Health Insurance - Apollo Munich

Health Wallet - A Revolutionary Health Plan

Sum Insured from 3-50 lakhs + Reserve benefit - covers OPD expenses; balance is carried forward to next policy year with 6% increment + Continuation cover - pay upto 50% of renewal premium from reserve Benefit sum insured post 5 continuous renewals+ Restore benefit to auto-reinstate your sum insured + Multiplier benefit offers a no claim benefit of 50% every year + Pre& Post hospitalization coverage for 60 days & 90 days + All Day-care procedures + Domiciliary treatment + Expenses for Organ Donor + Worldwide Emergency Care + Emergency Ambulance + Health Checkup ( if reserve benefit sum insured is more than Rs 5000) + Recovery Benefit + Optional Deductible+ Lifelong renewal + No additional loadings at renewal due to claims + No sub-limits + No co-payment + Critical Advantage Rider Our first of a kind Health plan with a unique Reserve Benefit which can be used for OPD expenses, any non-payable items under health insurance claim or to pay upto 50% of your renewal premium. Your Reserve Benefit will keep on increasing every year and any unutilized balance under this benefit will be carried forward to next year with 6% bonus.
The option to convert the plan to a full-fledged Indemnity Health Insurance plan without re-evaluation of health status or any pre policy check if Insured Person has been insured with Us for first time under this Policy before the age of 50 years and has policy has been renewed with us for continuous 5 years. This plan also comes with additional benefits like Restore benefit, that automatically reinstates the basic sum insured in case you exhaust it in a policy year and multiplier benefit which rewards you for every claim free year.

Eligibility
  • This policy covers persons in the age group 91 days to 65 years. The maximum entry age is restricted to 65 years. The Minimum entry age for Adult Dependent is 18 years and Maximum entry age is 65 years.
  • Children between 91 days and 5 years can be insured provided either parent is getting insured under this Policy.
  • There is no maximum cover ceasing age on renewals.
  • The policy will be issued for a period of 1 year period, the sum insured & benefits will applicable on Policy Year basis.
  • This policy can be issued to an individual and/or family .The family includes following relationships spouse, dependent children and dependent parents and dependent in laws.
  • The policy offers option of covering on individual sum insured basis and on family floater basis.
  • A maximum of 6 members can be added in a single policy, whether on an Individual or Family floater basis.
  • In an individual policy, a maximum of 4 adults and a maximum of 5 children can be included in a single policy. The 4 adults can be a combination of Self, Spouse, Father, Father in law, Mother or Mother in law.
  • In a family floater policy, a maximum of 2 adults and a maximum of 5 children can be included in a single policy. The 2 adults can be a combination of Self, Spouse, Father, Father in law, Mother or Mother in law .
  • In a family floater the age of the eldest member will be considered while computing premium for the family.
  • In a individual policy Sum Insured of the Dependent insured members should be equal to or less than the Sum Insured of the primary insured member. Incase where two or more children are covered, the Sum Insured for all the children must be same. Sum insured of Dependent Parents must be the same.
Benefit:
Plan Benefits
  • In-Patient Hospitalisation - The medical expenses for coverage for hospitalization of more than 24 hrs.
  • Pre-Hospitalisation - The medical expenses that you incur due to illness during the 60 days immediately before you are hospitalised.
  • Post-Hospitalisation - The medical expenses you incur in the 90 days immediately after you are discharged from hospital.
  • Day-Care Procedures - The medical expenses for all day-care procedures, which do not require 24 hours hospitalization due to technological advancement, are covered.
  • Domiciliary Treatment - The treatment expenses involved in getting a treatment done at home which otherwise would need hospitalization.
  • Organ Donor - Treatment expenses for the organ donor at the time of organ transplant.
  • Emergency Ambulance - Expenses incurred if ambulance service is used on the way to hospital for hospitalization (up to Rs. 2000).
  • Ayush Benefit - The Medical expenses for in-patient treatment taken under Ayurveda, Unani, Sidha and Homeopathy.
  • Recovery Benefit - Lump sum benefit of Rs. 10000, if hospitalized for more than 10 days.
  • Worldwide Emergency Care - Covers emergency hospitalisation expenses outside India upto the specified limit.
  • Restore Benefit - Automatic re-instatement of the basic sum insured, if the basic sum insured and multiplier benefit has been exhausted during the policy year. Basic sum insured will be re-instated only once in a policy year.
  • Reserve Benefit - Provides a separate sum insured which can be used for OPD expenses, any non-payable items under health insurance claim or to pay upto 50% of your renewal premium. Reserve Benefit will keep on increasing every year and any unutilized balance under this benefit will be carried forward to next year with 6% bonus.
  • Health Check-up - Reimbursement of expenses incurred on preventive health check-up.
  • Additional Cover for Critical Advantage Rider (optional) - You can opt to cover yourself worldwide at our network centers against treatment expenses for 8 major illnesses that include Cancer, Coronary Artery by-pass surgery, Heart Valve replacement / repair, Neurosurgery, Live Donor Organ Transplant, Bone Marrow Transplant, Pulmonary artery graft surgery and Aorta Graft Surgery. The rider offers you freedom to not only avail best healthcare services world over but also covers all travel costs for the insured and accompanying relative, accommodation expenses, second opinion & post hospitalization expenses. This rider will be offered where base policy Sum Insured is Rs.10 lacs & above. This rider can be issued to an individual and/or family only on individual Sum Insured basis.
Others Benefits
  • Multiplier Benefit - You get a bonus of 50% of the basic sum insured for every claim free year accumulating up to 100%. (In the event of a claim, the bonus shall be reduced by 50% of the Basic Sum Insured at the time of renewal).
  • Continuation of Cover – Option to pay upto 50% of renewal premium from Reserve Benefit. Benefit is available after 5 continuous renewals.
  • Waiver of Deductible benefit - The option to convert the plan to a full-fledged Indemnity Health Insurance plan with no underwriting or medicals is available only at renewal between 55-60 years provided you have enrolled with Us under this policy before the age of 50 years and have renewed with us continuously without a break.
  • Cashless Service - You need to obtain a pre-authorization for all planned admissions atleast 48 hours prior to actual admission or regularize any emergency admission within 24 hours post the admission. The details of the process and the documentation requirements are given in the guide-book sent along with the policy.
  • Sum Insured Enhancement - Sum Insured can be enhanced only at the time of renewal subject to no claim have been lodged/ paid under the policy. If the insured increases the sum insured one grid up, no fresh medicals shall be required. In cases where the sum insured increase is more than one grid up, the case shall be subject to medicals. In case of increase in the sum insured waiting period will apply afresh in relation to the amount by which the Sum Insured has been enhanced. However, the quantum of increase shall be at the discretion of the company.
  • Portability - If you are insured with some other company’s health insurance and you want to shift to us on renewal, you can. Our portability policy is customer friendly and aims to achieve the transfer of most of the accrued benefits and makes due allowances for waiting periods etc.
  • Tax Benefits - With the Health Wallet Insurance Plan you can avail tax benefits for the premium amount under Section 80D of the Income Tax Act. (Tax benefits are subject to changes in Tax Laws).
 Policy Renewal
  • Our Health Wallet policy offers lifelong renewability i.e there is no maximum cover ceasing age in this policy.
  • Grace Period of 30 days is provided for renewing the policy.
  • Waiting periods as mentioned in the policy wording gets reduced by 1 year on every continuous renewal of your Health Wallet Insurance policy.
  • Renewal premium are subject to change with prior approval from IRDA. Any change in benefits or premium (other than due to change in age) will be done with the approval of the IRDA and will be intimated at least 3 months in advance.
 Waiting Period
  • All treatments within the first 30 days of cover except any accidental injury.
  • Any pre-existing condition will be covered after a waiting period of 3 years
  • 2 years waiting period for specific diseases like cataract, hernia, joint replacement surgeries, surgery of hydrocele etc.
 Exclusions
  • Expenses arising from HIV or AIDS and related diseases
  • Congenital diseases, mental disorder or insanity, cosmetic surgery and weight control treatments
  • Abuse of intoxicant or hallucinogenic substances like intoxicating drugs and alcohol
  • Hospitalization due to war or an act of war or due to a nuclear, chemical or biological weapon and radiation of any kind.
  • Pregnancy, dental treatment, external aids and appliances .
  • Items of personal comfort and convenience.
  • Experimental, investigative and unproven treatment devices and pharmacological regimens.
 
