Cigna TTK ProHealth Plus Insurance Plan
Cigna TTK ProHealth Plus Insurance Plan - Our ProHealth Insurance Plus Plan provides an insurance coverage ranging from Rs. 4.5 lakhs to Rs. 10 lakhs. All hospitalization expenses such as treatment costs, diagnostics, drugs and accommodation charges are covered. Pre & Post Hospitalization expenses are also covered for a specified number of days.
This plan has been designed to provide comprehensive coverage for all unforeseen health complications as well as give maternity benefits and cover expenses pertaining to the medical treatment of the newborn. Other important features include Health Maintenance Benefits covering consultation and pharmacy charges, Cumulative Bonus for a claim free year, Expert Opinion on Critical Illnesses and a Worldwide Emergency Cover. A Health Check up is also available on every renewal.
- Sum insured options: Rs. 4.5 lakhs, Rs. 5.5 lakhs, Rs. 7.5 lakhs and Rs. 10 lakhs
- Entry age & renewal: The minimum entry age is 91 days for children and 18 years for adult. There is no maximum age limit for entry under this policy.The plan provides lifetime renewal opportunity.
- Is a medical test required before enrolment? It depends on the age and the sum insured that you have opted for.
- What determines premium? Apart from age, lifestyle, sum insured, gender and results of the medical test (if undertaken), the geographical location also determines premium. Cities have been divided into 3 separate zones.
- Policy period: One can choose between 1 year and 2 years term
- Family discount: 10% discount on the premium amount on enrolling more than 2 family members under a single individual policy.
Key Features - Cigna TTK ProHealth Plus Insurance Plan
IN-PATIENT HOSPITALIZATION
- Covered up to single private room.
DOCTORS’ FEES, NURSING, ANESTHESIA, BLOOD, OXYGEN, OPERATION THEATRE CHARGES, SURGICAL APPLIANCES, MEDICINES, DRUGS AND CONSUMABLES
- Under single private room we will cover hospitalization expenses such as surgeon’s fees, nursing, anesthesia, blood, oxygen, operation theater charges, surgical appliances, medicines, drugs and consumables up to the sum insured.
PRE - HOSPITALIZATION
- You may incur some expenses before you are hospitalized, like doctor’s fees, pharmacy related expenses or diagnostic tests. All such costs will be covered by us up to 60 days before your hospitalization.
POST - HOSPITALIZATION
- After you get home from the hospital, there are still expenses to be taken care of, like consultation fees, diagnostic tests, pharmacy related costs among other things. We will cover such expenses related to your hospitalization up to 180 days after your discharge.
DAY CARE TREATMENT
- You might need to be hospitalized for less than 24 hours for certain procedures like dialysis, radiation therapy, cataract surgery among others. We will cover the cost of such procedures up to the sum insured.
DOMICILIARY TREATMENT
- If you need to be treated at home due to a bed shortage at the hospital or because your doctor prescribed home care, we will cover the expenses for it, up to the sum insured.
AMBULANCE COVER
- We understand the need for emergency ambulance service; should you need immediate assistance we will cover the ambulance expenses up to 3000 rupees every time you get hospitalized.
DONOR EXPENSES
- For situations like an organ transplant, the medical expenses incurred for the in-patient hospitalization of the donor is also covered up to the sum insured.
PRE-EXISTING DISEASES WAITING PERIOD
- Pre-existing diseases will be covered after 36 months of continuous coverage under this plan.
EXPERT OPINION ON CRITICAL ILLNESS
- We understand your need for an Expert opinion from our network of medical practitioners for deciding on the best course of action. We cover the cost of an Expert opinion on listed critical illnesses such as cancer or stroke before you decide on the best treatment or procedure.
RESTORATION OF SUM INSURED
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If the Sum Insured and Cumulative Bonus (if any) is insufficient due to claims paid & accepted, we will restore 100% of Sum Insured once in a policy year to meet future claims for all unrelated diseases/injury.
