Prohealth Plan
  • Know About the Plan & its Variants
  • Explore the Features & Eligibility
  • Inclusions and Exclusions

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ManipalCigna ProHealth Insurance

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:

  • ProHealth Protect
  • ProHealth Accumulate
  • ProHealth Plus
  • ProHealth Preferred, and
  • ProHealth Premier

Read along to explore more about the plan:

Eligibility Criteria of ManipalCigna ProHealth Insurance:

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

Key Features of ManipalCigna ProHealth Insurance

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:

Basic Coverage

  1. In-patient Hospitalization

    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.

  2. Pre-hospitalization

    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.

  3. Post-hospitalization

    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.

  4. Road Ambulance

    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.

  5. Domiciliary Hospitalisation

    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.

  6. Day Care Treatments

    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.

  7. Organ Donor Expense

    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.

  8. Maternity Expenses

    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.

  9. New Born Baby Expense

    It covers the reasonable expenses devoted to the treatment of newborn babies up to 90 days after the delivery.

Vaccination for the First Year

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.

  1. Worldwide Emergency Cover

    In-patient treatment of any illness that happened on a foreign land away from Indian boundaries also gets coverage.

  2. Reload of Sum Insured

    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.

  3. Health Maintenance Benefit

    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.

  4. Health Checkups

    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.

Value Added Covers

  1. Cumulative Bonus:

    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.

  2. Health Rewards

    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

  3. Health Check-ups

    The plan offers a complete Health Check-up facility at the network providers irrespective of the claim status.

  4. Expert Opinion on Critical illness

    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.

Optional Covers

  1. Reduction in the Maternity Waiting Period

    The time limit of waiting can be minimized from 48 months to 24 months if the insured has chosen this add-on cover.

  2. Deductible

    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.

  3. Voluntary Co-Pay

    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.

  4. Cumulative Bonus Booster

    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%.

  5. Hospital Daily Cash Benefit

    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.

  6. Waiver of Mandatory Co-pay

    One has the option to remove the mandatory co-pay applicable for persons aged 65 years and above.

Sample Premium Illustration Of ManipalCigna ProHealth Insurance

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
5.5 Lakhs 12,929 16,939 19,456 NA NA
7.5 Lakhs 15,398 19,334 22,251 NA NA
30 Lakhs 22,015 29,563 28,295 48,462 NA
1 Crore NA NA NA NA 68,458

**Last Updated on August, 2021

What is Covered Under ManipalCigna Pro Health Insurance Plan?

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
Pre-Hospitalization 60 Days
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
Donor Expenses Covered
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
AYUSH Coverage Covered
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
x
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%
Max: 200%
Guaranteed: 10%
Max: 200%
Guranteed: 5%
Max: 200%
Hospital Daily Cash Rs 1,000 Rs 2,000 Rs. 3,000 Rs. 1,000
Waiting Periods
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

What is Not Covered Under ManipalCigna Pro Health Insurance Plan?

  • Dental treatment
  • Circumcision
  • Sterility and Infertility
  • Routine medical check-up and diagnostic tests
  • Breach of law
  • Expenses related to any unproven treatment
  • Aliments arising out of alcohol and drug abuse
  • Cosmetic surgery except for reconstructive surgery for burns and accidents

How To Buy ManipalCigna Prohealth Plan?

Buying From ManipalCigna Health Insurance
Buying From Policyx Website ManipalCigna Health Plan

How Can I Renew My ManipalCigna Prohealth Plan Online?

Let's discuss the renewal process of Manipal Cigna Health Insurance. Follow the below steps to renew your policy easily:

  • Visit the official website of Manipal Cigna Health Insurance and click on the 'Renew' option.
  • Enter your policy number and click 'Proceed' Fill in other information, if prompted.
  • You will get the renewal premium amount.
  • Click on the 'Pay now' option to make the online payment.
  • On successful payment, you will receive a policy transaction number. A new policy kit will be emailed to you within 48 hours.

How To File A Claim For ManipalCigna Prohealth Plan?

Cashless Process

  • Inform the company about planned (48 hours prior) or unplanned (within 24 hours) hospitalization.
  • Provide the health card and ID proof at the network hospital.
  • Then, the network hospital will send the pre-authorization form and medical records to ManipalCigna, which will verify all the details.
  • During discharge, the network hospital will send the discharge summary to the company authorizing the amount.
  • Once everything is sorted, ManipalCigna will make the payment to the network hospital.

Reimbursement Process

  • Intimate the company about the hospitalization. Get the treatment done and pay the expenses.
  • During discharge, collect all the necessary documents such as original hospital bills, receipts, discharge summary, investigation reports, pharmacy bills, and submit them to ManipalCigna with the duly filled claim form.
  • ManipalCigna will assess the documents.
  • If the claim is approved, the amount will be transferred to your registered bank account.

Manipal Cigna Important Links


Find Out What Customers Are Saying

(Showing latest 5 reviews only)

- 4.5/5 (31 Total Rating)

October 6, 2021

Vishal Malhotra

Jaipur

A few months back, I purchased a health plan from Manipal Cigna. I must say that the company offers helpful services

September 8, 2021

Sumit Samota

Pune

the customer support service was at par....over the last 10 years I have dealt with a number of insurance companies fooling me. But manipal cigna stood by its words and settled my claims

September 8, 2021

Karam Wahi

Bhopal

honestly, the plan from manipal cigna was a blessing in disguise.... got a majority of my bills covered owing to this plan....so very grateful

August 6, 2021

Avinash Sachdeva

Coimbatore

Thanks, PolicyX to find this affordable policy for me. Even ManipalCigna has reimbursed my claim on time. I am very happy with the service of both PolicyX and ManipalCigna.

May 7, 2021

Vivaan Kumar Sanghwi

Bengaluru

Just got my ManipalCigna Health Insurance renewed today. I feel this is the best gift I can give to me and my family members. The company looks after all my healthcare needs. Thank you ManipalCigna for looking after my health so well.

Last updated on August, 2021

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