Star Health | Manipal Cigna | |
---|---|---|
Claims Settlement Ratio ** | 80.62% | 90.02% |
Number of Lives Covered * | 1,16,17,000 | 1,101,000 |
Network Hospitals | 9,900 + | 6,500 + |
|
Medi Classic | Comprehensive plan | Family Health Optima | Arogya Sanjeevani | ProHealth | ProHealth Select |
---|---|---|---|---|---|
In-patient Treatment | |||||
Covers hospitalisation expenses due to an disease/ illness/injury | Covers hospitalisation expenses due to an disease/ illness/injury | Covers hospitalisation expenses due to an disease/ illness/injury | Covers hospitalisation expenses due to an disease/ illness/injury | ProHealth Protect: For sum insured up to Rs.5.5 Lakhs - Covered up to Single Private Room For sum insured Rs.7.5 Lakhs and Above - Covered up to any Room Category except Suite or higher category ProHealth Plus: Any hospital room except Suite ProHealth Preferred: Any hospital room except Suite ProHealth Premier: Any hospital room except Suite ProHealth Accumulate: For sum insured up to Rs.5.5 Lakhs - Covered up to Single Private Room For sum insured Rs.7.5 Lakhs and Above - Covered up to any Room Category except Suite or higher category |
Covered |
Room Rent | |||||
Basic: 2% of base sum insured maximum up to Rs.5,000 Gold - 3 & 4 Lakhs: Rs.5,000 per day 5 to 25 Lakhs: Private single A/c Room |
Private single standard A/c Room | 3 & 4 Lakhs: Rs.5,000 per day 5 to 25 Lakhs: Single standard A/c room |
2% of sum insured subject to a maximum of Rs.5,000 per day | Up to Single Private Room / Unlimited eligibility based on plan opted | Covered up to Single Private Room |
ICU Charges | |||||
Covered | Actual | Covered | 5% of sum insured, maximum up to Rs.10,000 per day | Covered up to sum insured | Up to 4% of sum insured for ICU up to a max of 7,000 |
Pre-hospitalization | |||||
Incurred for a period not exceeding 30 days prior to the date of hospitalization, for the disease/illness, injury | Up to 60 days | Up to 60 days | Up to 30 days | Up to 60 days Covered | Up to 60 days Covered |
Post-hospitalization | |||||
Basic: 60 days from the date of discharge from the hospital (payble 7% of hospitalization expenses maximum of Rs.5,000 per hospitalization) Gold: 60 days from the date of discharge from the hospital |
Up to 90 days | Up to 90 days | 60 days after discharge from the hospital | Up to 90 days Covered | Up to 90 days Covered |
Day Care Procedures | |||||
All day care procedures are covered | All day care procedures are covered | All day care procedures are covered | All day care procedures are covered | 500 plus listed Day Care treatments covered up to sum insured | 171 procedures, covered up to full sum insured |
Domiciliary Treatment | |||||
Covered | Covered | Not Covered | Covered | Treatment at home covered up to sum insured | Covered up to sum insured |
Emergency Ambulance | |||||
Up to Rs.750 per hospitalisation and overall limit of Rs.1,500 per policy period | Actual | Up to Rs.750 per hospitalisation and overall limit of Rs.1,500 per policy period | Up to Rs.2,000 per hospitalisation | ProHealth Plus: Up to 2,000 per event ProHealth Protect: Up to 3,000 per event ProHealth Plus: Actual expenses per event ProHealth Preferred & ProHealth Premier: Up to 2,000 per event ProHealth Accumulate: Up to 2,000 per event |
Up to 2,000 per hospitalization event |
Dental Treatment | |||||
Not Covered | 5 & 7.5 Lakhs: Rs.5,000 10 to 25 Lakhs: Rs.10,000 50 Lakhs to 1 Crore: Rs.15,000 |
Not Covered | Not Covered | Not covered | Not covered |
Bariatric Surgery | |||||
Not Covered | 5 to 15 Lakhs: Rs.2,50,000 20 Lakhs to 1 Crore: Rs.500,000 |
Not Covered | Not Covered | Yes, if Bariatric surgery cover is opted | Not covered |