For example, an insured has taken a cover of Rs. 5.5 lakhs and a claim of Rs. 5 lakhs has been paid. Now, he is admitted to hospital for an unrelated disease and files a fresh claim of Rs. 1 Lakh. Under restoration benefit, the policy will provide an additional Rs.5.5 Lakhs of Sum Insured. Fresh claim and any future claims can be settled out of the balanced Sum Insured plus the restored Sum Insured within the same policy year.
MATERNITY EXPENSES
- We provide a coverage upto Rs. 15,000 for normal delivery and Rs. 25,000 for a C-section. Maternity coverage will be available after 48 months of your enrollment with us.
NEW BORN BABY EXPENSES
- If your newborn is in need of hospitalization, we will cover the expenses of the medical treatment up to the sum insured under the maternity coverage.
FIRST YEAR VACCINATIONS
- We care about the health of your new born. That’s why we cover first year vaccinations expenses of the new born as per the National Immunization programme. The cover will be in addition to the maternity sum insured.
HEALTH MAINTENANCE BENEFIT
- We provide reimbursement of Rs.2000/- each year to cover out-patient expenses such as doctor’s consultation, pharmacy expenses or diagnostic tests.
CUMULATIVE BONUS FOR NO CLAIMS
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You can even benefit from staying healthy. We increase the sum insured by 10% for each claim free year upto a maximum of 50%.
For example, if you have a coverage of Rs. 5.5 Lakhs and there is no claim in the first year, an additional Sum Insured of Rs. 55,000 will be allowed as Cumulative Bonus. If a claim is made in the second year, the earned Cumulative Bonus is not reduced.
HEALTHY REWARDS
- Points can be earned for each year of premium paid and accumulated for 2 years. Rewards can also be earned for enrolling and completing our Online Wellness Programs. These earned Reward Points can be used to get a discount in premium from the 3rd Annual Premium or they can be redeemed for equivalent value of Health Maintenance benefits.
WORLDWIDE EMERGENCY COVER
- You might need to avail emergency medical assistance when you are abroad. We understand the problems you might face in such situations. Don’t worry, we will cover your medical expenses abroad up to the full sum insured on reimbursement basis.
FREE LOOK PERIOD
- We know your need to try something before you trust it. A period of 15 days from the receipt of the policy document is available to review the terms and conditions of this policy. You can choose to cancel the policy by stating the reason for cancellation. If there are no claims in the policy, we will refund the premium paid.
HEALTH CHECK-UP
- We encourage the people we serve to stay healthy, thats why, we provide a comprehensive health check-up for all insured persons above 18 years at each renewal.
DEDUCTIBLE
- We provide an option to select a deductible of Rs 1 Lakh, Rs. 2 Lakhs or Rs. 3 Lakhs depending on the Sum Insured. The deductible amount will apply on the sum of all admissible claims in that policy year. This means that of your claims (should any be arising), you choose to pay the deductible amount either out of your own pocket or with the aid of an existing health insurance policy.
REDUCTION IN MATERNITY WAITING PERIOD
- We will reduce the waiting period for Maternity Expenses from 48 months to 24 months from the date of inception of first Policy with us under this benefit. New Born Baby cover and First year vaccinations will also follow reduction in waiting period. This benefit can be opted by paying additional premium
VOLUNTARY CO-PAYMENT*
- This option (when exercised) would mean that you choose to pay the first 10% or 20% of the claim and the balance would be covered by your plan. * Voluntary Co-pay & Deductible can not be opted in the same plan.
CRITICAL ILLNESS ADD-ON
- Persons between 18 to 65 years can opt for Critical Illness cover as add-on benefit. We will give a lump sum amount equal to Sum Insured in case of first diagnosis of the covered critical illnesses. In case of a family floater policy, once a claim has been paid for a critical illness under this benefit we will provide for 100% reinstatement of Sum Insured once during the lifetime of the policy for the other person covered.
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