Optima Restore - Our Bestselling Plan

Sum Insured from 3-50 lakhs + Restore benefit to auto-reinstate your sum insured + Multiplier benefit offers a no claim benefit of 50% every year + Pre& Post hospitalization coverage for 60 days & 180 days + Discounts at renewal with the “Stay Active” Benefit + Emergency Ambulance  Health Checkup ( for sum insured greater than 15 lacs) to Health Checkup at renewals A Health Plan which restores your Sum Insured when you need it the most. ApolloMunich brings you Optima Restore, our best-selling product since it was launched in 2012.
The policy has three incredible benefits- Restore, Multiplier and Stay Active.
Restore is a super benefit, which instantly adds 100% of sum insured if you partially or fully utilize your policy sum insured.

 Restore benefit features:-

  • It is applicable only once during a policy year and is not carried forward to the next year.
  • Single claim size cannot exceed sum of base sum insured & multiplier benefit(if any).
Multiplier Benefit gives you a 100% increase in Sum Insured after 2 claim free years
Stay Active benefit rewards customers who lead an active lifestyle, the benefit allows a customer to enjoy premium discounts simply by walking. We also provide a mobile application “Health Jinn” that allows you to track your progress.
Get cashless access to over 4500+ network hospitals in over 800 cities.

 Eligibility
  • We offer coverage from the age of 5 years onwards with maximum entry age of 65 years. A dependent child can be covered from the 91st day (if either parents are covered under this policy).
  • You and/ or your family members namely spouse, dependent children, dependent parents / parents in law are eligible for buying this cover on individual sum insured basis. (we offer a family discount of 10% if 2 or more family members are covered under the same policy)
  • Maximum 6 members can be added in a single policy. In an individual policy, a maximum of 4 adults and a maximum of 5 children can be included in a single policy.
  • Your premium at renewal may change due to a change in your age or changes in the applicable tax rate.
  • The policy period options include period of 1 or 2 years(s). (We offer 7.5% discount if you opt for a 2 year policy).
Benefits

Plan Benefits
  • In-Patient Hospitalisation
The medical expenses for coverage for hospitalization of more than 24 hrs with no room rent limits.
  • Pre-Hospitalisation

    The medical expenses that you incur due to illness during 60 days immediately before you are hospitalized.
  • Post-Hospitalisation

    The medical expenses you incur in the 180 days immediately after you are discharged from hospital. .
  • Day-Care Procedures

    The medical expenses for all day-care procedures covered, which do not require 24 hours hospitalization due to technological advancement, are covered.
  • Domiciliary Treatment

    The treatment expenses involved in getting a treatment done at home which otherwise would need hospitalization.
  • Organ Donor

    Treatment expenses for the organ donor at the time of organ transplant.
  • Daily Cash for Choosing Shared Accommodation

    A lump sum amount given for selecting a shared room in a network hospital.
  • Emergency Ambulance

    Expenses incurred if ambulance service is used on the way to hospital for hospitalization (up to Rs. 2000).
  • Preventive Health Checkup

    Reimbursement for a preventive health checkup package taken for general assessment of health status, it does not include any diagnostic or investigative medical tests for evaluation of illness or a disease. This benefit is available at renewal at the end of a block of 2 years on base sum insured of 5 lacs and annually on base sum insured of 10 Lacs and above.
  • Restore Benefit

    Automatic re-instatement of the basic sum insured, if the basic sum insured and multiplier benefit has been exhausted during the policy year. Basic sum insured will be re-instated only once in a policy year.
  • E-opinion

    On request of the Insured person diagnosed with a crticial illness, We will arrange for a second opinion from a medical practitioner selected by the insured person from Our panel. This benefit can be availed once in a policy year.
  • Additional Cover for Critical Advantage Rider (optional)

    You can opt to cover yourself worldwide at our network centers against treatment expenses for 8 major illnesses that include Cancer, Coronary Artery by-pass surgery, Heart Valve replacement / repair, Neurosurgery, Live Donor Organ Transplant, Bone Marrow Transplant, Pulmonary artery graft surgery and Aorta Graft Surgery. The rider offers you freedom to not only avail best healthcare services world over but also covers all travel costs for the insured and accompanying relative, accommodation expenses, second opinion & post hospitalization expenses. This rider will be offered where base policy Sum Insured is Rs.10 lacs & above. This rider can be issued to an individual and/or family only on individual Sum Insured basis.
  • Stay Active Benefit

    In order to reward your healthy lifestyle, we will offer a discount at each renewal if you achieve an average step count target on the mobile application provided by us in the specified time interval.

