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 Protect is sold by Manipal Cigna and iHealth Plus is sold by ICICI Lombard. 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 Protect is quite basic. It offers little protection and may not be entirely suitable if you are looking for robust protection. However, iHealth Plus is a premium policy tailored to cover as many use cases as possible. So in all honesty, you are 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 Protect. 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 88.90% with more than 6,500+ network hospitals in tow.


iHealth Plus meanwhile comes from ICICI Lombard’s stable:

ICICI Lombard Health Insurance company is a joint venture between India's ICICI Bank and Canada's Fairfax Holdings. They are one of the leading insurance companies with over 270 branches spread across India.

However, with a claim settlement ratio of 86.67% and a measly network of 6,700+ hospitals, their performance needs significant improvement.

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Compare Insurances

Network hospitals6,500+6,700+
Claim settlement ratio

(avg. of last 3 years)

88.9%86.67%
Co-payment

20%

(if purchased after turning 65)

No

Room rent

Single Private room

Any Room

Disease sub-limit

No

No

Pre existing diseases waiting

4 years

2 years

Pre/Post hospitalization

60/90 days

30/60 days

No claim bonus

5% per year

(up to 200%)

10% per year

(up to 50%)

Domiciliary
Ayush treatments
Restoration benefit

100% restoration

(unlimited no. of times

for any illness)

100% restoration

(once for different illness)

Health check-up
Once every 3 years
Once every year
Maternity

Available

(up to ₹50,000 after 3 years)

Out Patient Department

Up to ₹5,000

(Annually)

Day care

Feature Comparison

co_pay

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, ProHealth Protect requires you to co-pay a part of the bill 20% if you purchase after turning 65 whereas iHealth Plus doesn’t impose a co-payment clause

room_rent

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 Protect only lets you stay in a single private room but you can pick any room you want with iHealth Plus.

disease_sublimit

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, neither ProHealth Protect imposes disease-wise sub-limits nor does iHealth Plus

ped

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 Protect imposes a waiting period of 4 years on pre-existing diseases while iHealth Plus extends a waiting period of 2 years on existing conditions.

pre_post

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 Protect covers expenses incurred 60 days before hospitalization and expenses incurred 90 days post-hospitalization. Meanwhile, iHealth Plus covers expenses incurred 30 days before hospitalization and expenses incurred 60 after hospitalization, although there may be different sub-limits

ncb

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 Protect offers a no-claim bonus of 5% whereas iHealth Plus offers a no-claim bonus of 10%. And the no-claim bonus may be capped at different levels too.

domiciallary

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 Protect offers domiciliary cover whereas iHealth Plus doesn’t offer domiciliary protection.

ayush

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 Protect covers Ayush procedures and iHealth Plus also extends coverage for Ayush treatments.

maternity

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 Protect doesn’t offer protection for maternity-related hospitalizations whereas iHealth Plus offers maternity cover.

opd

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 Protect doesn’t offer OPD protection whereas iHealth Plus offers OPD cover.

Final Conclusion

Since this isn’t a fair comparison, to begin with, we will only tell you this much. If you want something that’s affordable, you could go for ProHealth Protect. However, if you want top-class protection, then it’s a no brainer, iHealth Plus is your go-to option.

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