Ayush Benefit | |||||
Not Covered | 5 to 15 Lakhs: Rs.15,000 per policy period 20 & 25 Lakhs: Rs.20,000 per policy period 50 Lakhs to 1 Crore: Rs.30,000 per policy period |
3 & 4 Lakhs: Up to Rs.10,000 per policy period 5 to 15 Lakhs: Up to Rs.15,000 per policy period 20 Lakhs & 25 Lakhs: Up to Rs.20,000 per policy period |
Covers in-patient care treatment under Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy up to sum insured |
In-patient hospitalization covered up to sum insured | Coverage for Ayurvedic, Yoga & Naturopathy, Unani, Siddha and Homeopathy up to the limit of sum insured |
Maternity Benefits | |||||
Not Covered | 5 Lakhs: Normal delivery - Rs.15,000 Caesarean - Rs.20,000 7.5 Lakhs: Normal delivery - Rs.25,000 Caesarean - Rs.40,000 10 to 25 Lakhs: Normal delivery - Rs.30,000 Caesarean - Rs.50,000 50 Lakhs to 1 Crore: Normal delivery - Rs.50,000 Caesarean - Rs.100,000 (24 months for first delivery from first inception of the policy) (24 months from claim under for next delivery) |
Not Covered | Not Covered | ProHealth Plus: 15,000 for normal; 25,000 for C-section (per event ProHealth Preferred: 50,000 for normal; 1 lac for C-section (per event) ProHealth Premier: 1 lac for normal; 2 lacs for C-section (per event) |
Not covered |
New Born baby cover | |||||
Not Covered | 5 to 25 Lakhs: Rs. 100,000 50 Lakhs to 1 Crore: Rs. 200,000 |
Up to 10% of sum insured or maximum of Rs.50,000 subject to availability of the sum insured (from 16th day to till the expiry of the policy) (provided if mother is insured for 12 months without break) |
Not Covered | Covered within maternity expenses | Not covered |
Organ Donor Expenses | |||||
Basic: Not Covered Gold: Covered |
Covered | 10% of sum insured or Rs.100,000 | Not Covered | Covered up to sum insured | Covered up to sum insured |
Vaccination (In case of post bite treatment) | |||||
Not Covered | Not Covered | Not Covered | Not Covered | Not covered | Not covered |
Daily Cash for Accompanying an Insured Child | |||||
Not Covered | Not Covered | Not Covered | Not Covered | Not Covered | Not Covered |
Health Check-up | |||||
Up to 1% of the average basic sum insured subjected to maximum of Rs.5000 is payable Sum insured 2 lakhs & above) |
5 Lakhs: Rs.2,000 7.5 Lakhs: Rs.2,500 10 Lakhs: Rs.3,000 15 Lakhs: Rs.4,000 20 & 25 Lakhs: Rs.4,500 50 Lakhs to 1 Crore: Rs.5,000 (Once in a block of every claim free years of continuous renewal) |
3 Lakhs: Rs.750 4 Lakhs: Rs.1,000 5 Lakhs: Rs.1,500 10 Lakhs: Rs.2,000 15 Lakhs: Rs.2,500 20 Lakhs: Rs.3,000 25 Lakhs: Rs.3,500 (available after every claim free year per policy) |
Not Covered | ProHealth Plus: Available each policy year(excluding the first year ProHealth Protect: Available once every 3 rd policy year ProHealth Preferred & ProHealth Premier: Available each policy year(excluding the first year) ProHealth Accumulate: Available once every 3 rd policy year |
Covered |
Hospital daily allowance | |||||
Not Covered | 5 Lakhs: Rs.500 7.5 & 10 Lakhs: Rs.750 15 & 20 Lakhs: Rs.1000 25 Lakhs: Rs.1,500 50 Lakhs & 1 Crore: Rs.2,500 (maximum 7 days/occurrence is payable) |
Not Covered | Not Covered | Not covered | Not covered |
Co-pay | |||||
No co-pay if entry age is below 60 years / 20% co-pay for ages above 60 years | No co-pay if entry age is below 60 years / 20% co-pay for ages above 60 years | No co-pay if entry age is below 60 years / 20% co-pay for ages above 60 years | 5% co-pay applicable on all claims | Covered | Covered |
Pre-existing diseases coverage | |||||
