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Med+Max tm Critical Illness |
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The Need for Critical Illness Insurance All members that enroll into any Med+Max Health Insurance Plan will be automatically covered for Critical Illness Insurance (members only, optional coverage available for dependants at additional cost). Coverage Critical Illness Diagnosis If an insured person is diagnosed with a critical illness, listed below, by a physician, the Company will pay a benefit subject to the Benefit Payment Conditions and Schedule of Benefits of the plan selected. Once a 100% of the maximum benefit amount has been paid for an insured person, coverage terminates and no further benefits are payable to that insured person. Life Threatening Cancer Pays benefits if an insured person is first diagnosed with life threatening cancer more than 90 after the person’s effective date of coverage. (The benefit is 10% payment after 30 days and before 90 days.) Heart Attack Pays benefits if an insured person is first diagnosed as having suffered a heart attack more than 30 days after the person’s effective date of coverage. Kidney (Renal) Failure Pays benefits if an insured person is first diagnosed with having suffered kidney (renal) failure more than 30 days after the person’s effective date of coverage. Stroke Pays benefits if an insured person is first diagnosed with having suffered a stroke more than 30 days after the person’s effective date of coverage. Coma Pays benefits if an insured person is first diagnosed as being comatose more than 30 days after the person’s effective date of coverage. Coronary Artery Bypass Graft Pays 25% of the benefit amount if an insured person is first diagnosed with a condition that necessitates a Coronary Artery Bypass Graft and receives the Coronary Artery Bypass Graft more than 30 days after the person’s effective date of coverage. This benefit is paid once per lifetime. Loss of Sight, Speech or Hearing Loss of Sight, Speech or Hearing Pays benefits if an insured person is first diagnosed with loss of Sight, speech or Hearing more than 30 days after the person’s effective date of coverage. Major Organ Transplant Pays benefits if an insured person is first diagnosed with a condition that necessitates a Major Organ Transplant and receives that Major Organ Transplant more than 30 days after the person’s effective date of coverage. Paralysis Pays benefits if an insured person is first diagnosed as being paralyzed more than 30 days after the person’s effective date of coverage. Severe Burns Pays benefits, depending on the severity of the burn, if an insured person is first diagnosed with having suffered a Severe Burn more than 30 days after the person’s effective date of coverage. BENEFIT REDUCES AT AGE 65. Pre-existing conditions covered after 12 consecutive months of coverage. These are brief descriptions of the coverage available under the policy. The policies will contain limitations, exclusions and termination provisions. Certain benefits may not be available in all states. Dependant Coverage (Optional) These benefits are included with all the plans and provide primary Member coverage only. If dependant coverage is needed it is available as an extra cost option on a per dependant basis.
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