Critical Illness

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. This benefit 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 Critical Illness Coverage is provided under a separate policy, you also must apply for an Arkansas Blue Cross and Blue Shield individual health insurance plan to obtain it. Coverage is available to Arkansas Blue Cross individual health insurance policyholders and their covered spouses, age 19 through 64.

Important note: To be eligible for a Health savings Account (HSA), you cannot be covered by insurance other than an HSA-compatible plan. Our critical illness policy should be considered “other insurance.”

Affordable rates for Critical Illness Coverage:

  $10,000 $20,000 $30,000
Per Covered Person Non-Tobacco Tobacco Non-Tobacco Tobacco Non-Tobacco Non-Tobacco
19-29 $  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

The covered person’s coverage terminates when 100 percent of the Face Amount has been paid.

PRE-EXISTING CONDITIONS LIMITATIONS FOR CERTAIN CONDITIONS:
The benefits of this policy will not be payable for any loss caused by a pre-existing 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 pre-existing condition means a specified critical illness which 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 pre-existing conditions.

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%
Carcinoma in Situ** 10%

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:
    1. 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.
    2. 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.
    3. All hyperkeratoses or basal cell carcinoma of the skin.
    4. All squamous cell carcinomas of the skin unless there has been spread to other organs.
    5. Prostatic cancers which are histologically described as TNM Classification T1 (including T1(a) or T1(b), or of other equivalent or lesser classification).

* 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 (Policy Form CIP-BLCH [3-06]) referenced here.

**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 percent of the remaining amount payable.

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