Insurance Plans May 20, 2020

Health Insurance Plans have become a necessity for many individuals because it helps to tackle medical emergencies when individuals fall short of funds. Everyone knows that a medical emergency can arise anytime so it is better to be prepared. If you also want to secure the health expenses then you must take a health insurance plan. You must see the ManipalCigna ProHealth Preferred Extra-Large Cover that promises you a minimum Sum Assured of 15 Lacs and you can take a maximum Sum Assured of 50 Lacs. Before knowing any other details of this plan, you must go through the benefits and add on benefits of the policy.

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ProHealth Preferred Plan of ManipalCigna Benefits

As you know that every health insurance has a certain amount of the Sum Assured so similarly you have the option to decide the amount of the Sum Assured. Let’s explore all the benefits of this plan including the amount of the Sum Assured.

Sum Assured

In this health insurance, there are three options to decide the Sum Assured. You will have to choose between 15 Lacs, 30 Lacs, and 50 Lacs. Once you have chosen the amount of the Sum Assured then the company will decide the amount of premium payable at the end of every year.

Inpatient Hospitalisation

In the case of the Inpatient Hospitalisation, the company will cover any room category in the hospital except the Suites and or the rooms in a higher category. In other words, the charge of the room in which you are hospitalized will be covered under the insurance plan but the Room must not be in a higher category or a suite.

Pre-hospitalization

In the pre-hospitalization benefit, the company will cover the medical expenses done before 60 days from the day of the hospitalization.

Post-Hospitalisation

In the Post-Hospitalisation benefit, the company will cover all the medical expenses done after 180 days post-hospitalization.

Day Care Treatment

The Day Care Treatment is covered up to the maximum limit of the Sum Assured that you have chosen at the beginning while taking the plan.

Treatment at Home

The Coverage for the treatment at home is covered up to a certain limit of the maximum Sum Assured that you have opted for while taking the ManipalCigna ProHealth Preferred Insurance Plan.

Ambulance Cover

An individual always needs an ambulance first whenever he wants to admit a patient to the hospital. So, you can reimburse all the ambulance expenses in this health insurance. The actual expenses incurred for the ambulance will be reimbursed.

Donor Expenses

If you are going through any surgery for the organ transplantation then the ProHealth Preferred insurance covers all the expenses done for buying the organ and paying to the donor. The maximum coverage will be up to the full sum assured that you have chosen while taking the policy

Worldwide Emergency Cover

If in case you are hospitalized outside India then the company will reimburse all your expenses up to a maximum limit of the full sum assured. It means that the benefits of this policy are available outside India or abroad.

Restoration of the Sum Assured

After making many claims in a year the amount of the Sum Assured reduces, so this benefit helps to restore the original value of the Sum assured and you can claim for the original amount of Sum Assured.

AYUSH Cover

The ManipalCigna ProHealth Preferred Plan also covers the expenses related to the Ayurvedic Treatment. It covers all the expenses done at the AYUST Hospitals and the maximum limit of the coverage would be the full Sum Assured.

Health Maintenance Benefits

The treatments that can be done without hospitalization and can be carried out in an outpatient department are known as health maintenance. You will get the Health Maintenance Benefits of up to 15000 per policy year.
You can reimburse the expenses done for diagnostic tests, preventive tests, drugs, prosthetics, medical aids (spectacles and contact lenses, hearing aids, crutches, wheelchair, walker, walking stick, lumbosacral belt), prescribed by the specialist Medical Practitioner up to the limits specified in the Schedule, Dental Treatments and AYUSH Forms of Medicines wherever prescribed by a Medical Practitioner.

Maternity Benefits

There are two maternity benefits in the ManipalCigna ProHealth Preferred Extra Large Cover insurance plan:-

  1. It gives a cover of up to 50000 in case of a normal delivery per event.
  2. It gives a cover of up to 100000 for C-Section per event.
  3. There is a waiting period of 48 Months for this benefit.

New Born Baby Expenses

The Preferred Extra Large Cover insurance plan also covers the expenses done on a newborn baby and the maximum cover for the newborn expenses is the amount of coverage given for the Maternity Expenses.

Value-Added Benefits

There are some other benefits as well as the ProHealth Preferred Plan. So, you must also see these benefits of the plan.

Health Check-Up

You can take a free health check-up every year except for the first policy year. All the insured whose age is 18 years and above can take the health check-up free of cost. The tests available free of cost in the health check-up are-

  1. Vitals
  2. ECG
  3. Total Cholesterol
  4. FBS
  5. Sr. Creatinine
  6. CBC
  7. SGPT
  8. Lipid Profile

Consult a Specialist

In case of a critical illness, you can take an expert opinion from the specialist doctor for free. This benefit can be taken only once in a year. You can have a look at the Critical Illnesses that are covered in this plan.

  1. Cancer of specific severity
  2. Myocardial Infarction (First Heart Attack of specified severity)
  3. Open Chest CABG
  4. Open Heart Replacement or Repair of Heart Valve
  5. Coma of specified severity
  6. Kidney Failure requiring regular dialysis
  7. Stroke resulting in permanent symptoms
  8. Major Organ/Bone Marrow Transplant
  9. Permanent Paralysis of Limbs
  10. Motor Neurone Disease with permanent symptoms
  11. Multiple Sclerosis with persisting symptoms

Cumulative Bonus

You will also get No Claim Bonus or Cumulative Bonus if you don’t make any claim in the policy year. The amount of the Sum Assured will be increased by 10% if no claims are made and it will keep on increasing every year unless and until it reaches 200% of the Sum Assured.

Eligibility Criteria of the ProHealth Preferred Insurance Plan

ParticularsDetails
Minimum Age of Entry for Children91 Days
Minimum Age of Entry for Children18 Years
Minimum Sum Assured15 Lacs
Maximum Sum Assured50 Lacs

The basis on which the Premium is Decided

  1. Insurance Plan that you are taking.
  2. Policy Term
  3. Applicant’s Age
  4. Type of Policy
  5. Applicant’s Gender
  6. Zone of Cover
  7. Optional Cover taken by you
  8. Add-on Benefit taken by you

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