ManipalCigna ProHealth Insurance is a comprehensive health insurance plan that protects you and your family in the time of medical emergencies. The plan comes loaded with basic covers, value-added covers, and optional covers.
The plan offers 5 variants that allow the policyholder to choose as per their needs and requirements. The variants available are:
Read along to explore more about the plan:
|Minimum Entry Age||Child - 91 days, Adult - 18 years|
|Maximum Entry Age||No limit|
|Sum Assured||Rs. 2.5 Lakhs-1 Crore|
|Policy Tenure||1, 2 & 3 years|
|Relationship Covered|| Individual Plan: Self, spouse, children, parents, siblings, parents-in-law, grandparents, and grandchildren, son-in-law and daughter-in-law, uncle, aunt, nephew, and niece. |
Floater Plan: Self, spouse, children, and parents. A floater cover can insure a maximum of 2 adults and 3 children under a single policy:
**Last Updated on August, 2021
The plan is an ideal health plan if you are looking for 360 protection in case of a medical emergency. The plan comes with basic covers, value-added covers, and optional covers. Have a look at them:
The insurer will provide compensation for all the expenses related to hospitalization that was incurred by the insured at the time of illness, accident, or any injuries. All the expenses related to ICU charges, pharmaceuticals, diagnostic process, fees of medical practitioner fee, nursing fee, operation theatre expense, etc will be given due coverage.
The insured will get a reimbursed amount of expenses incurred 60 days before hospitalization which mainly include charges of medicines, drugs, medical tests, doctor consultation, physician, etc.
All the expenses incurred within the 90 days after getting discharged or relief from the hospital will be reimbursed by the insurer on submitting a claim.
When the insured is medically unfit and needs immediate transfer to the hospital then this emergency ambulance service can be availed up to Rs 3000 per hospitalization.
The insurer will also pay for the expenses when the treatment of the illness or any disease is taken at home due to the critical condition of the insured or the non-availability of the accommodation. The diseases treated should last for 3 days and the treatment is taken under the advice of an expert doctor.
Some of the illnesses get treated within 24 hours of a day on the advice of a doctor and expenses are paid by the insurer. Prohealth insurance includes more than 500 daycare procedures as listed in the policy.
This will cover the in-patient hospitalization expenses towards organ transplantation. The donor treatment for the extraction of the organ will be covered up to a percentage of the sum insured.
The expenses of deliveries took upon by the insured are covered by the insurer after a waiting period of 48 months. Insured can avail this coverage up to a maximum of 2 deliveries.
It covers the reasonable expenses devoted to the treatment of newborn babies up to 90 days after the delivery.
The vaccinations were taken for the newly born baby during the first year of childbirth. Vaccines for Hepatitis B, Measles, chickenpox, diphtheria, tetanus are essential for a baby to lead a healthy life.
In-patient treatment of any illness that happened on a foreign land away from Indian boundaries also gets coverage.
When the insured confronts the total exhaustion of the sum insured in previous claims, then he is left with an option to refill the sum insured. The refill option is applicable for one time during the tenure of the policy.
Under this, all necessary medical expenses can be covered which becomes inevitable by the insured. It will cover medical tests, preventative tests, drugs, prosthetics, dental treatments, medicines, etc.
The insured will be given the ease of medical check-ups for certain illnesses. The health check-up is applicable on every renewal of the policy, in the case of Prohealth Plus, Preferred, and Premier plan. While in Protect plan, the health check-ups are available once in every 3rd year of the policy.
To avail of cumulative benefits, renewal has to be applied within the grace period. The bonus will accumulate a maximum of up to 200% of the Sum Insured. The bonus is not for maternity, newborn baby, first-year vaccination, and worldwide emergency.
ManipalCigna has launched its online wellness programs to facilitate the insured in evaluating his/her health conditions and assist in improving degraded health. Insured can secure reward points equal to 1% of the premium deposited for years by seeking interest in online programs
The plan offers a complete Health Check-up facility at the network providers irrespective of the claim status.
The insured can avail the facility of procuring a second opinion from a chain of network medical practitioners if the insured is detected with any of the listed critical illnesses.
