Overview
The Manipal Cigna ProHealth Plus plan is a comprehensive health insurance policy offering sum insured options from ₹4.5 lakhs up to ₹50 lakhs. It provides in-built coverage for maternity and newborn expenses, outpatient consultations through Health Maintenance Benefit, and worldwide emergency medical treatment. The plan features unlimited restoration of sum insured (for unrelated illnesses), guaranteed cumulative bonuses of 10% increase, maximum up to 200% of Base SI, and access to high-end hospital rooms (except suites). It also rewards healthy behavior with redeemable Healthy Reward points, making it a well-rounded choice for individuals and families seeking extensive health protection.
Experts' Review
Written by Nikhil Nair
Senior Writer
The Manipal Cigna ProHealth Plus plan is a strong contender in the mid-to-high range of health insurance segments, offering a broad spectrum of benefits that extend beyond standard coverage. Its key USPs include maternity [Covered upto 15,000 for standard delivery and 25,000 for C- Section per event, maximum upto 2 deliveries] and newborn coverage (both with a waiting period of 48 months), outpatient consultation reimbursement [Covered up to 2000 Per Policy Year], and worldwide emergency medical cover [Covered up to full Sum Insured once in a Policy Year], which are not universally available in comparable plans. The unlimited restoration (for unrelated illnesses) of the sum insured and guaranteed cumulative bonuses, a 10% increase, maximum up to 200% irrespective of claims, enhances long-term value.
However, the plan is priced on the higher side, with premiums typically 15-20% more expensive than similar offerings from peers like Max Bupa or HDFC ERGO for comparable sum insured levels. While it offers access to high-end hospital rooms, suites are excluded, which may be a limitation for some. The plan doesn’t have disease-wise sub-limits; however, a mandatory co-pay of 20% applies to all claims for insured individuals aged 65 years and above, regardless of entry age. This can be waived by opting for the Waiver of Mandatory Co-pay cover.
Pros
Offers a wide range of features.
Insurer has a solid track record with great claim and service metrics.
Offers ManipalCigna Health 360 Advance, which makes this policy stand out.
Cons
No significant drawbacks found.
Manipal Cigna
Key Insights
Founded
2014
Manipal Cigna was established 11 years ago, making it a relatively new entrant with a developing track record.
Claims Experience
91% claims settled in 30 Days
Manipal Cigna settles 91% of all claims it receives demonstrating strong credibility.
Network Hospitals
8,500+
Manipal Cigna maintains a moderate network of 8,500 hospitals, offering reasonable coverage across key locations.
Complaints
24 complaints per 10,000 claims registered
Manipal Cigna experiences a moderate number of complaints, indicating room for improvement in addressing customer concerns.
Features
All
Great
Good
ManipalCigna Health 360 Advance
STANDOUT
Extended coverage with no room restriction, unlimited restoration of sum insured even for same illness along with air ambulance coverage.
Co-payment
If you bought this policy, you have to pay 20% of the bill every time you make a claim after you turn 65. Otherwise, you are good to go. The insurer will pay all costs up to the sum insured.
Customisable
Choose a co-payment between 10% and 20% to reduce premiums.
Customisable
Waives off 20% of the co-payment if purchased at the age of 65 years or above.
Room Rent
Shared rooms are okay. Single private rooms are okay. Most rooms are okay unless it’s a suite room — the expensive stuff. Then you’ll have to start splitting the bill.
Customisable
Change Any room to Twin Shared room.
Disease sub-limit
No funny business here. If your insurer hasn’t explicitly stated they won’t cover a certain illness, you can claim the full amount up to the sum insured, irrespective of the disease you’re dealing with. Meaning this policy doesn't impose the dreaded disease wise sub-limits.
Pre existing diseases waiting
If you’re already dealing with diabetes, cardiovascular problems or any such illnesses, the insurer will cover all costs arising out of these pre-existing problems after you wait for 3 years.
Add-ons
Cumulative Bonus Booster
Recommended
Additional bonus of 25% up to a maximum of 200%, irrespective of any claim in the previous year.
Supreme Bonus
Recommended
Additional bonus of 100% up to a maximum of 800%, irrespective of any claim in the previous year.
ManipalCigna Health 360 Shield
Recommended
Covers list of 68 non-medical items as per list I upto ₹1,00,000.
Waiver of Mandatory Co-payment
Recommended
Waives off 20% of the co-payment if purchased at the age of 65 years or above.
ManipalCigna Health 360 OPD cover
Get coverage for outpatient and e-consultations i.e. doctor visits along with coverage for prescribed diagnostics and pharmacy based on the option taken.
Hospital Cash
Hospital cash benefit paid out if hospitalization is at least 1 day, with a maximum payout of ₹1000 to 3000 for up to 30 days.
Room Rent Modifier
Change Any room to Twin Shared room.
Aggregate Deductible
Choose deductible between ₹10,000 and ₹25,000 and get a discount on premiums.
Co-payment
Choose a co-payment between 10% and 20% to reduce premiums.
Maternity Waiting Period Reduction
Reduces the maternity waiting period from 4 years to 2 years.
ManipalCigna Health 360 Advance
Get extended coverage with no room restriction, unlimited restoration of sum insured even for same illness along with air ambulance coverage.
Permanent Exclusions
Conditions or treatments that the policy clearly says it will not cover.
Expenses related to any admission primarily for diagnostics and evaluation purposes are excluded.
Diagnostic expenses not related or incidental to current diagnosis and treatment are excluded.
Expenses for admission primarily for bed rest and not for treatment are excluded.
Custodial care at home or in a facility for help with daily activities is excluded.
Services for terminally ill individuals addressing non-medical needs are excluded.
Disclaimer: For illustration purposes only - exact terms are in the policy wording.
Specific Illness
The following illnesses are not covered under the policy for 2 years.
Cataract and other disorders of lens and retina
Hysterectomy for menorrhagia, fibromyoma, prolapse of uterus, or myomectomy for fibroids (unless necessitated by malignancy)
Surgery of hernia
Surgery of hydrocele
Benign ear, nose, and throat (ENT) disorders and surgeries (including tonsillectomy, adenoidectomy, mastoidectomy, tympanoplasty)
Waiting Period
30 days Initial waiting period
2 years Specific illness waiting period
3 years Pre-existing disease waiting period
Ditto's Take
◦ Standard ◦
After a close look at the waiting periods, it’s safe to say they are fairly standard.
Customer Reviews
M
Mahesh S.
Maternity and newborn expenses covered is a big plus for young families.
M
Manju V.
Outpatient consultations up to ₹2,000 annually is very practical.
M
Mohan G.
Worldwide emergency medical treatment gives peace of mind when traveling.
P
Poonam J (new)
While worldwide emergency is covered, need to check conditions for planned treatments abroad if any.
N
Nitin K (new)
Priced on the higher side, typically 15-20% more expensive than comparable plans.
N
Naveen P.
Access to high-end hospital rooms (except suites) is good.
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Frequently Asked Questions
Does ProHealth Plus have waiting periods?
- 30-Day Waiting Period: Hospitalizations won’t be covered for the first 30 days of the policy unless it’s an accident.
- Specific Illness Waiting Period: There’s a 2-year waiting period for a list of diseases which is a mandate before you can start claiming.
- Pre-Existing Disease Waiting Period: There's a 3-year waiting period for any pre-existing disease you may have while buying the policy.
- Maternity and Newborn Waiting Period: There’s a 4-year waiting period before you can make claims related to pregnancy and childbirth.
Does ProHealth Plus have room rent restrictions?
Does ProHealth Plus offer a restoration benefit?
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