Optional Covers

• Day Care Treatment Benefit
• Accidental Death
• Total Disability Cover
• Critical Illness Add-on Cover

 

Eligibility and Key Features  of ManipalCigna ProHealth Cash Plan

 

Plan Name	Features	Max. Days of Coverage Per Year	Age Eligibility
Plan I – Basic Plan	Sickness Hospital Cash Benefit Accident Hospital Cash Benefit ICU Cash Benefit Worldwide Cover	60 days/ 90 days / 180 days	Min – 91 days, Max 65 years (at time of entry)
Plan II – Enhanced Plan	Sickness Hospital Cash Benefit Accident Hospital Cash Benefit ICU Cash Benefit Worldwide Cover Convalescence Benefit Companion Benefit Compassionate Benefit	60 days/ 90 days / 180 days	Min – 91 days, Max 65 years (at time of entry)
Optional Covers	Day Care Treatment Benefit Accidental Death & Permanent Total Disability Cover Critical Illness Add-on Cover	60 days/ 90 days / 180 days	Min – 91 days, Max 65 years (at time of entry) Min Age for Accidental Death & Permanent Total Disability Cover  Is 5 years

Pre Policy Check Ups
 

Sum Insured	Age (Completed In Years)	Test(s)
INR 500 – 3000	Up to 45	No Test
	46 to 55	Tests shall be based on Medical declarations by the Insured and Underwriting evaluation.
	56 and above	Set 2 - MER, ECG, Total Cholesterol, Hba1c, Sr Creatinine, CBC, SGPT
INR 3500 – 5000	Up to 35	No Test
	36 to 55	Tests shall be based on Medical declarations by the Insured and Underwriting evaluation.
	56 and above	MER, ECG, Total Cholesterol, Hba1c, Sr Creatinine, CBC, SGPT

 

Benefits you get in ManipalCigna ProHealth Cash  

•    Sickness Hospital Cash benefit
The plan will pay a Daily Cash Benefit for each continuous and completed period of 24 hours of Hospitalization due to injury.
•    Accident Hospital Cash benefit
The plan will pay 2 times the Daily Cash Benefit for each continuous and completed period of 24 hours of Hospitalization for illness.
 
•    ICU Cash benefit
For hospitalization in an Intensive Care Unit for treatment of illness and injury, the plan will pay 3 times the Daily Cash Benefit. Coverage is limited to a maximum of 15 days per Insured Person per Policy Year.
•    Worldwide Cover
You might need to get hospitalized in a Hospital room Or Intensive Care Unit (ICU) outside India for medical assistance due to illness or injury. Don’t worry; the plan will pay 3 times the Daily Cash Benefit for medically necessary treatment.
•    Convalescence Benefit
There can be a situation when you may need a long hospital stay. The plan will pay a lump sum equal to 5 times the Daily Cash Benefit for hospitalization of at least 10 consecutive days.
•    Companion Benefit
While you are hospitalized you may need a family member to take care of you. The plan ensures that you get continuous care with additional pay of 50% of your Daily Hospital Cash Benefit.
•    Compassionate Benefit
The plan pays the Nominee a lump sum amount equal to 10 times the Daily Cash Benefit on unfortunate death of the insured person during the course of hospitalization due to accidental injury.
•    Access to Online Wellness program
The plan will pay the Nominee a lump sum amount equal to 10 times the Daily Cash Benefit on unfortunate death of the insured person during the course of hospitalization due to accidental injury.
•    Day Care treatment
The plan pays a lump sum benefit amount lower of 5 times the Daily Cash Benefit or Rs.25,000, to the Insured Person for Day Care Treatment. The benefit shall be available for a maximum of 5 Day Care Treatments per Insured Person per Policy Year. For Cataract, coverage is limited to 1 surgery in a Policy year per Insured Person.

•    Accidental Death and Permanent Total Disablement
In case of Accidental Death or Permanent Total Disablement the plan will pay the sum insured as specified.
•    Critical Illness Add-on
Persons between 18 to 65 years can opt for Critical Illness cover as add-on benefit. The plan will give a lump sum amount equal to Sum Insured in case of first diagnosis of the covered critical illness. Once claim is paid the Critical Illness benefit will cease to exist for that person.


Additional Features of ManipalCigna ProHealth Cash

•    Grace Period
There is a grace period of 30 days for renewal of a single premium policy from the date of expiry.
•    Revival Period 
For installment premium policies, the revival period shall be 15 days.
•    Free Look in Period
A period of 15 days from the receipt of the policy document is available to review the terms and conditions of this policy. You can choose to cancel the policy by stating the reason for cancellation and the premium after retaining 50% of costs for any medical tests (if conducted) will be refunded. Cancellation will be allowed only if there are no claims reported.
•    Portability
You can port your existing health insurance policy to the ProHealth Cash policy, provided you are covered under an Indian Health Retail policy from a non- life insurance company.

•    Income Tax Benefit
Along with other benefits, you can also claim tax deduction u/s 80D as per IT Act 1961 for premium paid towards this policy. For premiums paid in cash, tax benefit u/s 80Dshall not be applicable. Please consult your tax advisor for more details
•    Cancellation
You can place a request for cancellation any time during the term of the policy; premium refund will be on short period basis.
•    First 30 Days Waiting Period
A waiting period of 30 days from the Inception Date of the Policy will be applicable for all hospitalization claims except in case of accidents.
•    First 90 Days Waiting Period & Survival Period (Applicable Only To Ci Add-On)
From the policy inception date, there will be a waiting period of 90 days before the symptoms of any critical illness first occur for you to be able to make a claim. A 30 days survival period will also apply.
•    Two Years Waiting Period
Two Years Waiting Period will be applicable for specific illnesses.
•    Pre-Existing Disease Waiting Period
48 months waiting period will be applicable for any Pre-existing diseases/Illness/Injury/conditions.
Key Exclusions

Claims arising out of or attributable to any of the following will not be paid:
•    HIV/AIDS and its complications
•    Genetic disorders 
•    Mental disorders 
•    Suicide or drug abuse
The above list is only indicative and not exhaustive. Please refer to the policy terms and conditions for complete details.