
ProHealth Accumulate
Cigna ProHealth Accumulate Plan helps you take care of your present healthcare expenses and build a reserve for your future health needs with accumulation of Health Maintenance Benefit which builds up a reserve with a 5 % bonus every year on the unutilized value. You can use the Health Maintenance Benefit to cover out-patient expenses including dental and AYUSH treatment and even to pay for deductible or co-pay amount or towards payment of non-admissible component of a claim. The plan works as a one stop solution from Day Care, Domiciliary to hospitalization cover.
Sum Insured
5,50,000 to 25,00,000
Premium starts from
11,706
Key Highlights
Cashless Treatment at 4500+ Network Hospitals
You don’t have to pay even a single paisa from your own pocket in more than 4500+ network hospitals, for all the treatments that are covered by the policy. The Insurer shall pay for your treatment directly to the hospital, maximum up to Sum Insured.
Day Care Treatments
Insurance company will pay for more than 170+ treatments that would require hospitalization for less than 24 hours. (Due to advancement in Technology). Please refer the terms for exact list of procedures.
Health rewards
You will be rewarded points equal to 1% of premium paid each year. In addition, you can accumulate points by opting for Cigna's online wellness programs. Each earned reward point will be valued at 1 Rupee. These accumulated points can be redeemed as a discount in premium from next renewal or reimbursed under health maintenance benefit or to avail services through Cigna's network partners.
Key Product Benefits to Check
Worldwide Emergency Cover
Your medical expenses outside the country will be covered upto the sum insured on reimbursement basis under the conditions that your condition is declared to be an emergency. The amount will be paid in rupees.
Expenses before and after Hospitalization
Your medical related expenses will be covered for a period of 60 days before and 90 days after hospitalisation. The medical expenses should be related to the condition for which you were hospitalised
Organ Donor expenses
Medical expenses of organ donor are covered upto Sum Insured, in case of organ transplant.
Reimbursement of Ambulance Expenses
You can claim upto Rs2000 spent on ambulance charges from one Hospital to another Hospital. This would be helpful for advanced/better equipped medical support/aid required for rescuing your health condition.
Out patient department expenses
You will be reimburshed for prescribed out patient medical expenses including diagnostic tests, drugs and dental treatment for upto Rs20000 per policy year.Any unutilised Health Maintenance Benefit limit will be carried forward to the next year.
Treatment at home
You can make a claim for medical expenses for treatment at home which would otherwise require hospitalisation either if the doctor advises that you are not in a condition to be moved to a Hospital or the Hospital room may not be available when you need the medical treatment or even the condition lasts and requires medical attention for at least three days
Exclusions to note
Pre exisiting diseases
In the first 4 years of subscription, Cigna will not pay for treating medical conditions that you may have been suffering from before purchasing the policy.
30 days waiting period
You can only claim for treatments of accidental injuries for the first 30 days after taking the policy
2 years waiting period
This policy covers some diseases/treatments like Cataract, Hysterectomy, Kidney Stone, Varicose veins, surgery of Tonsils and sinuses …etc., only after 2 years.
Additional Covers Available
Critical Illness
This cover will provide 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 Cigna will provide for 100% reinstatement of Sum Insured once during the lifetime of the policy for the other person covered.
Cumulative Bonus Booster
This cover helps to increase your Sum Insured by 25% for each claim free year up to a maximum of 100% when there are no claims paid or outstanding in the expiring Policy Year provided that the policy is renewed without a break.
FAQ’s
What is the maximum number of claims allowed over a year?
Any number of claims is allowed during the policy period. However the sum insured is the maximum limit under the policy.
What Identification proof do I have to carry for Hospitalisation?
You should carry thelHealth card provided by the company with this Policy, along with a valid photo identification proof (Voter ID card / Driving License / Passport / PAN Card / any other identity proof as approved by the Company).
What is Health Maintenance benefit ?
This benefit covers reimbursement of outpatient expenses incurred by Insured person upto the limits specified under the plan. It can be used to cover diagnostic tests, medical aids, drugs, prosthetics, dental treatments and alternative forms of medicines.
The list of hospitals change or remain the same ?
The Company - Cigna, at its sole discretion, reserves the right to modify, add or restrict any Network Hospital for Cashless services available under the Policy. Before availing the Cashless service, the Policyholder / Insured Person is required to check the applicable list of Network Hospital on the Company’s website.
What is the time limit to submit the claim in case I do not use cashless facility?
You should submit your claim within 15 days from date of discharge from the hospital
Is my claim payable in grace period?
Cigna will not be liable to pay for any claim arising out of an Injury/ Accident/ Condition that occurred during the Grace Period.
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