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Cigna TTK ProHealth Plus Plan

Cigna TTK’s ProHealth Plus Plan is a comprehensive health insurance plan which gives you value for money. The coverage features are exhaustive while the premium is affordable. The plan allows premium discounts, wellness packages and health related rewards.

Key features of the plan

  • There is no bar on the entry age. Individuals of all ages can buy the plan. Moreover, the plan is renewable lifelong.
  • The plan can be taken for up to 3 years.
  • Premium discounts are given for buying a 2 or 3 year policy or when 2 or more family members are added to the plan.
  • The plan covers treatments taken abroad too through its Worldwide Emergency Cover up to the Sum Insured.
  • 1% of the premium paid can be earned as Healthy Rewards. These rewards can then be used to discount renewal premiums or used as Health Maintenance Benefits.
  • There is a Critical Illness rider available under the plan which pays an additional Sum Insured in case of diagnosis of a covered critical illness.

How does the plan work?

Step 1 – the policyholder chooses the Sum Assured, the policy term and the members covered.

Step 2 – the policyholder can also choose any additional coverage from 5 optional benefits. Critical Illness Rider can also be added by paying an additional premium.

Step 3- If the covered member (s) face any medical contingency and the related expenses are covered by the plan the expenses incurred are paid by the plan.

Step 4 – if the plan matures and no medical contingencies occur, no benefit is paid.

Example

Karim, a non-smoking male aged 35 years, buys the plan for himself for a Sum Assured of Rs.10 lakhs.

Option 1 – Karim suffers an accident and is hospitalized. His total hospital bill comes to Rs.7.5 lakhs. Since the bills are within the Sum Insured, the entire clam is paid by the policy. However, if the medical bills had exceeded Rs.10 lakhs, the company would pay only Rs.10 lakhs.

Option 2 – if the plan matures and Karim doesn’t suffer any medical emergency, no benefit is paid.

Plan benefits

  • Medical benefits – the list of medical expenses covered by the plan and their extent is as follows:
  • Hospitalization Covered
    Day care treatments Covered up to the Sum Insured
    Pre-hospitalization 60 days
    Post hospitalization 180 days
    Domiciliary hospitalization Covered up to the Sum Insured
    Organ donor expenses Covered up to the Sum Insured
    Ambulance cover Up to Rs.3000 per hospitalization
    Worldwide Emergency Cover Covered up to the Sum Insured
    Health Maintenance Benefits (OPD expenses) Covered up to Rs.2000
    Maternity expenses Normal delivery– lower of actual expenses or Rs.15,000
    Cesarean delivery – lower of actual expenses or Rs.25,000
    New born baby cover Covered up to the maternity benefit limit
    First year vaccinations Available
    Restoration of Sum Assured Covered once in a policy year
    Health check-ups 1 check-up annually for adults aged 18 years and above
    Expert Opinion on Critical Illness Covered
    Healthy Rewards 1% of premium paid
  • Optional Coverage benefits – the plan allows 5 types of additional coverage features which can be added to the plan. These features are as follows:
    • Deductible – by choosing a deductible of Rs.1-3 lakhs, you can reduce your premium.
    • Reduction in Maternity Waiting – through this option, the maternity waiting period reduces to 24 months.
    • Voluntary co-payment – by choosing a co-payment of 10% or 20%, the plan premiums can be reduced.
    • Waiver of mandatory co-payment – by paying an additional premium the policyholder can waive the mandatory co-payment of 20% which is applicable if the insured is 65 years and above.
    • Cumulative Bonus Booster – through this benefit, the No Claim Bonus increases to 25% to increase the Sum Insured by 100%.
  • No Claim Bonus – if the policyholder does not make a claim in any policy year he earns a cumulative bonus of 10% increase in the Sun Insured subject to a maximum of 100%.
  • Premium discounts – premium discounts are allowed for the following:
  • For buying a long-term policy – 7.5% discount for a 2 year policy and 10% for a 3-year policy.
  • For including family members – 10% for covering 2 or more family members

Eligibility Criteria

  Minimum Maximum
Age at entry (in completed years) Policyholder and adults - 18 years
Dependent children – 91 days
No limit
Term of the plan 1 year 3 years
Premium paying options Single pay
Sum Assured Rs.4.5 lakhs Rs.10 lakhs

What is not covered by the plan?

Illnesses suffered during the first 30 days of the plan commencement are not covered.

Critical Illnesses suffered during the first 90 days of the plan commencement are not covered.

Pre-existing illnesses or conditions and maternity related expenses are not covered by the plan in the first 4 years of the policy

Specific illnesses are not covered in the first two years of the plan.

Illnesses or accidents caused due to genetic disorder or stem cell surgery, substance abuse, participation in adventure sports or hazardous activities, criminal acts, attempted suicide, war and hazardous substances, etc. are not covered.

Treatments like dental treatments, cosmetic treatments, artificial life support, weight loss treatments, non-allopathic treatments or due to HIV/AIDS, etc. are not covered.

Premium Illustration

Below are the sample rates of premium payable by a non-smoking male for different combinations of age and Sum Insured. The policy is taken for 1 year.

FAQs