ManipalCigna Plans

ManipalCigna ProHealth Insurance

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ProHealth Plan - Smart plan for a healthier life

Who is eligible for this plan?
  • Minimum entry age: Child - 91 days, Adult - 18 years
  • Maximum entry age: No limit
  • Cover Type: Individual and Family Floater
  • Policy Period: 1, 2 and 3 years
Key features
  • Room rent: Upto Single Private Room / Unlimited eligibility based on plan opted
  • Co-pay: No co-pay if age < 65 yrs / Optional 10%-20% co-pay for ages > 65 yrs
  • Restoration Benefit: Multiple Restorations per year for unrelated illnesses

ManipalCigna Health Insurance Review

ManipalCigna Health Insurance
ManipalCigna Health Insurance sum insured
2.5 lacs − 100 lacs options available
Incurred Claims Ratio *
62.00%
ManipalCigna Health Insurance tenure options
1 or 2 years options available
Claims Settlement Ratio **
90.02%
List of network hospitals
6,500+ hospitals
Number of policies issued *
229,817
Maximum family floater coverage
Self, Spouse + 3 dependent children
Number of lives covered *
1,101,000
* As per IRDAI report for 2018-19   |   ** As per NL25 data published on the Insurance Company website

ManipalCigna ProHealth Insurance benefits

  • Coverage
  • Benefits
  • Waiting Period
  • Exclusion

ManipalCigna ProHealth Insurance coverages

Young singles & couples

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

Planning a family or 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

Benefits of ManipalCigna ProHealth insurance

Coverage Benefits at a Glance ProHealth Protect ProHealth Plus ProHealth Preferred ProHealth Premier ProHealth Accumulate
Basic Cover
Sum Insured (SI) (figures in ₹ in Lacs) 2.5, 3.5, 4.5, 5.5, 7.5, 10, 15, 20, 25, 30, 50 4.5, 5.5, 7.5, 10, 15, 20, 25, 30, 50 15, 30, 50 100 5.5, 7.5, 10, 15, 20, 25, 30, 50
In-patient Hospitalization For Sum Insured up to `5.5 Lacs - Covered up to Single Private Room

For Sum Insured `7.5 Lacs and Above - Covered up to any Room Category except Suite or higher category
Any hospital room except Suite For Sum Insured up to `5.5 Lacs- Covered up to Single Private Room
For Sum Insured `7.5 Lacs and Above - Covered up to any Room Category except Suite or higher category
Pre Hospitalisation Up to 60 days
Post Hospitalisation Up to 90 days Up to 180 days Up to 90 days
Day-care Treatment 500 plus listed Day Care treatments covered up to Sum Insured
Domiciliary Treatment Treatment at home covered up to Sum Insured
Ambulance Expenses Up to ₹ 2000 per event Up to ₹ 3000 per event Actual expenses per event Up to ₹ 2000 per event
Donor Expenses Covered up to Sum Insured
Worldwide Emergency Cover Covered up to full Sum Insured once in a Policy Year
Restoration of Sum Insured Multiple Restoration is available in a Policy Year for unrelated illnesses, injury in addition to the Sum Insured opted
AYUSH Cover In-patient hospitalization covered up to Sum Insured
Health Maintenance Benefit Up to ₹500 Up to ₹2000 Up to ₹15000 Option ₹5000, ₹10,000,₹15,000,₹20,000
Maternity Expenses^ NA ₹ 15000 for normal; ₹ 25000 for C-section (per event) after a Waiting Period of 48 months ₹ 50000 for normal; ₹ 1 lac for C-section (per event) after a Waiting Period of 48 months ₹ 1 lac for normal; ₹ 2 lacs for C-section (per event) after a Waiting Period of 48 months NA
New Born Baby Expenses^ NA Covered within maternity expenses NA
First Year Vaccinations^ NA Covered over & above maternity expenses NA
Value Added
Health Check-Up (for all insured aged 18 years & above) Available once every 3rd policy year Available each policy year(excluding the fi rst year) Available once every 3rd Policy year to all insured persons who have completed 18 years of Age
Available once every 3rd Policy year to all insured persons who have completed 18 years of Age Available once during the Policy Year
Cumulative Bonus (% increase in Sum Insured) Guaranteed 5%, Max - 200% Guaranteed 10%, Max - 200% Guaranteed 5%, Max - 200%
Healthy Rewards Earn points equivalent to 1% of premium paid and additional points max. up to 19% from our wellness programs. Redeem earned points against renewal premium or as Health Maintenance Benefi t anytime or as equivalent value while availing services through our Network Providers
Optional
Hospital Daily Cash Benefit (for each 24 hours hospitalization) ₹ 1000 ₹ 2000 ₹ 3000 ₹ 3000 ₹ 1000
Deductible* ₹ 1/2/3/4/5/7.5/10 Lacs NA NA ₹ 50,000, 1/2/3/4/5/7.5/10 Lacs
Reduction in Maternity Waiting Maternity waiting period Reduced from 48 months to 24 months
Voluntary Co-Payment* 10% or 20% as opted NA NA 10% or 20% as opted
Waiver of Mandatory Co-pay Available Available Available Available Available
Cumulative Bonus Booster Guaranteed 25%, Max - 200% NA Guaranteed 25%, Max - 200%
Add-on
Critical Illness# (lumpsum additional 100% of SI opted) Available Lump sum payment of an additional 100% of Sum Insured Opted NA Lump sum payment of an additional 100% of Sum Insured Opted
*Voluntary Co-pay & Deductible cannot be opted under the same plan. ^Waiting Period of 48 months applies. #Available with 1 & 2 years policy terms.

