ManipalCigna ProHealth Prime Insurance

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*Tax benefit is subject to changes in tax laws. Standard T&C Apply

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      ManipalCigna ProHealth Prime Insurance

      ManipalCigna ProHealth Prime Insurance is a comprehensive health insurance plan that offers coverage for ambulance service, hospitalization, OPD treatment, mental illness, HIV/ AIDS, domiciliary treatment, etc. to individuals and families. It also comes with several value-added covers, including annual health check-ups, premium waiver benefit, unlimited teleconsultation, cumulative bonus and domestic second opinion.

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      ManipalCigna ProHealth Prime Insurance: Key Highlights

      Categories Specifications
      Sum Insured Rs 3 lakh to Rs 1 crore
      Policy Tenure 1 year, 2 years, 3 years
      Network Hospitals 7600+
      Incurred Claim Ratio (2020-21) 61.13%
      Pre-existing Diseases Waiting Period 91 days/ 24 months/ 36 months
      Co-payment 10% (under Active plan only)
      Discount 20% family discount
      3% standing instruction discount
      Up to 10% long term discount
      Up to 20% wellness discount

      Benefits of ManipalCigna ProHealth Prime Insurance

      Take a look at some of the most attractive benefits of a ManipalCigna ProHealth Prime Insurance plan:

      Unlimited Restoration of Sum Insured

      Under this plan, the policy sum insured is restored to 100% every time a claim is raised and the full coverage amount is available for the next claim.

      Annual Health Check-up

      With this plan, all adult insured members are eligible for an annual health check-up at the network providers of the insurance company.

      Unlimited Tele-Consultation

      The insured can avail unlimited consultations with doctors in the insurance company’s network over the phone through calls or chats. 

      Discounts from Network Providers

      With this plan, the insured can avail discounts on diagnostic tests, pharmacy and health supplements taken through a network provider of the insurance company.

      Daily Cash for Shared Accommodation

      ManipalCigna Health Insurance Company will provide a daily cash allowance in case the insured opts to stay in a shared hospital room. 

      Cumulative Bonus

      The insurance company grants a cumulative bonus of 25% for up to a maximum of 100% in case no claims are raised in the previous policy year. This bonus increases the policy sum insured without any increase in the premium amount. 

      Premium Waiver Benefit

      In case the policyholder is diagnosed with any of the listed critical diseases or dies in an accident, then the insurance company will waive off the renewal premium for one year.

      Domestic Second Opinion

      The policy comes with an option to avail second medical opinion from doctors within India once a year in case the insured is diagnosed with one of the 36 listed critical illnesses.

      Convalescence Benefit

      If the insured is hospitalized for 10 or more consecutive days, then the ManipalCigna Health Insurance Company will pay a lump sum amount to cover the loss of income.

      Switch Off Benefit

      This plan comes with an option to switch off the health insurance coverage for up to 30 days and earn a discount on renewal premiums in case the insured is travelling abroad.

      Wellness Program

      Policyholders can earn rewards by opting for the Healthy Life Management Program offered by the insurance company and improving their health parameters, such as daily step count.

      ManipalCigna ProHealth Prime Insurance Eligibility Criteria

      Here are the eligibility criteria to buy a ManipalCigna ProHealth Prime Insurance policy:

      Parameters Eligibility Criteria
      Minimum Entry Age Adult – 18 years
      Child – 91 days
      Maximum Entry Age Adult – No limit
      Child – 25 years
      Coverage Type Individual and family floater
      Relationships Covered Individual - Self, spouse, children, parents, siblings, parents-in-law, grandparents, son-in-law, daughter-in-law, uncle, aunt, niece and nephew
      Family Floater – Self, spouse, children and parents
      Renewability Lifetime

      Types of ManipalCigna ProHealth Prime Insurance Plan

      The ManipalCigna ProHealth Prime Insurance comes in three types:

      • Protect Plan – The Protect plan is available with sum insured options of Rs 3 lakh to Rs 1 crore.
      • Advantage Plan – The Advantage plan comes with a sum insured option ranging from Rs 5 lakh to Rs 1 crore.
      • Active Plan – The Active plan offers a sum insured option ranging from Rs 3 lakh to Rs 15 lakh.

      Inclusions of ManipalCigna ProHealth Prime Insurance

      ManipalCigna ProHealth Prime Insurance includes the following coverage:

      • In-patient Hospitalization
      • Outpatient Expenses (Available under Advantage plans)
      • Modern & Advanced Treatments
      • Mental Illness
      • HIV/AIDS and STD
      • Pre-Hospitalization
      • Post-Hospitalization
      • Donor Expenses
      • Day Care Treatments
      • Domiciliary Hospitalization
      • AYUSH Treatment
      • Road Ambulance
      • Air Ambulance (Excluded under Active plans)
      • Bariatric Surgery (Excluded under Active plans)
      • Convalescence Benefit (Available under Active plans)

      Optional Covers:

      • Non-Medical Items
      • Deductible (Available under Protect plans)
      • Infertility Treatment (Excluded under Active plans)
      • Personal Accident Cover (Excluded under Active plans)
      • Cumulative Bonus Booster (Excluded under Active plans)
      • Health Check-up (Available under Active plans)
      • Worldwide Accidental Emergency Hospitalization (Available under Active plans)
      • Critical Illness Add-on Cover (Excluded under Active plans)

      Optional Packages:

      The ManipalCigna ProHealth Prime Insurance plan comes with four optional packages:

      Enhance Plus: (Under Protect Plans)

      • Room Accommodation Upgrade
      • Health Maintenance Benefit
      • Maternity Expenses + New Born Baby Expenses

      Assure: (Under Protect Plans)

      • Room Accommodation Limit
      • Disease Specific Sub-limits
      • Capping on Modern & Advanced Treatments

      Enhance: (Under Advantage Plans)

      • Room Accommodation Upgrade
      • Maternity Expenses + New Born Baby Expenses

      Freedom: (Under Protect and Advantage Plans)

      • Room Accommodation Upgrade
      • Worldwide Emergency Hospitalization with Outpatient Cover

      Exclusions of ManipalCigna ProHealth Prime Insurance

      ManipalCigna ProHealth Prime Insurance excludes the following coverage:

      • Dental treatment
      • Obesity-related treatment
      • External congenital anomaly
      • Donor screening cost
      • Treatment for alcoholism or substance abuse 
      • Cosmetic or plastic surgery

      ManipalCigna ProHealth Prime Insurance Waiting Periods

      Check out the waiting periods under the ManipalCigna ProHealth Prime Insurance plan below:

      Category Waiting Period
      Pre-existing Diseases Waiting Period 90 days/24 months/36 months
      Initial Waiting Period 30 days
      Specific Illness Waiting Period 24 months
      Bariatric Surgery 36 months
      Maternity Expenses 36 months
      Critical Illness Cover 90 days

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