• ManipalCigna ProHealth Plus Insurance Plan

    Health Insurance
    • Premiums as low as Rs12/day for coverage of Rs.4 Lakhs*
    • 10,000+ hospitals for cashless treatment
    • Claim up to Rs. 55,000 deduction under section 80D**

    ManipalCigna is one of the standalone health insurance service providers in India. The company is renowned for its diverse range of plans targeted at people with different requirements. ManipalCigna ProHealth Plus is a comprehensive health insurance cover provided by the company. This policy is designed in such a way that it appeals to people with differing insurance requirements. This policy provides coverage for the whole family, and it comes with flexible terms and conditions.

    Eligibility for ManipalCigna ProHealth Plus Insurance Plan

    The eligibility criteria for ManipalCigna ProHealth Plus can be outlined as follows.

    • The proposer for this policy cover must be at least 18 years old.
    • Dependent children from age 91 days can avail this coverage.
    • There is no maximum entry age for this policy cover.
    • For sum insured less than Rs.10 lakh, medical examination is required for people who are 46 years and above.
    • For sum insured Rs.10 lakh, medical examination is required for people who are 41 years and above.

    Features of ManipalCigna ProHealth Plus Insurance Plan

    Some of the key features of ManipalCigna ProHealth Plus can be listed as follows.

    • There are 4 sum insured options available under this policy cover - Rs.4.5 lakh, Rs.5.5 lakh, Rs.7.5 lakh, and Rs.10 lakh.
    • All pre-existing diseases can be covered after 36 months of continuous policy coverage.
    • There is a 30-day waiting period for all illnesses from the date of inception for this policy. However, this waiting period does not apply for accidental hospitalisation.
    • Free health checkup is offered by the company after each renewal for policyholders who are more than 18 years of age.
    • For diagnosis and treatment of various listed critical illnesses, the company covers the cost of expert second opinion.
    • Voluntary deductible option is available for Rs.1 lakh, Rs.2 lakh, and Rs.3 lakh. Based on the option chosen, the premium charges can be reduced.
    • Voluntary copayment option is also available for 10% or 20% of the total claim. Deductible and copayment cannot be opted for the same policy.
    • There is a free look period of 15 days for policyholders to review the terms and conditions of the policy.
    • Policyholders can avail a grace period of 30 days for renewal from the date of expiry for this policy cover.
    • Existing health insurance covers with other insurance companies can be ported to ManipalCigna.
    • Premium amount paid towards this policy is eligible for tax relief as per Section 80D of the Income Tax Act.

    Benefits of ManipalCigna ProHealth Plus Insurance Plan

    The benefits offered by ManipalCigna ProHealth Plus can be given the following table.

    In-patient hospitalisation All expenses up to the sum insured limit
    Ambulance cover Up to Rs.3,000 per hospitalisation
    Organ donor expenses Covered up to the sum insured limit
    Worldwide emergency cover Coverage available for medical expenses arising across the world
    Sum insured restoration Up to 100% following a claim (only once during a policy period)
    Health maintenance benefit Up to Rs.2,000 per year for out-patient expenses
    Maternity expenses benefit Up to Rs.15,000 (for normal delivery) Up to Rs.25,000 (for C-section) Waiting period of 48 months applicable
    Newborn expenses cover Up to the sum insured limit under the maternity coverage
    Cumulative bonus Up to 10% per claim-free year subject to a maximum of 100% of the sum insured

    Add-on Covers

    Reduction in waiting period for maternity expenses With this add-on cover, the waiting period for maternity coverage can be reduced from 48 months to 24 months. This cover also reduces the waiting period for new born baby cover and vaccination cover.
    Waiver of mandatory copay This cover waives off the mandatory copay requirement for insured persons 65 years of age and above.
    Cumulative expense booster With this cover, the cumulative bonus sum insured can be boosted to 25% per claim-free year. This is subject to a maximum of 100%.
    Critical illness cover This cover provides compensation following the first diagnosis of a critical illness named in the policy document.

    Exclusions of ManipalCigna ProHealth Plus Insurance Plan

    There are certain exclusions for which the company is not liable to make any payments. Some of these exclusions can be listed as follows.

    • Treatments related to HIV, AIDS, and related complications
    • Treatments for any kinds of genetic disorders
    • Expenses related to mental disorders
    • Treatment for drug abuse or rehabilitation
    • Suicide or any kinds of intentional self injuries
    • Any other exclusions mentioned in the policy document

    Claim Procedure

    The claim procedure for ManipalCigna medical insurance policies are simple and straightforward. For planned hospitalisation, the company must be notified at least 3 days in advance. In case of emergency hospitalisation, the company must be contacted within 48 hours of admission in the hospital. For cashless treatments, you must provide a valid identity proof. Cashless claim form can be obtained from the network hospital itself. Once the documentation is done, the company will authorize the cashless claim request.

    For reimbursement claims, the company will require all claim documents along with the proofs of hospitalisation. All bills, medical certificates, diagnostic reports, physician certificates, etc. must be provided while filing for the claim. All these documents must be submitted within 15 days after discharge from the hospital. Once the documents are submitted, the company will validate the documents and settle the claim amount to the insured person.

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