ManipalCigna ProHealth Insurance Premier Plan

From individual to family health insurance plans, ManipalCigna presents its customers with some of the best features and benefits. The second largest healthcare chain in the country, ManipalCigna, owns a network of 27 hospitals all across India. The company has several accolades to its name, including 'Economic Times Best Promising Brands' in 2015. With over 77 branches and 93,000 satisfied customers pan India, ManipalCigna is indeed a preferred choice when it comes to health insurance.

The ProHealth Insurance Plan is a health plan that covers all your family members. This plan has three variants-

• ManipalCigna ProHealth Protection Plan
• ManipalCigna ProHealth Preferred Insurance Plan
• ManipalCigna ProHealth Insurance Premier Plan.

In this article, we will specifically discuss the ManipalCigna ProHealth Insurance Premier Plan.

A high-end and comprehensive health insurance plan, ProHealth Insurance Premier helps you get exhaustive coverage for yourself and your family. With a sum insured as high as INR 1 crore, the plan offers multifarious advantages. Let us take a look at its most highlighting features:

Having a health insurance plan in today’s times, is nothing less than a basic necessity. Surrounded by lifestyle diseases and deadly viruses, you never know when a trip to the hospital may be required. Being under the umbrella of a comprehensive health insurance policy ManipalCigna - ProHealth Insurance Premier Plan offers you numerous benefits. Mentioned below are some of them:

• Wide coverage for your whole family: A wide range of coverage for you and your entire family, including pre and post-hospitalisation, doctor’s fees, lab tests, medicine costs, newborn baby or maternity expenses. You get to choose an extensive sum assured of INR 100,00,000. You also get road and air ambulance cover, over 500 days of day-care treatment facility, AYUSH cover, daily hospital cash and many other add-ons offered by ManipalCigna Health Insurance.

• Large network of hospitals: With a worldwide hospital network of over 6500, ManipalCigna offers you the best possible treatments and facilities that are cashless. Make sure that you keep a check on the list of network hospitals, especially in your vicinity.

• Tax savings: Tax advantages are available in accordance with the Income Tax Act, 1961 regulations under section 80(D). If you are below 60 years old, you can save taxes on the premium up to INR 25,000. Senior citizens can save up to INR 50,000.

In fact, if you pay a premium for your senior citizen parents as well, you can save tax upto INR 75,000 per annum.

• Discounts: You can avail of a discount of up to 7.5% on the entire premium amount paid upfront for a two-year policy period and a 10% discount for a three-year policy period. In the case of multi-individual plans for families, coverage for more than two people can get you up to a 20% discount on the entire premium.

• Short Waiting period for pre-existing ailments: The waiting period for pre-existing diseases is 24 months, thus making high-cost treatment accessible to you by serving a short waiting period only.

• Quick Claims: If you have taken the treatment from a network hospital, and all your related documents are finely arranged and approved, the company claims that your cashless claim can be settled in just 90 minutes.

It is important to understand that every health insurance plan comes with specific waiting periods. Unless this time is served, a claim cannot be made.

ManipalCigna ProHealth Insurance Plan provides a range of coverage. The coverage can be divided into two sections- Individual and Family cover. Let's get into detail-

• Sum insured: ManipalCigna ProHealth Premier Plan offers a high sum insured so that the patient does not suffer any financial crisis at the time of hospitalisation. The insured can avail of treatment up to INR 1 crore.

• Restoration Benefit: Applicable from the second claim onwards, at any point during the term of your policy, if you exhaust your coverage and need more, the sum insured will be restored. The unlimited respiration benefit can be used for related as well as unrelated hospitalisations.

• Pre and Post-Hospitalisation: As the name suggests, the patient is eligible to get the expenses covered prior to admission and after they're from the hospital. The insured may start receiving the coverage up to 60 days and 180 days before and after hospitalisation, respectively.

• Maternity Expenses: ManipalCigna ProHealth Insurance Premier Plan provides a cover of a maximum of INR 1 lakh for normal childbirth and ₹2 lakh for C-sections. The insured can avail of this cover for a maximum of two times (for each type of delivery).

• Other Benefits:

Apart from the aforementioned, the following expenses are also covered-

• Complete ambulance charges: Option to choose any room without any room rent sub-limit
• Coverage offered across the globe
• Donor expenses
• AYUSH treatment
• Home treatment cover
• Annual health check-up (excluding first policy year) and rewards for healthy living.

Like all health insurance plans, few medical conditions remain uncovered by ManipalCigna Health Insurance. For these medical conditions, the insured is extended no cover-

• Circumcision
• Cosmetic treatment (except reconstructive surgeries)
• Dental treatment
• Infertility and sterility
• Diagnostics
• Routine check-up
• Breaching of any law
• Unproven treatment expenses
• Health issues due to alcoholism or drugs
• Copay charges or deductibles
• Non-medical/inadmissible expenses

ManipalCigna has very simplified eligibility criteria to make it easy for the customer to apply for health insurance plans.

• Entry Age: Minimum: Children: 91 days, Adults: 18 years & Maximum: No limit
• Type of Cover: Family Floater and Individual
• Premium Frequency: Monthly, Quarterly, Half-Yearly, Yearly

All insured individuals and close family members including nominees must be aware of the right claim filing procedure. It saves a lot of time and effort during claim filing and keeps them off any misguidance. When filing a claim, it is important that you inform the insurer or the TPA well in advance, that is, 48 prior, in case of a planned hospitalisation. However, if it is an emergency hospitalisation, you can inform ManipalCigna within 24 hours of the admission.

The following are the procedures for cashless and reimbursement claim filing for ManipalCigna ProHealth Insurance Premier Plan-

Cashless Claim

Cashless treatments can be availed at any of the network hospitals of ManipalCigna. The following is the process for filing a claim-

• You must inform your insurance provider, ManipalCigna, about the
• At the network hospital, you need to fill and submit the pre-authorization form
• By fax or email, you can send the form to ManipalCigna/ appointed TPA for hospitalisation claim approval
• After verification, you will receive a confirmation from ManipalCigna
• In case, your claim gets rejected due to some reason, you still must proceed with the hospitalisation and treatment
• Later on, you can file for a reimbursement claim to receive the sum insured

Claim for Reimbursement

Reimbursement claim is put forth when the insured receives the medical treatment at a non-network hospital. The following is the process for the same-

• Inform your insurance provider about hospitalisation within the timelines
• Pay the hospital bill upfront at the time of discharge
• Then, fill out and submit the claim form with the company/ TPA
• Attach all the necessary documents as listed
• Once verified, your claim will be approved, and the admissible expenses will be disbursed to your bank account
• In case the claim is not approved, the reason for the same will be conveyed to you.

As compared to reimbursement claims, there is hardly any paperwork required when you make a cashless claim. However, it is advisable that before you begin filing any claim for the medical treatment received, you must keep with you the following documents-

• A claim form that is duly filled and signed by the insured
• An identity proof
• Recent photographs
• A letter by the hospital confirming the hospitalisation of the patient
• Reports of all the tests
• Medical receipts
• Original bills
• Discharge summary
• Original pharmacy bills

The company may ask the insured to present other documents if required.

Comprehensive health insurance plans with both individual and floater options, ManipalCigna ProHealth Premier Plan is designed to provide complete protection against any illnesses and unexpected medical expenses. It includes a number of extra advantages like cumulative bonuses, maintenance perks, reinstatement of the insured amount, global emergency coverage, etc. when you choose ManipalCigna ProHealth Premier Plan, it offers the best possible coverage for you and all your loved ones.