Other Benefits

  • Multiplier Benefit

    You get a bonus of 50% of the basic sum insured for every claim free year accumulating up to 100%. (In the event of a claim, the bonus shall be reduced by 50% of the Basic Sum Insured at the time of renewal).
  • Cashless Service

    You need to obtain a pre-authorization for all planned admissions atleast 48 hours prior to actual admission or regularize any emergency admission within 24 hours post the admission. The details of the process and the documentation requirements are given in the guide-book sent along with the policy.
  • Sum Insured Enhancement

    Sum Insured can be enhanced only at the time of renewal subject to no claim have been lodged/ paid under the policy. If the insured increases the sum insured one grid up, no fresh medicals shall be required. In cases where the sum insured increase is more than one grid up, the case shall be subject to medicals. In case of increase in the sum insured waiting period will apply afresh in relation to the amount by which the sum insured has been enhanced. However, the quantum of increase shall be at the discretion of the company.
  • Portability

    If you are insured with some other company’s health insurance and you want to shift to us on renewal, you can. Our portability policy is customer friendly and aims to achieve the transfer of most of the accrued benefits and makes due allowances for waiting periods etc.
  • Tax Benefits

    With the Optima Restore Individual Health Insurance Plan you can presently avail tax benefits for the premium amount under Section 80D of the Income Tax Act. (Tax benefits are subject to changes in Tax Laws).
 Renewal Policies
  • Our Optima Restore policy offers lifelong renewability i.e there is no maximum cover ceasing age in this policy
  • Grace Period of 30 days for renewing the policy is provided under this policy.
  • Waiting periods as mentioned in the policy wording gets reduced by 1 year on every continuous renewal of your Optima Restore Insurance policy.
  • Renewal premium are subject to change with prior approval from IRDA. Any change in benefits or premium (other than due to change in age) will be done with the approval of the IRDA and will be intimated atleast 3 months in advance.
 Exclusions
  • All treatments within the first 30 days of cover except any accidental injury.
  • Any pre-existing condition will be covered after a waiting period of 3 years.
  • 2 years waiting period for specific diseases like cataract, hernia, joint replacement surgeries, surgery of hydrocele etc.
  • Expenses arising from HIV or AIDS and related diseases.
  • Congenital diseases, mental disorder or insanity, cosmetic surgery and weight control treatments.
  • Abuse of intoxicant or hallucinogenic substances like intoxicating drugs and alcohol
  • Hospitalization due to war or an act of war or due to a nuclear, chemical or biological weapon and radiation of any kind.
  • Pregnancy, dental treatment, external aids and appliances unless covered under the specific Easy Health Insurance Plan.
  • Items of personal comfort and convenience.
  • Experimental, investigative and unproven treatment devices and pharmacological regimens.

Easy Health - An Affordable Plan

Sum Insured starting from 1-15 Lakhs + Hospitalization + Pre-hospitalization + Post-hospitalization + All Day-care procedures + Domiciliary treatment + Daily Cash + Expenses for Organ Donor + Emergency Ambulance + Health Check-up + Critical Illness+ Critical Advantage Rider (for sum insured equal or greater than 10 lacs) + Discounts at renewal with the “Stay Active” benefit Our Easy Health Individual Plan protects you not only from unforeseen emergency expenses but also offers a comprehensive cover for medical treatment of illnesses and accidents requiring in-patient hospitalisation. The Plan offers coverage on individual sum insured basis & also offers an add-on optional cover for listed Critical Illnesses.

  Eligibility

  • We offer coverage from the age of 5 years onwards with maximum entry age of 65 years. A dependent child can be covered from the 91st day (if either parent is covered under this policy).
  • You and/ or your his family members namely spouse, dependent children, dependent parents, parent-in-law, grandparents and grand children are eligible for buying this cover. (we offer a family discount of 5% if 2 family members are covered and family discount of 10% if 3 or more family members are covered under the same policy)
  • Maximum 6 members can be added in a single policy. In an individual policy, a maximum of 4 adults and a maximum of 5 children can be included in a single policy. The 4 adults can be a combination of Self, Spouse & either set of parents or grandparents or parents in Law.
  • Your premium at renewal may change due to a change in your age or changes in the applicable tax rate.
  • The policy period options include period of 1 or 2 years(s). (We offer 7.5% discount if you opt for a 2 year policy).
 Benefit

