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Get Lowest Rates for ManipalCigna ProHealth Plan

Mediclaim Plans starting @ Rs 250* / month

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50+ Lakhs Happy Customers
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Save Upto ₹75k Under 80D
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ManipalCigna ProHealth Plan

ManipalCigna Health Insurance Company Limited (formerly known as CignaTTK Health Insurance Company Limited) is a joint venture between the Manipal Group, a leader in the field of healthcare delivery and higher education in India and Cigna Corporation, a global health services company with presence in 30+ countries and serving 160 million+ customers around the world. With a deep focus on health and wellness, ManipalCigna Health Insurance offers a full suite of insurance solutions ranging from health, personal accident, major illness, travel and global care to individual customers, employer-employee, and non-employer-employee groups to meet their diverse health needs.

Highlights

  • Flexibility in offering through four separate plan alternatives – Protect, Plus, Preferred & Premier
  • No maximum entry age
  • Provides lifetime renewal opportunity
  • Option of 1 year, two years and three years term
  • 10% discount on the premium amount for enrolling more than two family members under a single individual policy.
  • Additional discount of 7.5% for choosing a two year and 10% for a three-year single premium policy

Scope of cover

Indivdual Plan

Entry Age

For children : 91 days

Adults :

Minimum : 18 years

Maximum : No Age Bar

Number of Members Covered

Maximum Members : 6

Maximum Adults : 4

Maximum Children : 2

Sum Insured

2.5 - 100 lakhs


discount

For longer policy term
family discount

Policy Periods Available

1, 2 years


Pre-Policy Medical Check-up

2.5 - 7.5 - 46 and above

10 lakhs - 41 and above
15 lakhs and more - 18 and above

Family Floater Plan

Entry Age

For children : 91 days

Adults :

Minimum : 18 years

Maximum : No Age Bar

Number of Members Covered

Maximum Members : 5

Maximum Adults : 2

Maximum Children : 3

Sum Insured

2.5 - 100 lakhs


discount

For longer policy term
family discount

Policy Periods Available

1, 2 years


Pre-Policy Medical Check-up

2.5 - 7.5 - 46 and above

10 lakhs - 41 and above
15 lakhs and more - 18 and above

Important Features

Day Care Treatments
Definition
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Day Care Treatments

Includes surgical processes conducted using local or general anaesthesia which requires less than 24 hours of hospitalization because of technological advancement in healthcare. Each company has a specific list of processes which are covered under this category.

Due to scientific advancement, some procedures/treatments do not require you to be hospitalized for a minimum of 24 hours to raise a claim. This plan covers such procedures.

No-Claim Benefits
Definition
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No-Claim Benefits

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In this policy no-claim bonus equal to 5% or 10% (depending on the variant) of basic sum insured up to a maximum of 100% is available. However, this benefit is not available in the Premium variant.

Organ Donor Cover
Definition
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Organ Donor Cover

Includes coverage for in-patient hospitalization expenses, offered to an organ donor for his/her treatment on harvesting an organ for the insured.

This benefit covers for any expenses related the organ donation for you up to the sum insured.

Pre Hospitalization
Definition
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Pre Hospitalization

Medical expenses incurred immediately before the insured individual is hospitalized are covered under this benefit. Usually, expenses up to 30 to 90 days before hospitalization are covered under the policy only after the in-patient hospitalization claim is accepted by the insurance company.

The insurance company will compensate you for the medical expenses related to your hospitalization up to 60 days before it.

Post Hospitalization
Definition
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Post Hospitalization

Medical expenses incurred immediately after the hospitalization are covered under this benefit.The coverage under this benefit would be available only for approved in-patient hospitalization claim is accepted by the insurance company. Usually, expenses up to 30 to 180 days post discharge are covered under the policy.

The insurance company will pay you for the medical expenses related to your hospitalization up to 90 to 180 days (depending on the plan variant) post hospitalization.

Restore Benefits
Definition
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Restore Benefits

A benefit offered by some of the insurance companies which reinstates your sum insured when it gets exhausted within a policy period based on the terms and conditions of the plan.

It offers restore benefit equal to 100% of the sum insured. However, this advantage is not available in Premium variant.

DEDUCTIBLE
Definition
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DEDUCTIBLE

The partial amount of expenses that has to be paid by the insured before the insurer pays the remaining expenses.

