Introduction
Before we start comparing these two policies we have to set out some ground rules.
Both products are marketed by different insurance companies. ProHealth Plus is sold by Manipal Cigna and Red Carpet Senior Citizens is sold by Star Health. 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. ProHealth Plus 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. However, Red Carpet Senior Citizens is specifically designed for senior citizens. 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 ProHealth Plus. The product 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.
Red Carpet Senior Citizens meanwhile 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%.
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Compare Insurances Insurance Parameters Recommended Not Recommended |  ProHealth Plus |  Red Carpet Senior Citizens |
|---|---|---|
| Network hospitals | 8,500+ | 14,000+ |
| Claim settlement ratio (avg. of last 3 years) | 90% | 83% |
| Co-payment | 20% (if purchased after turning 65) | 30% |
| Room rent | Any Room (Except suite) | Any Room (up to 1% of sum insured) |
| Disease sub-limit | No | Yes |
| Pre existing diseases waiting | 3 years | 1 years |
| Pre/Post hospitalization | 60/180 days | 30/ days |
| No claim bonus | 10% per year (up to 200%) | |
| Domiciliary | ||
| Ayush treatments | ||
| Restoration benefit | 100% restoration (unlimited no. of times for different illness) | |
| Health check-up | Once every year | Once every year |
| Maternity | Available (up to ₹25,000 after 4 years) | |
| Out Patient Department | Up to ₹2,000 (Annually) | Up to ₹1,000 (cap of ₹200 on each consultation) |
| 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, both policies impose a co-payment clause if you’re hospitalized. ProHealth Plus requires you to co-pay a part of the bill 20% if you purchase after turning 65 whereas Red Carpet Senior Citizens imposes a co-payment clause of 30%
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, ProHealth Plus lets you stay in any room except a Suite, whereas Red Carpet Senior Citizens only lets you stay in a room whose rent doesn’t exceed 1% of the total sum insured.
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, ProHealth Plus doesn’t impose a disease wise sub-limit whereas Red Carpet Senior Citizens imposes disease-wise sub-limits on Cataracts, Cerebro vascular accident, Cardio vascular diseases, cancer, breakage of bones.
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, ProHealth Plus imposes a waiting period of 3 years on pre-existing diseases while Red Carpet Senior Citizens extends a waiting period of 1 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, ProHealth Plus covers expenses incurred 60 days before hospitalization and expenses incurred 180 days post-hospitalization. Meanwhile, Red Carpet Senior Citizens covers expenses incurred 30 days before hospitalization and expenses incurred null 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, ProHealth Plus offers a no-claim bonus whereas Red Carpet Senior Citizens doesn’t offer 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, ProHealth Plus offers domiciliary cover whereas Red Carpet Senior Citizens doesn’t offer domiciliary protection.
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, ProHealth Plus covers Ayush procedures and Red Carpet Senior Citizens 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, ProHealth Plus offers maternity cover whereas Red Carpet Senior Citizens doesn’t offer protection for maternity-related hospitalizations.
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, ProHealth Plus offers OPD coverage, and Red Carpet Senior Citizens also offers OPD coverage, although the sub-limits may be different.
Final Conclusion
It should be obvious by now. ProHealth Plus is packed with features, while Red Carpet Senior Citizens is specifically meant for senior citizens. 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.
Other Manipal Cigna ProHealth Plus Comparisons
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