Waiting Period of ManipalCigna ProHealth insurance

  • First 30 days waiting period is applicable for all illnesses other than accidents
  • 90 days waiting period will be applicable for listed Critical Illness where Critical Illness Add on cover has been opted.
  • 2 years Waiting Period will be applicable for specific illnesses.
  • A 48 months of waiting period will be applicable for Maternity, New Born and First year Vaccination expenses (Except where Reduction in Maternity Waiting is opted)
  • A Personal waiting period may apply to individuals depending upon declarations on the proposal form and existing health conditions. Please refer to the “Special Conditions” Column on your Policy Schedule to identify if any personal waiting period is applied to your Policy.
  • A 48 months waiting period will be applicable for any Pre-existing disease for Protect, a 36 months waiting period for any Pre-existing disease for Plus and Accumulate plan and 24 months waiting period for Preferred & Premier Plan.

Exclusions of ManipalCigna ProHealth insurance

We will not cover any costs towards
  • Stem cell implantation/surgery.
  • Dental treatment other than due to accident.
  • HIV/ AIDS and related complications
  • Vitamins and tonics unless forming part of treatment.
  • Artificial life maintenance, including life support machine use.
  • Treatment for rehabilitation measures, private duty nursing, respite care.
  • Treatment from persons not registered as Medical Practitioners.
  • Ailment requiring treatment due to drug abuse/ alcohol and treatment for de-addiction, or rehabilitation.
  • Any illness resulting from the Insured committing any breach of law.
  • Any cosmetic surgery unless forming part of treatment.
  • Charges incurred primarily for diagnostic purposes.
  • Costs of donor screening.
  • Any form of Non-Allopathic treatment except treatment covered under AYUSH Cover under the policy.
  • Expense for injury of insured whilst engaging any adventure sports.
  • Expenses caused by ionizing radiation or contamination by radioactivity from any nuclear fuel.
  • All expenses arising from foreign invasion & warlike operations, whether war be declared or not.
  • We shall not be obliged to make any payment that is brought about as a consequence of deliberate

Manipal Cigna health insurance FAQ's

No, as per the guidelines of ManipalCigna ProHealth Insurance, medical check up shall be required only if:
  • any insured member covered is greater than 55 years
  • Or sum insured >50 lakh.
  • Insured member >45 years and upto 55 years will undergo an underwriting call and medicals (if required) will be scheduled.

Medical check-up depends upon the disease declared, age of insured person and Sum Insured. Pre-policy medical check-up typically has Medical Examination Report by the Physician, few blood & Urine tests & ECG. Additional test like TMT, 2D echo, Sonography etc can also be part of the PPC check up list depending on the health status, Sum insured and age of the customer.

Pre-existing waiting period for ManipalCigna ProHealth Insurance Plan is 48/36/24 months (as per plan). That means, your pre-existing diseases declared at the time of policy purchase will be covered after 4/3/2 years subject to continuous renewals.

You can port your existing health insurance policy to ProHealth. The below supporting documents will be required:
  • Portability Form
  • Proposal Form
  • Previous insurance policy copies of last 4 years

A compulsory co-payment of 20% is applicable on all claims for Insured Persons aged 65 years and above irrespective of the age of entry in to the Policy. Co-pay will be applied on the admissible claim amount. For persons who have opted for a Waiver of Mandatory Co-pay the same will not apply. In case the Insured has selected the Voluntary co-pay under Optional Cover and/or chooses to avail treatment outside his Zone of Cover, then the co-pay percentages will apply in conjunction

Brochure

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Proposal form

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Policy wordings

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    InstantCover Insurance Web Aggregator Private limited
    710, 6th B Cross, 16th Main Road, Koramangala 3rd Block, Bangalore - 560 034.

  • +91-(80)-41744345
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CIN: U66000KA2018PTC117713 | IRDAI Web aggregator License Code Number: IRDAI / INT / WBA /53/ 2018, Valid till 07/08/2022
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