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ManipalCigna ProHealth Prime Advantage Plan: Overview
Buying health insurance that provides 360-degree coverage against medical emergencies for you and your family is essential today. ManipalCigna ProHealth Prime Advantage is a plan that covers OPD expenses such as consultation, diagnosis, and pharmacy. Additionally, the plan offers the freedom to choose any room category during hospitalization, covers cashless non-medical expenses, and provides annual health check-ups from the first policy year, irrespective of previous claims.
The ManipalCigna Prime Advantage plan is a variant under the ManipalCigna ProHealth Prime health plans. The other two variants are Prime Protect and Prime Active.
Relationships Covered
For Individual Plans
- Self
- Spouse
- Children
- Parents
- Parents-in-law
- Son-in-law
- Daughter-in-law
- Grandparents
- Grandchildren
- Uncle
- Aunt
- Nephew
- Niece
- Brother
- Sister
For Family Floater Plans
- Self
- Spouse
- Children
- Parents
A floater cover can insure a maximum of 2 adults and 3 children under a single policy.
Key Features of ManipalCigna ProHealth Prime Advantage Plan
The ManipalCigna ProHealth Prime Advantage plan offers policyholders enhanced OPD coverage and zero deductions for non-medical expenses (e.g., nursing, consultation, diagnosis, drugs). Key features of this plan include:
- Unlimited restoration of the sum insured, up to 100% of the base Sum Insured (SI).
- Option to switch off the policy for up to 30 days while traveling abroad, with a discount on premium renewal.
- One-year premium waiver if diagnosed with a critical illness or in case of accidental disability.
- Freedom to choose any room category, including suites, during hospitalization.
Additional Major Benefits
This comprehensive health plan offers additional major benefits:
Better Care
- Annual health check-ups from the 1st policy year.
- Wellness programs.
- Earn rewards up to 20% of the base premium on renewal by meeting pre-defined walking step limits.
Base Covers
- In-patient
- Out-patient
- Pre and post-hospitalization
- Modern treatment
- Road ambulance
- Donor expenses
- Air ambulance
- Bariatric surgery
- Daycare procedures
- Domiciliary treatment
- Daily cash benefit for shared room accommodation
- AYUSH treatment
- And more
Value-Added Covers
- Enhanced health support including domestic second opinion for up to 36 critical illnesses.
- Unlimited teleconsultations.
- Up to 200% cumulative bonus on SI.
- Switch-off premium benefits.
- Wellness tracking.
Optional Covers
- Coverage for non-medical expenses up to SI.
- Personal accident cover (twice the plan's SI, up to INR 50 Lakh, for accidental death/disability/PPD).
- Deductible option (aggregate of all claims in a policy year).
- Cumulative bonus booster.
- Infertility treatment cover.
- Critical illness add-on cover.
Optional Packages
A bundle of additional benefits to extend support beyond the base plan's coverage. Options available with the Prime Advantage health plan:
| Package Options | Coverage Benefits |
|---|---|
| Enhance | Maternity expenses, newborn cover, 1-year vaccination charges, necessary medical termination of pregnancy (covered up to two pregnancies in a lifetime, applicable at 10% SI on each delivery, up to INR 1 Lakh). |
| Newborn care coverage for delivery complications, post-partum health support, and baby's healthcare up to 91 days from delivery. | |
| Freedom to opt for any room category, including suites or private rooms. | |
| Freedom (for Indian residents only) | Choice of best rooms for comfort during hospitalization and treatment. |
| Worldwide emergency hospitalization with out-patient coverage for emergency treatment outside India. |
Waiting Periods
Waiting periods for this plan vary by condition:
- For specified diseases: 24 months
- For pre-existing diseases: 36 months for Sum Insured up to INR 5 Lakh; 24 months for Sum Insured INR 7.5 Lakh and above.
- Bariatric surgery & Maternity treatment: 36 months
- ManipalCigna Critical Illness add-on cover: Initial waiting period - 90 days; Survival period - 30 days.
How to Claim ManipalCigna Prime Advantage
To avail of claim settlement services, follow these steps:
- Visit the official website of ManipalCigna Health Insurance.
- Click on the 'Claim' button in the header, then navigate to 'Raise a claim' > 'Proceed to raise a claim'.
- For claim intimation, fill out the pre-authorized form on the official website with your date of birth and policy number, then 'Submit'.
- You can call the toll-free number 1800-102-4462 or email [email protected] for claim settlement procedure information.
- Reach out to PolicyX.com for further assistance.
Inclusions
Here are the detailed benefits of the ManipalCigna Prime Advantage Health Insurance Plan:
- Your plan's coverage restores its sum insured value up to 100% upon exhaustion of any claim made in the policy year. This safeguards you and your family in case of related or unrelated illnesses. Unlimited restoration is applicable only after the second claim and onwards.
- Policyholders can switch off their health insurance for up to 30 days if they are traveling abroad.
- Policyholders can avail of a one-year premium waiver if diagnosed with any critical illness listed in the policy schedule or in case of death. This provides peace of mind regarding future medical and financial protection for their family.
- The plan provides access to advanced medical treatments such as mental illness, medically necessary bariatric surgery (up to SI, maximum INR 5 Lakh), HIV/AIDS, and STDs.
- All premiums paid towards the ManipalCigna Prime Advantage Plan are eligible for tax benefits under Section 80D of the Income Tax Act, 1961.
Exclusions
This policy schedule lists the following exclusions:
- Hazardous/adventure sports, nuclear wars, defensive attacks.
- Breach of law, alcoholism, drug, or substance abuse.
- Unproven/experimental treatments.
- Suicide or attempted suicide.
