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Cigna TTK ProHealth Protect Plan

Cigna TTK’s ProHealth Protect Plan is a health insurance plan which allows affordable coverage. The plan has all the necessary coverage features while the premiums are low. The plan can be taken as a family floater plan for the family or as an individual plan for self.

Key features of the plan

The plan provides Worldwide Emergency Cover under which the plan covers treatments taken anywhere in the world. The plan allows attractive premium discounts which go as high as 30% thus making premiums affordable on the policyholder’s pockets. OPD benefits are also provided by the plan For maintaining a healthy lifestyle the policyholder can earn a reward of 1% of the premium paid. This reward can be used to discount renewal premiums. The Sum Insured is restored back to 100% if it is ever exhausted in a policy year. The plan also provides health and wellness benefits through its Protectiv Healing and Proactiv Living. Pre-policy health check-ups are required if the insured is aged 46 years or above.

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 4 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

Mohit, aged 45 years buys a family floater plan to cover himself, his wife and two kids. He opts for a Sum Insured of Rs.10 lakhs and choose a plan tenure of 1 year.

Option 1 – Mohit’s eldest daughter fractures her leg for which she is hospitalized. The hospital bills amount to Rs.75, 000. Mohit’s family floater health plan settles a cashless claim.

Option 2 – if the plan matures and Mohit 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 for a single private room
    Day care treatments Covered up to the Sum Insured
    Pre-hospitalization 60 days
    Post hospitalization 90 days
    Domiciliary hospitalization Covered up to the Sum Insured
    Organ donor expenses Covered up to the Sum Insured
    Ambulance cover Up to Rs.2000 per hospitalization
    Worldwide Emergency Cover Covered up to the Sum Insured
    Health Maintenance Benefits (OPD expenses) Covered up to Rs.1500
    Restoration of Sum Assured Covered once in a policy year
    Health check-ups 1 check-up once every 3rd policy year
    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:
    1. Deductible – by choosing a deductible of Rs.1-3 lakhs, you can reduce your premium.
    2. Voluntary co-payment – by choosing a co-payment of 10% or 20%, the plan premiums can be reduced.
    3. 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.
    4. 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 5% increase in the Sun Insured subject to a maximum of 100%.
  • Premium discounts – premium discounts are allowed for the following:
    1. For buying a long-term policy- 7.5% discount for a 2 year policy and 10% for a 3-year policy.
    2. For including family members – 10% for covering 2 or more family members
    3. Online discount – if the policy is bought online, there is a discount of 10%

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.2.5 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 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