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Frequently Asked Questions

What is the Survival Period?

The survival period is the amount of time you must survive following the diagnosis of a covered critical illness, before you will receive your lump sum benefit. Some do and you’ll need to ask us or an agent to see if  there is a probationary period or a survival period and when does it get paid out. The standard to the industry response is typically upon diagnosis the carrier will pay benefit. There may however be a exclusionary or probationary period.

What is Exclusionary period or Probationary Period?

Probationary period is the time you may have to wait before a policy’s coverage actually goes to cover you. This is not when the policy is in force or issued. This means what time frame from the time your policy coverage has begun, that the policy needs to be in force before the policy pays for that covered condition.  You should check at time of applying by asking agent and/or checking policy or brochure. This is typical in health insurance. Most carriers for critical illness start right away there are a vast amount that require 30-90 days for certain conditions such as cancer.In the past historically, carriers accepting of a pre-existing condition require that you must be on the plan before the carrier will pay out on that said condition (i.e. one year). Group plan or a Guaranteed issue critical illness insurance plan may have a waiting period you’ll need be on the plan before coverage pays, and both do vary.

What is the difference between Cancer Insurance and Critical Illness Insurance?

These terms have been used only by the public as interchangeable and they are certainly not. Critical illness insurance covers the basics which are Stroke, Heart attack, and guess what else? CANCER. It also can cover other conditions depending on carrier, and by state. Such other critical illness covered conditions could be paralysis, and major burns coma,  Multiple Scleroses (MS), Blindness, deafness, major organ transplant, loss of limbs, some also cover any terminal illness diagnosed or double as a critical illness and life insurance policy. Cancer insurance only covers cancer.

How many kinds of plans are there and which one is right for me?

There are too many as they all have a platform base and then can change into a new animal based on your particular needs. Critical illness insurance vs. Cancer insurance for example, cancer coverage does just that while critical illness covers a great deal more(see above). There are two basically in the industry on cancer insurance whereby one covers as an indemnity or expense policy. This is where the policy lists exactly what it will pay per medical condition and a certain dollar amount limit to that treatment. The other is a lump sum payment which has the dollar limit that you the insured sets at the time of the application. Upon diagnosis it will pay out to the insured one lump sum to be used as the insured sees fit.

Does a policy cover you wherever state you are in?

It covers you if you travel you still have a policy and where your diagnosed shouldn’t matter but again every critical illness insurance carrier is different and they abide also by the state as well, so you can always inquire. What does matter is can you get a policy coverage where you reside. Typically, if you live in a state more than 6 months out of the year, that is your primary residence or residential state. That is the place in which to get the coverage.

How do I know what carriers or plans are available in my state?

Nearly every state in the United States has a critical illness insurances or cancer insurances  available, not all, but most. To find out what states are available, or to find your specific state and the carrier and/ or plans available click here State availability.

What is a return of premium or “ROP”?

ROP short for “return of premium” means just that. When you pay an insurance premium monthly you can opt for the ROP however, it does cost more on your cost monthly. Thus, if you want your premiums returned to you in full prepare to pay more for this luxury benefit. True, it is risk free IF you make timely payments for the designated time frame. So… how long is that time frame. Well could be about twenty (20) years. If you have no qualm paying timely and for that period okay but if you leave them or stop after 13.6 years in this example you paid more monthly for no reason. Most do not offer this but it is available for example with the Humana cash cancer only plan. Again not perhaps with the standard critical illness policies though so decide well.

What is a Waver of Premium WOP?

In the case of a person not being able to work or disabled is usually the time a person might be out of work or disabled and not being able to work and as a result derive income to pay his or her premiums. In that light a special rider may be purchased on the plan that states you may have a waiver of premium and the policy will not cancel. Many are very costly to add on and in the case of critical illness coverage or cancer insurance, the rates of the premiums may be so small it may not warrant adding. Many carriers may have different terms or definitions to this so check and see per carrier or insurance plan for specific details.

Critical illness and other health insurance or supplements “tax deductible”?

Most Critical illness insurance policies are in fact tax deductible . It is typical that the carrier will state to check with your CPA or accountant to be sure. It is primarily either federal law or state law and there again even though you would have to check the common response has been if you claim it on your taxes as an individual paying then that is okay, but come time to collect on a claim for critical illness the benefit could then be taxed. This is not always the case and again it could be based on the plan as well with the carrier in that state. If company is paying and they take the tax break you see the outcome as listed above.

Voluntary Benefits

Health insurance benefits usually referred to health insurance supplemental medical and non-medical products that are offered to employees or workers to those who voluntarily exercise the option to pay for it themselves. Since it is offered to the employer for his employees the business is offering benefits to those that wish it without cost to the emploer. There is an option the employer has to pay for this but typically is then is often offered as a group plan and tax benefits or advantages may vary as well as state to state. Voluntary benefits offered also may be called worksite benefits as different carriers and definitions vary. Coverage that may be offered through voluntary insurance may be critical illness insurance and or cancer insurance,disability insurance,(LTC) long term care insurance and accident insurance or a hospital insurance plan some call gap or bridge plans. Voluntary benefits can lower costs by providing supplemental coverage to high deductible health insurance that is not covered. Benefits often paid to client directly.

What is a Critical illness?

Critical illnesses are usually severe conditions that are diseases or medical conditions that require immediate medical attention from medical professionals and may be life threatening. Conditions can include but not limited to Heart attack, Strokes, Cancer, Major burns, Paralysis, loss of limb etcetera. It can require special attention and there are varying degrees of critical illness that may require critical care such as trauma from accident or severe injury or a disease or condition built up developing over a period of time.

How does the benefit get paid out?

The money typically is a cash benefit. The money would come directly to the insured and can be used however the insured wishes. Often times, but not always is the cash benefit in a lump sum paid as a tax free. Varying factors may apply so check with carrier on your state and regulations and/or a tax accountant.

What is critical illness insurance otherwise known as:

  1. Critical care insurance
  2. Serious illness insurance
  3. Dread disease insurance
  4. Often misused as catastrophic insurance
  5. Specified illness insurance
  6. Supplemental health insurance
  7. Voluntary benefit insurance
  8. Worksite insurance

Critical illness may be one type of plan that can make up the marketed name such as supplemental health insurance can include other types. (see “Supplemental Health” tab in menu bar at top for more comprehensive list.)

To find out more or get a list of company information call the CI Resource Center on this site 1-561-210-5822.