• ManipalCigna ProHealth Insurance Accumulate 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 operates as a standalone health insurance service provider in India. The company is renowned for its range of health insurance plans that cater to the requirements of customers with different needs. ProHealth Insurance Accumulate is a unique health insurance plan that builds a reserve within the insurance plan for your future requirements. In addition to the reserve benefit, this cover also comes with a range of hospitalisation benefits to provide adequate coverage for the insured.

    Eligibility for ManipalCigna ProHealth Insurance Accumulate

    ManipalCigna has set forth the following eligibility criteria that must be met by potential policyholders.

    • The minimum entry age for the policy is 18 years for adults and 91 days for children.
    • There is no maximum entry age for this policy.
    • This policy can also be renewed throughout one’s lifetime.

    Features of ManipalCigna ProHealth Insurance Accumulate

    The key features of ManipalCigna ProHealth Insurance Accumulate can be listed as follows:

    • This policy comes in 5 different sum insured options - Rs.5.5 lakh, Rs.7.5 lakh, Rs.10 lakh, Rs.15 lakh, and Rs.25 lakh.
    • This policy is available in 1 year, 2-year, or 3-year policy terms.
    • A 7.5% premium discount is available if a 2-year policy term is chosen, and a 10% discount is available if a 3-year policy term is chosen.
    • There is an option to avail Health Maintenance Benefit (HMB) to set aside a specific reserve amount every year for future health needs.
    • The accumulated HMB can be used to pay for outpatient expenses, dental treatment, AYUSH treatment, or any non-admission component of a claim.
    • Pre-hospitalisation and post hospitalisation medical expenses can be covered for up to 60 days and 90 days respectively.
    • Pre-existing conditions can be covered after 48 months of continuous policy coverage.
    • The premium amount for the policy is based on various factors such as age, lifestyle, sum insured amount, gender, medical examination results, location, etc. of the insured person.
    • If more than 2 members of a family are covered in a single individual policy, a premium discount of 10% is available under this policy cover.
    • Pre-insurance medical examination is required based on the age of the insured and sum insured chosen.
    • Policyholders can choose voluntary copayment between 10% and 20% to get additional premium discount.
    • This policy comes with 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 from the date of expiry to renew this policy cover. However, there will not be any coverage for the days during which the premium is not paid.
    • As per section 80D of the IT Act, the premium amount paid towards this policy is eligible for income tax relief.

    Benefits of ManipalCigna ProHealth Insurance Accumulate

    The key benefits offered by this medical insurance cover can be given as follows:

    In-patient hospitalisation All medical expenses up to the sum insured limit
    Day care treatment All day care expenses up to the sum insured limit
    Domiciliary treatment Covered up to the sum insured limit
    Worldwide emergency cover Coverage for medical expenses
    Emergency ambulance cover Up to Rs.2,000 per hospitalisation
    Organ donor cover Covered for all medical expenses related to organ transplant
    Restoration of sum insured Up to 100% restoration of sum insured (once in a policy year) without any extra premium
    Health Maintenance Benefit Reimbursement up to Rs.20,000 per year for various health needs
    Free health checkup Once every three years
    Cumulative bonus 5% per claim-free year subject to a maximum of 100%
    Voluntary deductible Multiple options between Rs.50,000 and Rs.5 lakh
    Mandatory copayment waiver (optional) Mandatory copayment waiver benefit available for people older than 65 years on payment of additional premium
    Cumulative bonus booster (optional) Up to 25% per claim-free year (maximum 100%) on payment of additional premium
    Critical illness cover (optional) Lump sum benefit equal to the sum insured upon first diagnosis of a named critical illness (subject to a 90-day waiting period)

    Exclusions of ManipalCigna ProHealth Insurance Accumulate

    Some of the exclusions named under ManipalCigna ProHealth Insurance Accumulate can be listed as follows:

    • Any kinds of self-inflicted injuries
    • Injuries arising out of war or warlike activities such as invasions
    • Any expenses related HIV, AIDS, sexually transmitted diseases, etc.
    • Genetic disorders of all kinds
    • Mental disorders and psychiatric treatments
    • Any expenses related to childbirth and pregnancy
    • Any treatments for drug abuse

    Claim Procedure

    ManipalCigna operates a helpline to deal with all the claim processes. It is better to notify the company 3 days in advance for planned hospitalisation. For emergency situations, the company can be notified within 48 hours. If you are looking for cashless treatment, you can contact the helpline and request pre-authorisation. Authorisation form can be obtained from the hospital and faxed to the company with the relevant documents. Once you have submitted all the necessary documents along with the authorisation form, the company will provide the approval for cashless treatment.

    Reimbursement claims follow a slightly different ordeal. Here, the claim filing must be made after discharge from the hospital. The company might require various documents such as medical bills, discharge summary, diagnostic reports, physician certificates, etc. Once the documents are all submitted, the company will verify the documents and validate the claim. After the verification process, the settlement amount will be paid to the policyholder.

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