Introduction
Before we start comparing these two policies we have to set out some ground rules.
Both products are marketed by different insurance companies. Comprehensive is sold by Star Health and ProHealth Preferred is sold by Manipal Cigna. So any meaningful comparison should include a comparison of the product alongside the insurers themselves.
Second, we know that both products have subtle differences in their core structure. Comprehensive is reasonably comprehensive. Sure, it doesn’t have all the bells and whistles, but it also doesn’t impose any mindless restrictions. ProHealth Preferred, meanwhile, is a relatively expensive premium policy tailored to cover as many use cases as possible. So while the differences in features may be subtle, the pricing could be drastically different depending on the cover amount you pick.
And finally, any comparison is ultimately futile without considering the use case. Who are you buying this policy for? You, your family, your parents?
That’s something you’ll need to answer before using this guide. So with that introduction out of the way, we can get to comparing the actual policies themselves.
Let’s start with Comprehensive. The product comes from Star Health’s stable:
Star Health Insurance is India's first standalone health insurance firm. And with an army of retail advisors pushing their products across the country, they’ve managed to capture a fair share of the Indian market.
The company also boasts a network of over 14,000+ hospitals and a decent claim settlement ratio of 83%.
ProHealth Preferred meanwhile comes from Manipal Cigna’s stable:
ManipalCigna Health Insurance Company is a collaborative partnership between Manipal Group and Cigna and together they have over 200 years of expertise in the healthcare business. And while the company has shown some potential recently, it still only corners a small part of the Indian market.
Also, they have a settlement ratio of 90% with more than 8,500+ network hospitals in tow.
Talk to IRDAI-certified experts
If you want help with selecting the best health policy tailored to your needs, book a FREE call with our experts today by clicking here.
Compare Insurances Insurance Parameters Recommended Not Recommended |  Comprehensive |  ProHealth Preferred |
|---|---|---|
| Network hospitals | 14,000+ | 8,500+ |
| Claim settlement ratio (avg. of last 3 years) | 83% | 90% |
| Co-payment | 10% (if purchased after turning 61) | 20% (if purchased after turning 65) |
| Room rent | Single Private room | Any Room (Except suite) |
| Disease sub-limit | Yes | No |
| Pre existing diseases waiting | 3 years | 2 years |
| Pre/Post hospitalization | 60/90 days | 60/180 days |
| No claim bonus | 50% per year (up to 100%) | 10% per year (up to 200%) |
| Domiciliary | ||
| Ayush treatments | ||
| Restoration benefit | 100% restoration (once for any illness after complete exhaustion of sum insured) | 100% restoration (unlimited no. of times for different illness) |
| Health check-up | Once every year | Once every year |
| Maternity | Available (up to ₹20,000 after 2 years) | Available (up to ₹1,00,000 after 4 years) |
| Out Patient Department | Up to ₹1,200 (cap of ₹300 on each consultation) | Up to ₹15,000 (Annually) |
| Day care |
Feature Comparison
Co payment
With a co-payment clause, the insurer will mandate that you pay a part of the bill. So if the bill adds up to Rs. 2,00,000 and the co-payment is set at 20% then you could be asked to pay Rs. 40,000 from the bill. In this case, both policies impose a co-payment clause if you’re hospitalized. Comprehensive imposes a co-payment of 10% whereas ProHealth Preferred imposes a co-payment of 20% if you’re hospitalized
Room rent
If the policy does impose room rent restrictions then the insurer may only let you stay in a room of a certain specification or impose a cap on the total room rent. If you were to breach either criterion then the insurance company may ask you to pay a portion of all the expenses you incurred while staying in the room. In this case, however, Comprehensive only lets you stay in a single private room whereas ProHealth Preferred lets you stay in any room except a Suite.
Sub limits
Some policies will tell you that they will cover all medical expenses up until the sum insured, but then impose caps on the total costs you can incur while dealing with a very specific list of diseases. We call these caps “Disease Wise Sub Limits.” In this case, Comprehensive imposes disease-wise sub-limits on Modern treatments whereas ProHealth Preferred doesn’t impose a disease wise sub-limit.
Waiting periods for pre-existing diseases
If you’re suffering from a lifestyle condition or if you’ve had surgery in the past, or if you’re dealing with an acute or chronic illness at the time of buying the policy, then the insurer may classify this as a pre-existing disease. And they may tell you that they will only cover these illnesses after some time. In this case, Comprehensive imposes a waiting period of 3 years on pre-existing diseases while ProHealth Preferred extends a waiting period of 2 years on existing conditions.
Pre and post Hospitalization expenses
Most people aren’t hospitalized right off the bat. Instead, they’ll have to go through a whole series of diagnostic tests before hospitalization and take medication post-discharge. These costs are outlined as pre-hospitalization expenses and post-hospitalization expenses respectively. In this case, Comprehensive covers expenses incurred 60 days before hospitalization and expenses incurred 90 days post-hospitalization. Meanwhile, ProHealth Preferred covers expenses incurred 60 days before hospitalization and expenses incurred 180 after hospitalization, although there may be different sub-limits
No claim bonus
Some policies will tell you that they will incentivize you for not making a claim in any given year. And they offer such incentives by offering extra cover on top of the existing sum insured. This extra cover is categorized as a no-claim bonus. In this case, however, Comprehensive offers a no-claim bonus of 50% whereas ProHealth Preferred offers a no-claim bonus of 10%. And the no-claim bonus may be capped at different levels too.
Domiciliary
Imagine you are forced to treat yourself at home because you don’t find a hospital bed, or you have a chronic condition that prevents you from visiting one, then, insurers may choose to cover your treatment even if you’re hospitalized at home. And such costs are collectively categorized as domiciliary treatment costs. In this case, however, Comprehensive offers domiciliary cover. And ProHealth Preferred also coves domiciliary expenses.
Ayush treatments
Most policies only cover treatments administered in a registered medical facility. However, on some occasions, you may want to pursue alternative treatments including homoeopathy, Ayurveda, Unani and Siddha. These treatments are collectively categorized as Ayush treatments. And in this case, Comprehensive covers Ayush procedures and ProHealth Preferred also extends coverage for Ayush treatments.
Maternity benefits
If you’re hospitalized during childbirth, then you may have to incur significant costs during delivery of your newborn, child care and other related matters during the course of the hospitalization. These costs are collectively termed maternity costs. And in this case, Comprehensive offers maternity cover and ProHealth Preferred offers maternity cover too, although the sub-limits for normal delivery and C-section procedures may be different, including the waiting period.
Out Patient Department (OPD)
Doctor visits and regular consultations aren’t usually covered by health insurance policies. They are categorized as Outpatient consultations (or OPD treatments) and patients have to bear the cost on their own. In this case, however, Comprehensive offers OPD coverage, and ProHealth Preferred also offers OPD coverage, although the sub-limits may be different.
Final Conclusion
It should be obvious that ProHealth Preferred offers better protection and extends a whole host of benefits that Comprehensive simply doesn’t offer. But considering Star Health has a claim settlement ratio that can only be considered sub-par at best, we would still recommend going with anything that Manipal Cigna has to offer.
Other Star Health Comprehensive Comparisons
Select the best plan with our help!
Get in touch to find out what plan works best for you. Zero fuss. Zero spam. Zero charges. Book a call now. Limited slots available!