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Critical Illness Insurance Plans

Critical illness insurance covers what the name says – critical illnesses. Typical illnesses this type of insurance covers include cancer, heart attack, stroke, and certain other illnesses that may vary based on the policy.

Because of the nature of this type of policy, which is designed to only cover serious illnesses, you will still have to pay out of pocket for treatment of any condition that is not described as a covered condition in the insurance policy. This means that any preventative care – such as regular doctor check-ups – or even urgent care treatment is not covered, and you will be responsible for paying out of pocket for the entirety of the cost.

Critical illness insurance may be a good option for you if:

  1. You don’t expect to go to the doctor much, if at all. Since they cover only critical illness, monthly premiums are typically lower than traditional plans. But, keep in mind that critical illness plans only cover certain conditions, so be prepared to pay expensive out-of-pocket costs if you do need medical attention.
  2. It’s outside Open Enrollment and you don’t qualify for Special Enrollment. Critical illness can help bridge the gap between coverage when you can’t enroll in a traditional plan, in the case that you are diagnosed with a covered condition.
  3. You don’t qualify for a government subsidy. Critical illness plans don’t meet minimum ACA requirements, so you won’t get any government help paying your plan premiums or out-of-pocket costs with this type of plan. If you’re eligible for government assistance, be sure to calculate that amount into your costs for both types of plans and weigh your options.
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Federal Contracting Statement Plans are insured or covered by a Medicare Advantage organization with a Medicare contract and/or a Medicare-approved Part D sponsor. Enrollment in the plan depends on the plan’s contract renewal with Medicare.

Third Party Material (TPMO) (Medicare.gov) We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE (TTY users should call 1-877-486-2048) 24 hours a day/7 days a week to get information on all of your options.

This website may not display all data on Qualified Health Plans being offered in your state through the Marketplace website or the federal Medicare program. This is not a complete listing of plans available in your service area. To see all available data on Qualified Health Plan options in your state, visit your state Marketplace website, go to the Health Insurance Marketplace website at https://www.healthcare.gov or consult https://www.medicare.gov.

Submitting this form does NOT affect your current enrollment, nor will it enroll you in a Medicare Advantage plan, Medicare Prescription Drug plan, Medicare Supplement Plan, or any other Medicare plan. QuoteLab, LLC is independent of the Medicare program and is neither associated with nor endorsed by The Centers for Medicare & Medicaid Services (CMS) or any other governmental agency.

The plans represented on HealthInsuranceUSA.org are Medicare Advantage HMO, PPO and PFFS organizations and stand-alone prescription drug plans with a Medicare contract. Enrollment in any plan depends on contract renewal. If you are paying Medicare Part B premium, you must continue to pay it to maintain coverage.

Not all plans offer all of these benefits. Benefits may vary by carrier and location. Limitations and exclusions may apply.

Every year, Medicare evaluates plans based on a 5-star rating system.

Part B Premium give-back is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.

Based on median Medicare Advantage benefit amounts for dental available across multiple plans and metro areas. Not all benefits available in specific plans or regions.

This information is not a complete description of benefits. Contact the plan for more information.

Limitations, copayments, and restrictions may apply.

[Benefits, premiums and/or copayments/coinsurance] may change on January 1 of each year.

Advertised Pricing:

There are several factors that impact your monthly premium; including your age, geographical location, annual income, dependents, and the type of plan you choose. Monthly premiums do not include out-of-pocket costs.

The advertised price may not be typical. It was generated using the Kaiser Family Foundation's subsidy calculator that was accessed on September 16, 2020. The following parameters were used: 21 year old adult, non-tobacco user, annual income of $24,700 in 2020, no children, and no available coverage through a spouse's employer. The resulting monthly premium was $30 per month (or $360 per year after $2,751 in subsidies) for a Bronze Plan. Even when using the same parameters, the resulting premium and subsidy calculations may be subject to change.