CignaTTK ProHealth Vs Max Bupa HeartBeat

FOR INTERNAL USE ONLY.
TO BE U
Product Name
Features
Entry Age (Adult)
Max Bupa Heartbeat

Entry age - 18 years
Maximum entry age - No Limit
Lifetime
Renewal Age
Age of Dependent Child (Min & Max No Age Limit
Entry Age) for Floater
Dependent Parents Covered
Sum Insured Options
Yes
Silver Plan - 2Lac, 3Lac,
Exclusive Plan - 5Lac, 7.5Lac & 10Lac
Platinum Plan - 15Lac, 20Lac & 50 Lac
Tenure ( Years)
Policy type - (Individual / Floater)
Plan payout basis
1 & 2 Years
Individual/ Family Floater
Reimbursement of actual expenses
Premium Band
Medical Test Requirement
Age wise
Based on Age & Sum Insured opted
Coverage
Hospitalisation
Pre Hospitalization
Post Hospitalisation
Day care Treatment
Domiciliary hospitalization
Ambulance Charges
Hospital Cash Allowance

Critical Illness
E Opinion
Recovery Grant/Convalescence
Silver plan: Shared Accommodation

Exclusive plan: Single Private Room
Platinum plan: Single Private room
upgradable to higher if available
30 days
60 days
All Day Care procedures, No specific list
displayed
Covered maximum 5% of SI
2000 for out of network in case of
emergency
Actual cost in network hospitals in case of
emergency
Not available
Not available
Available only for Platinum Plan
Not available
Organ Donor
Covered upto Full SI
Out Patient Expenses General
Covered only for Platinum Plan

Varies from 10K to 20 K depending on the
Basic SI. 80% of unutilized amount can be
carried to the next yr. Maximum carry
forward is 2.5 times of SI
Out-patient dental treatment

Out Patients Pharmacy
Maternity
No specific cover
Not available
Covered from 20,000 to 1,00,000
depending upon the plan & Sum Insured
Opted. New born baby covered if maternity
claim is paid upto expiry of policy along
with vaccinations for the first year.
Pre - Existing Illness
After 4 years of waiting (48 months)
Restoration
Worldwide Emergency Cover
Not Available
Not available
Features
Claim Processing
Cumulative Bonus (No Claim)
Inhouse
Not available.
Long Term Discount on premium

Health Check up
Co-pay / Deductible/Sublimits
On renewal,
voucher worth 10% of last premium
received is given as Cumulative Benefit
(explained under Renewal Special Feature
below)
Not available
Health Check Up once in 2 years for Silver
plan and on each renewal in Gold/Platinum
plans irrespective of claim status
Co-pay: 20% for all claims made by persons
above 65 years.
Deductible (annual
aggregate basis): 1/2/3 lacs available under
Silver plan only.
Sublimit: 1% of SI on room rent for Silver Plan.
Pre & Post covered upto 15/20% under
Silver & Gold Plan.
Renewal Special Features
Health Relationship Loyalty Programme:

Customer can avail health services and
products worth up to 10% of last received
premium, every year on renewal of policy.
USE ONLY. TO BE USED FOR TRAINING PURPOSE. NOT TO BE CIRCULATED TO CUSTOMERS.

ProHealth Protect
ProHealth Plus
Min Entry Age: 18 Years
Lifetime
Max Entry Age: No limit
Lifetime
Min Entry Age: 91 days
Yes
Rs. 2.5 Lac/3.5 Lac/ 4.5 Lac
Yes
Rs. 4.5 Lac/5.5 Lac/7.5 Lac/10 Lac
1 year/2 year
Individual & Family Floater
Reimbursement of actual
expenses / Benefit payout for
Critical Illness
1 year/2 year
Reimbursement of actual expenses
/ Benefit payout for Critical Illness
Age and Zone Wise

Medicals required for insured
aged 46 years & above
Age and Zone Wise

SI 4.5 Lac/ 5.5 Lac/ 7.5 Lac Medicals required for insured aged
46 years & above
SI 10 Lac - Medicals
required for insured aged 41 years
and above
In-patient hospitalization
expenses as per actual.
Room rent (shared room) as
per actual
In-patient hospitalization expenses

as per actual.
Room
rent (single private room) as per
actual
60 days
90 days
171 listed procedures
60 days
180 days
Covered upto full Sum Insured
Upto Rs.2000/- per

hospitalization event
Upto Rs.3000/- per hospitalization

event
Not available
Lump sum payment of full Sum
Insured if opted
Not available
Insured if opted
Expert opinion available once

during policy year for each
insured

during policy year for each insured
Not available
Not available
Max Age: 23 years
Rs.500/- available to redeem

against OPD expenses
Rs.2000/- available to redeem

against OPD expenses
Not available
Covered upto 15,000 for normal

delivery and 25,000 for CSection per event after a waiting
period of 48 months
New Born baby
cover also available Vaccination
expenses is covered over & above
Maternity SI
Pre-existing disease covered

after 48 months
Pre-existing disease covered after

36 months
When the basic SI & earned cumulative bonus is insufficient due to claims paid or accepted as pa
the
sameupto
will be
to 100%Covered
of basic upto
SI. This
require the Basic SI + CB to be exha
Covered
fullrestored
Sum Insured
full does
Sum not
Insured
completely.
TPA
5 % increase in Sum Insured
maximum upto 50 %.
No reduction in SI in case of a
claim
TPA
10 % increase in Sum Insured maximum upto 50 %.
reduction in SI in case of a claim
7.5% for a 2 years policy term

