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Manipal Cigna ProHealth Prime (Active) + Key Add-ons

ILM Ratings

Claims Experience:

Customer Service:

Product Benefits:

Introduction to Manipal Cigna ProHealth Prime (Active) + Key Add-ons

Manipal Cigna ProHealth Prime (Active) is a health insurance policy offered by Manipal Cigna Health Insurance Company. A health insurance plan serves as a protective shield for your savings and healthcare needs, allowing you to lead a happy and fulfilling life. With Manipal Cigna's ProHealth Prime (Active) Plan, you can enjoy peace of mind, knowing that essential medical care will be taken care of, without the worry of unexpected financial burdens from medical expenses. It offers several unique benefits and features, including coverage for certain pre-existing diseases like diabetes, hypertension, etc. from the 91st day onwards, making it a preferred choice among individuals.

Claims Experience:

Customer Service:

Product Benefits:

Quick Overview:

What's Good?

• Cheaper than other products in the market
• Asthma, Diabetes, Hypertension, Dyslipidemia, Obesity related conditions are covered from 91st day
• Discount available on pharmacy, diagnostics & health supplements if purchased from network providers
• Offers global emergency accidental hospitalization coverage

What's Not Good?

• Limitations on the type of hospital room you choose
• Monthly premium payment mode not available
• Received higher number of complaints during policy purchase compared to other insurers
• Received higher number of complaints on claim settlement compared to other insurers
• Our study observed their responses on Twitter to be relatively slower than other insurers

About ManipalCigna Health Insurance Company Limited

JV Partners

Turnover (GWP)

Number of Policies

Number of Claims

Detailed Product Overview

Hidden Conditions

Exclusions Unique to this Policy

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Did you know

1- Health insurance data and ratings were last updated in April 2026. All data has been sourced from product brochures, policy wordings, prospectus, public disclosures (Q4, FY 2024-2025), insurer websites, and the IRDAI website.

2- The Claims Settlement Ratio data is taken from NL-37, insurer public disclosures (Q4, FY 2024-2025). It is calculated by dividing health insurance claims settled divided by health insurance claims reported plus those outstanding at the start of the year.

3- The data related to claim complaints and policy purchase complaints is taken from NL-45, insurer public disclosures (Q4, FY 2024-2025).

4- The Solvency Ratio data is taken from NL-26, insurer public disclosures (Q4, FY 2024-2025).

5- The data related to claims settled within 30 days is taken from NL-39, insurer public disclosures (Q4, FY 2024-2025). It is calculated by dividing number of health insurance claims paid within 30 days by the total health insurance claims paid during the year.

6- The Claims Incurred Ratio data is taken from NL-4 and NL-5, insurer public disclosures (Q4, FY 2024-2025). It is calculated by dividing the Net Claims Incurred by the Net Earned Premium.

7- The Turnover data is taken from NL-4, insurer public disclosures (Q4, FY 2024-2025). It is calculated by converting net written premium to gross written premium.

8- The number of policies and claims data is taken from NL-45, insurer public disclosures (Q4, FY 2024-2025).

9- The Claim Rejection Ratio data is taken from NL- 37, insurer public disclosures (Q4, FY 2024-2025). It is calculated by dividing total claims repudiated and rejected by the sum of total claims outstanding at the beginning of the year and total claims reported during the period.

10- For now, we have considered the most comprehensive plans from leading insurance companies. We will keep updating the product pages with new plans in the coming days.

11- We have rated only those plans that can be serviced by individual advisors. This is because of our strong belief that health insurance customers need professional assistance from individual advisors before and after purchase. We do not recommend and hence do not rate direct-to-customer health insurance plans or plans where there aren't enough advisors available to service.

12- Affordability assessment of plans:

• The affordability of comprehensive plans is assessed using premiums for a family of two adults (30 years old) and one child (1 year old) residing in Zone 1, opting for a cover of ₹10 Lakhs.
• The affordability of Care Freedom Plan is assessed for a 46-year-old couple in Zone 1 with ₹10 lakh cover; premium as of 16th April 2026.
• The affordability of Care Freedom (Plan 1) is assessed for ₹5 lakh cover; premium as of 16th April 2026.
• The affordability of Acko Platinum Health Insurance is assessed using premiums for a family of two adults (30 years old) and one child (1 year old) residing in Zone 1, opting for a cover of ₹25 Lakhs. And, the premium is as of February 2024.
• The affordability of ICICI Lombard MaxProtect (Premium) is assessed using premiums for a family of two adults (30 years old) and one child (1 year old) residing in Zone 1, opting for a cover of ₹1 Crore. And, the premium is as of February 2024.
• The affordability of Niva Bupa - Senior First (Platinum), Manipal Cigna - Prime Senior (Elite) is assessed using premiums for a family of two adults (61 years old) residing in Zone 1, opting for a cover of ₹10 Lakhs. And, the premium is as of February 2024.
• The affordability of Aditya Birla Activ One (VIP+) is assessed using premiums for a family of two adults (30 years old) and one child (1 year old) residing in Zone 1, opting for a cover of ₹50 Lakhs. And, the premium is as of March 2024.
• The affordability of Aditya Birla Activ One (VIP) is assessed using premiums for a family of two adults (30 years old) and one child (1 year old) residing in Zone 1, opting for a cover of ₹50 Lakhs. And, the premium is as of April 2024.
• The affordability of Care Advantage Plan is assessed using premiums for a family of two adults (30 years old) and one child (1 year old) residing in Zone 1, opting for a cover of ₹25 Lakhs. And, the premium is as of April 2024.
• The affordability of IndusInd General Health Global (Elite) Plan is assessed using premiums for a family of two adults (30 years old) and one child (1 year old), opting for an India cover of ₹1.5 Crores and global cover of $0.15 Million. And, the premium is as of August 2024.
• The affordability of Star Health - Premier is assessed using premiums for a family of two adults (61 years old) residing in Zone 1, opting for a cover of ₹10 Lakhs. And, the premium is as of April 2025.
• The affordability of ManipalCigna - LifeTime Health (India) is assessed using premiums for a family of two adults (30 years old) and one child (1 year old) residing in Zone 1, opting for a cover of ₹50 Lakhs. And, the premium is as of April 2025.
• The affordability of Care Insurance Senior Health Advantage is assessed using premiums for a family of two adults (61 years old) residing in Zone 1, opting for a cover of ₹10 Lakhs. And, the premium is as of June 2025.
• The affordability of Optima Secure Global & Optima Secure Global Plus Plans is assessed using premiums for a family of two adults (30 years old) and one child (1 year old), opting for an India cover of ₹1 Crore. And, the premium is as of February 2026.
• The premium for Optima Super Secure is available only for a 3-year tenure and the pricing has been considered accordingly.

13-Premium ratings are as of 19th January 2026.

• For Activ One (VYTL), asthma was considered as the PED for premium retrieval.
• Aditya Birla Health – Activ Health Platinum (Enhanced): child age set to 5 years (minimum allowed).
• Care Plus: one adult must be 35+; test case updated accordingly to meet the minimum requirement.
• Care Supreme (Vikas): one adult must be 30+; test case updated accordingly to meet the minimum requirement.

14- We have considered the Inflation Protection benefit under Acko’s Platinum and Standard Health Plan instead of the No Claim Bonus Benefit.

15- We have only considered features, benefits, and limits of ‘India Cover’ under IndusInd General's Health Global (Elite) Plan.

16- The product benefits section is based on a sum insured of ₹10 Lakhs and only highlights the top benefits and features of health insurance plans.

17- Only those hidden and special conditions that apply to the benefits and features we have considered are included on the product pages.

18- The product pages only include the most significant specific exclusions under each plan, which we've simplified for better understanding.

19- The product pages do not include any generic terms, conditions, or exclusions (those that are the same and apply to all health insurance plans).

20- If the policy wording, brochure, or prospectus states that a benefit/feature is available with a specific plan but it is not available online when generating the premium quote, we have not considered that benefit/feature to be available with the plan.

21- We take into account more parameters, beyond those shown above, when calculating the customer service rating.

22- The response time on X (Twitter) was calculated using a sample set of tweets from July 2025 to December 2025 (analyzed in January 2026). The Response time on Toll Free was last evaluated in March 2026.

23- The metrics like claim complaints, policy purchase complaints, response time on Twitter and toll-free are not related to a specific product but are related to the overall performance of the insurance company.

24- The network hospitals' data was last updated in January 2026.

Your use of the website shall be governed by the Terms and Conditions and Privacy Policy of our website.

Manipal Cigna ProHealth Prime (Active) is a health insurance policy provided by the Manipal Cigna Health Insurance Company.