The time limit of waiting can be minimized from 48 months to 24 months if the insured has chosen this add-on cover.
The option of deductibles is only available under Protect and Plus plans of Prohealth. The insured can select the number of deductibles (can be 1L, 2L, or 3L) on the sum insured. The deductible sum will be used for the aggregate claims made in each policy year.
The insurer will pay 10/20% of the amount to settle admissible claims, irrespective of the age and number of claims applied by an insured person. The rest of the amount has to be paid out by the insured.
The insured can receive a 25% increase in the amount of sum insured for every claim-free year and if the renewal of policy is done without any delay. The maximum limit of increase is 200%.
With this cover, one can avail of a fixed daily cash benefit after completing 24 hours of hospitalization and will help you to take care of the miscellaneous expenses.
One has the option to remove the mandatory co-pay applicable for persons aged 65 years and above.
For a better understanding of how much premium one needs to pay under different plan variants and different sum insured options, we have created a sample illustration of the same. In the below graph we're representing the premium that has to be paid by a male aged 30 years for four different types of the cover amount i.e. 5.5 lakh, 7.5 lakh, 30 lakh, 1 crore. Have a look at it:
|Sum Insured Options||Plan Variants|
|ProHealth Protect||ProHealth Plus||ProHealth Accumulate||ProHealth Preferred||ProHealth Premier|
**Last Updated on August, 2021
|Parameters||ProHealth Protect||ProHealth Plus||ProHealth Preferred||ProHealth Premier||ProHealth Accumulate|
|Sum Insured||2.5, 3.5, 4.5, 5.5, 7.5, 10 15, 20, 25, 30, 50||4.5, 5.5, 7.5, 10 15, 20, 25, 30, 50||15, 30, 50||100||5.5, 7.5, 10 15, 20, 25, 30, 50|
|In-patient Hospitalization||Covered up to single private room facility||Any hospital room except Suite||Covered up to single private room facility|
|Post Hospitalization||Up to 90 Days||Up to 180 Days||Up to 90 Days|
|Ambulance Cover||Upto Rs. 2000 per event||Up to Rs. 3000 per event||Actual Expenses per event||Upto Rs. 2000 per event|
|Worldwide Emergency Cover||Covered up to the sum insured, one in a policy year|
|Restoration of Sum Insured||Multiple restorations are available for unrelated illness/injury|
|Health Maintenance Benefit||Up to Rs 500||Up to Rs 2000||Up to Rs. 15,000||5,000, 10,000, 15,000 & 20,000|
|Maternity Expenses||x|| Rs. 15,000 for normal delivery,|
Rs. 25,000 for c-section
| Rs. 50,000 for normal delivery,|
Rs. 1 Lakhs for c-section
| Rs. 1 Lakhs for normal delivery,|
Rs. 2 Lakhs for c-section
|New Born Baby Expenses||x||Covered with Maternity Expenses||x|
|First Year Vaccinations||x||Covered over & above with Maternity Expenses||x|
|Cumulative Bonus|| Guaranteed: 25%|
| Guaranteed: 10%|
| Guranteed: 5%|
|Hospital Daily Cash||Rs 1,000||Rs 2,000||Rs. 3,000||Rs. 1,000|
| First, 30 days waiting period is applicable for all illnesses other than accidents.|
24 months waiting period applies to specific ailments.
Pre-existing diseases: 24 months for Preferred & Premier plans; 36 months for Accumulate & Plus plans & 48 months for Protect plan.
First, 90 days waiting period and 30 days survival period apply to the Critical Illness Add-on Cover (if opted).
**Last Updated on August, 2021
Let's discuss the renewal process of Manipal Cigna Health Insurance. Follow the below steps to renew your policy easily:
Documents Required For Health Insurance
Hospital Daily Cash
Benefits of Health Insurance for Students
Reasons To Buy Health Insurance In Your 20s
What is Domiciliary Hospitalization
Introduction About Ayushman Bharat Yojana or PMJAY
Common Exclusions In A Health Insurance Policy
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Vivaan Kumar SanghwiBengaluru
Last updated on August, 2021
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