What Illnesses are Covered by Critical Illness Insurance? Here’s What to Expect

Dealing with health problems is never easy, but the right insurance can help. If you are diagnosed with a covered illness, critical illness insurance provides a lump sum payment. This payment can be used however you see fit: paying off medical bills, making up for missed wages, or anything else you need. Before you buy a critical illness insurance policy, however, it’s important to understand which illnesses it covers.

Critical illness insurance policies define “critical illness” very narrowly. The illnesses that are covered will be listed in the policy. Illnesses that are not listed will not be covered. Additionally, the illnesses that are covered may be subject to restrictions exclusions. As just one example of a possible restriction, many policies will exclude pre-existing conditions for a set period of time. Additionally, within a broad category of illness, certain other restrictions may apply.

Not all critical illness insurance policies offer the same coverage. Some will cover a broader range of illnesses than others. Despite these variations, critical illness insurance policies typically include coverage for the following illnesses. Other illnesses may be covered as well. 


Every year, 23.2 million adults in the United States are diagnosed with cancer, and 9.4 percent of the adult population has been diagnosed with cancer at some point.

Although we often talk about cancer as if it were a single illness, there are actually more than 100 different types of cancer. The treatments and prognoses vary significantly depending on the type of cancer involved. Critical illness insurance policies typically cover certain types of cancer, but read the policy for restrictions. 

Heart Attack or Coronary Bypass

Approximately 28.2 million adults in the United States, or 11.5 percent of the population, have been diagnosed with heart disease. It is ranked as the number one cause of death.

When an artery is blocked, blood flow is blocked, and a heart attack occurs. In some cases of heart disease, coronary bypass surgery is needed to unblock an artery and improve blood flow. Critical illness insurance policies often cover heart attacks and coronary bypass surgery.


A stroke can occur when one of two things happens: blood supply to the brain is blocked or a vessel in the brain bursts. This is a serious medical event that can lead to physical and cognitive problems. Approximately 7.8 million adults in the United States have experienced a stroke.

Kidney/Renal Failure and Organ Transplant

Kidney failure is a serious condition in which the kidneys stop functioning properly. Kidney transplant and dialysis are the primary treatments for end stage renal disease. Approximately 5.1 million adults in the United States have kidney disease, which is ranked as the ninth leading cause of death. 

Critical illness insurance policies often cover kidney failure and end stage renal disease. Other medical conditions requiring organ transplant may also be covered.

Read Your Policy

It is important to read your policy carefully to understand the restrictions that apply. Because policies vary, you should also compare plans to find the one that is most suited to your needs. A licensed insurance agent can help you through this process.

Want to learn more? Get a critical illness insurance quote.