Is your insurance taking care of your healthcare expenses?
How do you know if your insurance coverage is taking care of your healthcare needs and expenses? Reading the policy document and cross-checking what they claim and what is being offered on the ground is typically the route most policyholders resort to at the time of hospitalisation. It is always a good idea to do some due diligence before a medical crisis, and even better so, before buying a policy when you have the option to compare and check price, plans, benefits, and coverage. To ensure you are extracting the best benefits from your insurance policy, here’s what you should know first: inclusions, exclusions, and exceptions. It is always prudent to know if all hospital expenses are covered by insurance, or you’ll have to pay a portion of the charges. The majority of hospital expenses are either part of your deductible or not covered by your insurance at all.
Before we get into the nitty-gritties about what your insurance plan may cover and what it may not cover, let’s go over some basics.
Expenses covered by your insurance, either by law or by the contract, include doctor visits, prescription drugs, emergency services, hospital room and board, dental and vision care, physical and occupational therapy, specific home health services, ambulance services, etc.
Expenses not covered by your insurance typically include utilities other than a designated hospital allowance, and the attendant’s hospitality, like food, room and board.
The new age health insurance plans cater to the most comprehensive insurance needs of the customer. Plans like the ManipalCigna ProHealth Prime Packages are the foremost players in the market and are rising above merely remaining just another health insurance.
The ManipalCigna ProHealth Prime Packages allow you to customise your health plans per your needs without any financial stress. It gives you better coverage in terms of cashless OPD care and zero deductions towards non-medical expenses.
It gives better control to the policyholder with policy features like the Switch off benefit, if you are travelling abroad, the freedom to choose/upgrade to any room as you wish and unlimited restoration of up to 100 per cent of your sum insured.
There’s also better care with the proactive approach from the policy provider that all policyholders must undergo an annual health check-up to stay in top health, not just in sickness, but also, for wellness’s sake. Also, the Wellness Program allows policyholders to earn reward points for completing wellness activities. As an incentive-driven activity, these reward points can be redeemed to get a discount on policy premiums at the time of renewal.
The ProHealth Prime Packages also cover expenses beyond hospitalisation, like the cost of OPD consultation, doctor’s visit, diagnostics like urine test, blood tests and any investigation to ascertain the presence/absence of any medical condition before and after hospitalisation and all pharmacy expenses besides some wellness offerings under the Wellness Program. They also cover non-medical expenses like costs of syringes, hand gloves and registration fees, which come under neither medicines nor consultancy or diagnostics but still make up for a significant portion of the overall cost.
The coverage of health insurance greatly depends on the types of insurers and the plans. A balanced policy will typically have the following:
Tips: Sub-limits, co-payments, deductibles, waiting periods, and non-medical consumables should always be cross-verified to ensure that there are not any out-of-pocket payments that will be incurred.
ManipalCigna’s ProHealth Prime plans are designed to fill common coverage gaps that most standard policies leave behind.
These features give you more stability, fewer out-of-pocket costs, and greater flexibility to receive treatment wherever you prefer.
ManipalCigna provides unique add-ons such as Switch, allowing policyholders to take better control of their coverage.
Wellness benefits reward you for staying healthy. You can earn wellness points through:
These accumulated points can be used to get:
Every policyholder deserves control over treatment, coverage, and cost. Plans like ManipalCigna’s put the power in your hands.
In short, control makes your health insurance plan more personalised, responsive, and aligned with your life stage.
Pre-existing diseases (PEDs) like diabetes, hypertension, asthma, or thyroid disorders significantly impact your policy terms.
Health insurance should not only protect you during illnesses-it should help keep you healthy.
A healthy lifestyle, supported by wellness programs, reduces claims and strengthens your long-term health.
If you discover gaps in your health insurance coverage, here’s how to fix them effectively:
Being proactive helps you stay financially protected during emergencies.
Portability allows you to switch insurers without losing continuity benefits. This is especially important when dealing with PEDs.
Portability is your right-use it to move to a plan that better supports your healthcare needs.
To achieve near-complete medical protection, you must take a structured approach.
An insurance framework, which is well planned, keeps you safe against medical inflation.
If you believe that your insurance plan does not cover certain expenses associated with your hospital stay or does not meet your desired insurance needs, you always have the option to port to a more complete insurance plan like the ManipalCigna ProHealth Prime Packages in terms of coverage and benefits.
The majority of standard policies tend to exclude the OPD costs unless a particular OPD rider is taken. But plans such as the ProHealth Prime of ManipalCigna have greater outpatient benefits, such as doctor visits, diagnostics, and pharmacy costs, which make regular healthcare affordable.
Select a comprehensive plan, having a large amount insured, and necessary riders, examine the yearly coverage and learn about the exclusions. When your existing policy does not meet your needs, you can think of shifting to a more comprehensive insurance company with benefits such as OPD cover, restoration, and modern treatment benefits.
Wellness benefits consist of rewards based on good health through step tracking, frequent check-ups, fitness or healthy biometrics. These points may be redeemed in terms of premium discounts or additional coverage. Most of the ManipalCigna plans will automatically monitor your activity using their wellness programs.
The majority of insurers provide policies to every age category, including infants and elderly people. Premiums do rise with age, but there is also comprehensive coverage even for the elderly. Lifelong renewability is also available with some of the plans, which guarantees protection throughout.
