- 1 What is Manipal Cigna Pro Health Group Insurance
- 2 Benefits of Manipal Cigna Pro Health Group Insurance Policy Plan
- 3 Manipal Cigna Pro Health Group Insurance Policy Cover
- 4 Manipal Cigna Pro Health Group Insurance Policy Not Covered
- 5 Document Required
- 6 Eligibility
- 7 FAQs
- 7.1 Q1. What are the details to be provided at the time of intimation of claim?
- 7.2 Q2. What is the entry age limit for Pro Health Group Insurance Policy?
- 7.3 Q3. What Sum Insured can be opted under Pro Health Group Insurance Policy?
- 7.4 Q4. Who can buy Pro Health Group Insurance Policy?
- 7.5 Q5. Why to choose Pro Health Group Insurance Policy?
- 7.6 Q6. What benefits are available under Pro Health Group Insurance Policy?
- 7.7 Q7. What benefits are included in the Base Cover?
- 7.8 Q8. What expenses are covered under In-patient hospitalization?
- 7.9 Q9. Is Home Nursing and Domiciliary treatment similar?
- 7.10 Q10. Is there the capping facility on the room rent available?
- 7.11 Q11. Will medical expenses before and after hospitalization be covered?
- 7.12 Q12. What happens when I undergo a treatment/ surgery under Day Care facility and get discharged the same day?
- 7.13 13. Is the Ambulance cost covered under this plan?
- 7.14 Q14. What is Disease category Sub-Limit?
- 7.15 Q15. Are Maternity / New born baby expenses covered in this plan?
- 7.16 Q16. Is Out-patient treatment covered?
- 7.17 Q17. What is difference between Outpatient treatment and Accumulate Cover?
- 7.18 Q18. What is Wellness Services program?
- 7.19 Q19. Will Health card be issued?
- 7.20 Q20. What is the maximum number of claims allowed in a policy year?
- 7.21 Q21. I am working in Chennai and covered under Pro Health Group Insurance Policy including my family. But my family members reside in Mumbai. Can everyone of us holds the right to claim under the policy?
- 7.22 Q22. Does Pro Health Group Insurance cover enteral feeding?
- 7.23 Q23. Are any Modern and Advanced treatments covered under Pro Health Group Insurance?
- 7.24 Q24. Is Artificial Life maintenance covered under Pro Health Group Insurance?
In search of a Group Health Insurance Policy Plan to keep your employees and their families safe and sound? Here we are with the Manipal Cigna Pro Health Insurance Policy Plan.
What is Manipal Cigna Pro Health Group Insurance
The Manipal Cigna Pro Health Insurance Policy Plans offered by the Manipal Cigna Health Insurance Group is a comprehensive medical insurance policy plan for your illness as it is packed up with loads and loads of basic covers, some value-added covers, and an optional cover too. The least age of entry in this policy is 91 days for children and it is 18 years of age for adults, and the most exciting news is that there is no specific maximum age for entry in this policy.
You can buy this policy on an individual basis or on a family floater basis for a period of 1 year, 2 years, or even 3 years as per your requirements and budget. If opted for the individual health Insurance coverage plan, you can include you legally wedded spouse, children, parents, siblings, son-in-law and daughter-in-law, or even parents-in-law, grandparents and grandchildren, uncle, aunt, nephew and niece under this policy. Whereas, if you have chosen the family floater type of coverage, then you can include your spouse, children, and parents. This health insurance policy makes sure and take care of all the expenditure which is related to various different health care assistance that the insured person and the family of the same, if covered.
Under the Manipal Cigna Pro Health Insurance Policy Plan, the approximate sum which is promised under the plan is the same and equal for all the members of a family, and all the family members are provided with a bounus option of increasing the approximate sum insured as per their needs and requirements. It has many highlighting features and benefits which can aid an employer to provide financial protection to its customers and their families in case of any health emergencies.
Benefits of Manipal Cigna Pro Health Group Insurance Policy Plan
The major features and benefits of the Manipal Cigna Pro Group Health Insurance Policy Plan are all listed below:-
1. The Manipal Cigna Pro Health Insurance Policy Plan tends to provides the best healthcare amenities to all the employees of a firm which have choosen the plan.