Available once in a block of 3
Available at each renewal, to all
years for all Insured persons
insured persons who have
who have completed 18 years of completed 18 years of Age.
age.
Co-pay: Options to choose
between 10% and 20%
copayment for each and every
claim
Sum Insured - Deductible
options
2.5 Lac - Not Availble
3.5 Lac - 1 Lac
4.5 Lac - 1 Lac/ 2 lac
Mandatory
Co-pay of 20% for insured aged
65 years & above.
Co-pay: Options to choose between

10% and 20% copayment for each
and every claim
Sum Insured - Deductible options
4.5 Lac - 1 Lac/ 2 Lac
10 Lac - 3 Lac
Mandatory Copay of 20% for insured aged 65
years & above.
Reward Points to be earned for each year of premium paid and accumulated for 2 years. Rewards
completing Our Online Wellness Programs. These earned Reward Points can be used to get a disc
Premium OR they can be redeemed for equivalent value of Health Maintenance vouchers.
CULATED TO CUSTOMERS.
18 Years
ProHealth Preferred
ProHealth Premier
Max Entry Age: No limit
Lifetime
e: 91 days
Max Age: 23 years
Lifetime
Yes
Rs. 15 Lac/30 Lac/ 50 Lac
Yes
Rs. 100 Lac
1 year/2 year
Critical Illness
1 year/2 year
Critical Illness
Age and Zone Wise

Medicals for all age group
Age and Zone Wise

Medicals for all age group
In-patient hospitalization expenses In-patient hospitalization

as per actual.
Room
expenses as per actual.
rent (single private room) as per
Room rent (single private room)
actual
as per actual
60 days
180 days
60 days
180 days
Actual expenses paid per

Actual expenses paid per

Not available
Insured if opted
Not available
Not available

during policy year for each insured during policy year for each
insured
Not available
Not available
Covered upto 1% of Sum Insured subject to maximum of 15000 per

policy year
Covered upto 50,000 for normal

delivery and 100,000 for CSection per event after a waiting
Period of 48 months
New Born baby cover
also available Vaccination
expenses is covered over & above
Maternity SI
Covered upto 50,000 for

normal delivery and 100,000
for C-Section per event after a
waiting Period of 48 months
New Born baby cover also
available
Vaccination expenses is covered
over & above Maternity SI
Pre-existing disease covered after 24 months
due to claims paid or accepted as payable,

require the
Basic SI
+ CB
to be exhausted
Covered
upto
a maximum
of Rs.10
Lac
TPA
red maximum upto 50 %.
a claim
No
for a 2 years policy term

completed 18 years of Age.
Not available
Covered upto a maximum of
Rs.10 Lac
TPA
Not available

completed 18 years of Age.
Co-pay/Deductible - Not available
Co-pay/Deductible - Not available
Mandatory Co-pay of 20% for

insured aged 65 years & above.
Mandatory Co-pay of 20% for

insured aged 65 years & above.
nd accumulated for 2 years. Rewards can also be earned for enrolling and
ward Points can be used to get a discount in premium from the 3rd Annual
Health Maintenance vouchers.

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FOR INTERNAL USE ONLY.

Max Bupa Heartbeat

Hospital Cash Allowance

Silver plan: Shared Accommodation

Covered upto Full SI

Out Patient Expenses General

Covered only for Platinum Plan

Out-patient dental treatment

Pre - Existing Illness

After 4 years of waiting (48 months)

Long Term Discount on premium

Renewal Special Features

Health Relationship Loyalty Programme:

USE ONLY. TO BE USED FOR TRAINING PURPOSE. NOT TO BE CIRCULATED TO CUSTOMERS.

Max Entry Age: No limit

Age and Zone Wise

Age and Zone Wise

In-patient hospitalization expenses

Covered upto full Sum Insured

Covered upto full Sum Insured

Upto Rs.2000/- per

Upto Rs.3000/- per hospitalization

Expert opinion available once

Expert opinion available once

Max Age: 23 years

Covered upto full Sum Insured

Covered upto full Sum Insured

Rs.500/- available to redeem

Rs.2000/- available to redeem

Covered upto 15,000 for normal

Pre-existing disease covered

Pre-existing disease covered after

7.5% for a 2 years policy term

Co-pay: Options to choose between

Max Entry Age: No limit

Age and Zone Wise

Age and Zone Wise

In-patient hospitalization expenses In-patient hospitalization

Covered upto full Sum Insured

Covered upto full Sum Insured

Actual expenses paid per

Actual expenses paid per

Expert opinion available once

Covered upto full Sum Insured

Covered upto full Sum Insured

Covered upto 1% of Sum Insured subject to maximum of 15000 per

Covered upto 50,000 for normal

Covered upto 50,000 for

Pre-existing disease covered after 24 months

due to claims paid or accepted as payable,

for a 2 years policy term

Available at each renewal, to all

Co-pay/Deductible - Not available

Co-pay/Deductible - Not available

Mandatory Co-pay of 20% for

Mandatory Co-pay of 20% for

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