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ManipalCigna Launches ProHealth Prime Plan – Covers OPD expenses

ManipalCigna ProHealth Prime Plan - Features, Eligibility, Why to consider, Why not to consider and Review

ManipalCigna launches new health insurance policy – ProHealth Prime which covers OPD expenses beyond regular health insurance plan benefits. Generally, health insurance plans cover medical expenses only in case of hospitalization. If anyone frequently incurs out of pocket expenses for medicines or tests, these are not covered by health insurance plans. To overcome this, ManipalCigna has launched this plan. In this article we would provide details on ManipalCigna ProHealth Prime Plan, Features, Eligibility, What does it cover, what it does not cover and finally provide our review.

Also Read: How good is that Star Health Premier Insurance Policy?

Eligibility to take ManipalCigna ProHealth Prime Plan

Any individuals above 18 years can take this policy. Children between 91 days to 25 years can be included in this health insurance plan.

Sum insured is between Rs 3 Lacs to Rs 1 Crore.

Policy can be taken for 1 to 3 year time frame.

Features in ManipalCigna ProHealth Prime

A) It covers the following OPD (Out Patient Department) Expenses.

Annual health checkups from first year onwards.

Consultation with over 6,000 doctors and over 16 major consultation specialists in both hospital and clinic based network.

Specific diagnosed expenses coverage over 20 chained networks and also at individual centres for major lab tests.

Covers Prescribed pharmacy expenses up to Rs 1.6 Lacs across Pan India.

This plan covers unlimited tele consultations.

Covers second opinion for over 36 listed critical illnesses.

One can get discounts on prescribed medicines, lab tests and health supplements.

Good part is that there are zero deductions towards these non-medical expenses.

One needs to register themselves + their dependents on ManipalCigna App to avail all these OPD expenses.

B) Other Health Insurance Plan Coverage

Coverage of in-patient expenses

Pre-Hospitalization medical expense coverage up to 60 days before the date of hospitalization.

Post-Hospitalization medical expenses coverage up to 180 days post the date of discharge of hospitalization.

Day care procures covered.

Coverage of domiciliary treatment at home.

Guaranteed Cumulative bonus of 25% per policy year up to 200% of the sum insured irrespective of claim.

Refer to policy document for a complete list of features and benefits.

Why to consider ManipalCigna ProHealth Prime Plan?

This is a comprehensive health insurance plan that covers a majority of health related expenses.

It comes with the unique feature of coverage of OPD expenses.

100% restoration of sum insured in case sum insured is exhausted.

Guaranteed Cumulative bonus of 25% per year up to 200% sum insured irrespective of a claim.

Free annual health checkups from first year onwards.

One can get unlimited tele-communications with doctors.

Second opinion on 36 listed critical illnesses.

Waiver of 1 year premium in case diagnosed for any listed critical illness or accidental death.

Covers non-medical expenses up to Sum Insured.

Why NOT to consider ManipalCigna ProHealth Prime?

Like any other health insurance plan, this medical policy does not cover expenses in case of injuries due to nuclear fuel or radiation due to hazardous or adventure sports etc.,

ManipalCigna latest Incurred Claim ratio is low – 61% to 62% during 2018-19 and 2019-20. Company might be honoring low medical claims. Check more about Incurred Claim Ratio here.

Should you opt for ManipalCigna ProHealth Prime?

ManipalCigna’s new policy is a comprehensive health insurance plan. It covers OPD expenses and non-medical expenses too. It has unique features like guaranteed bonus on sum insured irrespective of claim, zero deductions on non-medical expenses etc., However, ManipalCigna incurred claim ratio is low. One should consider all these pointers before opting for this health insurance plan.

Source: ManipalCigna ProHealth Prime Plan Brochure

Suresh KP

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