2. This policy believes in hassle free procedures especially in the case of medical emergencies, so they offers cashless claim settlement in all the registered network hospitals.
3. With the affordable and economical premium amounts, the Manipal Cigna Pro Health Insurance Policy Plan offers the comprehensive healthcare services as well.
4. The customer care support is active and live for 24×7.
5. The Manipal Cigna Pro Health Insurance Company has its own staff settled for the Health Administration Team which aims at providing and serving extremely quick disbursement of claims.
6. This policy plan are flexible enough and be switched to the family floater plan to the individual cover.
7. The policy provides income tax benefits U/S 800 of the IT Act as well.
Manipal Cigna Pro Health Group Insurance Policy Cover
The inclusion of the policy plans which are offered by the Manipal Cigna Pro Health Insurance Policy Plan are as mentioned below:-
1. All the expenses that might arise because of the travelling in the ambulance are covered in this policy.
2. The cost of expenses which is up there in case of maternity hospitalization and birth of a newborn baby are all included in the plan.
3. Diseases that is there with an individual either since birth or before applying for the policy plan.
4. All the expenses of all the daycare processes and procedures are included in the policy plan.
5. Not only this, but all the expenses related to the pre and post hospitalization are also taken care of under this policy plan.
6. All the cost of operation theatre are also covered.
7. Cost of pacemaker, process of dialysis, expenditure that might arise because of organ transplant procedure, radiotherapy, and the most expensive process of cancer treatment the chemotherapy are also covered.
Manipal Cigna Pro Health Group Insurance Policy Not Covered
The exclusions of the Manipal Cigna Pro Health Insurance Policy Plans are mentioned below:-
1. Any act that shows the signs of self-injury or self-harm is not included in the policy plan.
2. Injuries that happens because of some presence of the policy owner in the criminal activities are not eligible for the benefits.
3. Treatments for HIV and AIDS are also not covered.
4. Injuries that happens because of being a victim of any criminal activity are not covered.
5. Suicidal attempts and injuries incurred because of the act of suicide are also not covered.
6. Unless and until the cosmetic and plastic surgeries are advised by the doctor to cure any medical condition, these two above mentioned surgeries are not included in the plans and policies by the Manipal Cigna Pro Health Insurance Company.
The list of documents required to apply for the Manipal Cigna Pro Health Insurance Policy Plan is mentioned below:-
1. Photograph of the person willing to buy the plan.
2. Age proof which can either be the birth certificate, Voter’s ID, PAN card or passport.
3. Identity proof which includes passport, Aadhaar card, PAN card or Voter’s ID.
4. Income Proof which can be your Form 16, salary slips, employment certificate, and more.
5. Address proof which can be the telephone bill, electricity bill, passport, bank statement, Voter’s ID, or more.
6. Medical test report that the person willing to buy a plan have to undergo before opting the plan.
The major and main eligibility criteria are mentioned and discussed below:-
1. Sum Insured – It ranges from ₹ 5000 up to ₹ 1 Crore.
2. Age of Entry – There is no such specific minimum or even the maximum age to enter in to the policy plan a child from day 1 of it’s birth up to the age of 25 years can be provided protection in a family health Insurance policy plan.
3. Type of Coverage – There comes two types of coverage under the Manipal Cigna Pro Health Group Insurance Policy Plan which are:- Individual Coverage and Family Floater Coverage.
4. Relationships Covered – The below mentioned and listed relationships are provided protection ij this policy plan:-
Self, Legal Spouse, Old Age Parents, Unmarried Children, Brother, Sister, Grandparents, Grandchildren, Parent in Laws, Son in Law, Daughter in Law, Uncle, Aunt, Niece and Nephew.
5. Policy Term – 1 year (>1 year, max up to 5 year’s term available for Credit Linked Policy)
6. Minimum Group Size – The group can have maximum of 7 family members.
7. Premium – One can pay premiums on a Monthly Basis, Quarterly Basis, Half-yearly Basis or even choose to pay the premiums Annually.
8. Renewal – Renewal can done only if the person opted the insurance policy plan is still in association with the group.
Q1. What are the details to be provided at the time of intimation of claim?
