ManipalCigna ProHealth Group Insurance Policy

ManipalCigna ProHealth Group Insurance Policy

ManipalCigna ProHealth Group Insurance Policy has been carefully designed to provide optimum and better insurance solution to Employer-Employee and Non-Employer-Employee groups. The policy offers comprehensive, flexible, simple and affordable healthcare insurance which can be customized to meet all kinds of requirements of all. It provides a full circle of healthcare facilities which includes base covers for essential benefits along with a range of optional covers.

ManipalCigna ProHealth Group Insurance Policy is available on individual and family floater basis and ensure that one get high quality healthcare benefits while making medical treatment expenses more manageable.

Eligibility criteria for ManipalCigna ProHealth Group Insurance Policy

Minimum entry age  There is no minimum or maximum age for entry in to the policy (Children from Day 1 up to 25 years can be covered in a family floater policy)
Maximum entry age No Limit
Sum Insured Rs 5000 up to Rs 1 Crore
Policy term 1 year (>1 year, max up to 5 year’s term available for Credit Linked Policy)
Premium payment Monthly/ Quarterly/ Half-yearly/ Annual payments
Relationships covered Self, legal spouse, dependent parents, unmarried children, brother, sister, grandparents, grandchildren, parent in laws, son in law, daughter in law, uncle, aunt, niece and nephew
Minimum Group size 7 members

Key highlights of ManipalCigna ProHealth Group Insurance Policy

  • ManipalCigna Lifestyle Protection Group policy comes with 7 in-built benefits with Base Cover.
  • The policy also comes with a total package of 42 need-based optional covers.
  • The policy offers lifetime renewal till the insured person remains associated with the group.
  • It gives you the Choice of Maternity, Dental, Vision, OPD, AYUSH treatment coverage, and more.
  • The Lifestyle Protection group policy also gives the choice Critical Illness, Personal Accident, and choice of Daily Cash benefits (Inpatient, ICU, Accidental, Worldwide Emergency, Convalescence, Companion and Chemo & Radiotherapy).
  • Multiple Cost Sharing options are available at the Corporate and Individual levels under this policy.
  • This plan provides be-spoke Wellness Services, Healthy Living, Condition Management with reward function, and more.
  • It offers Fixed or Indemnity payout as applicable.
  • Hospital, home care to OPD expenses are covered under one plan.
  • Apart from all these, the insurer ensures with dedicated claims and customer support management.

Inclusions in ManipalCigna ProHealth Group Insurance Policy

Base Cover includes:

  • Inpatient Hospitalization
  • Day Care
  • Pre & Post Hospitalization
  • Domiciliary Treatment
  • Road Ambulance
  • Donor Expenses
  • Choice of multiple need-based Optional Covers

Exclusions in ManipalCigna ProHealth Group Insurance Policy

  • Ailment requiring treatment due to use, abuse of the drug, intoxicating substance.
  • Any Illness or Hospitalization arising or resulting from any breach of law.
  • Any stay in the hospital without undertaking any treatment.
  • All Illnesses/expenses caused by ionizing radiation or contamination by radioactivity from any nuclear fuel.



What is ProHealth Group Insurance Policy?

ProHealth Group Insurance Policy offers coverage to a defined group of people, for example, employees of an organization, members of a society or professional association, or an affinity group. The plan has been specifically designed to provide medical coverage to members of a particular group in case of hospitalization due to illness or injury. This plan offers comprehensive coverage with base covers and a range of multiple options to choose from as per the group's requirements.

What benefits are included under the base cover of the ProHealth Group Insurance policy?

The base cover includes:
i. In-patient Hospitalisation Expenses Cover
ii. Day Care Treatment Cover
iii. Pre-Hospitalisation Medical Expenses Cover
iv. Post-Hospitalisation Medical Expenses Cover
v. Road Ambulance Cover
vi. Domiciliary Hospitalisation Cover
vii. Donor Expenses Cover

What expenses are covered under In-patient hospitalization?

Medical Expenses towards room charges, doctor fees, surgeon fees, specialist fees, anesthetist's fees, radiologist, pathologist fees, operation theatre, nursing charges, medicines, diagnostic tests, medical and/or surgical appliances are covered under in-patient hospitalization.

Is there a capping on the room rent allowance?

Under base cover per day, room rent allowance is limited up to 1% of Sum Insured opted and 2% of Sum Insured for ICU. However, this capping can be altered as per below-mentioned options:
• Select percentage limit of Sum Insured for per day Room Rent
• Select an amount limit on per day Room Rent
• Select limit on room type (Category)
For ICU hospitalization, the limit will be two times room rent

Does ProHealth Group Insurance policy cover medical expenses before and after hospitalization be covered?

ManipalCigna ProHealth Group Insurance policy will reimburse the medical expenses of an insured person incurred during pre and/or post-hospitalization. Base cover includes 30 days pre-hospitalization and 60 days post-hospitalization expenses. However, you have the option to choose this coverage from 0 days to 180 days.
Please note that Pre & Post medical expenses claims should be related to the same illness/condition the insured has been admitted to the hospital.

Does ProHealth Group Insurance policy offer Maternity / Newborn baby expenses coverage?

Yes, they are available under optional covers. Maternity expenses towards delivery or termination up to 2 events up to the limits selected under the plan as an optional benefit.
• Normal delivery, routine or elective cesarean or complicated pregnancy or Pre and
Post Natal expenses are covered.
• Newborn baby coverage is available with a sub-limit option. It can form a part of the maternity sub-limit or in addition to maternity expenses cover.
• Option to choose the cover for Surrogacy pregnancy

Does the ProHealth Group Insurance policy cover Out-patient treatment expenses?

Medical expenses incurred towards out-patient treatment are covered up to the Sum Insured selected. Anyone or a combination of the following can opt under the cover:
1) Consultation
2) Diagnostics
3) Pharmacy
4) Medical Aids
6) Dental
7) Vision
8) Physiotherapy
9) Over The Counter (OTC) Medicine

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