Critical illness insuranceFinancial support for life's critical moments Even with major medical coverage, employees facing a critical event can still be on their own when it comes to out-of-pocket costs. These can include deductibles, copays and coinsurance, plus other costs from changes in daily activities like child care and transportation. Symetra's critical illness insurance is designed to provide financial support to people of all ages, in all stages of life. Our benefits go beyond standard critical illness coverage and can be valuable for employees whether they're just entering the workforce, starting a family or planning for retirement. |
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Products, features, terms and conditions may vary by state and may not be available in all U.S. states or any U.S. territory. |
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Benefits for every phase of life
Our critical illness plan is highly flexible to meet the unique needs of your clients. Start with a core or enhanced core plan, which includes standardly covered conditions, then see how adding additional modules and conditions can help you build competitive benefit options for your clients.
Core coverage
- Advanced Alzheimer's disease
- Advanced multiple sclerosis (MS)
- ALS (Lou Gehrig’s disease) and other motor neuron diseases
- Coma
- Coronary artery disease needing surgery or angioplasty
- End-stage renal failure
- Heart attack (myocardial infarction)
- Invasive cancer
- Loss of hearing
- Loss of sight
- Loss of speech
- Major organ failure
- Minor cancer
- Occupational HIV
- Paralysis
- Parkinson's disease
- Severe burns
- Stroke
Enhanced core coverage
Core coverage plus:
- Non-melanoma skin cancer
- Stem cell (bone marrow) transplant
- Sudden cardiac arrest
- Transient ischemic attack
Family planning module
- Infertility Level I (medication and IUI)
- Infertility Level II (surgery and embryo implantation)
- Infertility Level III (egg retrieval)
Childhood conditions module
Major congenital structural abnormality:*
- Anencephaly
- Cleft lip/palate
- Club foot
- Complex congenital heart disease
- Omphalocele
- Spina bifida (excluding occulta)
Congenital metabolic disorder:*
- Cystic fibrosis (CF)
- Gaucher's disease
- Niemann-Pick
- Phenylalanine hydroxylase deficiency
- Phenylketonuria
- Tay Sachs
Congenital chromosomal abnormality:*
- Achondroplasia
- DiGeorge syndrome
- Down syndrome
- Fragile X
- Glucose-6-phosophate dehydrogenase deficiency (G6PD)
- Hemophilia
- Muscular dystrophy
- Neurofibromatosis
- Prader Willi
- Sickle cell disease
- Turner syndrome
Chronic medical condition commonly diagnosed in childhood:*
- Asthma
- Bronchopulmonary dysplasia
- Cerebral palsy (CP)
- Epilepsy
- Human growth hormone deficiency (HGHD)
- Scoliosis
- Type 1 diabetes
Enhanced childhood conditions module (any or all can be added to Core plan):
- Autism spectrum disorder- DSM-V severity level 3
- Autism spectrum disorder- DSM-V severity level 2
- Autism spectrum disorder- DSM-V severity level 1
- Developmental delay
*Including, but not limited to
Infectious diseases module
- Anaerobic bacteria
- Anthrax
- Aspergillus
- Bacterial pneumonia
- Candida
- Cholera
- Clostridium difficile (C. Diff)
- Covid-19/pandemic type illness
- Diphtheria
- Ebola
- Encephalitis
- Enterococcus
- Escherichia coli (E-coli)
- Flesh-eating bacteria
- Hepatitis (occ or non-occ)
- HIV (occ or non-ccc)
- Influenza
- Legionnaire's disease
- Malaria
- MRSA (methicillin resistant staphylococcus aureus)
- MSSA (methicillin susceptible staphylococcus aureus)
- Necrotizing fasciitis
- Occupational hepatitis (requires positive diagnosis, no hospitalization)
- Occupational tuberculosis (requires positive diagnosis, no hospitalization)
- Plasmodium
- Rabies
- Rocky Mountain spotted fever
- Sepsis
- Streptococcus
- Tetanus
- Tuberculosis (occ or non-occ)
- Typhoid
Diabetes module
- Type II diabetes
- Severe complications of Type II diabetes
Enhanced cardiac module
- Sudden cardiac arrest
- Transient ischemic attack (mini stroke)
- Severe chronic heart failure (Class IV ONLY— inability to perform physical activity without discomfort, and symptoms of heart failure at rest)
- Severe chronic heart failure (Class III and IV BOTH—limitation in physical activity due to symptoms and comfortable only at rest, inability to perform physical activity without discomfort, and symptoms of heart failure at rest)
Pregnancy and childbirth module
- Severe complication of birth Level I (infant requiring a minimum of two days of level II nursery care)
- Severe complication of birth Level II (infant requiring a minimum of two days of level III or IV NICU care)
- Severe complication of pregnancy (complications requiring hospitalization or extended-stay delivery)
Mental illness module
- Significant mental illness
- Severe mental illness diagnosis
Autoimmune conditions module
Severe autoimmune disease provision (including but not limited to all of the following conditions):
- Addison’s disease
- Ankylosing spondylitis
- Crohn's disease
- Dermatomyositis
- Myasthenia gravis
- Polymyositis
- Primary sclerosing cholangitis (PSC)
- Psoriatic arthritis
- Rheumatoid arthritis
- Sarcoidosis
- Scleroderma (systemic sclerosis)
- Systemic lupus erythematosus
- Ulcerative colitis
Autoimmune thyroid disease provision (includes the following conditions):
- Grave's disease
- Hashimoto's thyroiditis
Post-treatment Lyme disease (chronic Lyme disease) provision
Pulmonary module
- Severe COPD
- Severe pulmonary fibrosis
Neurological module
- Benign brain tumor
- Benign spinal tumor
- Brain aneurysm
- Dementia
- Huntington's disease
Compelling features to empower your customers
- Ability to customize benefits to meet the unique needs of every group.
- No waiting periods, preexisting condition limitations or age-based benefit amount restrictions standardly included.
- Portability and continuation options.
- Option to include unlimited recurrences of the same condition with separation periods between diagnoses as short as six months.
- Broad definitions for medical conditions, with coverage for hundreds of potential diagnoses.
- Flexible premium rate structures to ensure successful integration with today's payroll and benefit administration platforms.
Tools to support your client discussions
Want to learn more? Contact your Symetra representative today.
Critical illness policies are insured by Symetra Life Insurance Company, 777 108th Avenue NE, Suite 1200, Bellevue, WA 98004. Products, features, terms and conditions may vary by state and may not be available in all U.S. states or any U.S. territory. They are designed to provide benefits at a preselected, fixed dollar amount for covered conditions. They are not a replacement for major medical or other comprehensive coverage, and do not satisfy the minimum essential coverage requirements of the Affordable Care Act. Base policy form number is SBC-04530 1/21.
Coverage may be subject to exclusions, limitations, reductions and termination of benefit provisions.