Frequently Asked Questions

Pre-existing diseases/illness/injury/conditions will be covered post 36 months of continuous cover depending upon the plan opted.

*Such waiting period shall reduce if the insured has been covered under a similar policy before opting for this policy, subject however to portability/migration regulations.

It means an increase in the Sum Insured granted by the insurer for policy period without an increase in the premium. The percentage of increase in sum insured is 5% each year. The maximum accumulation is up to 100%

The pre-policy medical check-up cost will be paid by ManipalCigna Health Insurance Company.

In case we are unable to underwrite your proposal we will intimate the same to you.

Pre-existing Disease means any condition, ailment or injury or disease:

a.  That is/are diagnosed by a physician within 36 months prior to the effective date of the policy issued by the insurer or its reinstatement; 

or

b.  For which medical advice or treatment was recommended by, or received from, a physician within 36 months prior to the effective date of the policy issued by the insurer or its reinstatement.

ProHealth Select offers wide range of protection including Inpatient, Day care, Pre and Post hospitalization benefits, Donor and Domiciliary cover. It provides Restoration of Sum Insured (SI) and Smart non- reducing Cumulative bonus as an inbuilt benefit.

Its optional Cumulative Bonus Booster works on non-reducing/guaranteed basis (as selected) and adds more flexibility to the policy coverage.You get unique choice of Re-assurance cover, Worldwide Emergency and Health Maintenance Benefit for OPD expenses.

You also have option to select Removal of Room Rent limit and Disease Specific Sub-limits. ManipalCigna offer Healthy Rewards as value added benefit associated with ProActiv Living Program.

All benefits are even offered for policies where Deductible or Voluntary co-pay has been opted.

#Voluntary Co-pay and Deductible cannot be taken under a single plan.

*Available for Plan A

#The covers are available as per the plan chosen.

It allows an increase in the Sum Insured by a fixed percentage as per below option. Cumulative Bonus Booster if opted will be in place of Cumulative Bonus in the base policy.

Option A) 10% increase in Sum Insured, maximum up to 100%. This will not reduce in case of a claim under the Policy. or

Option B) 25% increase in Sum Insured, maximum up to 100%. This will not reduce in case of a claim under the Policy. or

Option C) 50% Increase in Sum Insured, maximum up to 100%.

Option D) 10% increase in Sum Insured, maximum up to 200% irrespective of a claim under the Policy.

Yes. Premium paid under the Policy shall be eligible for income tax benefit under Sec 80 D of the Income Tax Act and any amendments thereon.

Your health insurance policy is in force across India. You can check whether there is any network hospital near to your residence as well the city of your current location.

Network hospitals are the hospitals that have tie up with the Third Party Administrator for cashless settlement of claims. If there is no network hospital, you can opt for reimbursement mode of settlement.

Apart from this, we also provide coverage in case of Emergency situations anywhere in the world (if cover opted, as per plan).

We do not have any such restriction on buying ProHealth Select. It's as per your choice if you wish to have additional coverage, however you must inform us regarding the existing policy at the time of buying the ProHealth Select plan.

Yes, new born aged 91 days and upto 23 years will be covered in this policy.

Children between the age group of 3 months (91 days) to 5 years will be covered only if either of the parents is covered. Children from 6 years to 18 years will only be covered if one of the parents is the proposer.

Children beyond 23 years if dependent on the parents can be covered under an individual policy.

The baby should be born to an insured and legally wedded wife or a lawfully adopted child.

The premium calculated for the given policy is for a defined period and cannot be bifurcated into parts. Also the coverage is available for the entire term opted under the policy. Accordingly, the refund of premium option is not available in this scenario.

Our ProHealth Select Plan A also provides optional benefit for worldwide emergency coverage outside of India.

Yes, under in-Patient hospitalization we will cover medical expenses towards  artificial life maintenance, including life support machine used as certified by the treating medical practitioner.

Yes, We will cover the medical expenses towards the enteral feeding during in- patient hospitalization, day care or domiciliary hospitalization maximum up to 15 days in a policy year.

Yes, under in-Patient hospitalization we will cover medical expenses towards listed

Modern and Advanced Treatments of the Insured Person 

subject to illness/injury. It includes:

•           Uterine Artery Embolization and HIFU

•           Balloon Sinuplasty

•           Deep Brain stimulation

•           Oral chemotherapy

•           Immunotherapy – Monoclonal Antibody to be given as injection

•           Intra vitreal injections

•           Stereotactic radio surgeries

•           Bronchial Thermoplasty

•           Vaporisation of the prostate (Green laser treatment or holmium laser treatment)

•           IONM ( Intra Operative Neuro Monitoring)

•           Stem cell therapy – Hematopoietic stem cells for bone marrow transplant for haematological conditions to be covered.

Yes, under an in-Patient hospitalization we will cover medical expenses related to HIV/AIDS, maximum up to Rs. 5 Lacs after a waiting period of 2 years.

For in-patient hospitalization, we will pay for the below medical expenses:

• Room rent for accommodation in Hospital room up to a max. of Rs.3000/- per day

• Intensive Care Unit charges for accommodation in ICU up to a max. of Rs. 7000/- per day

• Operation theatre charges,

• Fees of Medical Practitioner,

• Anaesthetist,

• Qualified Nurses,

• Specialists,

• Cost of diagnostic tests,

• Medicines,

• Drugs and consumables, blood, oxygen, surgical appliances and prosthetic devices recommended by the attending Medical Practitioner and that are used intra operatively during a Surgical Procedure.

The age eligibility of the insured for taking the policy is the Entry Age. Age means completed age as at the inception date.

An individual policy can be taken for self, lawfully wedded spouse, children, parents, siblings, parent in laws, grandparents and grandchildren, son in-law and daughter in-law, uncle, aunty, nephew & niece.

Family floater with maximum 2 adults and 3 children can be taken for self, spouse, dependent children or dependent parents.

Health Check-up is available as an optional cover in ProHealth Select Plan A. For insured who have completed 18 years of age can avail a comprehensive health check-up with Our Network Provider once every year as per the table below.

Full explanation of Tests is provided here:

Vitals – include (height/weight, BMI and BP, abdominal girth), FBS- Fasting Blood Sugar, CGT – Gamma-Glutamyl Transpeptidase, ECG-Electrocardiogram, CBC-ESR- Complete Blood Count-Erythrocyte Sedimentation Rate, SGPT- Test Serum Glutamic Pyruvate Transaminase, SGOT – Serum Glutamic Oxaloacetic Transaminase, TSH –Thyroid Stimulating Hormone, TMT – Tread Mill Test

Under a health insurance policy co-payment works as a cost sharing mechanism where the policy holder/insured will bear an agreed specified percentage of each & every admissible claim amount.

In ProHealth Select Plan A one can opt for a 10% or 20% Voluntary co-pay. It will apply on each claim under the policy.