What is critical illness cover in health insurance? It is a type of insurance that pays a monetary benefit if the insured is diagnosed with a condition that is in the insurance policy’s predefined critical illnesses list.
Critical illnesses are life-threatening ailments that often require intensive, extensive and prolonged medical treatment. Consequently, someone who has been diagnosed with a critical illness is expected to incur considerable medical expenses that typical health insurance plans may not sufficiently cover.
The specific conditions covered by critical illness insurance plans vary among policies and insurance companies. They may include but are not limited to the following:
Stroke
Heart attack
Chronic kidney disease
Diabetes
Chronic obstructive pulmonary disease
Hypertensive heart diseases
Alzheimer’s disease
Parkinson’s disease
Blindness
Deafness
Brain injury
Meningitis
Carcinoma-in-situ
Coma
End-stage liver disease
Poliomyelitis
Vegetative state
Aphasia
Benign brain tumour
Health Insurance vs. Critical Illness Insurance
Doesn’t a health insurance plan already cover critical illnesses? If you already have health protection, should you still consider getting critical illness insurance? It depends.
If your medical insurance in the UAE has an annual medical limit greater than AED 7 million and does not limit critical illness inclusions or exclude critical illnesses, you probably don’t need to obtain a separate critical illness cover. However, consider getting critical illness insurance if your health plan has a low limit and excludes critical illnesses.
How Does a Typical Health Insurance Plan Work?
Health insurance plans protect against unexpected illness or injury by providing you with the means or capacity to obtain medical treatment. They may pay for in-patient and out-patient expenses, including hospital accommodation, diagnostic procedures, surgeries, medication, and doctor’s fees.
Comprehensive medical insurance typically covers critical illnesses but is subject to contestability periods, pre-existing clauses and other policy terms and conditions. Additionally, claims made for critical illness care and treatment are allowed only up to the policy’s annual medical limit. Some policies also set individual limits on specific medical conditions and procedures.
How Does Critical Illness Insurance Work?
While health insurance plans allow you to charge medical expenses to your policy and against your annual medical limit, critical illness insurance plans pay out a lump sum if you are diagnosed with one of the policy’s predefined critical illnesses.
If you’re diagnosed with ischemic heart disease and your critical illness insurance covers it, you can file a claim for it. Upon confirmation, validation and qualification of your claim, the insurance company will pay you your critical insurance benefit.
Critical illness protection may exist as a:
Stand-alone policy
An included benefit (e.g., life insurance policy with critical illness cover)
An insurance rider
Excellent term life insurance policies have critical illness benefits built in. If your life insurance does not cover critical illnesses, consider adding it as a rider. This means additional premium payments for the add-on benefit. You can also get a stand-alone critical illness insurance policy, if available.
How about health insurance? If your health plan does not cover critical illnesses, limits protection to only a few conditions, or has a low annual medical limit, consider getting stand-alone or add-on critical illness insurance.
How Important Is Critical Illness Insurance?
Do you need critical illness insurance? You may not need it now, but you will be thankful you have it if you ever need it in the future.
No one wishes to be critically ill, but what will you do if that happens? It’s certain you will feel the immense financial burden of its absence.
1. Financial Protection
A heart bypass surgery may cost greater than AED 110,000. Thrombectomy for a stroke may set you back more than AED 50,000. One cycle of chemotherapy costs between AED 300,000 and AED 400,00 – and you need approximately four to eight cycles, so that’s a bill of approximately AED 3.2 million in the upper ranges.
The above figures do not even include the cost of diagnostic procedures, rehabilitation and post-operative care. You’ll also need to figure in the price of hospital stays, nursing care, laboratory procedures, and other miscellaneous expenses leading to and resulting from treatment.
This is why critical illness insurance is essential. It protects you against the financial burden of getting treated for a critical illness.
Without a critical illness benefit, you must use your savings to pay your medical bills using your savings. You may even have to liquidate your assets to pay for your treatment.
2. Wage Protection
Critical illness benefits can replace or at least mitigate lost wages.
If you become critically ill, you must take extended leaves of absence at work. While on leave, you will need funds to tide you and your family over until you are well enough to return to work. The benefit payment from your critical illness insurance policy will provide these much-needed funds.
3. Quality of Life Protection
If you’re diagnosed with a critical illness but don’t have insurance for it, what will happen? You will use your savings or liquidate your assets to pay for your treatments. You may even have to borrow money from friends, family and your bank.
Once you become well, you will have to face the prospect of rebuilding your finances and paying off your debts. Worse, if something goes wrong and you fail to make it, you will leave your grieving family much worse off financially.
Without savings or properties (your bereaved spouse paying off loans while taking care of day-to-day expenses), your family will not be able to maintain the lifestyle they are accustomed to. Your loved ones’ quality of life will decline.
If you have critical illness insurance, none of that has to happen. Your insurance benefit will pay for your medical bills. You and your family can remain debt-free and live comfortably.
4. Peace of Mind
If you become critically ill, you will have to decide whether to get treated or not. Thinking about the costs, you may opt for no treatment. Even if you have the means, you may choose not to undergo life-saving procedures to ensure your medical bills won’t leave your family destitute.
You won’t have to make this painful decision if you have critical illness insurance. You’ll have peace of mind as you undergo all necessary procedures because you know your insurance will cover your bills.
Get Critical Illness Cover
Critical illness insurance pays a benefit if the insured becomes critically ill, as long as the policy covers the condition. It is distinct from health insurance and perfectly complements life insurance products.
Get critical illness insurance if you want protection against medical bills and wage loss and to protect your peace of mind and your family’s lifestyle.
HAYAH is a licensed and regulated insurance company in the UAE. We provide life insurance, medical insurance, and savings and pension plans for individuals and businesses. Talk to us about our life insurance with critical illness insurance coverage.