Question 1

Does ProHealth Preferred have waiting periods?

Accepted Answer

Yes. ProHealth Preferred imposes 4 kinds of 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 2-year waiting period for any pre-existing disease you may have while buying the policy. Maternity and Newborn Waiting Period: There’s a 4-year waiting period before you can make claims related to pregnancy and childbirth. However, you can reduce your waiting period down to 2 years by paying an additional premium.

Question 2

Does ProHealth Preferred have room rent restrictions?

Accepted Answer

No. ProHealth Preferred lets you stay in any room available in the hospital except the Suite Room - for which you’d have to share costs with the insurer.

Question 3

Does ProHealth Preferred offer a restoration benefit?

Accepted Answer

Yes, ProHealth Preferred allows you to claim the full cover any number of times repeatedly if you are hospitalized for different complications, in a policy year

Question 4

Does ProHealth Preferred cover AYUSH treatments?

Accepted Answer

Yes. ProHealth Preferred does cover AYUSH Treatments.

Question 5

Does ProHealth Preferred offer a bonus?

Accepted Answer

Yes. ProHealth Preferred offers a no-claim bonus. Every year, you go without making a claim, your sum insured grows by 10% up to a maximum of 200% of the sum insured.

Question 6

Does ProHealth Preferred offer maternity benefits?

Accepted Answer

Yes. ProHealth Preferred does offer maternity benefits covered up to  Rs. 50,000 for normal delivery and Rs. 1,00,000 for C-Section delivery per event up to two deliveries.

Question 7

Does ProHealth Preferred offer international coverage?

Accepted Answer

Yes. ProHealth Preferred offers international coverage. But it only affords protection if it’s an emergency hospitalization.

Question 8

Does ProHealth Preferred offer dental protection?

Accepted Answer

No. ProHealth Preferred does not offer dental protection.

Question 9

Does ProHealth Preferred offer coverage for outpatient consultations?

Accepted Answer

Yes. ProHealth Preferred does cover Outpatient Consultations of up to ₹15,000 annually.

Question 10

How are the premiums calculated for ProHealth Preferred?

Accepted Answer

The premiums are calculated after taking into account your age, your location (zonal), your medical condition, (any pre-existing diseases), and lifestyle habits (smoking, drinking, etc.)

Question 11

Can I avail myself of a discount on ProHealth Preferred?

Accepted Answer

Yes. ProHealth Preferred does provide discounts. - You can get a flat 25% discount on your premium if 2 or more members get covered under the policy. You can also get a long-term discount of 7.5% for selecting a 2-year policy and 10% for selecting a 3-year policy. Moreover, you can avail yourself of a discount of up to 2.5% on your subsequent renewals by staying healthy and accumulating health points.

Question 12

Does ProHealth Preferred have entry and exit restrictions?

Accepted Answer

No. ProHealth Preferred is made for children aged 90 days and above, and 18 years and above for adults. There are no such restrictions on entry and exit. For maternity benefits, the entry age is between 18 years and 45 years.

Question 13

How do you file a claim if you have ProHealth Preferred?

Accepted Answer

In the case of emergency hospitalization, you have to intimate the insurer of making the claim as soon as you get the patient admitted. In the event that isn’t possible, you must intimate the insurer within 48 hours of hospitalization with the patient’s Health Insurance ID. Simply drop an email to customercare@manipalcigna.com with the policy number, hospital name, date of hospitalization and you’re good to go OR call them at 1800-102-4462. In the case of planned treatment, you have to intimate the insurer 72 hours before admission. But if you can do it sooner, you should probably consider doing that as insurance companies may take a while to investigate the veracity of your request. Check for partnered hospitals — Each insurer will have a dedicated network of hospitals they’ll have partnered with. Once you find a partner hospital of your liking, you can try to make the claim on a cashless basis. All you have to do is fill out a pre-authorization request form (available here) and submit it to the hospital. Once the request for pre-authorization has been granted, you have to avail the treatment within 15 days of the pre-authorization date. If you don’t find a network hospital or the cashless claim doesn’t go through, then you’ll have to fill the claim form post-discharge and send it to the insurer with all the other hospital records deemed necessary within 30 days.

Question 14

What documents do I need to file a claim if I have ProHealth Preferred?

Accepted Answer

Claim-Form signed by the hospital. Investigation and Medical reports. The final bill including the breakup. Discharge Summary. Invoices deemed necessary. Cash Memos. Receipt and investigation test reports from a pathologist supported by the note from the attending medical practitioner/ surgeon prescribing the test. Nature of operation performed and surgeon's bill and receipt. Self-declaration/MLC/FIR in case of accident cases.

ProHealth Preferred

Manipal Cigna

Manipal Cigna

ProHealth Preferred

What's good here?

Covers international treatments

You most likely don't have to split the bill

You always have full cover irrespective of the disease

Pre & Post hospitalization expenses covered

Day Care treatments covered

Full coverage even if you are forced to hospitalize at home

Doctor consultations covered

You can pick any room so long as it’s not a Suite

Short waiting period for Pre Existing Diseases

Good Restoration Benefit

Free Health Checkups every year

Covers Alternative Medicine

What's okay here?

Special Bonus for being healthy and not claiming insurance

Maternity benefits offered

Frequently Asked Questions

Does ProHealth Preferred have waiting periods?

Does ProHealth Preferred have room rent restrictions?

Does ProHealth Preferred offer a restoration benefit?

Does ProHealth Preferred cover AYUSH treatments?

Does ProHealth Preferred offer a bonus?

Does ProHealth Preferred offer maternity benefits?

Does ProHealth Preferred offer international coverage?

Does ProHealth Preferred offer dental protection?

Does ProHealth Preferred offer coverage for outpatient consultations?

How are the premiums calculated for ProHealth Preferred?

Can I avail myself of a discount on ProHealth Preferred?

Does ProHealth Preferred have entry and exit restrictions?

How do you file a claim if you have ProHealth Preferred?

What documents do I need to file a claim if I have ProHealth Preferred?

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