Network hospitals
8500+
Incurred claim ratio
99.96%
Sum insured
Up to 3 Cr
No. of Plans
1
Solvency Ratio
1.5
Pan India Presence
77+
Buying health insurance that provides you and your family a 360-degree coverage against medical emergencies is the need of this hour. ManipalCigna ProHealth Prime Advantage is a plan that covers OPD expenses like consultation, diagnosis and pharma. Apart from this, the plan gives you the freedom of choosing any room category at the time of hospitalisation, covers cashless non-medical expenses, and annual health check-ups from the first year of policy issuance irrespective of the claims you’ve raised previously in the same year.
ManipalCigna Prime Advantage plan by ManipalCigna Health Insurance Company is a subsidiary plan type under the ManipalCigna ProHealth Prime health plans. The other two plan variants under the ManipalCigna ProHealth Prime plan are- Prime Protect and Prime Active.
The plan covers relationships as:
For Individual plans: Self, Spouse, Children, Father, Mother, Father-in-law, Mother-in-law, Son-in-law, Daughter-in-law, Grand-parents, Grandchildren, Uncle, Aunt, Nephew, Niece, Brother, Sister
For Family Floater plans: Self, spouse, children and parents. A floater cover can insure a maximum of 2 adults and 3 children under a single policy
The plan variant ManipalCigna ProHealth Prime Advantage promises to provide its policyholders with better coverage of escalation to OPD, and zero deductions towards non-medical expenses (nursing, consultation, diagnosis, drugs, etc). Furthermore, you can avail of the better control mechanism under this plan which says;
This all-rounded health plan is not limited to just these benefits, here are other major benefits of the plan as well:
Package options | Coverage benefits |
---|---|
Enhance | Maternity expenses, newborn cover, 1-year vaccination charges, necessary medical termination of pregnancy, etc (covered up to two pregnancies in the whole lifetime, applicable at a rate of 10% SI on each of the two deliveries up to INR 1 Lakh. |
Newborn care coverage under which any kind of delivery complications, and post-partum health support against any complications along with the baby’s healthcare up to 91 days from the day of delivery is borne by the insurer. | |
Room accommodation is a great convenience with this optional package as you get the freedom to opt for any category of room including suite, private room, etc according to your choice. | |
Freedom (only applicable to Indian residents) | Opt for the best rooms for your best comfort during hospitalisation and treatment of a disease. |
Worldwide emergency hospitalisation with an out-patient coverage benefit allows the insured to receive out-patient treatment in a situation of emergency outside India. |
To understand ProHealth Prime Advantage Insurance in detail, take a look at the below table:
18 years to No Max Limit
Individual and Family Health Insurance
5 L | 10 L | 25 L | 50 L | 1 Cr
30 Days
Lifelong
1/2/3 years
*Initial Waiting Period is the time period between the issuance of the policy and the time it starts actively. During this period, a policyholder has to wait to avail of the benefits offered under a health insurance plan.
Read more specifications in the brochure.
With wide coverage options available, ProHealth Prime Advantage Insurance Plan allows you to choose your ideal coverage as per your family’s health requirements. Take a look at the coverage under every SI option available and choose your ideal coverage:
Room Rent
Covered
ICU Charges
Covered
Pre-Hospitalization
Covered
Post-Hospitalization
Covered
Domiciliary Hospitalization
Covered
Daycare Treatment
Covered
OPD Charges
Covered
COVID-19 Treatment
Covered
Cataract
Covered
No Claim Bonus
Covered
Automatic Restoration
Covered
Daily Hospital Cash
Covered
Organ Donor
Covered
Maternity Cover
Covered
New Born Baby Cover
Covered
AYUSH Treatment
Covered
IVF Treatment
Covered
Modern Treatment
Covered
Ambulance
Covered
Air Ambulance
Covered
Compassionate Travel
Not Covered
Global Coverage
Covered
E-Consultation
Covered
Health Check-Up
Covered
Second Medical Opinion
Covered
Vaccination
Covered
Co-payment
Not Covered
Sub-limits
Not Covered
The room rent limit is the maximum bed charge you can claim if you are hospitalised. Common Room categories covered under room rent are all kinds of rooms including single, private and AC rooms (except suite).