Ans – The Pro Health Group Insurance Policy Plans provides protection to a specified group of people, for an example individuals working in a firm, members living and working in a society or some professional associations or even an affinity group. This plan has been especially structured to serves the policy owners and their families with all sort of medical coverage in case of hospitalization because of illness or injury. This plan also offers a comprehensive protection coverage with a base covers and a long list of several options to choose as per the needs and requirements of the group members.
Q2. What is the entry age limit for Pro Health Group Insurance Policy?
Ans – The coverage is available to the Group Member or the Employee of the Policy owner or even the Non-Employer group of people registered or nominated by the policy owner. The coverage is available for the dependent children starting from day 1 of birth up to the age of 25 years.
Q3. What Sum Insured can be opted under Pro Health Group Insurance Policy?
Ans – The Manipal Cigna Pro Health Group Insurance Policy Plan provides a wide range of Sum Insured options ranging from ₹ 5, 000 up to ₹ 100 Lacs.
Q4. Who can buy Pro Health Group Insurance Policy?
Ans – The policy plan is made available to any homogeneous group, association or firm, institutions and the corporate body with the clause that it has it’s Central Administration and subject to minimum group size of 7 individuals only.
Q5. Why to choose Pro Health Group Insurance Policy?
Ans – One should and must choose the Manipal Cigna Pro Health Group Insurance Policy Plan because it holds the best position among the many other plans in the race. The various features and benefits are designed in such a manner that they meet the needs and requirements of the insurance owner of our country. Alterations of the plans by the customers according to the needs and requirements is the most highlighting feature offered by the Manipal Cigna Pro Health Group Insurance Policy Plan.
Q6. What benefits are available under Pro Health Group Insurance Policy?
Ans – The Manipal Cigna Pro Health Group Insurance Policy Plan offers a 360° of protection includes 7 big inbuilt benefits under the Base cover and other 42 benefits under the Optional Covers.
Q7. What benefits are included in the Base Cover?
Ans – The Base Coverage Plan includes:
i. In-patient Hospitalisation costs are covered.
ii. Day Care Treatment Coverage.
iii. Pre-Hospitalisation And Post – Hospitalization Medical Expenses are also taken care under the policy plan.
iv. Ambulance Assistance at a road emergency is covered.
v. Domiciliary Hospitalisation Cover.
vi. Donor Expenses Cover.
Q8. What expenses are covered under In-patient hospitalization?
Ans – The in-patient hospitalization covers all the Medical Expenses that includes the room charges, operation theatre costs, doctor’s consultant fees, specialist fees, surgeon fees, anesthetist’s fees, radiologist, pathologist costs, nursing expenses, prescribed medicines costs, diagnostic tests, medical and/or surgical equipments.
Q9. Is Home Nursing and Domiciliary treatment similar?
Ans – No, Domiciliary treatment can be considered as the treatment facility which is provided at the pateint at home due to lack of accommodation space in the hospital or the nursing home or in the extreme cases where to shift the patient from his or her home or place have a lot of risks involved. And in case of the Home Nursing a qualified and skilled nurse is asked by the hospital authorities to provide all the nursing services to the insured person at home because he or she is evidently facing major problems to cope up with the daily living activities which includes washing, dressing, toileting, feeding and more. Home Nursing comes in the section of the optional cover under the policy plan.
Q10. Is there the capping facility on the room rent available?
Ans – In the base cover, rent for the room per day is seen restricted up to 1% of the Sum Promised opted and 2% of Sum Insured for the ICU. However, this capping can be enhanced and amended as per the below options:
• Opt the percentage limit of the Sum Insured for per day Room Rent.
• Choose an amount limit according to your level for daily Room Rent.
• Select limit on room type.
Q11. Will medical expenses before and after hospitalization be covered?
Ans – Pre-hospitalization expenditures are the medical costs that comes up right before the insured person is hospitalized. And the post-hospitalization medical expenses covers all the expenses that bills up immediately after the insured individual goes home from the hospital.
Q12. What happens when I undergo a treatment/ surgery under Day Care facility and get discharged the same day?
Ans – It points out to any medical treatment and or any surgical procedures which are:
i) Being done under the General or Local Anesthesia in a hospital or a day care center in less than 24 hours because of technological advancement, and
ii) The processes or procedures that will require a hospitalization of more than 24 hours. Treatment which an individual usually takes on an outpatient basis is not considered to be eligible in the scope of this definition.
