Insurance Plans 241 views May 21, 2020

ManipalCigna ProHealth Premier Extra Large Cover

Major Surgeries and Hospitalization are very costly these days it makes the individual drain out all the savings. Therefore it is advisable to take a health insurance plan before it is too late. The health insurance plan not only gives you an insurance cover but also they remain with you during your hard time. You can take a look at the ManipalCigna ProHealth Premier Extra Large Cover insurance plan that has the only option for the Sum Assured of INR 100 Lacs. Under this insurance, you will get a cover for hospitalization, Ambulance Expenses, and many other health-related expenses. So, you must go through all the benefits of this insurance plan and find out how they will be fruitful during your health issues.

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Benefits of ManipalCigna ProHealth Premier Extra Large Cover insurance plan

Before taking any health insurance plan, an individual takes a thorough look at each and every features, benefits, and hidden clauses of the policy. So, you can explore all the features and the amount of compensation covered in this policy.

Sum Assured

In this insurance plan, the amount of Sum Assured is Rs.100 Lacs and it can’t be decreased or increased. The only option for the amount of the Sum Assured is Rs.100 Lacs in the Premier Plan of ManipalCigna ProHealth.

Inpatient Hospitalisation

If you are hospitalized somewhere due to some disease then the company will cover all types of room categories in the hospital except the rooms in a higher category or the Suites. In other words, the company will compensate for the charge of the room in which you are hospitalized but the Room should not be in a higher category or a suite.

Hospitalization Benefits

There are two benefits in the hospitalization benefits and they are pre-hospitalization and post-hospitalization benefits

  1. In the pre-hospitalization benefit, the company will cover the medical expenses done prior to 60 days from the day of hospitalization.
  2. In the Post-Hospitalisation benefit, the company will cover all the medical expenses done after 180 days once the patient is discharged.

Day Care Treatment

The company will compensate for the day care treatment expenses up to a maximum limit of the Sum Assured that you have decided in the beginning.

Domiciliary Treatment

The Domiciliary Treatment Expenses are covered up to a certain limit of the maximum Sum Assured that you have opted for while taking the ManipalCigna ProHealth Premier Insurance Plan.

Ambulance Cover

An Ambulance is always needed at the very first instance of hospitalization and it also holds a certain amount of expenses. So, you can reimburse all the ambulance expenses in this health insurance plan up to the actual expenses incurred for the ambulance cover.

Donor Expenses

If in case you are going through any surgery related to organ transplantation then the ProHealth Premier insurance plan covers all the expenses done for buying the organ and paying the price of the organ to the donor. The maximum coverage will be up to the full sum assured that that is Rs.1 Crore.

Worldwide Emergency Cover

The company will reimburse all your expenses up to a maximum limit of the full sum assured if you got hospitalized abroad. It means that you can enjoy the benefits of this policy outside India or abroad.

Restoration of the Sum Assured

Usually, the Sum Assured reduces after making many claims in a policy year, so this benefit will help you to restore the original value of the Sum assured that was in the beginning and you can claim for the original amount of Sum Assured easily.

AYUSH Cover

This Plan also covers the expenses related to the Ayurvedic Treatment. It covers all the expenses done at the AYUSH Hospitals and the maximum limit of the coverage would be the full Sum Assured.

Health Maintenance Benefits

There are some treatments that can be done without hospitalization and can be cured in an outpatient department. So these types of treatments are known as health maintenance. In the ManipalCigna ProHealth Premier Extra-Large Cover, you will get the Health Maintenance Benefits of up to Rs.15000 per policy year.

The Amount of Rs.15000 can be used to compensate 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 Premier insurance plan:-

  1. It gives a cover of up to Rs.100000 in case of a normal delivery per event.
  2. It gives a cover of up to Rs. 200000 for C-Section per event.
  3. There is a waiting period of 48 Months for this benefit.

New Born Baby Expenses

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

Value-Added Benefits

Now, you must explore some of the value-added benefits of this health insurance plan. Explore all of them and see how they will help you during your medical emergencies.

Free Health Check-Up

You can have a free health check-up after every policy year but not in the first policy year. All the insured having the age of 18 years and above can take the health check-up free of cost. The tests available in the free 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 have an expert opinion free of cost from the specialist doctor. You can enjoy this benefit only once in a year and the Critical Illnesses that are covered in this plan are:-

  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 ManipalCigna ProHealth Premier Extra Large Cover insurance plan

ParticularsDetails
Minimum Age of Entry for Children91 Days
Minimum Age of Entry for Children18 Years
Minimum Sum Assured100 Lacs
Maximum Sum Assured100 Lacs

Information Needed while Making a Claim for the Health Insurance

  1. Policy Number
  2. Name of the Policyholder
  3. Name of the Insured Person
  4. Nature of Illness or Injury
  5. Name and Address of the Medical Practitioner
  6. Name and Address of the Hospital
  7. Date of Admission
  8. Any other necessary information asked by the company.

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