Covered after a waiting period of 4 years | Covered after a waiting period of 4 years | Covered after a waiting period of 2 years | Covered after 4 years of continuous coverage without break | Preferred plan & Premier plans covered after 24 months Accumulate & Plus plans covered after 36 months Protect plan covered after 48 months |
Not Covered |
Restore Benefit | |||||
200% of Base Sum Insured for unrelated illness/diseases | 100% of Base Sum Insured for unrelated illness/diseases | Thrice up to 100% of Base sum insured for plans with sum insured 3 lakhs and above | Not applicable | Up to 100% of Base sum insured per year | Up to 100% of Base sum insured per year |
General waiting period | |||||
30 days | 30 days | 30 days | 30 days | 30 days | 30 days |
Renewal Benefit / Cumulative Bonus | |||||
Basic: 5% of the basic sum insured for every claim free year subject to a maximum of 25% Gold: 25% of basic sum insured in the second year and additional 20% of the basic sum insured for each subsequent years subject to a maximum of 100% |
5 Lakhs: 50% on base sum insured for every claim free year and up to 100% 7.5 Lakhs to 1 Crore: 100% of the basic sum insured for every claim free year |
25% of Sum Insured after first year if claim free and additional 10% for the subsequent years (Maximum allowable bonus is 100%) |
5% on base sum insured for every claim free year and up to 50% | ProHealth Plus: Available once every 3 rd policy year ProHealth Protect & ProHealth Plus: Guaranteed 5%, Max - 200% ProHealth Preferred & ProHealth Premier: Guaranteed 10%, Max - 200% ProHealth Accumulate: Guaranteed 5%, Max - 200% |
5% each year maximum up to 100% on non-reducing basis |
Emergency Air Ambulance | |||||
Not Covered | Up to Rs.2,50,000 per hospitalization, not exceeding Rs.5,00,000 per policy period | 3 to 5 Lakhs: Not Covered 5 to 25 Lakhs: Up to 10% of the sum insured |
Not Covered | Not covered | Not covered |
Available sum insured options | |||||
Basic plan: 1.5 to 15 Lakhs Gold plan: 3 to 25 Lakhs |
5 Lakhs to 1 Crore | 3 to 25 Lakhs | 1 to 5 Lakhs | ProHealth Plus: Rs.4.5, 5.5, 7.5, 10, 15, 20, 25, 30, 50 Lakhs ProHealth Protect: Rs.2.5, 3.5, 4.5, 5.5, 7.5, 10, 15, 20, 25, 30, 50 Lakhs ProHealth Premier: Rs.100 Lakhs ProHealth Preferred: Rs.15, 30, 50 Lakhs ProHealth Accumulate: Rs.5.5, 7.5, 10, 15, 20, 25, 30, 50 Lakhs |
ManipalCigna ProHealth Select Insurance Plan A: Rs.0.5 1,2,3,4,5,7,10,15,20,25 lakhs Plan b: Rs.2,3,4,7,10,15,20,25 lakhs |
Policy can be purchased for | |||||
1/2 years | 1/2 years | 1 year | 1 year | 1/2/3 years | 1/2/3 years |
Eligibility criteria | |||||
5 Months to 65 years. Therefore only renewals will be accepted without capping on the exit age | Adults from 18 to 65 years (dependents 3 months to less than 25 years) | Adults from 18 to 65 years (dependents 16 days to less than 25 years) | Adults from 18 to 65 years (dependents 3 months to less than 25 years) | Min Entry Age: Child - 91 days, Adult - 18 years Max Entry Age: No limit |
Minimum Entry Age: 91 Months Maximum Entry Age For Dependent Children: 23 Years Maximum Entry Age for Adults: 65 years |
Renewability | |||||
Renewal for whole life | Renewal for whole life | Renewal for whole life | Renewal for whole life | Renewal for whole life | Renewal for whole life |
Claims loading | |||||
No Loading | No Loading | No Loading | No Loading | No Loading | No Loading |
Portablity(At the time of renewal) | |||||
Yes | Yes | Yes | Yes | Yes | Yes |
Tax Benefits Limit | |||||
Income tax benefit under section 80D | Income tax benefit under section 80D | Income tax benefit under section 80D | Income tax benefit under section 80D | Income tax benefit under section 80D | Income tax benefit under section 80D |
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