ManipalCigna ProHealth Plus Plan
Product Overview
ManipalCigna ProHealth Insurance Plan is an inpatient hospitalization policy which provides coverage for expenses related to hospitalization such as room rent, doctor expenses, medical bills, day care treatments, etc. Apart from Age, lifestyle, sum insured, gender & medical condition, the geographical location also determines the premium.
Unique Features - ManipalCigna ProHealth Plus Plan
- Cumulative Bonus - There will be no reduction in the incremental sum assured accumulated in the form of NCB, in the event of a claim during the policy period.
- This plan offers a Healthy Rewards Program (i.e. 1% of the premium paid each year) that encourages you to stay healthy along with an Annual Health Check-ups & an Expert Opinion on Critical Illness.
- Worldwide Emergency Medical Assistance Cover & Health Maintenance Benefit Cover (i.e. Reimbursement of Rs. 2000/- each year to cover out-patient expenses).
- 100% Restoration of the Sum Insured is available during the policy year to meet the future claims for all unrelated diseases/injury.
- Pre & Post-Hospitalisation expenses (Like - Doctor's Fees, Pharmacy related expenses, diagnostic test, etc.) are covered up to 60 & 180 days.
- Maternity Expenses, New Born Baby Expenses & First Year Vaccinations Expenses for the baby are covered under the policy.
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OneInsure App Benefits
Critical Features - ManipalCigna ProHealth Plus Plan
- Room Rent:
Limits imposed towards room and ICU rent expenses
Single private Room
- Co-Payment:
Specific % of the admissible claim amount to be borne by the Insured.
- Compulsory 20% Co-Pay for insured aged 65 yrs or above whenever he attains this age (Waiver option with extra premium).
- Has the option of choosing a Voluntary Co-payment of 10% or 20% on the admissible claimable expenses.
- No Claim Bonus:
Cumulative Bonus offered in the event of No claim during the policy year.
10% of Basic Sum Insured up to a maximum of 100% for each unclaimed year in case opted for . (The cumulative bonus will not be reduced in event of any claim)
- Pre-Existing Diseases:
Means any condition, ailment or injury or related condition(s) for which you had signs or symptoms, and / or were diagnosed, and / or received medical advice/ treatment, within specified months prior to the first policy issued by the insurer.
- 3 years waiting period for Pre-Existing Diseases.
- Maternity is covered after 4 years of waiting.
Eligibility Criteria
- Minimum Age of Entry:- 91 days
- Maximum age of Entry:- No Limit
- Renewal Age:- Life Long Renewal
- Sum Insured:- 4.5 Lakhs, 5.5Lakhs, 7.5Lakhs, 10Lakhs
- Policy Tenure:- 1 & 2 years
- Family Definition:-
Individual Plan - Self, Spouse, Children, Parent, Siblings, Parent-in-laws, Grandparents & Grandchildren
Family Floater - Self, Spouse, Dependant Children & Dependant Parents - Premium Calculated on Basis of:- Age, (i.e. sum Insured Chosen)
Add Ons
| Features | Description |
|---|---|
|
Critical Illness Cover |
Entry Age - 18yrs to 65yrs (Life Long Renewal) A lump-sum critical illness benefit amount equivalent to the Sum Insured opted under the policy to the Insured person, on the first diagnosis of the covered critical illness. A waiting period of 90 days from the date of issuance of first policy shall apply for claiming under this benefit. A Survival Period of 30 days is applicable for the claim to be paid. Covered Critical Illnesses: |
| Cumulative Bonus Booster | If opted, an additional Sum Insured of 25% will be added as Cumulative Bonus at the time of renewal in case there is no claim in the expiring policy. Maximum accumulation is upto 100%. This benefit is available in place of cumulative bonus. |
| Waiver of Mandatory Co-payment | You have the option to remove Mandatory Co-pay applicable for persons aged 65 years & above on payment of an additional premium. |
| Reduction in Maternity Waiting | We will reduce the waiting period for Maternity Expenses from 48 months to 24 months from the date of inception of first Policy with us under this benefit. New Born Baby cover and First-year vaccinations will also follow a reduction in waiting period. This benefit can be opted by paying an additional premium. |
Additional Discounts
- Family Discount - The insured will get 10% Family Discount for covering more than 2 family members under the same policy under the individual policy option.
- Long Term Policy Discount - The insured will get 7.5% discount for selecting a 2 years policy.
- Co-pay Discount - A discount of 7.5% for opting 10% Co-pay and a discount of 15% for opting a 20% Co-pay on the Policy
Exclusions
- Genetic Disorder
- Dental treatment, dentures or surgery
- Circumcision
- Birth control procedures, contraceptive supplies and services
- Routine medical check-up and diagnostic tests
- AIDS and all diseases/illnesses caused by or related to HIV
- All sexually transmitted diseases
- Mental illnesses
- Ailments arising out of alcohol and drug abuse
- Cosmetic surgery except reconstructive surgery for burns and accidents.
- Any form of non-allopathic treatment
- Any robotic or remote surgery
- Any amount which falls under the deductible or co-pay
- Non-medical expenses listed as per IRDA
Note: Any claims arising out of or attributable to any of the following is not covered, Please refer policy T & C for a detailed list of exclusions.
Tax Benefits
The premium paid towards Health Insurance for Individual (Self, Spouse, Children & Parents) & Parents (Senior Citizens) qualifies for deduction under Section 80D of the Income Tax Act, 1961.
Claim Process
In case you would like to know about the Claim Process or would like to register a Claim please click the link below
