MANIPALCIGNA PROHEALTH INSURANCE
| Benefit | ProHealth – Protect Plan | ProHealth – Plus Plan |
| Room rent limit | Single private a/c room. | Any category except suite and above |
| No claim bonus | ₹27,500 per year and upto maximum of additional ₹11 lakh In case of claim, your no claim bonus will not be reduced. | ₹55,000 per year and upto maximum of additional ₹11 lakh In case of claim, your no claim bonus will not be reduced |
| Free health checkup | Once every 3 years Free health checkup for every 3 years for adult insured members in the designated diagnostic centers. |
Once every year after 1st renewal Free health checkup every year after renewal for adult insured members in the designated diagnostic centres |
| Existing Illness cover | Covered after 4 years. | Covered after 3 years |
Why you need this Plan ?
ONE PLAN MULTIPLE BENEFITS
1
Pre-Hospitalization coverage
You may incur some expenses before you are hospitalized, like doctors fees, pharmacy- related expenses, or diagnostic tests. All such costs will be covered by us for up to 60 days (in all ProHealth plans) before your hospitalization.
You may incur some expenses before you are hospitalized, like doctors fees, pharmacy- related expenses, or diagnostic tests. All such costs will be covered by us for up to 60 days (in all ProHealth plans) before your hospitalization.
2
Post-Hospitalization coverage
After you get home from the hospital, there are still many expenses to be taken care of, like consultation fees, diagnostic tests, pharmacy-related costs among other things. We will cover such expenses related to your hospitalization up to 90/180 days (as per plan) after your discharge.
After you get home from the hospital, there are still many expenses to be taken care of, like consultation fees, diagnostic tests, pharmacy-related costs among other things. We will cover such expenses related to your hospitalization up to 90/180 days (as per plan) after your discharge.
3
In-patient Hospitalization
We pay for room charges, intensive care unit charges, doctor's fee, diagnostic tests, medications, blood, oxygen, operation theater charges, etc. if you get admitted to a hospital for in-patient care, for more than 24 consecutive hours. We will also cover the hospitalization expenses towards artificial life maintenance, listed modern treatments and HIV/AIDS.
We pay for room charges, intensive care unit charges, doctor's fee, diagnostic tests, medications, blood, oxygen, operation theater charges, etc. if you get admitted to a hospital for in-patient care, for more than 24 consecutive hours. We will also cover the hospitalization expenses towards artificial life maintenance, listed modern treatments and HIV/AIDS.
4
Restoration of Sum Insured (Any number of times)
In case the Sum Insured inclusive of earned cumulative bonus (if any) or Cumulative Bonus Booster (if opted & earned) is insufficient due to claims paid or accepted as payable during the policy year, then we will restore 100% of the Sum Insured for any number of times in a policy year. Restoration is available for unrelated illness, injury.
In case the Sum Insured inclusive of earned cumulative bonus (if any) or Cumulative Bonus Booster (if opted & earned) is insufficient due to claims paid or accepted as payable during the policy year, then we will restore 100% of the Sum Insured for any number of times in a policy year. Restoration is available for unrelated illness, injury.
5
Day Care Treatment (Hospitalization less than 24 Hours)
Treatments such as operations on the eyes, ligament tear, chemotherapy, Haemodialysis etc require you to stay hospitalized for less than 24 hours. We cover 546 such day-care treatments
Treatments such as operations on the eyes, ligament tear, chemotherapy, Haemodialysis etc require you to stay hospitalized for less than 24 hours. We cover 546 such day-care treatments
6
Cumulative Bonus
You shall get guaranteed cumulative bonus (Upto 200% of Sum Insured). While no claim bonus only increases the sum insured for every claim-free year, guaranteed cumulative bonus is available irrespective of any claims. The Sum Insured increases every year by 5/10% (as per plan). eg If you take a ProHealth Plus Plan of 5,50,000 Lakhs, sum insured shall increase by Rs.55,000(10%) every year.
You shall get guaranteed cumulative bonus (Upto 200% of Sum Insured). While no claim bonus only increases the sum insured for every claim-free year, guaranteed cumulative bonus is available irrespective of any claims. The Sum Insured increases every year by 5/10% (as per plan). eg If you take a ProHealth Plus Plan of 5,50,000 Lakhs, sum insured shall increase by Rs.55,000(10%) every year.
7
Health Maintenance Benefit (For Out-patient Medical Expenses and more)
We cover expenses incurred by you on Diagnostic tests, drugs, medical aids such as spectacles, contact lenses, walker etc. under Health Maintenance Benefit. Coverage shall depend on plan taken. To know more about about the coverage and limits associated with each plan, kindly refer the brochure
We cover expenses incurred by you on Diagnostic tests, drugs, medical aids such as spectacles, contact lenses, walker etc. under Health Maintenance Benefit. Coverage shall depend on plan taken. To know more about about the coverage and limits associated with each plan, kindly refer the brochure
8
AYUSH Cover
We want you to avail the treatment of your choice. Hence, our ProHealth plans also support alternate treatments including Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy.
We want you to avail the treatment of your choice. Hence, our ProHealth plans also support alternate treatments including Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy.
9
Health Check-Up
We will provide for a comprehensive Health Check-Up as listed in the eligibility table in policy T&C, to all Insured Persons who are 18 years of age irrespective of claim status. For Protect & Accumulate plan – Available once every 3rd Policy year. For Plus, Preferred and Premier Plan – Available once each year, excluding the first policy year.
We will provide for a comprehensive Health Check-Up as listed in the eligibility table in policy T&C, to all Insured Persons who are 18 years of age irrespective of claim status. For Protect & Accumulate plan – Available once every 3rd Policy year. For Plus, Preferred and Premier Plan – Available once each year, excluding the first policy year.
10
Ambulance Cover
Medical emergencies can happen anytime. So, we cover expenses incurred for transportation by an ambulance service provider to the hospital for treatment. The coverage limit shall depend upon the plan taken by you.
Medical emergencies can happen anytime. So, we cover expenses incurred for transportation by an ambulance service provider to the hospital for treatment. The coverage limit shall depend upon the plan taken by you.