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A plan specially designed to suit your health needs, at every life stage. Just as your loved ones take care of you in illness, inculcating healthy habits and nursing you back to the best of health. [UIN CTTHLIP18045V031819]
ProHealth Plan

 

ManipalCigna Health insurance is a joint venture between the Manipal Group, an eminent player in the field of healthcare delivery and higher education in India and Cigna Corporation, a global health services company with over 200 years of experience. At ManipalCigna our mission is to improve the health, well-being and peace of mind of those we serve. As your partner in illness and wellness, we offer a full suite of health insurance products and services to meet your individual needs. Our wide network of healthcare facilities supports you to ensure your physical, emotional and
financial well-being. We are committed to offering you an easy and lifetime access to quality healthcare so you can live a healthier and more secure life.

WHAT IS YOUR LIFE STAGE ?

Young singles & couples

  • ProHealth Protect - cover for the essentials
  • ProHealth Accumulate - quality cover when you need it

Planning a family/a family with kids

  • ProHealth Plus - base cover when you have/or are planning kid(s)
  • ProHealth Preferred - higher cover when you have/or are planning kids
  • ProHealth Premier - complete cover for all health needs

Singles, Couples & Family - Excluding pregnancy (Daily Health Needs)

  • ProHealth Accumulate - quality cover for your health needs and more

Complete peace of mind

  • ProHealth Preferred - cover when you need more of everything
  • ProHealth Premier - high-end health solution

 

YOUR AWARD WINNING PROHEALTH PLAN COMES LOADED WITH BASIC COVERS, VALUE ADDED COVERS AND OPTIONAL COVERS FOR YOU TO CHOOSE.

BASIC COVERS

In-patient Hospitalization: If you are admitted to a hospital for more than 24 hours of illness or injury, we will take care of the room charges, ICU expenses, nursing charges, doctor fees, surgeon fees, blood, oxygen, operation theatre charges and other medical expenses. 

Pre-Hospitalization: We will reimburse medical expenses incurred before the date of hospitalization.

Post-Hospitalization: We don’t just cover you when you are in the hospital, but are also with you through the recovery process. Medical expenses incurred after you are discharged will also be covered.

Day Care Treatment: We will pay for medical expenses if you undergo a treatment that needs less than 24 hours of hospitalization. We cover 500 plus listed Day Care procedures.

Domiciliary Treatment: Medical treatment taken at home is also covered in case your condition is not suitable for hospital transfer or if there is no hospital bed available. Pre and Post hospitalization expenses up to 30 days each will also be covered.

Ambulance Expenses: We believe that nothing should come between you and timely treatment. That's why you are covered for transportation expenses by an ambulance service provider to the hospital.

Donor Expenses: We will cover in-patient hospitalization cost of the donor for a major organ transplant.

Worldwide Emergency Cover: Emergencies will not necessarily hit you when in India. We will cover in-patient medical expenses for emergency treatment outside the country for full Sum Insured on re-imbursement basis once in a policy year.

Restoration of Sum Insured: You may claim for an illness and God forbid, there could be multiple unrelated illness/injury that requires you to get hospitalized.This benefit restores the Sum Insured any number of times under the policy to additional 100% in a policy year if the balance Sum Insured and Cumulative Bonus or Cumulative Bonus Booster (if any) is insufficient to settle a claim (for unrelated illness/injury).

AYUSH Cover: We will cover in-patient medical expenses up to the limit of Sum Insured toward non-allopathic treatments such as Ayurveda, Yoga & Naturopathy, Unani, Siddha & Homeopathy for hospitalization arising due to accident or illness undertaken in a government hospital or government recognised institute.

Health Maintenance Benefit: An illness, no matter how small, needs attention. And we make sure that happens. We will cover costs of doctor fees, diagnostic tests, drugs, dental treatments and alternative medicines upto the reimbursement limit under each plan. Fresh coverage will be available at each policy year.

You can even choose a plan which allows:

  • - Carry forward of unutilized HMB balance each year on renewal
  • - Utilization of HMB amount up to 50% towards payment of premium from
  • 1st renewal
  • - Utilization towards payment of deductible or co-pay (if any) and
  • non-admissible expenses
  • - Bonus @ 5% on any unutilized HMB at renewal.

Maternity Expenses: We will cover expenses for the delivery/medically necessary termination of pregnancy (maximum up to 2 events) during the lifetime of an insured between 18 to 45 years after a waiting period of 48 months.

New Born Baby Expenses: Until the baby is 90 days old, we will cover medical expenses incurred towards the treatment of the child within maternity expenses limit.

First Year Vaccination: We will also pay for vaccination charges for your baby till he/she completes 12 months.

 

VALUE ADDED COVERS

Healthy Rewards: We want you to always stay healthy. You can earn reward points equal to 1% of premium paid. In addition, you can accumulate points maximum up to 19% of last premium paid by opting for our Wellness Programs. The accumulated points can be redeemed against premium from 1st renewal of policy, or reimbursed under Health Maintenance Benefit anytime in the policy year, or as discount in fees when availing services of our network partners.

