What does critical illness protection cover?
Guardian Direct covers 4 categories of life-changing illnesses. Click on each to view coverage details.
Heart & Vascular Conditions
Heart & Vascular Conditions
Covers heart attack, stroke (brain cell death due to a blockage), heart failure requiring a transplant, or arteriosclerosis (hardening of the arteries) requiring intervention.
Covers invasive cancer (cancer that has spread), cancer in situ (cancer confined to the location of origin), or a benign brain tumor. Note that skin cancer is not covered.
Covers kidney failure requiring either dialysis or a transplant.
Other Major Organ Failure
Other Major Organ Failure
Covers other major organ failure requiring a transplant, including both lungs, liver, pancreas or bone marrow.
See the Shopper's Guide to Cancer Insurance (last accessed 2019), provided by the National Association of Insurance Commissioners, to see if cancer insurance is right for you.
About critical illness protection
Critical Illness Protection Plus is a lump sum cash benefit payable directly to you after diagnosis of a serious illness. The cash benefit supplements your existing medical insurance and is usable in any way you choose, including to offset deductibles or copays, travel to treatment centers, household expenses, or even for experimental treatments.
How it works
Guardian Direct offers financial relief after you or a loved one receives a Critical Illness diagnosis.
After you or a family member are diagnosed with a critical illness, you present the diagnosis to Guardian for verification.
Cash Benefit Received
Guardian pays a lump sum cash benefit directly to you -- not to doctors or hospitals -- based on the verified critical illness diagnosis (no waiting period, no deductible, no lengthy process, no extra steps).
Pay any bills you choose, from deductibles, copays and coinsurance to transportation to treatment centers to mortgage, groceries and childcare expenses or even to experimental treatments not covered by your medical insurance.
Who is eligible?
Determine if you are a good candidate for Guardian Direct Critical Illness Protection Plus before you apply.
Good candidates typically:
are in excellent health
have no pre-existing critical conditions
are under 65 years of age
have medical insurance
Good candidates do not have a history of:
cancer or tumors
AIDS, HIV+ or other blood disorders
chronic or progressive organ diseases
During quoting and checkout you will be asked some brief questions about your medical history to better
assess whether you would be eligible.
Frequently Asked Questions
Questions about Guardian Direct Critical Illness insurance? We've got answers.
Individual Critical Illness insurance products are underwritten by The Guardian Life Insurance Company of America, New York, New York. Products are not available in all states. Policy limitations and exclusions apply. The actual limitations and exclusions that apply to your Critical Illness Plan are governed by the policy forms approved for use in your state. Please refer to your policy for a complete list of limitations and exclusions. In the event of a conflict between this document and the language stated in your Guardian insurance policy, the language of the policy shall control. This policy provides limited benefits only.
Rates are guaranteed for one year for your policy of benefits initially selected. Policies renew annually up to age 75.
Critical Illness Individual Policy Form IP-CI-16 et. al.
New Mexico Residents - Important Notice
The coverage provided under your benefits plan or policy underwritten by Guardian is limited in nature and may not provide financial protection for significant costs that you could incur for the diagnosis or treatment of COVID-19 ("Corona virus") related illness.
If you do not have comprehensive major medical coverage, in addition to the plan or policy issued by our company, you may incur significant uninsured medical expenses associated with the diagnosis and treatment of illness caused by COVID-19.
Major medical plans offer robust consumer protections, and are required to waive all deductibles, co-pays and other cost sharing expenses for the diagnosis or treatment of COVID-19 related illness. Your policy or plan with us is not a major medical plan and does not provide such protections.
If you do not have major medical coverage, you may:
1. Contact a licensed insurance broker or agent to see about major medical coverage availability.
2. To see if you are eligible for a special enrollment period for major medical coverage through the New Mexico Health Insurance Exchange, contact beWellnm toll-free at 1-833-862-3935.
3. To see if you are eligible for Medicaid coverage and to complete an application, please call the Human Services Department's Medicaid Expansion Hotline toll-free at l-855-637-6574 or visit https://www.yes.state.nm.us/yesnm/home/index.
4. To see if you are eligible for high risk pool coverage, please contact the New Mexico Medical Insurance Pool (the "High Risk Pool") at 1-844-728-7896 or https://nmmip.org/. If you are uninsured and have a COVID-19 diagnosis, your condition qualifies you for Pool coverage.
The Centers for Disease Control and the New Mexico Department of Health each have websites with considerable information on COVID-19. Visit each website at https://www.cdc.gov/ or http://cv.nmhealth.org/. Individuals who have symptoms consistent with COVID-19 should immediately call the NM Department of Health at 1-855-600-3453.
Information on the approved state and product specific online enrollment form numbers can be viewed here: Online Enrollment Form Numbers