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ManipalCigna’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.
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.
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.
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.
|Hospitalization||Covered for a single private room|
|Day care treatments||Covered up to the Sum Insured|
|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|
|Age at entry (in completed years)||Policyholder and adults - 18 years
Dependent children – 91 days
|Term of the plan||1 year||3 years|
|Premium paying options||Single pay|
|Sum Assured||Rs.2.5 lakhs||Rs.10 lakhs|
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.
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.