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Guardian Critical Illness Protection Plus Gold

Coverage Summary
(see your policy for further details)
How it Works

Critical Illness Protection Plus is a lump sum benefit that can supplement your existing medical coverage.  It can help with expenses that medical insurance typically does not cover.  Upon diagnosis of a covered critical condition, you will be eligible to receive a lump sum payout as described in the schedule below. That lump sum can be used in any way you choose, including to offset deductibles, other out-of-pocket costs, or services such as experimental treatments.

Your Plan Benefits
Guardian Pays
% of $20,000 lump sum plan benefit
(see Certain Plan Limitations below)
Heart & Vascular Conditions
Heart Attack
100% 1st occurrence, 50% recurrence
Stroke
(acute cerebrovascular event)
100% 1st occurrence, 50% recurrence
Heart Failure
(requiring a transplant)
100% 1st occurrence, 50% recurrence
Arteriosclerosis
(with need for intervention)
30% 1st occurrence, recurrence not covered
(see policy for full list of coverage)
Cancer Related Conditions

Invasive Cancer is a cancer that has spread from its site of origin to adjacent tissues

Non-Invasive Cancer or Carcinoma in Situ is a cancer that is confined to the location from which it started, and has not spread to adjacent tissues

Invasive Cancer
100% 1st occurrence, 50% recurrence
Non-Invasive Cancer
30% 1st occurrence, recurrence not covered
Benign Brain Tumor
75% 1st occurrence, recurrence not covered
Skin Cancer
Not Covered
(see policy for full list of coverage)
Major Organ Failure

Other Major Organ Failure is the irreversible failure of both lungs, liver, pancreas, or bone marrow

Kidney Failure
(requiring dialysis or transplant)
100% 1st occurrence, 50% recurrence
Other Major Organ Failure
(requiring a transplant)
100% 1st occurrence, 50% recurrence
(see policy for full list of coverage)
Certain Plan Limitations
Multiple Critical Illness Conditions at the Same Time

When one Critical Illness condition causes or contributes to another Critical Illness condition, the plan benefit is limited to only one Critical Illness condition. The plan pays the greater benefit of the two Critical Illness conditions

Multiple Critical Illness Conditions in the Same Category

Plan benefit for multiple Critical Illness conditions in the same category (e.g., Heart Attack and Stroke) is limited to occurrences separated by at least 3 months

Recurrence

Plan benefit for a 2nd occurrence of the same condition is limited to an occurrence separated from the 1st occurrence by at least 6 months, during which you have not exhibited symptoms or received treatment (excluding preventive medications).  Additional occurrences beyond the 2nd occurrence are not covered

Pre-Existing Conditions

A pre-existing condition includes any condition for which you, during the 6-month period prior to coverage in this plan, consulted with a physician, received treatment, or took prescribed drugs

Plan benefit for pre-existing conditions is limited to occurrences at least 6 months following the coverage start date

Deductibles
What you pay out-of-pocket before your plan pays benefits
You Pay
There is no deductible

$0

Maximum Payouts
The maximum amount Guardian will pay per occurrence diagnosis
Maximum Guardian Pays
Lump Sum Benefit Amount $20,000
Ongoing Eligibility Requirements
Renewability

Coverage is renewable annually. Premiums will not change because of a change in your health.

Premiums may occasionally change, however, for all members of a class. If premiums change, you will receive at least 60 days advance notice

Exclusions
(see your policy for further details)

This Policy will not pay benefits for any Critical Illness caused by, or related to, directly or indirectly, any of the following:

  • That is not listed as a Critical Illness.  (Covered Critical Illnesses are summarized above and described in further detail in your policy.)
  • Participating in a felony, riot or insurrection.
  • Intentionally causing a self-inflicted Injury, while sane or insane. 
  • Committing or attempting to commit suicide, while sane or insane. 
  • Engaging in any illegal activity.
  • Caused by, contributed to by, or resulting from voluntary use of any poison, chemical, prescription or non-prescription drug or controlled substance unless:
    • It was prescribed for You by a Doctor, and
    • It was used as prescribed.  In the case of a non-prescription drug, this Policy does not pay for any Critical Illness resulting from or contributed to by use in a manner inconsistent with package instructions.  "Controlled substance" means anything called a controlled substance in Title II of the Comprehensive Drug Abuse Prevention and Control Act of 1970, as amended from time to time.
  • Arising from war or act of war, declared or undeclared.
  • For which Diagnosis is made outside the United States, unless the Diagnosis is confirmed in the United States.  In that case, the Critical Illness will be deemed to occur on the date the Diagnosis was made outside the United States.
  • That is diagnosed while the person is not covered by this Policy.
  • For which Diagnosis is made by a Doctor who is the Policyowner, his or her Spouse, child, parent, sibling or business associate.
  • For which Diagnosis is made while You are not alive, unless otherwise specified under Covered Critical Illnesses in your policy.

Critical Illness Insurance is underwritten by The Guardian Life Insurance Company of America, New York, NY. Products are not available in all states. Policy limitations and exclusions apply.  Those shown above are illustrative only.  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 plan documents for a complete list of limitations and exclusions. Plan documents are the final arbiter of coverage. 

Policy Form # IP-CI-16

#2017-43582 (exp. 7/19)