Manipal Cigna ProHealth Select Plan

If you are looking for a health insurance plan, choose a plan that helps you secure your health today and reassure your future. Manipal Cigna Health Insurance company with its ProHealth Select Plan, lets you customise your plan according to your needs. Manipal Cigna ProHealth Select Plan provides a reassurance benefit which allows an automatic extension of 2 years for the policy without paying any premium in case of permanent disability due to an accident or a critical illness. We will discuss the policy more later in this article.

Let us learn about the company first!

Manipal Cigna Health Insurance Company is a joint venture between Manipal group, India’s second largest healthcare chain and Cigna Corporation, a global health services company with a presence in 30 + countries and 225 years of experience. The company was recognised as the Best Healthcare Brand in 2021 by Economic Times. It offers a cashless facility at 6500+ network hospitals.

This article covers all the details of the Manipal Cigna ProHealth Select Policy.

ProHealth Select plan extends coverage in the time of need for you and your family. Here are the features of the plan at a glance.

Manipal Cigna ProHealth Select policy offers many benefits including basic covers, value-added covers and optional covers. The policy also has certain exclusions and waiting periods. Let us have a look.

Basic Covers

• In-patient Hospitalization medical expenses for more than 24 hrs are covered and include room rent, ICU and operation theatre charges, Fees of medical practitioners, nurses, anaesthetists, and specialists, cost of diagnostic tests, medicines, blood, oxygen, appliances and prosthetic devices as recommended. Modern and advanced treatments are also covered.
• Pre-hospitalisation medical expenses upto 60 days prior to hospitalisation.
• Post-hospitalization medical expenses upto 90 days immediately post hospitalisation.
• Day Care Treatments that require less than 24 hours of hospitalisation are covered and include 171 procedures upto the sum insured.
• Domiciliary Treatment covered upto sum insured for conditions which require a minimum of 3 days of treatment as advised by a medical practitioner.
• Ambulance Cover upto ₹ 2000 per insured person per hospitalisation
• Donor Expenses cover in-patient hospitalisation medical expenses towards the donor for an organ transplant.
• Restoration of Sum Insured is allowed once per policy year.
• AYUSH Cover includes in-patient medical expenses upto the sum insured towards non-allopathic treatments like Ayurveda, Yoga & - Naturopathy, Unani, Siddha and Homeopathy.

Value Added Covers

• Cumulative Bonus of 5% is applicable each year upto a maximum of 100% on a non-reducing basis.
• Healthy Rewards allows you to earn reward points
• equal to 1% of the premium paid
• By completing an array of wellness programs offered by the company
• Which can be redeemed as a premium discount at the renewal of for availing services through any network provider. 1 reward point = ₹ 1

Optional Covers

The optional covers are available on payment of additional premium and extends the policy coverage. These covers if opted, apply to all the insured persons under a single policy.

• Deductible option provides the flexibility to choose a deductible amount under the policy in a policy year. Deductible options are ₹ 1 lakh, ₹ 2 lakhs, ₹ 3 lakhs, ₹ 4 lakhs, and ₹ 5 lakhs.

• Cumulative Bonus Booster cover provides the following 4 choices

  • 10% increase in sum insured
  • 25% increase in sum insured
  • 50% increase in sum insured
  • 10% increase in sum insured maximum upto 200%

• Removal of Room Rent Limit covered upto single private room

• Re-assurance allows automatic extension of policy for a period of 2 years in case the insured is diagnosed with a critical illness or suffers from a permanent disability due to an accident.
• Health Check Up (Plan A only) for every insured person above the age of 18 is provided once each year.
• Worldwide Emergency Cover (Plan A only) covers medical expenses for emergency treatments for an illness or injury sustained outside India, which cannot be postponed until the insured returns to India.
• Disease Specific Sublimit (Plan A only) allows you to select sub-limit options for certain diseases as per the three options available with plan A.
• Health Maintenance Benefit (Plan A only) reimburses the cost of OPD expenses that are medically necessary, diagnostic and preventive tests, drugs, medical aids as advised by the medical practitioner and dental treatments and alternative forms of medicines.
• Add-on Benefit allows you to avail of critical illness add-on cover with the policy.

Waiting Period

• 30 days for all illnesses other than accidents
• 24 months for specified procedures and diseases
• 48 months for pre-existing diseases
• 90 days waiting period for critical illness under reassurance and add-on cover

• Any illness resulting from a breach of law committed by the insured
• Suicide or drug abuse
• Contamination from radiation or nuclear fuel
• Foreign invasion or civil war
• Diagnostic and evaluation expenses
• Rehabilitation and respite care
• Obesity or weight control treatment
• Cosmetic procedures
• Gender change treatment
• Adventure Sports
• Maternity expenses
• Unproven Treatment

ProHealth Select Plan is available in two variants: Plan A and Plan B. It offers many benefits and the flexibility to choose your coverage.

• Customisation - The plan allows customisation through a range of optional covers like cumulative bonus booster, removal of room rent limits, or selection of disease-specific sub-limits.
• Reassurance - It waives your premium and automatically extends your policy term for 2 years in case of an unforeseen event such as an accident or diagnosis of a critical illness. This facility supports you in difficult times, where you don’t have to worry about insurance coverage.
• Sum insured options - The plan offers multiple sum insured options through two variants. You can choose one option depending on your needs and budget. You can choose a sum insured from ₹ 0.5 lakh to ₹ 25 lakhs.
• Long Policy Term - You can choose a policy term for upto 3 years under the policy, thus, you don’t have to worry about renewing the policy every year. In addition, there is a 10% discount on opting for a 3-year policy term.
• Healthy Rewards - The plan rewards you for maintaining good health and lets you earn rewards upto 1 % of the premium paid.

For successful claim settlement, always provides complete documentation and information timely. The claims are settled only when you follow the advice of the medical practitioner. Any claim arising as a result of failure to follow a medical practitioner’s advice is not entertained. In case of any illness or injury, first, notify the insurance company either on call or in writing. The following details should be provided at the time of the intimation of the claim.

• Policy number
• Name of the policyholder
• Name of the insured person for whom claim is requested
• Name of the illness/injury
• Details of the hospital and medical practitioner
• Date of admission
• Any other information

For Cashless Claim

Cashless facility is available through a network hospital only. An updated list of network hospitals is available on the company’s website. Inform the company about planned hospitalisation at least 3 days before hospitalisation. For emergency hospitalisation, inform the company within 48 hrs. A cashless facility can be used at a network hospital by using your health card.

For Reimbursement claim:

The insured should provide all the documents within 15 days of discharge from the hospital. The documents required are

• Duly filled and signed claim form
• Original pre-authorization request
• Copy of preauthorization approval letter
• Copy of photo Id verified by the hospital
• Operation Theater notes (if any)
• Original hospital bill
• Original investigation reports, Xray, MRI etc.
• Original pharmacy bill

We all know there is no one size fits all plan when we talk about health insurance. So it is important that you are allowed to choose your own coverage. Manipal Cigna ProHealth Select Plan gives you the opportunity to do so. Once you have decided to purchase a health insurance policy, read the policy document carefully and understand all the details. Always maintain an emergency fund or a top-up plan to fund the treatments not covered in the policy, and don't depend on health insurance only. Hence, spending little time understanding vital aspects of health insurance is crucial and will save you from future surprises.