Manipal Cigna LifeTime Health – India Plan
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| Manipal Cigna LifeTime | Amount | Remark |
| Max cover | 50/75/100/150/200/300 L | 50/75/100/150/200/300 L | 50/75/100/150/200/300 L |
| Age | Child : 91 Days – 25 Years Adult : 18 years – 65 years | Child : 91 Days – 25 Years Adult : 18 years – 65 years | Child : 91 Days – 25 Years Adult : 18 years – 65 years |
| Waiting Period | 30 days | 30 days | 30 days |
| Pre existing diseases | 24 months | 24 months | 24 months |
| Specified diseases | 24 months | 24 months | 24 months |
| Bariatric surgery waiting period | 24 months ( Add on) ( Health +) | 24 months ( Add on) ( Health +) | 24 months ( Add on) ( Health +) |
| Maternity waiting period | NO | NO | NO |
| Mental illness cover waiting period | NA | NA | – cover pertains to IPD coverage for anxiety, stress, depression |
| OPD waiting period | 30 days | 30 days | 30 days |
| Dental OPD waiting period | 30 days | 30 days | 30 days |
| Critical illness waiting period | 90 days( add on) – survival waiting period of 30 days | 90 days( add on) – survival waiting period of 30 days | 90 days( add on) – survival waiting period of 30 days |
| Pre Policy medical Test | After 55 years | no charges on test. even if policy is rejected | |
| Co -payment | No | No | No |
| Deductibles | ADD on | 5/10 L | 5/10 L Aggregate Deductible Not applicable health check up |
| First claim SI | SI + Bonus | SI + Bonus | SI + Bonus |
| Maximum claim | SI/ Restored SI + Bonus | SI/ Restored SI + Bonus | SI/ Restored SI + Bonus |
| Room Rent caping | Yes / Add on (360 Advance) | upto SI, – SI upto 2 Cr any room except suite or higher category – SI 2 cr to 3 cr covered any room category -Add on (360 Advance- Any Category Room ) | – SI upto 2 Cr any room except suite or higher category – SI 2 cr to 3 cr covered any room category including suite rooms – Rider health 360 advance – any room category If the Insured Person is admitted to a room category higher than the one specified in the Policy Schedule, the Policyholder/Insured Person shall bear a ratable proportion of the total Associated Medical Expenses (including surcharge or taxes) in proportion to the difference between the room rent of the entitled room category and the room rent actually incurred. |
| ICU cover | Yes | upto SI | upto SI |
| Disease Based caping | No | No | No |
| IPD | Yes / Add on (360 Advance) | upto SI, – SI upto 2 Cr any room except suite or higher category – SI 2 cr to 3 cr covered any room category -Add on (360 Advance- Any Category Room ) | a. Reasonable and Customary charges for Room Rent for accommodation in Hospital room up to room category as per the Sum Insured1. b. Intensive Care Unit charges, c. Operation theatre charges, d. Fees of Medical Practitioner/ Surgeon, e. Anaesthetist, f. Qualified Nurses, g. Specialists, h. Cost of diagnostic tests, i. Medicines, j. Drugs and consumables, blood, oxygen, surgical appliances and prosthetic devices recommended by the attending Medical Practitioner and that are used intra operatively during a Surgical Procedure.we will cover the expenses towards artificial life maintenance, including life support machine use, even where such treatment will not result in recovery or restoration of the previous state of health under any circumstances unless in a vegetative state, as certified by the treating Medical Practitioner.- Medical exnses related the eternal feeding is covered for max 15 days in a policy year |
| Pre Hospitalisation | 60 days | upto SI | upto SI |
| Post Hospitalisation | 180 days | upto SI | upto SI |
| Day Care procedure | Yes | upto SI | All day care treatment covered |
| Advance technology method | Yes | upto SI | – The following Modern and Advanced Treatment methods will be covered when availed under In-patient Hospitalization or as a Day Care Treatment: • Uterine Artery Embolization and HIFU • Balloon Sinuplasty • Deep Brain stimulation • Oral chemotherapy • Immunotherapy – Monoclonal Antibody to be given as injection • Intra vitreal injections • Stereotactic radio surgeries • Bronchial Thermoplasty • Vaporisation of the prostate (Green laser treatment or holmium laser treatment) • IONM ( Intra Operative Neuro Monitoring) • Stem cell therapy – Hematopoietic stem cells for bone marrow transplant for haematological conditions to be covered. |
| Home care treatment | NA | NA | NA |