13. Is the Ambulance cost covered under this plan?
Ans – Yes, the Pro Health Group Insurance Policy will reimburse all the cost that have incurred in transportation of the insured person using a registered ambulance service provider to any of the network hospitals for treatment of the illness or injury.
Q14. What is Disease category Sub-Limit?
Ans – The Disease category sub-limit covers the major medical expenses of the distinct illness or injury up to the certain limit opted for that particular disease category. There is absolutely no restrictions on the number of claims that you ask for in the current policy year, provided the claims does not go up and above the specified limit.
Q15. Are Maternity / New born baby expenses covered in this plan?
Ans – Yes, the maternity/new born baby expense coverage are available as an optional covers. The maternity expenses coverage is available from the time of delivery or termination to up to two events up to the limits opted by the individual under the plan as an optional benefit.
• The coverage is provided for the normal delivery, routine or the elective caesarean or in case of complicated pregnancy or even the Pre and Post Natal expenses are covered.
• New born baby expenses are covered along with the sub- limit option. It can become a part of the maternity sub-limit or can be in addition to all the maternity expenses coverage.
• The individual also have the option to choose the cover for the Surrogacy pregnancy.
Q16. Is Out-patient treatment covered?
Ans – The medical expenses that are up there for you in the treatment on an out-patient basis are also under the coverage up to the Sum Insured that you have opted for. Any one or the combination of the following can be selected under the cover:
4) Medical Aids
9) Over The Counter (OTC) Medicine
Q17. What is difference between Outpatient treatment and Accumulate Cover?
Ans – When the policy owner is hospitalized and the doctor keeps him or her in the network hospital for more than 24 hours for receiving treatment is considered to be as in-patient treatment. Where as the Out-patient treatment is when the insured individual visits a clinic or any of the network hospitals or even a consultation room for diagnosis and treatment based on the suggestion and recommendation of a medical practitioner. In this outpatient treatment, the patient is not admitted to the hospital.
Q18. What is Wellness Services program?
Ans – The Wellness Services Program provides benefits and features in various Wellness Services ranging from:
1) Tracking your Health
2) Medical Attendant Services
3) Regular Health Check Ups
4) Registered Doctor’s Consultations
5) Health tips or newsletters
6) Well-baby Care
7) Well-Mother Care
Q19. Will Health card be issued?
Ans – Yes, a health card will be given to all the group members who are provided protection under the policy. The Health Card resembles way too much with the identity cards issued to us in schools and colleges. This card will make you eligible to avail the cashless hospitalization facility at any of the network hospitals across the country. A health card basically contains the basic details including the contact details of the TPA. In case of any medical emergency, you can make a call on these numbers to clear your queries and questions. This card is needed to be shown at the time of admissions in the network hospital along with your pass post size photograph, identification proof and address proof.
Q20. What is the maximum number of claims allowed in a policy year?
Ans – There is no particular limit on the number of claims you go for in a policy plan in an year, provided the claim is within the limit of sum insured that you have opted.
Q21. I am working in Chennai and covered under Pro Health Group Insurance Policy including my family. But my family members reside in Mumbai. Can everyone of us holds the right to claim under the policy?
Ans – Yes, you and your family members are under the eligibility list to claim and avail all the benefits associated with the policy across India. Cashless facility will also be made available at all the network hospitals. In case of any emergency situation or if you take admission in a hospital falling out of the network hospitals list, then in that case you can go for the reimbursement process by submitting all the documents, details and bills.
Q22. Does Pro Health Group Insurance cover enteral feeding?
Ans – Yes, the insurance policy plan provides coverage for all the medical expenses that arises because of the enteral feeding during the in- patient hospitalization, day care or in case of domiciliary hospitalization which can be maximum of 15 days in a policy tenure.
Q23. Are any Modern and Advanced treatments covered under Pro Health Group Insurance?
Ans – Yes, under the in-patient hospitalization the insurance company offers coverage for all the medical expenses that is up there because of Medically Necessary Modern and Advanced Treatment of the person Insured facing illness and difficulty in recovery.
Q24. Is Artificial Life maintenance covered under Pro Health Group Insurance?
Ans – Yes, under in-patient hospitalization the insurance company covers all the major medical costs towards the artificial life maintenance, which simply includes the life support system which used a certified medical professional for treatment.