ManipalCigna Pro Health Plus Plan

Brief Overview - ManipalCigna ProHealth Plus Plan

A standalone health insurance company Manipal Cigna Health Insurance Company is a collaboration between Manipal Group of Companies and Cigna Corporation. With skilled expertise and robust experience of such strong groups, Manipal Cigna Health Insurance Company is providing the customers with multiple health insurance plans and products. 

However, it is the diversity of health plans that are offered by the company which sets them apart from their counterparts. Each plan is crafted in a way that suits different customer needs. The company also has a well-established network of over 4,500 hospitals where customers can avail the facility of cashless hospitalisation

In this article, we are going to discuss one such plan, ManipalCigna ProHealth Plus Plan. A comprehensive health insurance plan offers you healthcare benefits that help in ensuring physical as well as emotional well-being. 

ManipalCigna ProHealth Plus Plan comes in multiple variants, and you can pick the option that suits you the most. 

Best Features of ManipalCigna ProHealth Plus Plan

1. ManipalCigna ProHealth Plus Plan offers comprehensive hospitalisation cover for you and your family
2. The Sum Insured ranges from INR 2.5 lakhs to INR 50 lakhs
3. The plan allows many premium discounts in the form of  Healthy Reward Points
4. You can get a Guaranteed Cumulative Bonus that can go up to 200%
5. The premiums that you pay can fetch you tax benefits under Section 80D of the Income Tax Act, 1961
6. You can avail lifetime renewals with ManipalCigna ProHealth Plus Plan
7. For insured members over the age of 65 years, there is a mandatory 20% of co-payment
8. This also covers maternity health insurance plan and newborn baby expenses
9. Alternative treatments are covered
10. Multiple discounts are offered with the plan
11. Variants: Protect/ Plus/ Preferred/ Premier/ Accumulate

Benefits of ManipalCigna ProHealth Plus Plan

1. In-patient Benefits
   ManipalCigna ProHealth Plus Plan offers adequate health coverage for your stay at the hospital. From room rent to the surgery costs, from nursing charges to the doctors’ fee, just about everything is covered.
2. Pre and Post-hospitalisation
   Your expenditure on the treatment would neither begin nor end with hospitalisation. Under this plan, the expenses related to the same injury/illness will be covered for 60 and 180 for both before and after the hospitalisation respectively.
3. Lifelong Renewability
   The ProHealth plan comes with the option of lifelong renewability. This means that you can have policy benefits for your whole lifetime. This way you have health insurance until an advanced age.
4. Restoration of Sum Insured
   In case you exhaust the sum insured limit and the cumulative bonus, the plan would restore the sum insured unlimited times, for the treatment of an unrelated illness or injury.
5. Ambulance Charges
   Charges for an ambulance service up to a limit of INR 3,000 per event would be covered, when the service is used for bringing the insured member to a hospital in an emergency.
6. Health Maintenance Benefit
   Get rewarded for staying fit and healthy. Get a health maintenance benefit up to INR 2,000.
7. Discounts
   The following discounts are available:
   • Family discount when the plan covers 2 and more members under an individual policy
   • Opt for a longer policy term and get discounts. When you opt for a policy term of 2 or 3 years, you get a discount of 7.5% and 10% respectively.
   • Get more discount when opting for co-payment
8. Day-care Procedures
   Some specific treatments require less than 24 hours of hospitalisation. Such procedures are called daycare procedures. Under ManipalCigna ProHealth Plus Plan, 546 such procedures are covered up to the sum insured.
9. Maternity Benefits
   Maternity related expenses such as delivery or medically required pregnancy termination, up to 2 times in the life of the insured (between 18 to 45 years of age) would be covered, after a waiting period of 48 months.
10. New Born Baby Cover
    Till your newborn baby is 90 days, all medical expenses towards its treatment would be covered. Vaccination charges till the baby turns 1 year, would also be covered.
11. Organ Donation
    In the case of a major organ transplant, the in-patient cost of the donor would be covered under this plan.
12. Domiciliary Treatment
    In case an insured member could not receive treatment in a hospital due to his/her ill health or due to unavailability of accommodation, the medical expenses that are incurred for the treatment at home would be incorporated under the plan.
13. AYUSH Coverage
    If you are a patient who favours alternative forms of medicine, such as Ayurveda, Yoga, Unani, Siddha and Homoeopathy,  you can get a cover for the expenses on such treatments as well.
14. Value-added Services
    • Second Opinion
      Get a second opinion for any of the listed critical illnesses, without spending from your pocket.
    • Cumulative Bonus
      The plan offers protection against inflation in the form of a guaranteed Cumulative Bonus that can be up to 200% of the sum insured.
    • Health Check-Ups
      Insured members who are over the age of 18 years are eligible for a health check-up.
15. Optional Covers
    There are many other options that you can opt for by paying a little extra. You can choose a deductible, get Daily cash benefit, Reduce the waiting period for maternity benefits and voluntary co-pay options.

