Introduction
Before we start comparing these two policies we have to set out some ground rules.
Both products are marketed by different insurance companies. Diabetes Safe is sold by Star Health and ProHealth Preferred is sold by Manipal Cigna. So any meaningful comparison should include a comparison of the product alongside the insurers themselves.
Second, we know that both products have massive differences in their core structure. Diabetes Safe is specifically designed for people suffering from diabetes/hypertension. However, ProHealth Preferred is a premium policy built for people who want to leave no stone unturned when it comes to their health. It’s expensive and it does pretty much everything you expect a good policy to do. So in many ways, you’re comparing apples and oranges here.
And finally, any comparison is ultimately futile without considering the use case. Who are you buying this policy for? You, your family, your parents?
That’s something you’ll need to answer before using this guide. So with that introduction out of the way, we can get to comparing the actual policies themselves.
Let’s start with Diabetes Safe. The product comes from Star Health’s stable:
Star Health Insurance is India's first standalone health insurance firm. And with an army of retail advisors pushing their products across the country, they’ve managed to capture a fair share of the Indian market.
The company also boasts a network of over 14,000+ hospitals and a decent claim settlement ratio of 83%.
ProHealth Preferred meanwhile comes from Manipal Cigna’s stable:
ManipalCigna Health Insurance Company is a collaborative partnership between Manipal Group and Cigna and together they have over 200 years of expertise in the healthcare business. And while the company has shown some potential recently, it still only corners a small part of the Indian market.
Also, they have a settlement ratio of 90% with more than 8,500+ network hospitals in tow.
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Compare Insurances Insurance Parameters Recommended Not Recommended |  Diabetes Safe |  ProHealth Preferred |
|---|---|---|
| Network hospitals | 14,000+ | 8,500+ |
| Claim settlement ratio (avg. of last 3 years) | 83% | 90% |
| Co-payment | No | 20% (if purchased after turning 65) |
| Room rent | Single Private room | Any Room (Except suite) |
| Disease sub-limit | Yes | No |
| Pre existing diseases waiting | 3 years | 2 years |
| Pre/Post hospitalization | 30/60 days | 60/180 days |
| No claim bonus | 10% per year (up to 200%) | |
| Domiciliary | ||
| Ayush treatments | ||
| Restoration benefit | 100% restoration (once for different illness) | 100% restoration (unlimited no. of times for different illness) |
| Health check-up | Once every year | |
| Maternity | Available (up to ₹1,00,000 after 4 years) | |
| Out Patient Department | Up to ₹5,500 | Up to ₹15,000 (Annually) |
| Day care |
Feature Comparison
Co payment
With a co-payment clause, the insurer will mandate that you pay a part of the bill. So if the bill adds up to Rs. 2,00,000 and the co-payment is set at 20% then you could be asked to pay Rs. 40,000 from the bill. In this case, however, Diabetes Safe doesn’t impose a co-payment clause whereas ProHealth Preferred requires you to co-pay a part of the bill 20% if you purchase after turning 65
Room rent
If the policy does impose room rent restrictions then the insurer may only let you stay in a room of a certain specification or impose a cap on the total room rent. If you were to breach either criterion then the insurance company may ask you to pay a portion of all the expenses you incurred while staying in the room. In this case, however, Diabetes Safe only lets you stay in a single private room whereas ProHealth Preferred lets you stay in any room except a Suite.
Sub limits
Some policies will tell you that they will cover all medical expenses up until the sum insured, but then impose caps on the total costs you can incur while dealing with a very specific list of diseases. We call these caps “Disease Wise Sub Limits.” In this case, Diabetes Safe imposes disease-wise sub-limits on null whereas ProHealth Preferred doesn’t impose a disease wise sub-limit.
Waiting periods for pre-existing diseases
If you’re suffering from a lifestyle condition or if you’ve had surgery in the past, or if you’re dealing with an acute or chronic illness at the time of buying the policy, then the insurer may classify this as a pre-existing disease. And they may tell you that they will only cover these illnesses after some time. In this case, Diabetes Safe imposes a waiting period of 3 years on pre-existing diseases while ProHealth Preferred extends a waiting period of 2 years on existing conditions.
Pre and post Hospitalization expenses
Most people aren’t hospitalized right off the bat. Instead, they’ll have to go through a whole series of diagnostic tests before hospitalization and take medication post-discharge. These costs are outlined as pre-hospitalization expenses and post-hospitalization expenses respectively. In this case, Diabetes Safe covers expenses incurred 30 days before hospitalization and expenses incurred 60 days post-hospitalization. Meanwhile, ProHealth Preferred covers expenses incurred 60 days before hospitalization and expenses incurred 180 after hospitalization, although there may be different sub-limits
No claim bonus
Some policies will tell you that they will incentivize you for not making a claim in any given year. And they offer such incentives by offering extra cover on top of the existing sum insured. This extra cover is categorized as a no-claim bonus. In this case, however, Diabetes Safe doesn’t offer a no-claim bonus whereas ProHealth Preferred offers a no-claim bonus.
Domiciliary
Imagine you are forced to treat yourself at home because you don’t find a hospital bed, or you have a chronic condition that prevents you from visiting one, then, insurers may choose to cover your treatment even if you’re hospitalized at home. And such costs are collectively categorized as domiciliary treatment costs. In this case, however, Diabetes Safe doesn’t offer domiciliary protection whereas ProHealth Preferred offers domiciliary cover.
Ayush treatments
Most policies only cover treatments administered in a registered medical facility. However, on some occasions, you may want to pursue alternative treatments including homoeopathy, Ayurveda, Unani and Siddha. These treatments are collectively categorized as Ayush treatments. And in this case, Diabetes Safe covers Ayush procedures and ProHealth Preferred also extends coverage for Ayush treatments.
Maternity benefits
If you’re hospitalized during childbirth, then you may have to incur significant costs during delivery of your newborn, child care and other related matters during the course of the hospitalization. These costs are collectively termed maternity costs. And in this case, however, Diabetes Safe doesn’t offer protection for maternity-related hospitalizations whereas ProHealth Preferred offers maternity cover.
Out Patient Department (OPD)
Doctor visits and regular consultations aren’t usually covered by health insurance policies. They are categorized as Outpatient consultations (or OPD treatments) and patients have to bear the cost on their own. In this case, however, Diabetes Safe offers OPD coverage, and ProHealth Preferred also offers OPD coverage, although the sub-limits may be different.
Final Conclusion
It should be obvious by now. ProHealth Preferred is packed with features, while Diabetes Safe is specifically meant for people suffering from diabetes/hypertension. But considering Star Health has a claim settlement ratio that can only be considered sub-par at best, we would still recommend going with anything that Manipal Cigna has to offer, if the policy is made available to you.
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