Almost Everything you’d Want to Know About Aflac’s Critical Illness Plan
We offer four Aflac plans: Life, Critical Illness, Accident, and Hospital Indemnity. While you might have a good guess at what each plan covers from the title alone, each one has their own set of benefits that you might not notice from a quick glance at the cover of a brochure.
The critical illness plan DOES pay you when you get critically ill, but it also pays you if you need a transplant, if you’re diagnosed with the same illness six months later, and also if you get certain routine health tests. The critical illness plan also automatically covers your children at no additional cost to you and provides them with additional coverage for specific child-facing diagnoses such as: cleft lip, cystic fibrosis, or type 1 diabetes.
How much is it? What do the different options mean?
The Critical Illness’s price varies based on the payout rate the policy holder chooses. Essentially you can decide if you want your policy to be worth between $10,000-$50,000. Your premium will go up with your policy’s value, and it also increases if you use tobacco.
For the current rate sheet please click here: https://www.sdpeba.org/benefits/active/aflac/critical-illness. And then click “Aflac Rates” on the right-hand side.
How does it Pay Out?
The critical illness plan is unique because payouts are based on the value of the plan you select and vary based on the type of claim you file. Essentially, you’ll receive a percentage of the “value” that you chose after submitting your claim. For example, if you need a bone marrow transplant, you’ll receive a 100% payout and get your plan’s full value. Whereas if you are diagnosed with a non-invasive form of cancer, you’ll receive 25% of your payout. Check your plan’s brochure for the specific values.
Diagnosis/Treatment
Value Payout
Cancer (Internal or Invasive) - 100%
Heart Attack (Myocardial Infarction) - 100%
Stroke (Ischemic or Hemorrhagic) - 100%
Limited Benefit Major Organ Transplant - 100%
Kidney Failure - 100%
Bone Marrow Transplant - 100%
Sudden Cardiac Arrest - 100%
Non-Invasive Cancer - 25%
Coronary Artery Bypass Surgery - 25%
Skin Cancer - $250
Mammogram - $200
Wellness Test (more info below) - $50
In order to receive your payout, you must submit a claim to [email protected]. If you need instructions on how to do so, click here.
Wellness
This plan features a “wellness” component that offers an annual payout of $50 for getting specific checkups in the form of “health screening” exams.
These exams are often related to the various diagnoses and qualifying events that offer a payout through the critical illness plan.
Critical Illness Wellness Tests
Mammograms offer a $200 payout annually and are separate from the other tests. This means that you can receive $250 just by getting a mammogram and any one of the other tests listed above. To reiterate, these tests only pay out once per calendar year. Meaning even if you get both a PCR COVID-19 Test and a Chest X-Ray you’ll only be able to submit one claim.
If you need instructions on how to submit a claim, click here.
How to Sign up and Important Notes
Aflac’s open enrollment period is during Open Enrollment. You can sign up for any of our four plans during this time. If you have Aflac specific questions you can always reach out to Will Stover ([email protected]) or Chris Judy ([email protected]), they can help get you set up, go over specific coverage, rates, and help you make the best decision when it comes to receiving care.
REMINDER. Aflac is not like a traditional health plan. You need to file a claim in order to receive benefits. No worries though, we’ll act as an intermediary between you and Aflac so it’s as simple as sending us a few emails detailing your illness and a pathology report signed by your doctor. You can find a guide we put together to help you through that process by clicking here.
Additionally, if you have any questions about what is or isn’t covered under the Aflac Critical Illness plan (or any of our other plans) feel free to email us at [email protected] or give us a call at 888-315-8027.