You have the option to choose a voluntary deductible of Rs.1 lakh, Rs.2 lakh or Rs.3 lakh. Although you’ll have to bear this amount during a claim, it will reduce the premium.

Good to Have Benefits

OPD Expense Cover
Definition
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OPD Expense Cover

Includes coverage for expenses on treatments which do not require 24 hours of hospitalization.

This plan does not cover expenses related to outpatient treatment.

Daily Hospitalization Allowance
Definition
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Daily Hospitalization Allowance

Includes lump sum compensation offered in some plans on a daily basis after every 24 hours of hospitalization.The amount offered under this benefit could be used to cover expenses additional to hospitalization expenses.

This policy does not offer any daily hospital cash.

Health Check-up
Definition
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Health Check-up

Includes complimentary health check-up provided by the insurance companies for certain health insurance plans.

Offers complimentary health check-up that covers some listed tests, once every three years or every year (depending on the plan variant), irrespective of the claim.

Home Hospitalization/ Domiciliary Hospitalization
Definition
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Home Hospitalization/ Domiciliary Hospitalization

Includes coverage for expenses borne when active treatment is provided to the insured (especially older patients) by health care professionals in the patient's home.

You can avail treatment at home up to the sum insured, provided it meets the pre-defined conditions.

Non- Allopathic Treatment Expense Cover
Definition
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Non- Allopathic Treatment Expense Cover

Includes coverage for expenses on treatment which do not use allopathic methods like Aurveda, Homeopathy, etc. The terms and conditions are different for different policies. This benefit is also refered to as Ayush benefit or Alternative treatment by some the insurers.

This plan does not cover expenses related to non-allopathic treatment.

Emergency Ambulance
Definition
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Emergency Ambulance

Includes coverage for expenses on ambulance for hospitalization of the insured.

This plan provides ambulance cover up to Rs.2,000 or actuals (depending on the plan variant) per hospitalization.

Value Adds

Eye-cover
Definition
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Eye-cover

Includes coverage for expenses on out-patient treatment of eyes. In some cases cost of spectacle is also covered under this benefit.

This plan does not provide coverage for eye treatment expenses.

Maternity Cover
Definition
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Maternity Cover

Includes coverage for delivery or related expenses of the insured. At times coverage for the new-born child is also provided under this benefit. Read More on Maternity Cover

This benefit is offered only for Plus, Preferred and Premium variant. For Plus plan, you are covered up to Rs.15,000 for a normal delivery and up to Rs.25,000, for a C-Section. Similarly, for Preferred and Premium plan, you are covered up to Rs.50,000 for a normal delivery and up to Rs.100,000 for a C-Section.

Dental Coverage
Definition
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Dental Coverage

Includes coverage for out-patient dental treatment expenses.

This policy does not cover any dental treatments.

Recovery Benefit
Definition
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Recovery Benefit

Includes lump sum benefit offered to an insured by some of the insurance companies after the hospitalization exceeds certain number of days. This benefit is also refered to as Convalescence benefit by some companies.

This plan does not offer any recovery benefit.

HEALTHY REWARDS
Definition
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HEALTHY REWARDS

The plan offers a rewards program where you get points equal to 1% of premium paid each year. You can accumulate them up to a 10% of premium paid in the policy. Each earned reward point equals to Rs.1, and you can redeem them for a discount in premium from next renewal. You can also reimburse them under health maintenance benefit or to enjoy services through the company's network partners.

EXPERT OPINION ON CRITICAL ILLNESS
Definition
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EXPERT OPINION ON CRITICAL ILLNESS

Includes additional coverage offered by some of the insurance companies to the insured upon diagnosis of any one of the listed critical illnesses. https://www.coverfox.com/health-insurance/critical-illness/

Under this benefit, you can claim for the cost towards an expert opinion on any of the listed critical illness before you seek the necessary treatment.

HEALTH MAINTAINANCE BENEFIT
Definition
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HEALTH MAINTAINANCE BENEFIT

Although the plan does not cover the OPD treatments or treatments for alternative medicine directly, it offers a reimbursement between Rs.500 to Rs.15,000 (depending on the plan variant) each year to take care of your OPD consultations or any alternate forms of medicine like Ayush, and so on.