| Domiciliary treatment Healthcare | Yes | upto 10% SI | i. The condition of the Insured Person does not allow a hospital transfer: or ii. Hospital bed was unavailable provided that the treatment of the Insured Person continues at least 3 days in which case the reasonable cost of any Medically Necessary treatment for the entire period shall be payable.-upto 10% SIThe following are not covered – • Asthma, bronchitis, tonsillitis, and upper respiratory tract infection including laryngitis and pharyngitis, cough and cold, influenza, • Arthritis, gout and rheumatism, • Chronic nephritis and nephritic syndrome, • Diarrhoea and all type of dysenteries, including gastroenteritis, • Diabetes mellitus and insipidus, • Epilepsy, • Hypertension, • Pyrexia of unknown origin. • Any use of artificial life maintenance including life support machine use. -Consumables |
| Alternate treatment ( AYUSH) | Yes | Upto SI | The following exclusions will be applicable in addition to the other Policy exclusions: i. Facilities and services availed for pleasure or rejuvenation or as a preventive aid, like beauty treatments, Panchakarma, purification, detoxification and rejuvenation. |
| Organ Donor expenses | Yes | upto SI | – Donor for harvesting the organ – No pre and post covered |
| Road Ambulance | Yes | upto SI | – to nearest Hospital – Diagnostic centre for advanced diagnostics – to move to better hospital due to lack of super speciality treatment in current hospital – The neccessaity of use of ambulance should be certfied by Medical Practitioner |
| Air Ambulance | Add on ( health +) /( advance 360) | Upto 10 L (over and above SI – health +) Upto 10L ( over and above SI- advance 360) | Health + – upto 10 lacs( over and above SI ) – to move to nearest hospital – to and fro from healthcare facilities within India – once in policy year for each insured person360 advance , – Upto 10 L – Get transportation expenses to the nearest hospital/ healthcare facility in case of life threatening condition demanding immediate attention |
| Reset Value/ Automatic recharge/Restore benifit | Yes/ ADD on ( 360 Advance) | upto SI/upto SI ( every year after first claim) | -Defaut unlimited – first claim restore start – claim shall not exceed total of Sum insured+ Restored Sum insured – not applicable on same illness and its complication – a health check up, robotic surgery, hiv aids cobver, mental cover- upto SI unlimited for both related and unrelated illneess – Applicable from second claim onwards.Not Avialable for -Domicillary – Advance technology Treatement -Global |
| Renewal benifits / No Claim Bonus | Add on | 15% no max limit | – Guaranteed Cumultaive Bonus 15% every year to no limit |
| Non Medical Expenses / Consumables | Add on( health + , 360 Shiled ) – | Health + medical devices and non medical upto 2 L and once( means any number of times per hospitalisation in 3 policy years ( over and above SI) 360 shield non medical upto SI and medical devices upto 1 L | Health + medical devices and non medical upto 2 L and once( means any number of times per hospitalisation in 3 policy years ( over and above SI) 360 Shield – Annexure III List 1- Autorised Medical practitioner during hospitalization or within 180 days of post hospitalization- any purchase shouls be done witthin 30 days ( medical devices list shared )- CPAP , Wheelchair, Suction Mahcine, Infusion Pump, Oxygen Concentrator, Ventilator, Prosthectic Device, Commode Chairs, Continuos Passive MotionDevices IN case of Knee Replacement |
| Maternity cover | Add On | upto 1 Lakh Optional cover for infertility – Max 2.5L( over and above maternity cover ) Surrogacy cover – upto 1 L ooctyne donor cover – upto 1 L | upto 1 Lakh -for upto 2 deliveries -medical termination of pregnnancy is also coveredOptional cover for infertility – Max 2.5L( over and above maternity cover )Surrogacy cover – upto 1 L Surrogacy in case of a medically necessary hospitalization for complications due to pregnancy through Surrogacy and Post-Partum Delive ooctyne donor cover – upto 1 L |
| Delivery complication cover | NA | NA | NA |
| New born baby cover | NA | NA | NA |
| First Year Vaccination of baby | NA | NA | NA |
| OPD dental treatment | Add on ( 360 OPD) | Package 1: 5K-20K ( multiples of 5K) Package 2: 10K – 30K( multiples of 5K) Package 3: 20-30K( multiples of 5K) | Package 1: 5K-20K ( multiples of 5K) only Doctor ConsultationPackage 2: 10K – 30K( multiples of 5K) 30-50K ( multiples of 10K) Doctor and Prescribed DiagnosticsPackage 3: 20-30K( multiples of 5K) 30-50K( multiples of 10K) Doctor Consultation, Prescrbied diagnostics, Prescribed Pharmacy -Through netwoorked Hosoitals only |
