Frequently Asked Questions

Policy holder will get 1% discount on the renewal premium if no claim has been made during the expiring policy tenure.

If you wish to insure more than 2 adults or 3 children in a floater plan, you need to buy an additional policy.
Under any plan of your choice, there is no family floater option. The family members can buy a multi-individual policy.

Under this policy company covers In-patient expenses towards the donor for harvesting of the Organ up to the Sum Insured.
We will cover below Organ donor expenses for Protect and Advantage plan Pre & Post Hospitalization expenses (Up to 30 days each) of the donor.
• Cost towards donor screening once in a Policy year for successful transplant.
• Complications arising during hospitalization or up to 30 days from date of discharge - Covered up to 25% of SI subject to maximum of ₹2 Lacs, Over and above SI.
We will not cover expenses towards the Donor in respect of cost associated to the acquisition of the organ

For calculating premium the country has been divided into 3 zones. Zone will be identified based on the location city of the insured person and premium will be calculated accordingly.
Zone I:
Delhi & NCR.
Districts in Gujarat: Ahmedabad, Gandhinagar, Surat, Vadodara.
Districts in Maharashtra: Mumbai, Thane, Navi Mumbai.
Districts in Andhra Pradesh /Telangana:Hyderabad, Khammam, Kothagudem, Hanamkonda, Warangal.
Districts in Uttar Pradesh: Mathura, Jyotiba Fule Nagar (Amroha), Aligarh.
Districts in Punjab: Amritsar, Gurdaspur.
Others: Kolkata, Rewari, Jind, Jhunjhunu, Patna.
Zone II:
Rest of the Bihar State Districts in Andhra Pradesh / Telangana: Ananthapur, Bapatla, Gadwal, Guntur, Jagtial, Kamareddy, Karimnagar, Kurnool, Mahabubnagar, Mancherial, Medak, Nalgonda, Nellore, Nizamabad, Peddapalli, Rangareddy, Suryapet, Wanaparthy
Districts in Punjab: Rupnagar (Ropar), Ludhiana, Fatehgarh Sahib, Mohali, Patiala
Districts in Maharashtra: Ahmednagar, Akola, Beed, Buldhana, Jalna, Latur, Nashik, Palghar, Pune, Raigad
Districts in Uttar Pradesh: Banda, Fatehpur, Kanpur
Others: Chennai, Bangalore, Wayanad, Chandigarh, Panchkula, Bokaro, Dhanbad
Zone III: Rest of India
(Note - Some areas (pin-codes) that are in the immediate vicinity of the districts mentioned in the zone definition above are classified in the respective zones of those districts) The premiums also depends on factors such as Age of the eldest Insured, Sum Insured opted, section of Optional Covers and Optional Packages.

ManipalCigna ProHealth Prime offers high Sum Insured to cover Hospitalisation expenses, Pre & Post Hospitalisation expenses & day care treatments. It also provides cover for Individuals with existing conditions such as Asthma, Hypertension, Diabetes, Obesity, Dyslipidaemia etc.

It is a comprehensive product with very innovative and beneficial covers such as coverage for Non-Medical Expenses, Option to choose ‘Any Room’ category, Switch off, Premium waiver benefit, Unlimited restoration of Sum Insured, Guaranteed Cumulative Bonus, Discount on Network Providers and much more.

There are optional packages and optional covers which makes the product highly customizable and making it suitable for all the customer segments.

Yes, treatments under  Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy are covered under this Product.

The pre-policy medical check-up cost will be paid by ManipalCigna Health Insurance Company.
In case we are unable to underwrite your proposal we will intimate the same to you.

Unless necessary endorsements or exemptions are made below diseases and expenses arising out of or attributable to any of the following will not be covered in the policy.
1. Investigation & Evaluation
2. Rest Cure, rehabilitation and respite care
3. Change of gender except for sex reassignment surgery for transgender persons
4. Cosmetic or Plastic Surgery
5. Hazardous or Adventure sports
6. Treatment for Alcoholism, drug or substance abuse or any addictive condition and consequences thereof
7. Expenses related to the treatment for correction of eye sight due to refractive error less than 7.5 diopters
Above List is only indicative and not exhaustive. Please refer the Policy Wordings for detailed list.

Insurance coverage that pays for medical and surgical expenses that are incurred by the insured person during the treatment of a disease or injury. Health insurance can either reimburse the insured for expenses incurred from illness or injury or pay the care provider directly through cashless facility

Yes, by visiting our website www.manipalcigna.com

The list of medical tests will be communicated by ManipalCigna Health Insurance Company to the customer at the time of processing the insurance application as they will depend upon the Age, Sum Insured opted and any medical history declared at the time of application.

Medicals will be triggered on the basis of the age of the insured, the plan type and sum insured selected.
** For details of medical tests kindly contact Customer Support Team, Health Advisor or Branch Service Desk.

One can opt in or opt out of the Cumulative Bonus Booster option at every renewal before and after accruing 200%.

Policy Period means the period between the inception date and the expiry date of the policy as specified in the Schedule to this Policy or the date of cancellation/termination of this policy, whichever is earlier.

For optional packages, customer can choose only one of the optional packages while
Customer can choose one cover or more than one from all the optional covers available (as per plan).

Pre-existing diseases/illness/injury/conditions will be covered post 24/36 months of continuous cover depending upon the plan and Sum Insured opted.
For Active plan: 90 days for Asthma, Diabetes, Hypertension, Dyslipidemia, Obesity related conditions
For all other conditions - 24 months.

Premium payment modes available under ProHealth Prime Insurance are Single, Half-Yearly, Quarterly, Monthly. Premium payment mode can only be selected at the inception of the Policy or at the renewal of the Policy. Loading will be applied on the premium for Half-Yearly, Quarterly and Monthly premium mode.

It includes all reasonable and customary vaccination expenses of the new born as per the
National Immunization Scheme (India) until the new born completes one year (ie.12 months).
If the policy ends before the new born baby completes 12 months, this benefit will continue subject to policy being renewed in the subsequent year.

Health Maintenance Benefit covers all medical expenses incurred on out-patient basis. This can be used for expenses such as

• Diagnostic tests, preventive tests, drugs, prosthetics, medical aids, prescribed by the specialist Medical Practitioner up to the limits specified in the Schedule.
• Towards Dental Treatments and Alternative Forms of Medicines wherever prescribed by a Medical Practitioner.

Under this benefit if the Sum Insured if not sufficient due to claims paid during the policy year then 100% of Sum Insured will get restored even in case of related illnesses
Sum Insured here would mean basic Sum Insured + Cumulative bonus/Cumulative Bonus Booster becomes insufficient.
For Active Plan if the Sum Insured is not sufficient due to claims paid during the policy year then 100% of Sum Insured will get restored  in case of unrelated illnesses.