Manipal Cigna ProHealth Preferred Health Insurance Plan
Overview
Highlights For
Manipal Cigna -Prohealth Preferred
Restoration
Commulative Bonus
Maternity Benefit
Convalescence Benefit
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
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 : 24 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 : 12 months
Listed specific illness
Waiting Period- PED : 24 Months
No pre-existing ailment related claims are accepted within this period.
Room Rent : Upto SI
Room rent for in-patient hospitalisation
ICU Charges : Upto SI
Charges for ICU hospitalisation
Co pay : No
% of the claim that the policyholder needs to pay out-of-pocket
Restore Benefit/ Recharge/ Refill : Multiple Restoration is available in a Policy Year for unrelated illnesses in addition to the Sum Insured opted
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 each policy year(excluding the first year), to all insured persons who have completed 18 years of Age
Free annual health check-up for all insured members according to the list of tests specfied in the policy document.
No Claim Bonus : A guaranteed 10% Increase in Sum Insured per policy year, maximum up to 200% of Sum Insured
% 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 SI
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 : Rs 3000 for each continuous and completed 24 Hours of Hospitalisation during the Policy Year up to a maximum of 30 days in a policy year
A specific fixed amount of money paid as a recovery benefit for extended hospitalisation.
Organ Donor : Upto SI
The costs for a surgical procedure of removal or damaged organ from the patient's body which could otherwise be fatal.
Bariatric cover : Yes
Expenses related to obesity-related conditions such as high BP, sleep apnea, arthiritis asthma, etc.
Daycare : Yes
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 : N0
All advanced treatment with upgrade in technology.
Health Management/ Wellness : Yes
Benefits provided for staying fit and managing health
Maternity Benefit : Covered upto `50,000 for normal delivery and `100,000 for C-Section per event, after a waiting Period of 48 months
All expenses related to childbirth or legal medical termination of pregnancy, usually upto a specified limit.