This plan encompasses hospitalisation and associated costs, including consumable items such as gloves, oxygen masks, etc. Notably, it stands out by offering coverage for specific pre-existing conditions like hypertension, diabetes, etc. from the 91st day. The plan extends its reach globally, covering emergency accidental hospitalisation expenses, all while being cost-effective. However, it lacks the flexibility of monthly premium payments. As per our research, the insurer has received a higher number of claim settlement and policy purchase complaints, indicating a subpar track record in terms of both purchase and claims service.

What are the benefits offered by the Manipal Cigna ProHealth Prime (Active) Plan?

• Inpatient hospitalisation coverage: Manipal Cigna ProHealth Prime (Active) Plan covers inpatient hospitalisation expenses, which include all costs associated with admission that exceed 24 hours, such as nursing care, medical consultations, prescription medications, intensive care unit (ICU), and any other related expenses.
• Pre-hospitalisation coverage: Pre-hospitalisation coverage includes the expenses you incur before hospitalisation, like consultations, tests, checkups, etc. To be eligible for this coverage, these expenses must be related to the medical condition that resulted in hospitalisation and should be approved as part of the inpatient hospitalisation coverage. The Manipal Cigna ProHealth Prime (Active) Plan covers pre-hospitalisation expenses for 30 days before hospitalisation, up to the sum insured.
• Post-hospitalisation coverage: Post-hospitalisation expenses are the medical costs you incur after you leave the hospital, including follow-up consultations with your doctor, medical check-ups, rehabilitation sessions, physiotherapy, and other related expenses. However, these expenses are eligible for coverage only if they are related to the medical condition for which you required hospitalisation and must be approved as part of inpatient hospitalisation coverage. Manipal Cigna ProHealth Prime (Active) Plan covers post-hospitalisation expenses for 60 days after hospitalisation up to the sum insured. Please note that the post-hospitalisation costs related to domiciliary treatments are covered for 30 days instead of 60 days.
• Daycare treatment coverage: Daycare treatment is a medical procedure or surgery that required a prolonged hospital stay in the past but can now be accomplished within 24 hours due to technological advances in the medical field. The Manipal Cigna ProHealth Prime (Active) Plan offers coverage for all such treatments without any limit, up to the sum insured.
• Domiciliary treatment coverage: These are treatments for illnesses or injuries that require immediate attention at the hospital but are given at home because of the severity of the patient’s medical situation or the absence of hospital beds in the vicinity. The Manipal Cigna ProHealth Prime (Active) Plan covers all domiciliary treatments up to 10% of the sum insured except for 14 illnesses.
• Organ donor coverage: The Manipal Cigna ProHealth Prime (Active) Plan covers the inpatient expenses of the organ donor up to the sum insured, where you are the recipient.
• Modern treatment coverage: Technological advancements have propelled healthcare into a phase of rapid progress, introducing modern treatments that were once unimaginable. Innovative treatments like stem cell therapy, robotic surgery, etc. are at the forefront, providing solutions for diseases that were once deemed incurable. The Manipal Cigna ProHealth Prime (Active) Plan covers the expenses of such modern treatments up to 50% of the sum insured.
• Non-medical expenses coverage: Non-medical expenses are costs related to consumables such as gloves, oxygen masks, nebulization kits, and other similar items. Manipal Cigna ProHealth Prime (Active) Plan covers such expenses up to the sum insured without any limit, if you opt for an add-on. Please bear in mind that items of personal comfort, toiletries, cosmetics and convenience are not covered.
• No Claim Bonus: Health insurers offer a No Claim Bonus as a reward if no claims are made during a policy year. The Manipal Cigna ProHealth Prime (Active) Plan provides 10% of the sum insured as No Claim Bonus. Furthermore, you can accumulate a maximum bonus of 100% of the sum insured under the plan. Remember, the accumulated bonus will reduce at the same rate it was earned, if any claims are made in the previous policy year.
• Super No Claim Bonus: The Super No Claim Bonus is an enhanced version of the No Claim Bonus and works similarly. However, the Manipal Cigna ProHealth Prime (Active) Plan doesn’t provide a Super No Claim Bonus.
• Restoration Benefit: The refill benefit is a valuable feature that restores the sum insured after it has been used up during a policy year. The Manipal Cigna ProHealth Prime (Active) Plan provides this benefit for unrelated illnesses. This feature is activated when both the sum insured and the No Claim Bonus are partially used up. Moreover, you can enjoy this benefit unlimited times in a policy year for subsequent claims.