Plan Benefits
  • In-Patient Hospitalisation - The medical expenses for coverage for hospitalization of more than 24 hrs.
  • Pre-Hospitalisation - The medical expenses that you incur due to illness during the 60 days immediately before you are hospitalised.
  • Post-Hospitalisation - The medical expenses you incur in the 90 days immediately after you are discharged from hospital.
  • Day-Care Procedures - The medical expenses for all day-care procedures, which do not require 24 hours hospitalization due to technological advancement, are covered.
  • Domiciliary Treatment - The treatment expenses involved in getting a treatment done at home which otherwise would need hospitalization.
  • Organ Donor - Treatment expenses for the organ donor at the time of organ transplant.
  • Daily Cash for- A lump sum amount given for selecting a shared room in a network hospital. 
  • Emergency Ambulance - Expenses incurred if ambulance service is used on the way to hospital for hospitalization (up to Rs. 2000).
  • Ayush Benefit - The Medical expenses for in-patient treatment taken under Ayurveda, Unani, Sidha and Homeopathy.
  • Health Check-up - A comprehensive health check-up involving a number of medical tests only once at the end of a block of four continuous claim free policy years.
  • Recovery Benefit - Lump sum benefit of Rs. 10000, if hospitalisation is for greater than 10 days - (For sum insured 15 lacs & above)
  • Stay Active Benefit - In order to encourage Insured members to stay healthy, we will offer a discount at each renewal if the insured member achieves the average step count target on the mobile application provided by us in the specified time interval (calculated from the policy risk start date).
  • Additional Cover for Critical Illness (optional) - You can opt for an additional cover for Critical Illness which covers for cancer, coronary artery (bypass) surgery, first heart attack (myocardial infarction), kidney failure (end-stage renal disease), major organ transplantation, multiple sclerosis, paralysis and stroke. The sum insured for Critical Illness can be either 50% or 100% of your basic sum insured subject to minimum of Rs. 100,000.
  • Additional Cover for Critical Advantage Rider (optional) - You can opt to cover yourself worldwide at our network centers against treatment expenses for 8 major illnesses that include Cancer, Coronary Artery by-pass surgery, Heart Valve replacement / repair, Neurosurgery, Live Donor Organ Transplant, Bone Marrow Transplant, Pulmonary artery graft surgery and Aorta Graft Surgery. The rider offers you freedom to not only avail best healthcare services world over but also covers all travel costs for the insured and accompanying relative, accommodation expenses, second opinion & post hospitalization expenses. This rider will be offered where base policy Sum Insured is Rs.10 lacs & above. This rider can be issued to an individual and/or family only on individual Sum Insured basis.
Others Benefits
  • Cumulative Bonus - You get a Cumulative Bonus (CB) of 10% for every claim-free year accumulating up to 100% (in the event of a claim, CB will be reduced by 10% of SI on the next renewal).
  • Cashless Service - You need to obtain a pre-authorization for all planned admissions atleast 48 hours prior to actual admission or regularize any ‘emergency’ admission within 24 hours post the admission. The details of the process and the documentation requirements are given in the guide-book sent along with the policy.
  • Sum Insured Enhancement - Sum Insured can be enhanced only at the time of renewal subject to no claim have been lodged/ paid under the policy. If the insured increases the sum insured one grid up, no fresh medicals shall be required. In cases where the sum insured increase is more than one grid up, the case shall be subject to medicals. In case of increase in the sum insured waiting period will apply afresh in relation to the amount by which the Sum Insured has been enhanced. However, the quantum of increase shall be at the discretion of the company.
  • Portability - If you are insured with some other company’s health insurance and you want to shift to us on renewal, you can. Our portability policy is customer friendly and aims to achieve the transfer of most of the accrued benefits and makes due allowances for waiting periods etc.
  • Tax Benefits - With the Easy Health Individual Health Insurance Plan you can presently avail tax benefits for the premium amount under Section 80D of the Income Tax Act. (Tax benefits are subject to changes in Tax Laws).
 
Stay Healthy Package

The “Stay Active” a program that not only encourages you to start moving and maintaining a healthy lifestyle but also rewards you with a premium discount at renewal. This is aided by additional benefits that include:
  • Online health assessment
  • Customized diet & exercise plan from our experts
  • E- storage facilities to store your medical reports for 24X7 access
  • Great offers & discounts on heath products & services
  • Set alerts to track your health appointments and medicinal intake
  • Exclusive health newsletter & helpline services
And lots more…
The above benefits are offered for policies with sum insured greater than 5 lacs.
In addition, Health Line Services & Discounts at our listed partner’s network are provided in all sum insured – You just need to call us and quote your customer ID to reach our experts and avail their help in primary consultation, health-related counseling, individual referrals, health information, nutrition and diet.
 
 Renewal Policies
  • Our Easy Health policy offers lifelong renewability i.e there is no maximum cover ceasing age in this policy.
  • Grace Period of 30 days for renewing the policy is provided under this policy.
  • Waiting periods as mentioned in the policy wording gets reduced by 1 year on every continuous renewal of your Easy Health Insurance policy.
  • Renewal premium are subject to change with prior approval from IRDA. Any change in benefits or premium (other than due to change in age) will be done with the approval of the IRDA and will be intimated atleast 3 months in advance.
 Exclusions
  • All treatments within the first 30 days of cover except any accidental injury
  • Any pre-existing condition will be covered after a waiting period of 3 years
  • 2 years waiting period for specific diseases like cataract, hernia, joint replacement surgeries, surgery of hydrocele etc.
  • Expenses arising from HIV or AIDS and related diseases
  • Congenital diseases, mental disorder or insanity, cosmetic surgery and weight control treatments
  • Abuse of intoxicant or hallucinogenic substances like intoxicating drugs and alcohol
  • Hospitalization due to war or an act of war or due to a nuclear, chemical or biological weapon and radiation of any kind
  • Pregnancy, dental treatment, external aids and appliances unless covered under the specific Easy Health Insurance Plan

Easy Health - Our Plan For Young Family

Sum Insured starting from 3 Lakhs to 50 Lakhs + Hospitalization + Pre-hospitalization + Post-hospitalization + All-care procedures + Domiciliary treatment + Daily Cash + Expenses for Organ Donor + Emergency Ambulance +  Emergency Air Ambulance(for sum insured greater than 15 lacs) +Health Check-up + Maternity expenses + Coverage for New Born Baby + Daily cash for accompanying an insured child + Critical Illness + Recovery benefit + Critical Advantage Rider(for sum insured equal or greater than 10 lacs)+ Discounts at renewal with the “Stay Active” benefit 

Our Easy Health Individual Plan protects you not only from unforeseen emergency expenses but also offers a comprehensive cover for medical treatment of illnesses and accidents requiring in-patient hospitalisation. The Plan offers coverage on individual sum insured basis & also offers an add-on optional cover for listed Critical Illnesses.

 

Our Exclusive Plan also covers maternity expenses, recovery benefit & also lets you avail the health checkup benefit at every fourth renewal irrespective of claims.

