ManipalCigna ProHealth Prime Insurance: Buy, Renew & Compare

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.

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

FAQs

Q1. Which pre-existing diseases are covered by ManipalCigna ProHealth Prime Insurance after 90 days?
Ans: The following pre-existing diseases are covered by the ManipalCigna ProHealth Prime Insurance policy after a waiting period of 90 days:
- Diabetes
- Hypertension
- Asthma
- Obesity
- Dyslipidaemia
Q2. Do ManipalCigna ProHealth Prime Insurance plans cover pre and post-hospitalization expenses?

Ans: Yes. Pre and post-hospitalization expenses are covered by the ManipalCigna ProHealth Prime Insurance plan. The Protect and Advantage plan variants cover pre-hospitalization expenses for 60 days and post-hospitalization expenses for 180 days. However, the Active plan covers pre and post-hospitalization expenses for 30 days and 60 days respectively.
Q3. Can children avail health annual check-up benefit offered by ManipalCigna ProHealth Prime Insurance?

Ans: No. The annual health check-up benefit is available only for adult insured members under the ManipalCigna ProHealth Prime Insurance policy.
Q4. Who can opt for the Cumulative Bonus Booster benefit under the ManipalCigna ProHealth Prime Insurance plan?

Ans: ManipalCigna ProHealth Prime Insurance policyholders with a sum insured of Rs 5 lakh and above can opt for the cumulative bonus booster benefit.
Q5. Can I pay the premium for my ManipalCigna ProHealth Prime Insurance policy in instalments?

Ans: Yes. You can pay the premium for your ManipalCigna ProHealth Insurance policy in annual, semi-annual, quarterly and monthly instalments.