Please remember that the limitations and conditions mentioned in the benefits above apply to a sum insured of Rs. 10 lakhs.

Manipal Cigna ProHealth Prime (Active): Financial Limits

• Room rent limit: It is the maximum amount your health insurer will cover for the room you stay in during your hospitalisation. If the room you choose falls within the limit specified by your health insurance policy, you won’t incur any additional costs. However, if the room you select exceeds the eligibility limit, a proportionate deduction applies. And you will be responsible for paying a proportionate share of the total bill, not just the difference in the room rent. In Manipal Cigna ProHealth Prime (Active) Plan, there is a room rent limit of up to a single private AC room.
• ICU rent limit: It is the maximum amount covered by your health insurance policy for your ICU stay in the hospital. The Manipal Cigna ProHealth Prime (Active) Plan covers the expenses associated with your ICU stay up to the sum insured without imposing any limit.
• Co-payment: A co-payment refers to a certain percentage of the claim amount that you must pay out of your own pocket. Once this amount is paid, the insurer will cover the remaining expenses. Under the Manipal Cigna ProHealth Prime (Active) Plan, there is a 10% copayment limit.
• Deductible: A deductible refers to a certain amount that you must pay from your end before your coverage kicks in to cover your medical expenses. Under the Manipal Cigna ProHealth Prime (Active) Plan, there is no deductible.
• Limits on surgeries/treatments: It is the maximum amount that a health insurance policy will pay for certain medical procedures or treatments. Some insurers have limits on the amount they will cover for certain procedures, while others may not. Under the Manipal Cigna ProHealth Prime (Active) Plan, the total knee replacement surgery is covered up to Rs 1,20,000 per knee per policy year and cataract treatment is covered up to Rs 30,000 per eye per policy year.

Please note that the above financial limits are taken for a 30-year-old individual, opting for a sum insured of Rs. 10 lakhs.

Manipal Cigna ProHealth Prime (Active): Waiting Periods & Exclusions

👉Waiting period

After you purchase a health insurance policy, some illnesses and diseases may not be covered for a certain period of time. This timeframe is referred to as the waiting period. Once the waiting period ends, you can claim for these conditions. Below are some of the types of waiting periods -

• Initial waiting period: A waiting period of 30 days applies for all medical conditions except accidents right after purchasing the policy. Meaning, you will not be able to claim for any hospitalisation expenses, except for accidents during this period.
• Waiting period for pre-existing diseases: Technically speaking, a pre-existing disease refers to a medical condition you have had in the past 36 months before buying a health insurance policy. Under the Manipal Cigna ProHealth Prime (Active) Plan, there is a waiting period of 24 months for pre-existing diseases. During this period, you cannot claim for medical expenses related to such diseases. Asthma, diabetes, hypertension, dyslipidemia, obesity-related conditions are covered from day 91.
• Waiting period for specific diseases: Besides the pre-existing conditions, insurers will have a list of specific medical conditions or illnesses that are subject to a waiting period, regardless of whether you have had those diseases before or not. This waiting period is determined by the insurer and is not based on your current health status. The Manipal Cigna ProHealth Prime (Active) Plan has a waiting period of 24 months in place for specific diseases.

👉Exclusions

Health insurance policies do not cover certain medical conditions at any cost. These are known as exclusions. Here are some of the types of exclusions -

• Standard Permanent Exclusions: All insurance providers are required to adhere to the list of ‘standard permanent exclusions’ established by IRDAI, which include -