 
Eligibility
  • We offer coverage from the age of 5 years onwards with maximum entry age of 65 years. A dependent child can be covered from the 91st day (if either parent is covered under this policy).
  • You and/ or your his family members namely spouse, dependent children, dependent parents, parent-in-law, grandparents and grand children are eligible for buying this cover. (we offer a family discount of 5% if 2 family members are covered and family discount of 10% if 3 or more family members are covered under the same policy)
  • Maximum 6 members can be added in a single policy. In an individual policy, a maximum of 4 adults and a maximum of 5 children can be included in a single policy. The 4 adults can be a combination of Self, Spouse & either set of parents or grandparents or parents in Law.
  • Your premium at renewal may change due to a change in your age or changes in the applicable tax rate.
  • The policy period options include period of 1 or 2 years(s). (We offer 7.5% discount if you opt for a 2 year policy).
 Benefit
Plan Benefits
  • In-Patient Hospitalisation - The medical expenses for coverage for hospitalization of more than 24 hrs.
  • Pre-Hospitalisation - The medical expenses that you incur due to illness during the 60 days immediately before you are hospitalised.
  • Post-Hospitalisation - The medical expenses you incur in the 90 days immediately after you are discharged from hospital.
  • Day-Care Procedures - The medical expenses for all day-care procedures, which do not require 24 hours hospitalization due to technological advancement, are covered.
  • Domiciliary Treatment - The treatment expenses involved in getting a treatment done at home which otherwise would need hospitalization.
  • Organ Donor - Treatment expenses for the organ donor at the time of organ transplant.
  • Emergency Ambulance - Emergency Air Ambulance-Covers expenses for ambulance transportation in an airplane or helicopter for emergency life threatening health conditions.
  • Daily Cash for Choosing Shared Accommodation - A lump sum amount given for selecting a shared room in a network hospital.
  • Daily cash for accompanying an insured child (less than 12 years) - A lump sum amount paid if an adult accompanies an insured child during hospitalization.
  • New Born Baby - An option is given to the policy holder to cover a new born baby (from Age 1-90 days).
  • Maternity Expenses - Covers maternity expenses incurred both before and after child birth procedures.
  • Ayush Benefit - The Medical expenses for in-patient treatment taken under Ayurveda, Unani, Sidha and Homeopathy.
  • Recovery Benefit - Lump sum benefit of Rs. 10000, if hospitalisation is for greater than 10 days - (For sum insured 15 lacs & above)
  • Health Check-up - A comprehensive health check-up involving a number of medical tests only once at the end of a block of three continuous policy years.
  • Stay Active Benefit - In order to encourage Insured members to stay healthy, we will offer a discount at each renewal if the insured member achieves the average step count target on the mobile application provided by us in the specified time interval (calculated from the policy risk start date).
  • Additional Cover for Critical Illness (optional) - You can opt for an additional cover for Critical Illness which covers for cancer, coronary artery (bypass) surgery, first heart attack (myocardial infarction), kidney failure (end-stage renal disease), major organ transplantation, multiple sclerosis, paralysis and stroke. The sum insured for Critical Illness can be either 50% or 100% of your basic sum insured subject to minimum of Rs. 100,000 & maximum Rs. 10, 00,000.
  • Additional Cover for Critical Advantage Rider (optional) You can opt to cover yourself worldwide at our network centers against treatment expenses for 8 major illnesses that include Cancer, Coronary Artery by-pass surgery, Heart Valve replacement / repair, Neurosurgery, Live Donor Organ Transplant, Bone Marrow Transplant, Pulmonary artery graft surgery and Aorta Graft Surgery. The rider offers you freedom to not only avail best healthcare services world over but also covers all travel costs for the insured and accompanying relative, accommodation expenses, second opinion & post hospitalization expenses. This rider will be offered where base policy Sum Insured is Rs.10 lacs & above. This rider can be issued to an individual and/or family only on individual Sum Insured basis.
Others Benefits
  • Cumulative Bonus - You get a Cumulative Bonus (CB) of 10% for every claim-free year accumulating up to 100% (in the event of a claim, CB will be reduced by 10% of SI on the next renewal).
  • Cashless Service - You need to obtain a pre-authorization for all planned admissions atleast 48 hours prior to actual admission or regularize any emergency admission within 24 hours post the admission. The details of the process and the documentation requirements are given in the guide-book sent along with the policy.
  • Sum Insured Enhancement - Sum Insured can be enhanced only at the time of renewal subject to no claim have been lodged/ paid under the policy. If the insured increases the sum insured one grid up, no fresh medicals shall be required. In cases where the sum insured increase is more than one grid up, the case shall be subject to medicals. In case of increase in the Sum Insured waiting period will apply afresh in relation to the amount by which the sum insured has been enhanced. However, the quantum of increase shall be at the discretion of the company.
  • Portability - If you are insured with some other company’s health insurance and you want to shift to us on renewal, you can. Our portability policy is customer friendly and aims to achieve the transfer of most of the accrued benefits and makes due allowances for waiting periods etc.
  • Tax Benefits - With the Easy Health Individual Health Insurance plan you can presently avail tax benefits for the premium amount under Section 80D of the Income Tax Act. (Tax benefits are subject to changes in Tax Laws)
 
Stay Healthy Package
The “Stay Active” a program that not only encourages you to start moving and maintaining a healthy lifestyle but also rewards you with a premium discount at renewal. This is aided by additional benefits that include
  • Online health assessment
  • Customized diet & exercise plan from our experts
  • E- storage facilities to store your medical reports for 24X7 access
  • Great offers & discounts on heath products & services
  • Set alerts to track your health appointments and medicinal intake
  • Exclusive health newsletter & helpline services
And lots more…
The above benefits are offered for policies with sum insured greater than 5 lacs.
In addition, Health Line Services & Discounts at our listed partner’s network are provided in all sum insured – You just need to call us and quote your customer ID to reach our experts and avail their help in primary consultation, health-related counseling, individual referrals, health information, nutrition and diet.

 Renewal Policies
  • Our Easy Health policy offers lifelong renewability i.e there is no maximum cover ceasing age in this policy
  • Grace Period of 30 days for renewing the policy is provided under this policy.
  • Waiting periods as mentioned in the policy wording gets reduced by 1 year on every continuous renewal of your Easy Health Insurance policy.
  • Renewal premium are subject to change with prior approval from IRDA. Any change in benefits or premium (other than due to change in age) will be done with the approval of the IRDA and will be intimated atleast 3 months in advance.
 Exclusions
  • All treatments within the first 30 days of cover except any accidental injury
  • Any pre-existing condition will be covered after a waiting period of 3 years
  • 2 years waiting period for specific diseases like cataract, hernia, joint replacement surgeries, surgery of hydrocele etc.
  • Expenses arising from HIV or AIDS and related diseases
  • Congenital diseases, mental disorder or insanity, cosmetic surgery and weight control treatments
  • Abuse of intoxicant or hallucinogenic substances like intoxicating drugs and alcohol
  • Hospitalization due to war or an act of war or due to a nuclear, chemical or biological weapon and radiation of any kind
  • Pregnancy, dental treatment, external aids and appliances unless covered under the specific Easy Health Insurance Plan
 
