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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

      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

      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

      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.

      Organ Donor expenses

      Medical expenses of organ donor are covered upto the sum insured opted, in case of organ transplant.

      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.

      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.

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      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.

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        Assets to be Covered

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          Your Health

          You need to take care of yourself so that you can provide your loved ones with all they need. Protect your health from any unwarranted financial troubles by opting for a health insurance plan.

          icontwo

          Family Health

          Your family means the world to you and is the most precious thing in your life. You would want to protect it at all costs. Protect your family with health insurance plan so that no financial problem can burden your family.

          Risks to be Covered

          Family

          Ambulance Charges

          The charges for transporting the insured person via ambulance before and after the hospitalization are covered under ambulance charges.

          70% Complete

          6/10
          Family

          Critical Illness

          Critical illness cover provides the insured a lump sum, in case he/she gets diagnosed with a critical illness such as cancer, sclerosis, coma, heart attack, paralysis, kidney failure, etc.

          70% Complete

          9/10
          Family

          Hospitalization expenses

          Hospitalisation Expenses means the medical treatment costs that is necessary andreasonable in scope to treat the condition for which the Insured Person was Hospitalisedto the extent that such cost does not exceed the reasonable charges. The patient has to be in the hospital for at least 24 hours. Generally covers ICU charges, surgery, anaesthesia, doctor's charges etc.

          70% Complete

          10/10
          Family

          Pre & Post Hospitalization Expenses

          Pre-hospitalization expenses include various charges related to medical tests before an individual gets hospitalized. Post hospitalization expenses include all expenses or charges incurred by an individual after he or she is hospitalized.

          70% Complete

          8/10
          Family

          Day Care Treatment expenses

          Day Care Treatment refers to medical treatment and/or surgical procedure which is undertaken under General or Local Anaesthesia in hospital / day care centre in less than 24 hours because of technological advancements. The expenses for these tratments are day care treatments.

          70% Complete

          9/10
          Family

          Domiciliary treatment expenses

          Domiciliary Hospitalization is the treatment of the patient taken at home due to lack of accommodation in the hospital/nursing home or the patient's condition being such that he/she cannot be shifted to the hospital

          70% Complete

          9/10
          Family

          Health Check up expenses

          Many insurers these days provide health check up feature for its insured members per some number of years. Many insurers also provide these check-ups as cashless at their network hospitals

          70% Complete

          6/10
          Family

          Organ donor expenses

          There are mainly 6 types of medical expenses incurred as far as the organ donor is concerned: Organ screening for compatibility, Pre-hospitalization costs, Hospitalization Costs, Organ transplantation surgery, Post-surgery complications & recovery, Post Hospitalization Costs for the Donor

          70% Complete

          7/10
          Family

          Second opinion expenses

          Second opition is requesting an examination and evaluation of a health condition by a second physician to verify or challenge the diagnosis by a first physician. Generally happens in case of critical illnesses

          70% Complete

          8/10
          Family

          Outpatient & Pharmacy Expenses

          Outpatient department (OPD) expenses, such as diagnostics tests, chemist bills, doctor's visit fees, dental treatment, medical bills etc, form a major portion of total healthcare cost these expenses are called OPD expenses

          70% Complete

          9/10
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          Our Expert Says

            Hi Dr.Mamtaa Goel, I am looking for a Health Insurance cover. Can you please brief me about this product

            Anonymus

            Mamtaa Goel

            This plan works as a one stop solution from Day Care, Domiciliary to hospitalization cover. Also you can enjoy Cumulative Bonus for 'No Claims', Second Opinion help on Critical Illnesses, Healthy Rewards and a Worldwide Emergency Cover when you are away from home. Even in multiple claims you are protected with 100% additional sum insured under Restoration. It helps you take care of your present healthcare expenses and build a reserve for your future health needs.

            Thank you so much for your help...

            Anonymus

            Mamtaa Goel

            It’s my pleasure. Please feel free to ask whatever questions you have. Myself or my friends will try our best to answer. Just click the below button and ask your questions.

            Our Experts Panel

              user

              Dr. Nandagopal Pothula

              Dr. Nandagopal Pothula has been in the field of Finance and Insurance for the past 19 years. He was the Senior Vice Presidentat Birla Sun Life Insurance and also served as the CEO of Reliance Life Insurance before founding India First Life Insurance Company. He is the CEO of Insurance Inbox.

              user

              Dr. Kamalakar Sai

              Kamalakar Sai has 22 years of experience in finance and insurance background. He has held key managerial positions at Birla Sun Life Insurance, Reliance Insurance, India First Insurance and is currently serving as the Director of Geosansar Insurance Brokerage Private Limited

              user

              Dr. Mamtaa Goel

              Mamtaa Goel is the Business Director at Insurance Inbox. She has an excellent 12 year record in the field of Insurance having served in senior managerail capacities at Reliance Insurance, TTK Healthcare and IndiaFirst Life Insurance.

              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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