| OPD treatment | |||
| Mental illness | Yes | upto SI | – only IPD covered – For disease related to The cover is available subject to below conditions: |
| HIV/AIDS & STD COVER | Yes | upto SI | Covered for medical expenses for a condition caused by or associated to HIV or HIV related Illnesses, including AIDS or AIDS Related Complex (ARC) and/or any mutant derivative or variations there of or sexually transmitted diseases (STD) derivative or variations thereof or sexually transmitted diseases (STD). The cover is available subject to below conditions: |
| High end diagnostic | No | No | No |
| Vaccination cover | No | No | No |
| Animal bite vaccination | No | No | No |
| Annual health check up | Yes | – Limits/ test based on opted SI ( over and above SI) | – once policy year to all insured person above 18 – health check up will conducted in only listed hospital ( over and above SI) |
| Second Opinion | Add on ( Health +) | Health + (over and above SI) | Health + – Insured has to place a request – Can be availed by each insured person once during the a ploicy year for one major illness and multiple times for different major illnessFor the purpose of this benefit, covered Major Illnesses shall include the below – 1. Cancer Treatment 2. Coronary Artery By-Pass Surgery 3. Heart Valve Replacement 4. Lung Transplant Surgery in case of End Stage Lung Disease 5. Kidney Transplant Surgery in case of End Stage Renal Failure 6. Liver Transplant Surgery in case of End Stage Liver Disease 7. Heart Transplant 8. Cardiac arrest (excluding angioplasty) 9. Bone Marrow Transplant 10.Neurosurgery 11.Surgical Treatment for Benign Brain Tumour 12.Pulmonary artery graft surgery 13.Aorta Graft Surgery 14.Stroke Treatment 15.Surgical treatment of Coma 16.Skin Grafting Surgery for Major Burns 17.Surgery for Pheochromocytoma 18.Permanent Paralysis of Limbs 19.Motor Neuron Disease with Permanent Symptoms 20.Multiple Sclerosis with Persisting Symptoms 21.Fulminant Viral Hepatitis 22.Bacterial meningitis 23.Alzheimer’s Disease 24.Cerebral aneurysm – with surgery or radiotherapy 25.Parkinson’s disease – resulting in permanent symptoms 26.Pneumonectomy – Removal of an entire lung 27.Surgical removal of an eyeball |
| E opinion/ teleconsultation | Add ( Health +) | No Impact on SI ( heath + ) | Health + Addon Consultations via tele/ chat mode with our team of Medical Practitioners, available through network – No Impact on SI |
| Daily Hospital Cash | Add on 1.hospital cash for major illness( Health +) 2.Chemotherapy and radio therapy cash ( health +) 3. Accidental Hospi cash(health +) | Rs 2.5 K max Rs 25K per hospitalization for major illnesses( over and above SI)( Health +)/ 2,500 for each sitting max upto 12 sitting in policy year( over and above SI) ( health +) daily 2,500 max 10 days per hospitalization ( over and above SI) ( health +) | Health + Rs 2.5 K max Rs 25K per hospitalization for major illnesses( over and above SI)2,500 for each sitting max upto 12 sitting in policy year( over and above SI) ( health +) chemotherapy and radia therapy treatment without hospitalization as day care care treatemnet without 24 hours of hospitalisationAccidental Hospi cash(health +) daily 2,500 max 10 days per hospitalization ( over and above SI) – For each continious and completed period of 24 hours hopitalisation due to accident |
| Recovery benifit / Covalescence benifit | Add on ( Health +) | Rs 50 K ( over and above SI) ( health +) | Rs 50 K ( over and above SI) ( health +) heath + hospitalization of 10 days or more |
| Personal accident cover | NA | NA | NA |
| Compasionate travel | NA | NA | NA |
| Extra Benifit | Yes | -Robotic and Cyber knife – Porting no waiting period -Premium Waiver benefit Domestic Concierge Services ( health +)( add on ) | – to be certified by medical practiioner – upto SI- – if Proposer suffers , PTD, PPD, or death within 365 days dues accident ; 1 year premium is waived off upon accidental death/ diagnosis of CI ( For the purpose of this benefit, Critical Illnesses shall include – Domestic Concierge Services ( health +)( add on ) |
| Global Cover | Add on | – Medical expenses worldwide within selected area of cover, for any medical emergency that leads to IPd or day care – it includes global post hosoitalisation and global road and air ambulance | |