 Easy Health - Our Premium Plan

Sum Insured starting from 4 Lakhs to 50 Lakhs+ Hospitalization + Pre-hospitalization + Post-hospitalization + All Day-care procedures + Domiciliary treatment + Daily Cash + Expenses for Organ Donor + Emergency Ambulance + Emergency Air Ambulance (for sum insured greater than 15 lacs)+Health Check-up + Maternity expenses + Coverage for New Born Baby + Daily cash for + Discounts at renewal with the “Stay Active” benefit accompanying an insured child + Critical Illness + Dental Treatment + Spectacles, contact lenses + E-opinion for critical illness + Recovery benefit + Critical Advantage Rider(for sum insured equal or greater than 10 lacs)

Our Easy Health Individual Plan protects you not only from unforeseen emergency expenses but also offers a comprehensive cover for medical treatment of illnesses and accidents requiring in-patient hospitalisation. The Plan offers coverage on individual sum insured basis & also offers an add-on optional cover for listed Critical Illnesses.

Our Premium Plan also covers maternity expenses, out-patient dental cover, recovery benefit and cost of spectacles & hearing aids & also let you avail health checkup benefit at every third renewal irrespective of claims.

 

NEW iCan Cancer Insurance - Covers Cancer Treatment Costs

iCan - Cancer Insurance Sum insured from 5-50 lakhs + Coverage for cancer treatment expenses + No medical examination + Conventional and Advanced treatments covered + Second opinion + Pre & post-hospitalisation coverage of 30 & 60 days + Emergency ambulance + Follow-up care post treatment

 

iCan - Features & Benefits

 

 NEW iCan Cancer Insurance for Women

 

Sum insured from 5-50 lakhs + Coverage for cancer treatment expenses + No medical examination + Conventional and Advanced treatments covered + Second opinion + Pre & post-hospitalisation coverage of 30 & 60 days + Emergency ambulance + Follow-up care post treatment

iCan - Features & Benefits

 

 Day2Day Care - Silver

Unlimited Consultations+ Pharmacy and Diagnostic expenses+ No waiting period+ Same premium over all ages+ Cashless Service+ No Pre Policy Checkup + Portability + Tax Benefits Today our changing lifestyle does not really allow us to always take proper care of our health and so we are becoming more and more dependent on frequent consultations and medicines. These medical expenses are not always from major illnesses, but it’s usually the small but frequent expenses on pharmacy, medical tests & doctor visits that add up & before you realize puts a dent in your savings. Apollo Munich brings you a unique plan that will help you manage exactly these daily medical expenses seamlessly.

 Eligibility

  • All persons in the age group of 91 days to 65 years. The minimum entry age for an adult is 18 years and maximum entry age is 65 years. The maximum entry age for a child is 25 years.
  • This policy can be issued to an individual and/or family. The family includes spouse, dependent children and dependent parents/parents-in law.
  • A maximum of 4 members can be covered in a single family floater policy with a maximum of 2 Adults and 3 children. The member combinations offered in a single family floater policy are: 1A+1C, 1A+2C, 1A+3C, 2A, 2A+1C and 2A+2C only. The 2 adults can be self & spouse. Dependent Parents/Parents-in-law will have to be covered in a separate policy.
  • A maximum of 6 members can be covered in a single individual policy on individual sum insured basis with a maximum of 4 adults and 5 children. The member combinations allowed in an individual policy are 1A, 1A+1C, 1A+2C, 1A+3C, 1A+4C, 1A+5C, 2A, 2A+1C, 2A+2C, 2A+3C, 2A+4C, 3A, 3A+1C, 3A+2C, 3A+3C, 4A, 4A+1C & 4A+2C only. The 4 adults can be a combination of Self, Spouse, either set of dependent parents/parents-in-law.

 

Benefit

Plan Benefits

 Outpatient Consultation (General & Specialist)- Unlimited for network & maximum up to 5 consultation after applying 20% co-pay in non-network.
Pharmacy & Diagnostics-This includes pathology, radiology, vaccination and physiotherapy(Up to Rs 5,000/year with 20% co pay for non-network).

Others Benefits

Portability - Any Insured Person in the policy has the option to migrate to similar indemnity health insurance policy available with us at the time of renewal subject to underwriting with all the accrued continuity benefits provided the policy has been maintained without a break as per portability guidelines issued by IRDAI. 

Tax Benefits - With the Day2Day Care Plan you can presently avail tax benefits for the premium amount under Section 80D of the Income Tax Act. (Tax benefits are subject to changes in Tax Laws).
Cashless Service - The plan offers 100% cashless redemption for outpatient expenses at our network providers.
No waiting period - The plans covers all inevitable outpatient expenses from day one.

 Renewal Policies

  • Our Day2Day Care policy offers lifelong renewability i.e there is no maximum cover ceasing age in this policy.
  • Grace Period of 30 days for renewing the policy is provided under this policy.
  • There is no waiting period in this policy.
  • Renewal premium are subject to change with prior approval from IRDA. Any change in benefits or premium (other than due to change in age) will be done with the approval of the IRDA and will be intimated atleast 3 months in advance.
 Exclusions
  • Any insured person committing or attempting to commit a breach of law with criminal intent, or intentional self-injury or attempted suicide while sane or insane.
  • Abuse or the consequences of the abuse of intoxicants or hallucinogenic substance such as intoxicating drugs and alcohol, including smoking cessation programs and the treatment of nicotine addiction or any other substance abuse treatment or services, or supplies.
  • Any inpatient treatment or daycare procedure.
  • Any naturopathy treatment.
 
Dengue Care Plan - Comprehensive & Exclusive Cover for Dengue Fever

Inpatient Treatment + Pre-hospitalization + Post-hospitalization + Shared Accommodation Benefit + Outpatient Benefits + Same Premiums Across All Age + No Pre Policy Check-up + Tax Benefits, Our first of a kind Dengue Care plan offers coverage for any medical expenses incurred on inpatient or outpatient treatment for dengue. You are not required to undergo any medicals at the time of taking the cover.