Health Check-up: Most of us take our health for granted. No more. For insured aged above 18 years, we will provide a Health Check-up facility at our Network Providers irrespective of the claim status. Expert Opinion on Critical Illnesses: Take a second opinion on listed critical illnesses from experts at no extra cost.

Cumulative Bonus: We will provide a guaranteed additional Sum Insured as Bonus under all plans at the time of renewal, irrespective of claim in the expiring policy. Cumulative Bonus will accumulate maximum up to 200% of Sum Insured.

 

OPTIONAL COVERS

Deductible: We provide an option to select a Deductible as per the plan.The deductible amount will apply on the sum of all admissible claims in that year. This means that from your claims (should any be arising), you choose to pay the deductible amount either out of your own pocket, or with the aid of an existing Health Insurance policy. You can also go for Waiver of Deductible within or after 48 months of continuous coverage by paying additional premium as applicable on renewal.

Hospital Daily Cash: Provides a fixed daily cash benefit for each continuous and completed 24 hours of hospitalization that will help you take care of out of pocket expenses. The benefit will be available up to 30 days per Policy Year.

Reduction in Maternity Waiting: You have the option to reduce the maternity waiting period from 48 to 24 months.

Voluntary Co-pay: This option (when exercised), would mean that you choose to pay the first 10/20% of the claim and the balance would be covered by your plan. 

Waiver of Mandatory Co-pay: You have the option to remove the mandatory co-pay applicable for persons aged 65 years and above.

Cumulative Bonus Booster: You have an option to increase policy Sum Insured with 25% Cumulative Bonus every year irrespective of the claim. Maximum accumulation is up to 200% of Sum Insured. This benefit is available in place of Cumulative Bonus.


RIDER:

Critical Illness Add-on Cover: We will pay a lump sum benefit up to your opted Sum Insured, in case of first diagnosis of the covered critical illnesses. 

 

MORE DETAILS ABOUT YOUR PROHEALTH INSURANCE

Premium: Premium will depend on the plan, Sum Insured, policy tenure, age, policy type, gender, zone of cover, optional covers and add-on benefit opted. To calculate premium, the country is divided into three zones.
 This zone based pricing enables you to pay as per the healthcare costs prevailing in your city. For details on premium, please refer to premium booklet.
 

Mandatory Co-pay: A co-pay of 20% will apply on all claims for insured aged 65 years and above.


DISCOUNTS:

  • - Family Discount of 25% for Protect and Plus Plans and 10% for Preferred, Premier and Accumulate Plans covering 2 and more family members under the same individual policy.
  • - Long-term Discount 7.5% on opting for a 2 year and 10% on opting for a 3 year single policy term.
  • - Co-pay Discount of 7.5% for opting 10% co-pay and 15% discount for opting a 20% co-pay.

• Renewals: Lifetime renewals available.

• Grace Period: 30 days on renewal with all continuation benefits.

• Free-look: A period of 15 days to cancel the policy with full refund. For any medical tests (if conducted) 50% of medical cost will be retained.

• Tax Benefit: Income Tax deduction available under Sec 80D, Income Tax Act 1961 (as amended).

• Cancellation: Request can be placed during the policy. Premium refund will be on short period basis.


WAITING PERIOD:
• First 30 days waiting period is applicable for all illnesses other than accidents.
• 24 months waiting period is applicable on specific ailments.
• Pre-existing diseases will not be covered for 24 months in Preferred & Premier plans; 36 months in Accumulate & Plus plans and 48 months in Protect plan.
• First 90 days waiting period and 30 days survival period is applicable to Critical Illness Add-on Cover (if opted).

 

KEY EXCLUSIONS

WE WILL NOT COVER ANY COSTS TOWARDS

  • HIV/AIDS and its complications 
  • Suicide or drug abuse 
  • Contamination from Nuclear fuel or radiation 
  • Foreign invasion or civil war

 

WHO IS ELIGIBLE FOR THESE PLANS?

  • Min Entry Age: Child - 91 days, Adult - 18 years
  • Max Entry Age: No limit
  • Cover Type: Individual and Family Floater
  • Policy Period: 1, 2 and 3 years

 

RELATIONSHIPS COVERED:

  • Individual Plan: Self, spouse, children, parents, siblings, parents-in-law,
  • grandparents and grandchildren, son-in-law and daughter-in-law, uncle,
  • aunt, nephew and neice.
  • Floater Plan: Self, spouse, children and parents. A floater cover can insure
  • a maximum of 2 adults and 3 children under a single policy.

 

THE KEY PILLARS UNDERLYING OUR SERVICES ARE:

Claims Handling: Our claims processing service is fast and accurate.You can rely on our claims service associate for easy, efficient and hassle-free claims.

Prevention and Well-being: We are proactive in identifying your health risks and helping you in their management. We go beyond paying claims by bringing to our customers, lifestyle programs that help them live healthier and happier lives.

 

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