Aetna Critical Illness Plan
The Aetna Critical Illness Plan pays cash benefits when a doctor diagnoses you with a covered serious illness or condition, like heart attack, stroke, cancer and more. Benefits can help you pay towards your medical plan's deductible, coinsurance or other everyday expenses. Benefits are paid as a percentage of the Face Amount, which is the maximum fixed dollar amount you could receive for each Critical Illness benefit. The Face Amount for your spouse and each of your dependents is a percentage of the Face Amount. For more details, including exclusions and limitations that apply, review the Aetna Critical Illness Plan Summary.
You do not need to be a member of the Carilion Clinic Medical Plan with Aetna in order to be eligible to enroll in the Aetna Critical Illness Plan. As long as you are in a full-time or regular part-time position, you are eligible to enroll in the plan. The enrollment is guaranteed, and no health history forms must be completed for enrollment. You can enroll during open enrollment, as a new hire in a full or regular-part time position, or if your experience a qualifying event.
You cannot have double coverage, which means if your spouse works for Carilion Clinic, you cannot both cover each other on this plan.
There are premium rates for tobacco and non-tobacco users. The tobacco status is based soley on the employee's use of tobacco products and not any covered dependents use of tobacco products.
There are three face value amounts to choose from: $10,000 "low", $20,000 "middle" or $30,000 "high". If you enroll a dependent under the Critical Illness Plan, they are eligible for 50 percent of the face amount the employee has enrolled in. Please review the plan summary for details on payment amounts for eligible claims.
Your premiums are based on your age at the start of the plan (calendar) year, even if you enroll during a qualifying event or outside of the annual open enrollment. An example is, you are hired on April 1 and enroll in the Critical Illness Plan. You had a birthday in March, prior to enrolling in the plan. Your premiums are based on the age you were in January of that same year.
Filing a claim is easy. Create or log into your account on the Aetna member website. Click "Report New Claim" and answer a few questions. If you are enrolled in the Carilion Clinic Medical Plan, Aetna will automatically retrieve any medical information needed to process your claim. If you are not enrolled in the Carilion Clinic Medical Plan, you will need to attach an itemized statement when filing your claim. You can also file a claim through the Aetna app on your mobile device. If your claim is approved, Aetna will mail you a check or directly deposit funds into your bank account, if you've enrolled in direct deposit.
If you no longer work for Carilion or are no longer eligible for the Critical Illness Plan, you can continue your coverage by pay premiums directly to Aetna. The plan design and premiums will be the same as the Carilion group plan. To continue coverage, please fill out and return a portability form to Aetna. Portability forms can be found at www.myaetnasupplemental.com at the bottom of the log in page under "Printable Forms". You can also call Aetna's Customer Service department within 30 days from your separation date with questions. or to request a paper form toll free at 800 607-3366, Monday -Friday, 8 AM - 6 PM in all time zones.
