your own.
Is critical illness insurance worth getting?
Critical illnesses such as a heart attack, stroke, and cancer are serious, stressful health conditions and events that can impact our physical, emotional, mental, and financial well-being. Critical illness insurance can be an important source of protection that helps maintain your overall wellness at a crucial time. And when it’s available through work, it’s both easy to get and easy to pay for.
Take the next step
Ask your supervisor or HR department whether critical illness insurance is available as part of your employee benefits. And if you'd like more information about how to decide which employee benefits are right for you, here's a guide that can help.
Do you think you'll need extra financial support if you or a family member is ever diagnosed with a severe ailment like cancer, heart attack, or stroke? If so, then yes, it's good to consider critical illness insurance. Severe illnesses often require specialized treatments, extended hospital stays, and long recovery periods, which can be financially draining. This type of coverage pays benefits directly to you, and you can use the money as you see fit.
Despite their benefits, critical illness policies can have drawbacks. There’s a cost to purchasing coverage, which may or may not work within your budget. Also, you may have some overlapping protection from another source (such as a critical illness rider in your life insurance policy). Before purchasing critical illness insurance – whether through work or on your own – you should always read through the schedule of benefits to understand what’s covered and how benefits are paid.
Critical Illness Insurance provides financial support following the diagnosis of a covered critical illness. The lump sum benefit is paid to you, so you can focus more on recovery, less on expenses, such as added child care, specialized equipment or home modifications. Plus, some policies pay out benefits for preventing, diagnosing, and treating less serious conditions. The financial support it provides can help keep you from depleting your savings or going into debt while you are dealing with a serious health issue.
Do you think you'll need extra financial support if you or a family member is ever diagnosed with a severe ailment like cancer, heart attack, or stroke? If so, then yes, it's good to consider critical illness insurance. Severe illnesses often require specialized treatments, extended hospital stays, and long recovery periods, which can be financially draining. This type of coverage pays benefits directly to you, and you can use the money as you see fit.
Despite their benefits, critical illness policies can have drawbacks. There’s a cost to purchasing coverage, which may or may not work within your budget. Also, you may have some overlapping protection from another source (such as a critical illness rider in your life insurance policy). Before purchasing critical illness insurance – whether through work or on your own – you should always read through the schedule of benefits to understand what’s covered and how benefits are paid.
Critical Illness Insurance provides financial support following the diagnosis of a covered critical illness. The lump sum benefit is paid to you, so you can focus more on recovery, less on expenses, such as added child care, specialized equipment or home modifications. Plus, some policies pay out benefits for preventing, diagnosing, and treating less serious conditions. The financial support it provides can help keep you from depleting your savings or going into debt while you are dealing with a serious health issue.
Need more information about other supplemental health insurance?
Resources to help you learn and compare.
Other supplemental health products you may be interested in
Cancer insurance
Provides a lump sum payment for cancer diagnosis, screenings, and treatment. Payments are made directly to you and can be used for any purpose.
Hospital indemnity insurance
Helps protect your finances from out-of-pocket expenses and other costs by paying benefits if you are admitted to a hospital or ICU for a covered sickness or injury.
Accident Insurance
This coverage helps protect your finances by paying a fixed benefits payment when you have unexpected medical bills for a covered accidental injury like a severe burn, broken bones, or have to visit an emergency room.
1 https://www.cdc.gov/heart-disease/data-research/facts-stats/index.html; referencing Tsao CW, Aday AW, Almarzooq ZI, Beaton AZ, Bittencourt MS, Boehme AK, et al. Heart Disease and Stroke Statistics—2023 Update: A Report From the American Heart Association. Circulation. 2023;147:e93–e621.
2 Lump sum payments, wellness benefits and hospitalization benefit are optional plan choices determined by your employer.
3 Groups under 10 eligible lives do not have “guarantee issue,” and depending on the group size and plan design, not all amounts may be guarantee issue.
In New York, Critical Illness is referred to as Specified Disease.
Guardian’s Group Critical Illness Insurance is underwritten and issued by The Guardian Life Insurance Company of America, New York, NY. Products are not available in all states. Policy limitations and exclusions apply. Optional riders and/or features may incur additional costs. This is a limited plan of supplemental health insurance that provides the specified financial support, as a lump sum or indemnity payment, following the diagnosis of a critical illness. This is not minimum essential coverage as defined by federal law. This coverage will not reimburse for hospital or medical expenses. Generic Policy Form # GP-1-CI-14; CI-23-P. The state approved form is the governing document.
1 https://www.cdc.gov/heart-disease/data-research/facts-stats/index.html; referencing Tsao CW, Aday AW, Almarzooq ZI, Beaton AZ, Bittencourt MS, Boehme AK, et al. Heart Disease and Stroke Statistics—2023 Update: A Report From the American Heart Association. Circulation. 2023;147:e93–e621.
2 Lump sum payments, wellness benefits and hospitalization benefit are optional plan choices determined by your employer.
3 Groups under 10 eligible lives do not have “guarantee issue,” and depending on the group size and plan design, not all amounts may be guarantee issue.
In New York, Critical Illness is referred to as Specified Disease.
Guardian’s Group Critical Illness Insurance is underwritten and issued by The Guardian Life Insurance Company of America, New York, NY. Products are not available in all states. Policy limitations and exclusions apply. Optional riders and/or features may incur additional costs. This is a limited plan of supplemental health insurance that provides the specified financial support, as a lump sum or indemnity payment, following the diagnosis of a critical illness. This is not minimum essential coverage as defined by federal law. This coverage will not reimburse for hospital or medical expenses. Generic Policy Form # GP-1-CI-14; CI-23-P. The state approved form is the governing document.