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Individuals and Families: Critical Illness Coverage
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These days, more patients than ever are fully recovering from cancer, heart
attacks and other serious illnesses. Recovering from the cost is another story.
The expenses not covered by traditional health insurance could leave you
responsible for thousands of dollars.
USAble Life’s* Critical Illness coverage pays a lump sum cash benefit of
$10,000, $20,000 or $30,000 upon the first positive diagnosis of a covered
critical illness.
That money can help cover the costs associated with recovering from a serious
illness — including home health care, experimental medical care,
transportation costs to and from treatment, and more. While this Critical
Illness Coverage is provided under a separate policy, you must also apply for
BlueChoice to obtain it. Coverage is available to BlueChoice policyholders and
their covered spouses, age 18 through 64.
*USAble Life is an independent company and operates separately from Arkansas Blue Cross and Blue
Shield. USAble Life does not sell or service Arkansas Blue Cross and Blue Shield products. USAble Life is
solely responsible for the critical illness policy referenced here.
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What is Covered
Covered Specified
Critical Illnesses |
Percentage
of Face Amount |
| Cancer |
100% |
| Heart Attack |
100% |
| Stroke |
100% |
| End Stage Renal Disease |
100% |
| Major Organ Transplant Surgery |
100% |
| Quadriplegia |
100% |
| Coronary Artery Bypass Surgery* |
25% |
Balloon Angioplasty, Stent
or Laser Relief Obstruction Procedure* |
10% |
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Carcinoma in Situ*
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10% |
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Rates
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$10,000 |
$20,000 |
$30,000 |
| Per Covered Person |
Non-Tobacco |
Tobacco |
Non-Tobacco |
Tobacco |
Non-Tobacco |
Non-Tobacco |
| 18-29 |
$ 3.80 |
$ 8.68 |
$ 7.60 |
$ 17.36 |
$11.40 |
$ 26.04 |
| 30-39 |
$ 6.48 |
$16.48 |
$12.96 |
$ 32.96 |
$19.44 |
$ 49.44 |
| 40-49 |
$10.80 |
$30.48 |
$21.60 |
$ 60.96 |
$32.40 |
$ 91.44 |
| 50-59 |
$17.48 |
$50.48 |
$34.96 |
$100.96 |
$52.44 |
$151.44 |
| 60-64 |
$24.00 |
$64.00 |
$48.00 |
$128.00 |
$72.00 |
$192.00 |
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*These benefits are payable only once per insured. If one or more of
these benefits are paid, the remaining amount payable will be the original Face
Amount reduced by all prior benefit payments. On the policy anniversary
following attainment of age 75, the Face Amount will be restated as 50% of the
remaining amount payable.
Waiting Period. No benefits will be paid for a
specified critical illness diagnosed during the first 30 days following the
insured's effective date.
Benefits Will Not Be Paid for:
This policy pays only for loss resulting from specified critical
illnesses or surgeries defined in the policy. We will not pay benefits for a
specified critical illness or surgery that occurs as a result of the following:
1) Conditions other than the specified critical illnesses or
surgeries defined in the policy, unless the condition was directly caused or
aggravated by the specified critical illness or surgery or the treatment of the
specified critical illness or surgery.
2) The covered person being diagnosed with a specific critical illness during
the waiting period.
3) The covered person participating or attempting to participate in an illegal
activity.
4) The covered person intentionally causing a self-inflicted injury.
5) The covered person committing or attempting to commit suicide, whether sane
or insane.
6) The covered person's involvement in any period of armed conflict, even if it
is not declared.
7) Surgeries performed outside of the United States or its Territories.
8) Other Exclusions: We will not pay the Specified Critical Illness Benefit for
the following:
a) Cerebral symptoms due to transient ischemic attack (TIA), reversible
neurological deficit, migraine, cerebral injury resulting from trauma or
hypoxia, and vascular disease affecting the eye, optic nerve, or vestibular
functions.
b) Melanomas of less than 1.5-mm maximum thickness as determined by
histological examination or which are less than Clark Level 3 depth of
invasion.
c) All hyperkeratoses or basal cell carcinoma of the skin.
d) All squamous cell carcinomas of the skin unless there has been spread to
other organs.
e) Prostatic cancers which are histologically described as TNM Classification
T1 (including T1(a) or T1(b), or of other equivalent or lesser classification).
Preexisting Conditions Limitations for Certain Conditions:
The benefits of this policy will not be payable for any loss
caused by a preexisting condition during the first 12 months the policy is in
force. After this 12-month period, however, loss due to such conditions will be
payable unless specifically excluded from coverage. This 12-month period is
measured from the effective date of coverage for each insured person. A
preexisting condition means a specified critical illness that is diagnosed or
treated within 12 months prior to the effective date of coverage for each
insured person. Conditions which are: (a) fully disclosed to us on the
application and (b) not excluded or limited by us are not considered
preexisting conditions.
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