ManipalCigna 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.

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

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.

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

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.

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

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
5) AYUSH
6) Dental
7) Vision
8) Physiotherapy
9) Over The Counter (OTC) Medicine