Eligibility

  • This policy covers persons in the age group 91 days to 65 years. The maximum entry age is restricted upto 65 years. The Minimum entry age for Adult is 18 years and maximum is 65 years. The minimum entry age for child is 91 days and the maximum is 25 years
  • No maximum cover ceasing age
  • An individual and/or his family members namely spouse, dependent children and parents are eligible for buying this cover.
  • This cover will be offered on individual Sum Insured basis only.
  • This is an annual policy.
  • The premium for the policy will remain the same for the policy period as mentioned in the policy schedule
  • A maximum of 6 members can be added in a single policy. A maximum of 4 adults and a maximum of 5 children can be included in a single policy.
 Plan Benefit

Inpatient Benefits

  • In-Patient Hospitalisation - Treatment arising from Dengue fever where Insured Person has to stay in a Hospital for more than 24 hours.
  • Pre-Hospitalisation - The medical expenses incurred due to illness during 15 days immediately before hospitalization.
  • Post-Hospitalisation - The medical expenses you incur in the 15 days immediately after you are discharged from hospital.
  • Shared Accommodation Benefit - If the Insured Person is Hospitalized in Shared Accommodation in a Network Hospital, exclusion for non payable items under Section III C v) of Policy wordings will be waived off.
Outpatient benefits

The following benefits are available to all Insured Persons during the Policy Period if NS1 (nonstructural protein 1) is positive in result. Any claims made under these benefits will be subject to Out-patient Sum Insured.

  • Outpatient Consultations - Outpatient consultation by a general Medical Practitioner for treatment of Dengue fever.
  • Diagnostic Tests - Outpatient diagnostic tests for Dengue fever taken by the Insured Person from a diagnostic centre
  • Pharmacy - Medicines purchased by the Insured Person from a pharmacy, provided that such medicines have been prescribed for treatment of Dengue Fever.
  • Home Nursing - We will also reimburse the Medical Expenses for necessary medical treatment taken by the Insured Person by our empanelled medical practitioner at home for treatment of Dengue fever.
Other Benefits

  • Cashless Service - You need to obtain a pre-authorization for all planned admissions atleast 48 hours prior to actual admission or regularize any emergency admission within 24 hours post the admission. The details of the process and the documentation requirements are given in the claim procedure document.
  • Tax Benefits - With the Dengue Care Plan you can presently avail tax benefits for the premium amount under Section 80D of the Income Tax Act. (Tax benefits are subject to changes in Tax Laws).
  • Renewal Terms - Dengue Care offers lifelong renewability i.e there is no maximum cover ceasing age in this policy. Grace Period of 30 days for renewing the policy is provided under this policy.
 
 Exclusions

  • Any Treatment other than for Dengue fever
  • Vitamins and tonics unless certified to be required by the attending Medical Practitioner as a direct consequence of an otherwise covered claim
  • Specified healthcare providers (Hospitals /Medical Practitioners)
  • Treatment rendered by a Medical Practitioner which is outside his discipline or the discipline for which he is licensed.
  • Any treatment or part of a treatment that is not of a reasonable charge, not Medically Necessary; drugs or treatments which are not supported by a prescription.
  • Charges related to a Hospital stay not expressly mentioned as being covered, including but not limited to charges for admission, discharge, administration, registration, documentation and filing.
  • Any non medical expenses mentioned in Annexure I of Policy wordings.
 
 
Optima Cash - Daily Hospital Cash Plan

Sickness Hospital Cash + Sickness ICU Cash + Accident Hospital Cash + Accident ICU Cash + Day-care Procedure Cash + Joint Hospitalization Cash (due to accident) + Convalescence Cash + Child Birth + Parent Accommodation  Optima Cash is our top up plan that provides coverage for daily cash benefit in case of hospitalisation due to illness or accidents. In addition, it also offers vast covers such as Day care procedures, convalescence benefit, parent’s hospitalization etc.

 Eligibility

  • We offer coverage from the age of 5 years onwards with maximum entry age of 65 years. A dependent child can be covered from the 91st day (if either parent is covered under this policy).
  • You and/ or your his family members namely spouse, dependent children (we offer a family discount of 10% if 2 or more family members are covered under the same policy)
  • Your premium at renewal may change due to a change in your age or changes in the applicable tax rate.
  • The policy period options include period of 1 or 2 years(s).
 Benefit

Plan Benefits
  • Sickness Hospital Cash -Daily cash amount paid for each continuous and completed period of 24 hrs , if the insured is hospitalised due to sickness.
  • Sickness ICU Cash - Twice the daily cash amount paid for each continuous and completed period of 24 hrs , if the insured is hospitalised due to sickness.
  • Accidental Hospital Cash - Daily cash amount is paid for each continuous and completed period of 24 hrs , if the insured is hospitalised due to accident.
  • Accident ICU Cash - Twice the daily cash amount for each continuous and completed period of 24 hrs , if the insured is hospitalised due to accident.
  • Day Care Procedure Cash - 50% of the Daily cash amount if the insured undergoes any of the 10 identified day care procedures which do not require 24 hours hospitalization due to technological advancements.
  • Joint Hospitalisation due to an Accident - Twice the daily cash amount for each continuous and completed period of 24 hrs , where two or more insured concurrently hospitalised due to accident.
  • Convalescence Cash - Lumpsum amount is paid if insured person is hospitalized beyond 7 continuous days.
  • Child Birth* - Lumpsum amount equivalent to twice the Sickness Daily Cash amount for maternity to female Insured in event of child birth.
  • Parent Accommodation - Daily Cash amount for parent’s accommodation if the Insured child is aged 12 years or less and is hospitalised for more than 72 hours.
*Additional Benefits covered under platinum plan

Other Benefits
  • Sum Insured Enhancement - Sum Insured can be enhanced only at the time of renewal subject to no claim have been lodged/ paid under the policy. If the insured increases the sum insured one grid up, no fresh medicals shall be required. In cases where the sum insured increase is more than one grid up, the case shall be subject to medicals. In case of increase in the sum insured waiting period will apply afresh in relation to the amount by which the sum insured has been enhanced. However, the quantum of increase shall be at the discretion of the company.
  • Cashless Service - You need to obtain a pre-authorization for all planned admissions atleast 48 hours prior to actual admission or regularize any emergency admission within 24 hours post the admission. The details of the process and the documentation requirements are given in the guide-book sent along with the policy.
  • Portability - If you are insured with some other company’s health insurance and you want to shift to us on renewal, you can. Our portability policy is customer friendly and aims to achieve the transfer of most of the accrued benefits and makes due allowances for waiting periods etc.
  • Tax Benefits - With Optima Cash Plan, you can presently avail tax benefits for the premium amount under Section 80D of the Income Tax Act. (Tax benefits are subject to changes in Tax Laws).
Health Line Services & Discounts

We provide Health Line Services & Discounts at our listed partners network – You just need to call us and quote your customer ID to reach our experts and avail their help in primary consultation, health-related counseling, individual referrals, health information, nutrition and diet.