| Critical Illness cover | Add on | Lumpsum payment | Rider Critical illness – on survival benefit – IRDA/NL-HLT/CTTK/P-H/V-I/390/Add-on (CI)13-14 Person Shoul be 18 years and above Once a claim has been accepted and paid for a particular Critical Illness for that particular Insured,the cover shall cease in respect of that Insured Person In case of a floater policy, We will provide for a 100% reinstatement of Sum Insured once during the lifetime of the Policy for the other adult Insured Person in the Policy. IRDA/NL-HLT/CTTK/P-H/V-I/390/Add-on (CI)13-14 – PED and Specific illlness are applicable 1. Cancer of Specified Severity Read CI defination for detailed discussion |
| Bariatric surgery cover | Add on ( Health +) | upto 5 L ( over and above SI) ( health +) | health + – medically necessary and Authorised by medical pratcitioneriii. The Insured Person satisfies following criteria as devised by NIH (National Institute of Health): a. The BMI should be greater than 37.5 without any co-morbidity; or greater than 32 with co-morbidity and b. Is unable to lose weight through traditional methods like diet and exercise. – waiting period of 2 years |
| Add Ons | Air ambulance( health +) | upto 10 lacs( over and above SI ) | applicable to once policy year for each person insured – upto 10 lacs( over and above SI ) – to move to nearest hospital – to and fro from healthcare facilities within India |
| Add Ons | Medical devices and Non medical items( health +) | – upto 2 lakhs ( over and above SI) | – Listed under list1 annexure III – Listed Medica devices • Artificial limb, • Cannula, • Catheter, • Colostomy bag, • CPAP machine, • Feeding tube, • Glucose meter, • Heating pad, • Hospital bed, • Infusion pump, • Nebulizer, • Oxygen concentrator, • Traction splint, • Ventilator, • Wheelchair, • Ankle Rehabilitation, • Back Support Belts, • Gel Heel Pads, • Heel And Elbow Suspension, • Hernia and Abdominal Support, • Hot and Cold Therapy Wraps, • Lancets And Lancing Devices, • Nebulizer Accessories, • Nebulizers, • Orthopedic Supports and Braces, • Rollators, • Urinary Bag Holders • Urinary Bags, • Prosthetic device, • Pulse oximeter, • Insulin Aids, • Insulin Pen Needles, • Insulin Syringes,-For medical devices – once in 3 policy year- – devices prescribed during hospitalization and post 180 days , bougt within 30 days |
| Add Ons | domestic second opinion (health +) | over and above SI | – Insured has to place a request – Can be availed by each insured person once during the a ploicy year for one major illness and multiple times for different major illnessFor the purpose of this benefit, covered Major Illnesses shall include the below – 1. Cancer Treatment 2. Coronary Artery By-Pass Surgery 3. Heart Valve Replacement 4. Lung Transplant Surgery in case of End Stage Lung Disease 5. Kidney Transplant Surgery in case of End Stage Renal Failure 6. Liver Transplant Surgery in case of End Stage Liver Disease 7. Heart Transplant 8. Cardiac arrest (excluding angioplasty) 9. Bone Marrow Transplant 10.Neurosurgery 11.Surgical Treatment for Benign Brain Tumour 12.Pulmonary artery graft surgery 13.Aorta Graft Surgery 14.Stroke Treatment 15.Surgical treatment of Coma 16.Skin Grafting Surgery for Major Burns 17.Surgery for Pheochromocytoma 18.Permanent Paralysis of Limbs 19.Motor Neuron Disease with Permanent Symptoms 20.Multiple Sclerosis with Persisting Symptoms 21.Fulminant Viral Hepatitis 22.Bacterial meningitis 23.Alzheimer’s Disease 24.Cerebral aneurysm – with surgery or radiotherapy 25.Parkinson’s disease – resulting in permanent symptoms 26.Pneumonectomy – Removal of an entire lung 27.Surgical removal of an eyeball |
| Add Ons | Bariatric surgery ( health +) | upto 5 lacs( over and above SI) | – medically necessary and Authorised by medical pratcitioner iii. The Insured Person satisfies following criteria as devised by NIH (National Institute of Health): – waiting period of 2 years |
| Add Ons | Convalescence ( health +) | 50,000( over and above SI) | – insured person hospitalsed for 10 consecutive days |
| Add Ons | hospital cash for major illness( health+) | daily 2,500 max 10 days per hospitalization ( over and above SI) | – if hospitalised under major illness |
| Add Ons | Chemotherapy and radio therapy cash ( health +) | 2,500 for each sitting max upto 12 sitting in policy year( over and above SI) | – chemotherapy and radia therapy treatment without hospitalization as day care care treatemnet without 24 hours of hospitalisation |
