Critical Illness
Baldwin County Schools offers a critical illness benefit through MetLife that provides a monetary benefit to help with the out-of-pocket medical and non-medical expenses upon diagnosis of a covered illness. Critical illness insurance helps you and your family maintain financial security during the recovery period of a serious medical event, such as cancer, heart attack, or stroke. This plan pays a benefit if the initial diagnosis for a covered illness is while the certificate is in force.
Coverage amount for employees and spouses are available in $5,000 increments, as follows:
Employee: $5,000, $10,000, $20,000, $30,000, $40,000, or $50,000
Spouse and Child(ren) (up to age 26): 50% of the employee amount (employee must be enrolled in coverage to elect spouse/child coverage)
There are no health questions when enrolling in this benefit. Additional information on the plans is below.
Features
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Benefits are paid in addition to any other insurance that you may have, and benefits are paid directly to you
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This plan pays a benefit if the initial diagnosis for a covered illness is while the certificate is in force. (See certificate for complete details.)
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This plan could may pay multiple times for the same or different covered conditions
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Benefits may be used however you'd like. Typical uses include:
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Out-of-pocket medical and non-medical expenses
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Home healthcare needs and home modifications
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Recovery and rehabilitation
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Child care or caregiver expenses
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Travel expenses to and from treatment centers
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Wellness Benefit Included
The voluntary Critical Illness plan includes a wellness benefit for covered preventive screenings, including but not limited to:
- Annual physical exam, biometric screening, or stress test on bicycle or treadmill
- Blood test for triglycerides, CEA, bone marrow, CA 15-3 (breast cancer), fasting glucose, Hemoglobin A1C
- Chest x-ray, mammograms, breast ultrasound, sonogram, MRI
- Serum testing for cholesterol levels (HDL & LDL) or protein electrophoresis (myeloma)
- Routine dental or vision exam
- Electrocardiogram or ultrasound screening for abdominal aortic aneurysms
- Colonoscopy, prostate-specific antigen testing, or pap smear
Wellness Benefit Amount
- Employee: $50
- Spouse: $50
- Child(ren): $50
- Maximum of once per per per insured
Simply submit your claim form along with proof of your screening to receive your screening benefit. Directions for submitting a claim are located on the Resources page.
| Covered Diagnoses and Conditions |
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| Benign brain tumor |
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Cancer
- Invasive: 100% - Non-invasive: 25% - Skin cancer: 5% $250 minimum |
| Coronary Artery Bypass Graft (CABG): 50% |
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Functional losses
- Coma - Loss of ability to speak, hearing, sight - Paralysis of 2+ limbs |
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Heart events
- Heart attack - Sudden Cardiac Arrest: 50% |
| Infectious diseases including COVID: 25% |
| Kidney failure |
| Major organ transplants |
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Progressive diseases
- ALS - Alzheimer’s - Multiple Sclerosis - Muscular Dystrophy - Parkinson’s Disease - Systemic Lupus Erythematosus (SEL) |
| Severe burns |
| Stroke |
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Childhood diseases incl but not limited to:
- Cerebral Palsy - Cleft lip or palate - Cystic Fibrosis - Type 1 Diabetes - Down Syndrome - Sickle Cell Anemia - Spina Bifida |
