Overview
Highlights For
Manipal Cigna -Prohealth Plus
Maternity Benefit
Restoration
Hospital Daily Cash Benefits
Commulative Bonus Booster
Features
Sub-limits
Health Check up
Free annual health check-up for all insured members according to the list of tests specfied in the policy document.
Ambulance
Transportation of the patient to the hospital and back home
Pre-Hospitalisation : 60 Days
The amount of expenses incurred during this period prior to hospitalisation such as diagnostic tests, doctor fees, medicines, etc. for investigiation purpose are also payable by the insurer
Post Hospitalisation : 180 Days
The amount of expenses incurred during this period after discharge from hospitalisation for the purpose of recovery such as follow-up tests, doctor fees, medicines, etc. are also payable by the insurer
Pre existing Disease cover : 36 months
Coverage for all Pre-Existing Diseases covered after a certain specified waiting period with continuous renewal.
Waiting Period- Initial : 30 days for all illnesses (NA on renewal and for accidents)
No claims are accepted within this period except due to accidents/ injury.
Waiting Period- Specific : 24 Months
Listed specific illness
Waiting Period- PED : 36 months
No pre-existing ailment related claims are accepted within this period.
Room Rent : Upto Sum Insured
Room rent for in-patient hospitalisation
ICU Charges : Upto Sum Insured
Charges for ICU hospitalisation
Co pay : No
% of the claim that the policyholder needs to pay out-of-pocket
Restore Benefit/ Recharge/ Refill : 100% upto Sum Insured
If the sum insured is exhausted due to hospitalisation expenses of one or more members, there is an automatic restoration of the sum insured for related or unrelated ailments.
Health Check up : available once each year, excluding the first policy year
Free annual health check-up for all insured members according to the list of tests specfied in the policy document.
No Claim Bonus : Cumulative Bonus: Guaranteed 10%, Max - 200% of SI
% of the sum insured that rises every claim free year.
Video/telephone consultation : No
E-consultation with expert doctors empanelled with the insurer for a second opinion.
Domiciliary hospitalization : Upto Sum Insured
Home care treatment where there are no beds in the hospital or paitient is not in a condition to be moved to the hospital, This treatment is provided under the supervision of a registered medical practitioner.
Ambulance : Actual incurred expenses paid per hospitalisation event
Transportation of the patient to the hospital and back home
Convalescence benefit : Option to avail Hospital Daily Cash benefit up to ₹ 2000 per day for miscellaneous expenses
A specific fixed amount of money paid as a recovery benefit for extended hospitalisation.
Organ Donor : Upto Sum Insured
The costs for a surgical procedure of removal or damaged organ from the patient's body which could otherwise be fatal.
Bariatric cover : No
Expenses related to obesity-related conditions such as high BP, sleep apnea, arthiritis asthma, etc.
Daycare : UPto Sum Insured
Covers in-patient hospitalisation expenses where the stay is <24 hours under a specified list of treatments
AYUSH : Yes
Alternative treatment coverage such as ayurvedic, unani, sidha and homeopathy which leads to hospitalisation.
Congenital Coverage : YEs
Covers medical expenses related to diagnosis and treatment of heriditary and internal congenital ailments/ conditions/ traits that exist from birth.
Modern Treatments : No
All advanced treatment with upgrade in technology.
Health Management/ Wellness : No
Benefits provided for staying fit and managing health
Maternity Benefit : covered up to ₹ 15000 for normal and ₹ 25000 for C-section per event, max 2 events;
All expenses related to childbirth or legal medical termination of pregnancy, usually upto a specified limit.