Health Insurance 377 views September 24, 2021

ManipalCigna ProHealth Preferred Plan provides coverage to couples who are planning to have kids or have kids. Here, you’ll get coverage against medical expenses up to INR 50 Lakh. Choose your preferred sum insured at inception and get coverage under this ManipalCigna Health Insurance Plan as per your need. Check the key features of the ManipalCigna ProHealth Preferred Plan on this page below.

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ManipalCigna ProHealth Preferred Plan Base Cover

You’ll get coverage against the following expenses during the policy term –
In-patient Hospitalization: Upon admission to a hospital for more than 24 hours, the insurer shall cover the following –

  • Room charges are covered up to any room category except suite or higher category
  • ICU expenses
  • Nursing charges, doctor fees, surgeon fees, blood, oxygen, operation theatre charges and other medical expenses
  • Modern treatments
  • Enteral feeding expenses
  • HIV and related illnesses
  • Pre & Post-Hospitalization Expenses

The insurer will reimburse medical expenses incurred before or after your hospitalization. You’ll get coverage for up to 60 days before the admission and up to 180 days after discharge. This benefit is payable to you if the insurer has accepted the in-patient hospitalization claim.

Day Care Treatment

If the treatment requires less than 24 hours of hospitalization, the insurer covers such expenses under day care treatment up to the sum insured.

Domiciliary Treatment

If treatment is taken at home due to your condition or the hospital isn’t nearby, the insurer will cover your medical expenses up to the sum insured. This benefit is available if the treatment lasts three days or more.

Ambulance Cover

Any expenses incurred due to transportation by an ambulance will be covered up to the sum insured.

Donor Expenses

The insurer covers in-patient hospitalization expenses for a major organ transplant up to the sum insured

Worldwide Emergency Cover

In case of an emergency, the insurer will cover in-patient medical expenses incurred outside the country.

AYUSH Cover

You’ll get coverage for non-allopathic treatments such as Ayurveda, Yoga & Naturopathy, Unani, Siddha & Homeopathy. This benefit is available if you receive treatment in a government AYUSH Hospital or teaching hospitals attached to government-recognized AYUSH College or Hospital.

Health Maintenance Benefit (HMB)

The insurer pays the doctor fees, diagnostic tests, drugs, dental treatments and alternative medicines up to INR 15,000 per policy year. You can choose to:

  • Carry forward the unutilized HMB balance on renewal
  • Utilize HMB up to 50% towards payment of premium from the first renewal
  • Utilize HMB for payment of deductible or co-pay (if any) and non-admissible expenses
  • Get a bonus of 5% on any unutilized HMB at renewal

Maternity Expenses

ManipalCigna ProHealth Preferred Plan covers maternity expenses for delivery or medical termination of pregnancy. You’ll get coverage up to INR 50,000 for normal delivery and INR 1,00,000 for C-Section per event. This benefit is available for up to 2 deliveries or termination during the lifetime of the insured. There is a waiting period of 48 months before you avail of this benefit.

Newborn Baby Expenses

After the baby is delivered, coverage is available to the baby after 90 days. The insurer will also pay for vaccination till the baby is 12 months old.

ManipalCigna ProHealth Preferred Plan Restoration Benefit

In case of multiple claims in a policy year, the insurer can restore the sum insured too. You can avail of this benefit if the combined sum insured and a cumulative bonus isn’t enough to cover your expenses.

ManipalCigna ProHealth Preferred Plan Value Added Services

The insurer provides you the following services to take care of your health during the policy period –

Health Check-up – Available each policy year except for the first year. This is available to all insured persons who have completed 18 years of age.

Expert Opinion on Critical illness (By a Specialist) – Take a second opinion on critical illnesses as specified in the policy schedule. This benefit is available once during the policy year.

Cumulative Bonus – A guaranteed 10% increase is provided at the time of renewal, irrespective of claim in the expiring policy year, up to 200% of the sum insured.

Healthy Rewards – Earn reward points equal to 1% of the paid premium by enrolling and completing ManipalCigna wellness programs. Utilize the reward points to pay the premium upon the first renewal or redeem them against HMB during the policy term.

Optional Covers Available Under ManipalCigna ProHealth Preferred Plan

Pay the additional premium and opt for any of the following optional covers to enhance your coverage –

Hospital Daily Cash Benefit

You’ll receive INR 3,000 for each continuous and completed 24 Hours of hospitalization, up to 30 days in a policy year.

Reduction in Maternity Waiting Period

The waiting period is reduced from 48 months to 24 months if you opt for this cover.

Waiver of Mandatory Co-payment

The mandatory co-payment of 20% shall be waived for insured aged 65 years and above.

Cumulative Bonus booster

A 25% increase in the sum insured is provided per policy year, up to 200% of the sum insured.

Critical Illness Add-on Cover for ManipalCigna ProHealth Preferred Plan

The insurer will pay a lump sum benefit up to your opted sum insured, upon the first diagnosis of the following critical illnesses –

  • Cancer of Specified Severity
  • Open Heart Replacement or Repair of Heart Valves
  • Coma of Specified Severity
  • Open Chest CABG
  • Myocardial Infarction (First Heart Attack of Specified Severity)
  • Kidney Failure Requiring Regular Dialysis
  • Stroke Resulting in Permanent Symptoms
  • Major Organ/Bone Marrow Transplant
  • Permanent Paralysis of Limbs
  • Motor Neurone Disease with Permanent Symptoms
  • Multiple Sclerosis with Persisting Symptoms

Free Look Period

You’ll get a free look period of fifteen days from the date of receipt of the policy document to review the terms and conditions. If the same is not acceptable, return the policy. Upon cancellation, get a refund of the paid premium after a deduction of medical examination and stamp duty charges. If the risk has already commenced, a deduction towards the proportionate risk premium for the period on the cover will be made. Whereas, if only a part of the cover has commenced, such proportionate premium commensurates during the free look period.

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