It is a special hospital department where patients with serious medical conditions are treated.
Medical expenses incurred before hospitalisation of the policyholder.
Medical expenses incurred after the discharge of the policyholder from the hospital.
Domiciliary hospitalization or home care treatments are the arrangements for an insured individual due to the unavailability of medical amenities in hospitals, or in a case where an insured member can not be admitted to the hospital due to an inability. The treatment should last equal to or more than 72 hours to get financial coverage.
Treatments that can be completed within 24 hours of hospitalization like blood dialysis, cataracts, etc.
Covers the cost of doctor consultations and prescribed medical tests that may not require hospitalization. .
It includes the treatment cost for COVID-19 with a confirmative diagnosis from a government-approved centre.
A common eye condition in which your vision gets blurred due to cloudy formation in your eyes.
For every claim-free year, insurance companies reward policyholders with an increase in the sum insured amount as a no-claim bonus or cumulative bonus on policy renewal. However, in the case of a claim, this bonus amount either lapses or is reduced by a certain percentage varying from one plan to the other.
It is a benefit in which an insurance company restores the amount of sum insured completely or up to a certain percentage after it gets fully exhausted in treatments. This restoration amount may vary from one plan to the other.
Daily hospital cash or Hospicash is a cash amount that you receive each day during the time of hospitalization to cover your non-medical expenses.
It is a cover that includes the cost of the procedure for removing the damaged or malfunctioning organs from the body. In most of the cases, the insurer pays for the hospitalization and transplant expenses for both the parties i.e. the donor and the receiver.
It refers to the cover that includes expenses for normal and c-section deliveries.
It takes care of the medical expenses that arise due to the hospitalisation of the newborn baby in case of any childbirth complications, medical challenges, and so on. Some of the common treatments that are covered under the newborn cover and these common treatments can vary from plan to plan:
Refers to the cost of medicines and procedures used under AYUSH (Ayurveda, Yoga & Naturopathy, Unani, Siddha, and Homeopathy) treatment.
In Vitro Fertilization (IVF) is a method of assisted reproductive technology. The common expenses incurred under IVF and infertility treatments are settled or reimbursed for:
Medical treatments that demand the use of modern technology and advanced machinery such as robotic surgeries, stem cell therapy, etc.
An ambulance is used to move the patient from home to the hospital, transfer them to another hospital, and take them for different tests outside the hospital.
Air ambulances are specially prepared planes that transfer the patient from one place to another in case of a health emergency.
Refers to the travelling expenses of a family member who’s visiting the hospital to look after the patient when the policyholder gets admitted to a hospital outside his/her residential city.
Any kind of medical/health emergency when you are outside of India is covered for hospitalization expenses, modern and specific treatments, etc.
If a policy offers e-consultation it allows policyholders to connect with a doctor for medical consultation through video chat, audio call, or chatbot.
A facility where the policyholder can avail of free health check-ups after fulfilling the company's eligibility criteria. In most cases, the insured member/s gets an annual health check-up cover.
If the policyholder wants, they may opt for a second medical opinion wherein the policyholder can consult another doctor within the company’s network of medical practitioners.
Coverage against the expenses incurred on vaccinations of either the newborn baby, for an animal bite, etc is provided by the insurance companies.
In the co-payment clause, policyholders have to pay a preset amount (either compulsorily or voluntarily) of the hospitalisation expense on their own and the insurer will pay the rest of the medical bill amount.
Sub limit is a condition in which the insurer will have to pay the medical expense up to a certain percentage and the remaining amount will have to be paid by the policyholder. For instance, if your policy covers room rent for upto 20% of the sum insured, but the expense of the same is more than 25%, you will have to pay the rest amount, i.e. 5%, for your room rent.