1. Investigation and evaluation: Hospital admission for observation or monitoring.
2. Rest, rehabilitation, and respite care: Admission to a facility for bed rest without active treatment.
3. Obesity or weight control: Treatment or surgery related to weight control or obesity.
4. Gender reassignment: Treatments aimed at altering the body’s characteristics to match that of the opposite sex.
5. Plastic or cosmetic surgery: Treatment or surgery intended to modify body characteristics or appearance.
6. Profession in hazardous or adventurous sports: Treatment expenses you incur from participating in adventurous activities such as river rafting, mountaineering, scuba diving,etc. as a professional.
7. Breach of law: Expenses incurred in treating individuals who have committed or attempted to commit a criminal act.
8. Excluded providers: Treatment received from medical practitioners or hospitals excluded by the insurance company.
9. Narcotics: Treating addiction to substances such as alcohol, drugs, etc.
10. Treatments in establishments specifically arranged for domestic purposes: Treatment in nursing homes, health spas, or similar establishments arranged entirely or partially for domestic reasons.
11. Dietary supplements, substances purchased without subscription: Vitamins, minerals, etc., not prescribed by a medical practitioner.
12. Refractive error: Expenses associated with correcting refractive errors of up to a maximum of 7.5 diopters to improve your vision.
13. Unproven treatments: Medical treatments, procedures, or surgeries that are not proven to be effective.
14. Expenses linked to birth control, sterility, infertility: Contraception, artificial insemination, sterilisation, advanced reproductive technologies such as IVF, GIFT, ZIFT, ICSI, gestational surrogacy, etc.
15. Maternity expenses: Expenses related to pre/post-natal care, childbirth-related hospitalisation, etc.

• Additional permanent exclusions: Insurance companies can impose additional exclusions for certain medical conditions or situations apart from the standard permanent exclusions. If you have a severe medical condition or a specific disease that is deemed risky by the insurer, they may choose to permanently exclude it from the policy.  The IRDAI has established a list of illnesses for which insurance companies can apply permanent exclusions. They cannot impose permanent exclusions on illnesses or diseases that are not on this list.
• Non-standard exclusions (Specific exclusions): Specific Exclusions are the medical conditions that are excluded from a health insurance policy apart from the standard permanent exclusions listed by the IRDAI. These specific exclusions are determined by the individual insurance company and can differ based on the policy’s terms and conditions. Here are some specific exclusions listed under the Manipal Cigna ProHealth Prime (Active) plan -

1. Expenses related to dental or orthodontic treatment unless required due to an accident.
2. Circumcision unless required due to accident or for treating a disease.
3. Expenses related to any external devices used during or post treatment.
4. Treatment expenses related to external birth defects.
5. Expenses related to organ donor screening and organ transplant surgery involving organs not harvested from a human body.
6. Expenses related to non-allopathic treatment (except for AYUSH in-patient treatments), hydrotherapy, acupuncture, etc.
7. Treatment expenses for injury or illness arising from nuclear, chemical or biological attack, weapons, etc.
8. Injury or disease resulting from invasion, act of foreign enemy, participation in any naval, military, air-force operation, warlike operations, etc.

What to expect in terms of claims experience if you buy from Manipal Cigna Health Insurance Company?

• Speed of claims: Manipal Cigna Health Insurance Company has settled 99.14% of claims in less than 30 days.  This means you can expect a quick and efficient claim settlement process.
• Claim-related complaints: As per our research, Manipal Cigna Health Insurance Company has received a higher number of claim-related complaints, compared to other insurers, accounting for 0.26%.
• Claims incurred ratio: It measures the company’s financial performance and represents the number of claims incurred compared to the total premiums collected in a financial year. Manipal Cigna Health Insurance Company has a claims incurred ratio of 63.78%.
• Claim settlement ratio: It denotes the percentage of claims successfully settled by the insurer as compared to the total number of claims they received in a financial year. Manipal Cigna Health Insurance Company holds a claim settlement ratio of 87.68%.
• Network hospitals: Manipal Cigna Health Insurance Company has a network of over 8,500+ hospitals across various locations. This vast network ensures that you can receive cashless treatments from a diverse range of healthcare providers across various locations.

How is Manipal Cigna Health Insurance Company's customer service?

• Policy purchase-related complaints: As per our research, Manipal Cigna Health Insurance Company has received a higher number of complaints related to its after-sales service, as compared to other insurers, accounting for 0.01%.
• Response on Toll-Free: Our research suggests that Manipal Cigna Health Insurance Company’s response time on their toll-free number is average.
• Response on Twitter: According to our research, Manipal Cigna Health Insurance Company has a slower response time on Twitter as well.

About Manipal Cigna Health Insurance Company

Manipal Cigna Health Insurance is a standalone health insurance company in India. It is a joint venture between the Manipal Group and Cigna Corporation. The company offers various insurance policies to cater to the unique needs of customers, such as individual insurance, family floater, personal accident insurance, critical illness insurance, group health insurance, hospital cash policies, etc. Founded in 2014, the company is headquartered in Mumbai, Maharashtra. The CEO and MD of the company is Mr. Prasun Sikdar.

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