| Add Ons | Accidental Hospi cash(health +) | 2,500 daily max 10 days per hospitalization( ove and above SI) | – hospitlization due to accident more than 24 hours |
| Add on | Domestic Concierge Services ( health +) | Value added Service | – concierge services may include personal Hospital visit/s by Our representative, assistance in claim documentation and collection of documents at discharge, for speedy claim settlement. – The benefit is available once in a Policy year for each Insured Person. -These services shall be available only on pre-intimation of a planned Hospitalization and intimation of an Emergency Hospitalization |
| Add on | |||
| Add on | Women + | over and above SI | – available to female of Age 12 years and above at the commencement of Policy with Us with respect to the Insured Person. – where female child turns 12 years of Age after the commencement of the Policy, selection of ‘Women+’ shall be allowed at the first renewal immediately after this instance -benefits under the package will be available to each eligible female on individual basis, for Individual as well as family floater policies. |
| Add on | Breast Cancer Screening( Women +) | over and above SI | -Annual Mammography screening will be available to each Insured female. – The screening will be arranged by Us and conducted at Our Network. |
| Add on | Cervical cancer screening ( women+) | over and above SI | – annual papanicolaou screeing at network hospital – The screening will be arranged by Us and conducted at Our Network. |
| Add on | cervical cancer vaccination ( women+) | each dose upto 2,500( over and above SI) | Reasonable charges of vaccine incurred towards vaccination as advised by Medical practitioner |
| Add on | Ovarian cancer screening ( women +) | over and above SI | – Annual ovarian cancer screening known as ultrasound and CA 125 at network hospital |
| Add on | osteoporosis screening (women +) | over and above SI | – Annual screening Dexa Scan at network hospital |
| Add on | Gynaecological consultation( women +) | over and above SI | -max 15 OPD consultation – For the purpose of this benefit, ‘Gynaecological Consultations’ shall mean consultation with a gynaecologist to assess well-being and functioning of the female reproductive system and determine the presence of diseases and infections. – It may also relate to hormonal imbalance, fertility and to a certain extent preconception, prenatal, and maternal care. -Follow up consultations shall also be covered under this benefit. |
| Add on | psychaitric and psycological consultation ( women +) | over and above SI | – max 5 OPD consultation at network hospital |
| Add on | Health 360 advance | – Unlimited restoration for same and different disease – Applicable from 2 clam onwards – Covers IPD, Pre and post , day care treatment, road ambulance, donor expenses , Ayush , Non medical items. – Room Any room category – Air ambulance ( Upto 10 L)( over and above SI ) | |
| Add on | Health 360 Shield | – medical equipments – hand gloves,masks, thermometer – upto SI – Durable medical equipment – CPAP , wheelchair, suction machine, etc upto 1 lac – non medical devices | |
| Add on | Health 360 OPD | pack 1 – pack 2 -pack 3 | – doctor consultation Rs 5k – 20k multi ple of 5 k -Doctor consultation 10k to 30k multiples of Rs 5k and 30k – 50 k in m ultiples of 10K – Doctor Consultation, Prescribed Diagnostics& Prescribed Pharmacy 10k to 30k multiples of Rs 5k and 30k – 50 k in multiples of 10K – Dental , Vision covered – diagnostic tests including Dental and Vision diagnostics,c get covered for expenses incurred for medicines prescribed by the Network Medical Practitioner for up to 20% of the Outpatient Sum Insured- only cashless service is available and amount left is not carried forward |
| Add on | CI | Lumpsum payment |
Conclusion :
What is Good ?
-Cheap premium for higher SI
-All Day Care/ Adv Technology covered
-No Copayment
-Add on of Women +
What is Ok ?
-Room Rent capping
-Bonus is covered but not much details mentioned
-Maternity Cover Add on – But not well defined
-Air ambulance covered as add on
What is Bad ?
-Restore not applicable on same illness and its complication
– Domiciliary treatment Healthcare – up to 10% SI
-Home care treatment is not covered
-Second Opinion not covered
Do you understand the policy while your purchase ? have you gone through the nuances of wordings ? if not here we can help you to realise your health insurance plan. You have any other query regarding you health insurance plan, you can reach me .