Waiting periods for this plan vary from condition to condition, like:
To avail of claim settlement services, the insured individual must follow the process below:
ManipalCigna Health Insurance Network Hospitals are present in 31 states nationwide. With a wide network of hospitals, ManipalCigna Health Insurance ensures that you are medically secured, irrespective of the city you reside in.
Read below to know in detail about the benefits of ManipalCigna Prime Advantage Health Insurance Plan:
Your plan’s coverage gets activated to restore its sum insured value stretching up to 100% on exhaustion of any claim made in the policy year. It happens to safeguard you and your family anytime in case of a related or unrelated illness. Given that, the unlimited restoration of the sum insured is applicable only after the 2nd claim is raised and onwards.
The policyholder is allowed to switch off their running health insurance for up to 30 days, in case they’re travelling abroad.
The policyholder can avail of a waiver of premium benefit under this plan for one year if diagnosed with any of the listed critical illnesses, mentioned as per the policy schedule, or in a case of death. This helps them to stay worry-free about their family’s medical and financial protection in the future.
The plan gives you access to advanced and modern-day medical treatment such as mental illness, medically necessary bariatric surgery (up to SI, subject to INR 5 Lakhs maximum), HIV/AIDS, and STDs.
All the premiums paid towards the ManipalCigna Prime Advantage Plan are eligible for tax benefits under Section 80D of the Income Tax Act, 1961.
This policy schedule has some exclusions that are mentioned below:
Hazardous/adventure sports/nuclear wars, defensive attacks, etc
Breach of the law, alcoholism, drug, or substance abuse cases, etc
Unproven/experimental treatments
Suicide or an attempt to suicide
To cater to the different medical needs of an individual & their family, ManipalCigna Health Insurance offers several Health Plans ranging from senior citizen plans to specialized plans for autistic children, to health insurance for cardiac patients, and many more.Take a look below to ManipalCigna Health Insurance plans explore more:
Individual and Family Health Insurance
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Group Health Insurance
ManipalCigna ProHealth Group Insurance Policy has been designed to provide more extensive and better insurance solutions to employer-employee and non-...
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ManipalCigna Health Insurance Company offers its Critical Illness policy which is also a global plan that assures you financial support during critica...
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Base health plan ManipalCigna Prime Advantage has multiple coverage benefits including - in-patient, out-patient, pre and post-hospitalisations, modern treatment, road ambulance, donor expenses, air ambulance, bariatric surgery, daycare procedures, domiciliary treatment, daily cash benefit on shared room accommodation, AYUSH treatment, and others.
You are eligible to buy value-added covers, optional packages, optional covers, critical illness rider add-ons, and much more with your base Prime Advantage health plan by ManipalCigna.
Yes, daycare procedures are covered up to the sum insured under this plan.
If you have the Prime Advantage plan, you can avail of health reward benefits which reflect on the renewal premium of your policy. If the policyholder walks from 6,000 to 10,000+ steps daily for up to 120 to 240 and above days, they are eligible to get up to 5% to 20% discounts on the premium renewal.
Yes. Lump sum payment up to 100% of the Sum Insured, if opted is covered under the add-on ManipalCigna Critical Illness cover.
Waiting periods for this plan vary from coverage to coverage, like:- For specified diseases- 24 months For pre-existing disease- For sum insured up to INR 5L is 36 months; For sum insured INR 7.5L and above is 24 Months Bariatric surgery & Maternity treatment- 36 months ManipalCigna Critical Illness add-on cover- Initial waiting period - 90 days and survival period- 30 Days
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Lives In: Delhi, NCR Expertise: Health & Term Insurance Simran has an experience of 4 years in content writing. She transitioned from hospitality and digital marketing to the insurance industry after her emerging interest in how vast insurance is. With her ability to write complex insurance concepts in a simple, relatable manner, she keeps her audience hooked and solves their doubts smoothly.
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