Overview
The Manipal Cigna ProHealth Protect plan is a flexible health insurance policy offering sum insured options from ₹2.5 lakhs up to ₹50 lakhs. It provides coverage for outpatient expenses under the Health Maintenance Benefit and worldwide emergency medical treatment. The plan includes access to high-end hospital rooms (except suites), restoration of sum insured, and wellness benefits like free health check-ups.
Experts' Review
Written by Nikhil Nair
Senior Writer
The Manipal Cigna ProHealth Protect plan is a solid health insurance option that covers most essential bases without imposing egregious conditions. Its USPs include outpatient coverage [Covered up to 500 Per Policy Year], and worldwide emergency treatment [Covered up to full Sum Insured once in a Policy Year], which are valuable additions not always found in similar mid-tier plans. The plan also offers multiple restorations of the sum insured in a Policy Year for unrelated illnesses, enhancing flexibility during multiple hospitalizations.
However, the no-claim bonus (NCB) is quite modest, at 5% per annum up to 200%, irrespective of claims, which is lower than the 50% annual NCB offered by the ProHealth Plus plan, potentially limiting long-term premium benefits. The basic cover includes 60 days pre-hospitalization and 90 days post-hospitalization, daycare procedures, domiciliary treatment, and AYUSH coverage — all up to the Sum Insured. It also offers an expert opinion from a specialist on critical illnesses, available once during a policy year.
The plan doesn’t have any disease-specific sub-limits; however, a mandatory co-pay of 20% is applicable on all claims for insured individuals aged 65 years and above, regardless of their entry age. This co-pay can be waived by opting for the Waiver of Mandatory Co-pay cover. Premiums for ProHealth Protect are generally 15-20% lower than ProHealth Plus, making it a more affordable choice for those who do not require extensive coverage or higher sum insured limits.
Pros
Feature set is satisfactory.
Insurer has a solid track record with great claim and service metrics.
Offers ManipalCigna Health 360 Advance, which makes this policy stand out.
Cons
Maternity benefits not offered, which is a notable gap.
Manipal Cigna
Key Insights
Founded
2014
Manipal Cigna was established 11 years ago, making it a relatively new entrant with a developing track record.
Claims Experience
91% claims settled in 30 Days
Manipal Cigna settles 91% of all claims it receives demonstrating strong credibility.
Network Hospitals
8,500+
Manipal Cigna maintains a moderate network of 8,500 hospitals, offering reasonable coverage across key locations.
Complaints
24 complaints per 10,000 claims registered
Manipal Cigna experiences a moderate number of complaints, indicating room for improvement in addressing customer concerns.
Features
All
Great
Good
ManipalCigna Health 360 Advance
STANDOUT
Extended coverage with no room restriction, unlimited restoration of sum insured even for same illness along with air ambulance coverage
Co-payment
If you bought this policy, you have to pay 20% of the bill every time you make a claim after you turn 65. Otherwise, you are good to go. The insurer will pay all costs up to the sum insured.
Customisable
Choose a co-payment between 10% and 20% to reduce premiums.
Customisable
Waives off 20% of the co-payment if purchased at the age of 65 years or above.
Room Rent
You can share a room or you could have a single room for yourself. But if you are looking for anything slightly fancy, be ready to foot a part of the bill.
Customisable
Change Single Private or Any room to Twin Shared room.
Disease sub-limit
No funny business here. If your insurer hasn’t explicitly stated they won’t cover a certain illness, you can claim the full amount up to the sum insured, irrespective of the disease you’re dealing with. Meaning this policy doesn't impose the dreaded disease wise sub-limits.
Pre/Post hospitalization
No worries if the doctor had to run a host of diagnostic tests before or after hospitalizing you. The insurer has your back. They will cover this amount in full for a pretty reasonable duration - 60 days before you are hospitalized and 180 days after discharge. This includes the cost of medication by the way.
Add-ons
Cumulative Bonus Booster
Recommended
Additional bonus of 25% up to a maximum of 200%, irrespective of any claim in the previous year.
Supreme Bonus
Recommended
Additional bonus of 100% up to a maximum of 800%, irrespective of any claim in the previous year.
ManipalCigna Health 360 Shield
Recommended
Covers list of 68 non-medical items as per list I upto ₹1,00,000.
Waiver of Mandatory Co-payment
Recommended
Waives off 20% of the co-payment if purchased at the age of 65 years or above.
ManipalCigna Health 360 OPD cover
Get coverage for outpatient and e-consultations i.e. doctor visits along with coverage for prescribed diagnostics and pharmacy based on the option taken.
Hospital Cash
Hospital cash benefit paid out if hospitalization is at least 1 day, with a maximum payout of ₹1000 for up to 30 days.
Room Rent Modifier
Change Single Private or Any room to Twin Shared room.
Co-payment
Choose a co-payment between 10% and 20% to reduce premiums.
Aggregate Deductible
Choose deductible between ₹1,00,000 and ₹10,00,000 and get a discount on premiums.
ManipalCigna Health 360 Advance
Get extended coverage with no room restriction, unlimited restoration of sum insured even for same illness along with air ambulance coverage.
Permanent Exclusions
Conditions or treatments that the policy clearly says it will not cover.
Expenses related to any admission primarily for diagnostics and evaluation purposes are excluded.
Diagnostic expenses not related or incidental to current diagnosis and treatment are excluded.
Expenses for admission primarily for bed rest and not for treatment are excluded.
Custodial care at home or in a facility for help with daily activities is excluded.
Services for terminally ill individuals addressing non-medical needs are excluded.
Disclaimer: For illustration purposes only - exact terms are in the policy wording.
Specific Illness
The following illnesses are not covered under the policy for 2 years.
Cataract and other disorders of lens and retina
Hysterectomy for menorrhagia, fibromyoma, prolapse of uterus, or myomectomy for fibroids (unless necessitated by malignancy)
Surgery of hernia
Surgery of hydrocele
Benign ear, nose, and throat (ENT) disorders and surgeries (including tonsillectomy, adenoidectomy, mastoidectomy, tympanoplasty)
Waiting Period
30 days Initial waiting period
2 years Specific illness waiting period
3 years Pre-existing disease waiting period
Ditto's Take
◦ Standard ◦
After a close look at the waiting periods, it’s safe to say they are fairly standard.
What's missing in the policy
Maternity benefits not offered.
Customer Reviews
A
Anjali Verma
I liked that OPD coverage was available through an add-on—added flexibility for small but frequent expenses.
R
Rajesh Singh
Worldwide emergency treatment gives peace of mind when travelling.
M
Meera Desai
Restoration of sum insured is available, which is crucial.
M
Mohan Kumar
Sum insured options are more limited compared to the Plus variant.
A
Arjun Nair
No-claim bonus capped at 25% per annum is lower than the 50% in ProHealth Plus.
B
Ben Stokes
More affordable than ProHealth Plus, with premiums 15-20% lower.
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Frequently Asked Questions
Does ProHealth Protect have waiting periods?
- 30-Day Waiting Period: Hospitalizations won’t be covered for the first 30 days of the policy unless it’s an accident.
- Specific Illness Waiting Period: There’s a 2-year waiting period for a list of diseases which is a mandate before you can start claiming.
- Pre-Existing Disease Waiting Period: There's a 3-year waiting period for any pre-existing disease you may have while buying the policy.
Does ProHealth Protect have room rent restrictions?
Does ProHealth Protect offer a restoration benefit?
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