Plan Details of ManipalCigna ProHealth Plus Plan

Waiting Period

• All treatment apart from accidental injuries have a 30-day waiting period, starting from the policy inception
• There is a 24-month waiting period applicable on specific diseases
• In the case of pre-existing diseases the waiting period is applicable in the following ways:
  1. Preferred and Premier Plan- 24 months
  2. Accumulate and Plus Plan- 36 months
  3. Protect Plan- 48 months

Free Look Period
One more benefit of the ManipalCigna ProHealth Plus Plan is that it comes with a free look period. The free-look is a 15-day period that begins from the date of policy inception. During this period you can review the terms and conditions of the policy. If you feel that the policy is not as per your stipulations you can return it on the condition that no claims have been made so far. 
Stating the cause of the return, you can make a refund request through a written application. The stamp duty charges and proportionate risk premium will be decreased from the premium amount that was spent and the refund would be initiated.

Grace Period
Once your ManipalCigna ProHealth Plus Plan reaches its expiry date, it enters the grace period. During this time you need to renew the policy if you wish to enjoy the policy benefits. If you were unable to renew your policy, and it has now expired, you can get in touch with customer care or a trusted insurance advisor for the renewal. 

Remember that for premium paying frequency of Single, Yearly, Half-yearly and Quarterly basis, the grace period is for 30 days. In the case of a monthly mode of health insurance premium payment, the grace period is for 15 days only. 

What is not Covered in ManipalCigna ProHealth Plus Plan?

Just like any other health insurance plan, there are certain exclusions under the ProHealth Plus Plan. Given below is an indicative list of some major exclusions, for an exhaustive list, please refer to the policy document:

1. Dental treatment
2. Circumcision
3. Infertility and sterility
4. Regular Medical Check-ups
5. No claims would be accepted when the policyholder tries to harm himself in any way
6. No claims would be accepted if the ailment or injury occurs due to drug abuse
7. No claims would be accepted when an injury occurs due to participation in any adventure sport or in an illegal activity
8. No claims would be accepted under any kind of civil war or foreign invasion

ManipalCigna ProHealth Plus Plan - Renewal of Policy

1. Online Method
   Policy renewal is a simple online process that takes just about a few minutes. Keep your policy-related documents and payment mode handy and visit the official website. Now go to ‘Make Payment’ or just click https://buyonline.manipalcigna.com/buy-health-insurance/renew. The portal is well illustrated, enter the details required and follow the instructions carefully. You can renew the policy through an insurance aggregator website as well. The premium can be paid online through Credit cards/ Debit cards/ Net banking or UPI Payments.
2. Offline Method
   Renewal of your policy can also be done offline. You can pay the premium by visiting the nearest Manipal Cigna branch office. You would have to complete the renewal related paperwork, for which you can take the help of an official. The payment can be made through cheque/ demand draft/ credit or debit card.
   If you are up for it, you can renew the policy through a trusted company agent.

ManipalCigna Health Insurance Company - Claim Procedure

Manipal Cigna follows a simple and transparent claim procedure, and if you follow all the company laid instructions, the claim would be settled without any hassle or hindrance. 
A hospitalisation may be planned hospitalisation or an emergency, and you can make a claim for both. When your doctor advises hospitalisation, the first thing to be done is to notify the company. 

If the hospitalisation is planned, you must inform the company at least 48 hours prior to admission to the hospital. In case of an emergency, you can inform the company within the first 24 hours of the hospitalisation.  

To notify the company you can either:

1. Call on the toll-free number 1800-102-4462 or
2. Send an email to cigna@mediassistindia.com
3. Register the Claim online on the company website

The Claim process depends on the kind of hospital you seek the treatment in. 

• ManipalCigna Cashless Claims
  You have the advantage of opting for cashless treatment at a network hospital. At the time of admission to the hospital, you would have to submit the claim form, pre-authorisation form along with the relevant medical documents. The company and the TPA would then authenticate the documents, and if the claim is approved, the hospital will begin the treatment. The company would clear the final bill.  It must be noted that the treatment expenses are covered only up to the sum insured. There may be certain uncovered expenses that you would have to pay for from your own pocket.
• ManipalCigna Reimbursement Claims
  You would not be able to avail of the cashless treatment facility in case you seek treatment from a non-network hospital. However, your medical expenses can be reimbursed. At a non-network hospital, you would have to pay for the treatment upfront. After the treatment, you get the amount reimbursed by the company.

When making a claim for reimbursement, you need to inform the company about the hospitalisation. At least 48 hours prior to admission in the hospital in case of planned treatment and within the first 24 hours in case of an emergency admission.  

You need to fill and sign the claim form which can be downloaded from the company website.  The other required documents are to be submitted at an office branch of Manipal Cigna. Post authentication of documents, the reimbursement claim amount will be transferred to your savings account.   

Policy Network Hospitals - ManipalCigna Health Insurance

Cashless health insurance treatment facilities are offered to the policyholders at network hospitals only. At these hospitals, the company settles the treatment bills directly, up to the sum insured. Getting the treatment at a network hospital is very easy and saves you the hassle of running around at the last minute. It is advised that you keep a check on the list of network hospitals available on the company website, as it is updated periodically.

Review of ManipalCigna ProHealth Plan

Ever since its establishment ManipalCigna has been able to make a place for itself in the insurance market and has settled claims worth over INR 621 crores. Under its Health Rewards programme, the company has over 54,000 happy customers. The ManipalCigna ProHealth plan is a comprehensive plan and is well-suited for people with varied backgrounds and health insurance needs. The company has built up a lot of reputation by settling 97% of cashless approvals in less than 2 hours.
ManipalCigna ProHealth plan also has the beneficial feature of reinstatement of the sum insured, making it a fabulous health insurance policy for family.

Customer Care Details - ManipalCigna Health Insurance