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ProHealth Plus is a great policy. It covers most bases. It doesn't have egregious conditions, it pays for emergency treatments when you're abroad, offers cover for maternity related expenses and even reimburses you for outpatient consultations (upto 2,000). The only caveat - It is a fairly expensive policy.

What's good here?

You most likely don't have to split the bill

If you bought this policy after you turned 65, you have to pay 20% of the bill every time you make a claim. Otherwise, you are good to go. The insurer will pay all costs up to the sum insured.

You can pick any room so long as it’s not a Suite

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.

You always have full cover irrespective of the disease

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 & post hospitalization expenses covered

No worries if the doctor had to run a host of diagnostic tests before or after hospitalizing you. The insurer has your back. They will cover this amount in full for a pretty reasonable duration - 60 days before you are hospitalized and 180 days after discharge. This includes the cost of medication by the way.

Good Restoration Benefit

Even after you claim part of the cover on one occasion, you will be allowed to claim the full cover any number of times repeatedly if you are hospitalized for different complications. All in the same year by the way!!!

Day Care treatments covered

If you’re hospitalized for less than 24 hours in lieu of a minor procedure, then the insurer will cover these costs too. Think dialysis, chemotherapy or minor surgeries.

Free Health Checkups every year

If you’re planning on getting a full body checkup every year just to make sure you’re in fine working condition, the insurer will cover the costs.

Full coverage even if you are forced to hospitalize at home

The insurer will bear the costs even if you are hospitalized at home due to a condition or the hospital running out of beds. In insurance lingo, they call this a policy with domiciliary cover.

Covers Alternative Medicine

Think of getting Ayurvedic, Homeopathic or other alternative treatments to cure an illness? Your insurer will cover you fully, up to the sum insured.

Doctor consultations covered

In the event, you are feeling sick and you want to visit your family physician for a general checkup, the insurer will cover the costs, up to a certain limit. In this case, it’s ₹2,000 annually.

What's okay?

Reasonable waiting period for pre-existing diseases

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.

Special Bonus for being healthy and not claiming insurance

Your sum insured increases by 10% each year, so long as you make no claims during this period. But before you get too ahead of yourself, do note that they’ll stop offering you the bonus when your sum insured increases by 200%. But hey, it's still a bonus.

Maternity benefits offered

The insurer will also cover expenses related to maternity— Think hospitalization expenses incurred while giving birth. But they’ll only pay upto ₹25,000 and make you wait 4 years before covering this expense.

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