WORLDWIDE EMERGENCY COVER
Definition
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WORLDWIDE EMERGENCY COVER

You can claim for reimbursement up to your sum insured or a maximum of Rs.10 lakh (depending on the plan variant) for any treatments covered under this policy anywhere in the world.

FREE LOOK PERIOD
Definition
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FREE LOOK PERIOD

For any reason, should you decide not to proceed with the policy, you can return the same and request for a refund within 15 days from the date of receipt of the policy document.

Add-on Covers

CRITICAL ILLNESS COVER
Definition
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CRITICAL ILLNESS COVER

Includes additional coverage offered by some of the insurance companies to the insured upon diagnosis of any one of the listed critical illnesses. https://www.coverfox.com/health-insurance/critical-illness/

At an additional premium, you will get a lump sum amount equal to Sum Insured in the case of the first diagnosis of the covered critical illnesses. In the family floater, once you claim for a critical illness, you will get 100% reinstatement of sum insured once during the lifetime of the plan for the other person covered. However, this option is not available in the Premium variant.

WAIVER OF MANDATORY CO-PAY
Definition
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WAIVER OF MANDATORY CO-PAY

With an extra premium, you can choose to waive the co-payment clause even after the age of 65 years.

Terms & Conditions

Room Rent / Room Category
Definition
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Room Rent / Room Category

Hospitals have a fixed tariff or rate chart for all rooms. Mediclaim depends on the amount of room rent limit specified in the policy document. The amount varies depending on the type of room category chosen.

The plan has defined limits for room rents, and varies from sharing the room to a single private one depending on the plan variant.

Co-Payment
Definition
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Co-Payment

The fixed amount the policyholder has to pay for covered services when they get the service. When both insured and insurer pay part of the medical expenses, it is called as cost sharing. This is applicable based on the policy you choose.

A compulsory co-payment of 20% applies to all claims for anyone aged 65 years and above irrespective of entry age. Likewise, if anyone has opted for a voluntary co-pay and if he chooses to take treatment out of the zone, then the co-pay percentages will apply in conjunction.

Waiting Period

Cooling Off Period
Definition
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Cooling Off Period

The period begins right after commencement of the policy within which you cannot claim for any illness except claims related to accident. This period is not applicable for subsequent renewals.

A 30 days cooling off period for all claims except any arising out of accidental injuries.

Specific Illnesses
Definition
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Specific Illness

The ailments of specific severity listed in the policy document are included under this category.

The policy covers some specific diseases/treatments only after 24 months. These include Cataract, Hysterectomy, Myomectomy for Fibroids, and so forth.

Pre-Existing Illnesses
Definition
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Pre-Existing Illnesses

The ailments that the insured was already diagnosed with before taking the policy.

A 48/ 36/ 24/ 24 months waiting period will be applicable for any Pre-existing disease for Protect, Plus, Preferred & Premier Plan respectively.

Survival period of 30 days applies for any claim related to critical illness. Similarly, there is a waiting period of 90 days before the symptoms of any critical illness first occur to be able to claim.

Waiting period for Maternity
Definition
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Waiting period for Maternity

A 48 months waiting period for maternity & newborn cover applies.

Permanent Exclusions

The Plan will not cover any liabilities towards the treatments of following conditions-

  • whose signs or symptoms first occur within 30 days of the policy period
  • attempted suicide
  • use of alcohol or drug
  • AIDS
  • Cost of donor screening
  • Genetic disorder and stem cell implantation/surgery.
  • Dental treatment other than due to an accident.
  • Congenital disease
  • infertility and in vitro fertilization.
  • hospitalization out of war, riot, strike and nuclear weapons

The details list on what the policy does not cover is available in the policy wordings.

Review of ManipalCigna ProHealth Insurance Protect

One of the greatest highlights of ManipalCigna’s Prohealth policy is the luxury of choice. With a broad range of sum insured and linked benefits, it is simpler to pick and choose the coverage that best suits your requirements as well as pocket. Most of the advantages like an optional cover for critical illness and worldwide coverage does not limit the policy’s offering. Thus, if you are looking for a comprehensive coverage for yourself or family, you can surely consider the plan.

**Reviews and ratings are based only on Benefits and Conditions. Things like Claim Settlement Ratio, Hospital Network have not been covered under product ratings. These are covered under Company ratings.

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