 Renewal Policies
  • Optima Cash offers lifelong renewability i.e there is no maximum cover ceasing age in this policy.
  • Grace Period of 30 days for renewing the policy is provided under this policy.
  • Waiting periods as mentioned in the policy wordings gets reduced by 1 year on every continuous renewal of your Optima policy.
  • Renewal premium are subject to change with prior approval from IRDA. Any change in benefits or premium (other than due to change in age) will be done with the approval of the IRDA and will be intimated atleast 3 months in advance.
 Exclusions
  • All treatments within the first 30 days of cover except any accidental injury.
  • Any pre-existing condition will be covered after a waiting period of 4 years .
  • 2 years waiting period for specific diseases like cataract, hernia, joint replacement surgeries, surgery of hydrocele etc.
  • Expenses arising from HIV or AIDS and related diseases.
  • Congenital diseases, mental disorder or insanity, cosmetic surgery and weight control treatments.
  • Abuse of intoxicant or hallucinogenic substances like intoxicating drugs and alcohol .
  • Hospitalisation due to war or an act of war or due to a nuclear, chemical or biological weapon and radiation of any kind.
  • Pregnancy, dental treatment, external aids and appliances unless covered under the Plan.
  • Items of personal comfort and convenience.
  • Experimental, investigative and unproven treatment devices and pharmacological regimens.
 
 
 Optima Plus - A Top Up Plan

Inpatient Treatment + Pre-hospitalization + Post-hospitalization + Day-care Procedures + Domiciliary Treatment + Expenses for Organ Donor + Emergency Ambulance There is a big insurance hiding inside a small one!! Our top up- Optima Plus plan offers to cover you for higher hospitalization expenditures at nominal premium. It is the only plan in India that offers an option to convert to a fully fledged nil deductible health insurance plan on retirement.

 Eligibility

  • We offer coverage from the age of 5 years onwards with maximum entry age of 65 years. A dependent child can be covered from the 91st day (if either parent is covered under this policy).
  • You and/ or your family members namely spouse, dependent children, dependent parents are eligible for buying this cover (we offer a family discount of 10% if 2or more family members are covered under the same policy)
  • The policy offers coverage on individual sum insured basis only.
  • Maximum 6 members can be added in a single policy. In an individual policy, a maximum of 4 adults and a maximum of 5 children can be included in a single policy.
  • Your premium at renewal may change due to a change in your age or changes in the applicable tax rate.
  • The policy period options include period of 1 or 2 years(s). (We offer 7.5% discount if you opt for a 2 year policy)
 Benefit

Plan Benefits
  • In-Patient Hospitalisation -The medical expenses for coverage for hospitalization of more than 24 hrs with no room rent limits.
  • Pre-Hospitalisation - The medical expenses that you incur due to illness during 60 days immediately before you are hospitalized.
  • Post-Hospitalisation - The medical expenses you incur in the 90 days immediately after you are discharged from hospital.
  • Day-Care Procedures - The medical expenses for enlisted 140 day-care procedures, which do not require 24 hours hospitalization due to technological advancement, are covered.
  • Domiciliary Treatment - The treatment expenses involved in getting a treatment done at home which otherwise would need hospitalization.
  • Organ Donor - Treatment expenses for the organ donor at the time of organ transplant.
  • Emergency Ambulance - Expenses incurred if ambulance service is used on the way to hospital for hospitalization (up to Rs. 2000).
Other Benefits
  • Conversion to Nil Deductible Policy - The option to convert the plan to a fully fledged Indemnity Health Insurance plan at retirement is available only at renewal between 58-60 years provided you have enrolled with Us under this policy before the age of 50 years and have renewed with us continuously without a break.
  • Cashless Service -You need to obtain a pre-authorization for all planned admissions atleast 48 hours prior to actual admission or regularize any emergency admission within 24 hours post the admission. The details of the process and the documentation requirements are given in the guide-book sent along with the policy.
  • Portability - If you are insured with some other company’s health insurance and you want to shift to us on renewal, you can. Our portability policy is customer friendly and aims to achieve the transfer of most of the accrued benefits and makes due allowances for waiting periods etc.
  • Tax Benefits - With the Optima Plus Health Insurance Plan you can presently avail tax benefits for the premium amount under Section 80D of the Income Tax Act. (Tax benefits are subject to changes in Tax Laws)
Renewal Policies
  • Our Optima Plus policy offers lifelong renewability i.e there is no maximum cover ceasing age in this policy
  • Grace Period of 30 days for renewing the policy is provided under this policy.
  • Waiting periods as mentioned in the policy wording gets reduced by 1 year on every continuous renewal of your Optima Plus Insurance policy.
  • Renewal premium are subject to change with prior approval from IRDA. Any change in benefits or premium (other than due to change in age) will be done with the approval of the IRDA and will be intimated atleast 3 months in advance.
 Exclusions
  • All treatments within the first 30 days of cover except any accidental injury.
  • Any pre-existing condition will be covered after a waiting period of 4 years.
  • 2 years waiting period for specific diseases like cataract, hernia, joint replacement surgeries, surgery of hydrocele etc.
  • Expenses arising from HIV or AIDS and related diseases.
  • Congenital diseases, mental disorder or insanity, cosmetic surgery and weight control treatments.
  • Abuse of intoxicant or hallucinogenic substances like intoxicating drugs and alcohol.
  • Hospitalization due to war or an act of war or due to a nuclear, chemical or biological weapon and radiation of any kind.
  • Pregnancy, dental treatment, external aids and appliances.
  • Items of personal comfort and convenience.
  • Experimental, investigative and unproven treatment devices and pharmacological regimens.
 
 
 Maxima - Our Comprehensive Plan That Covers For The Little Illnesses Too

Doctor Consultations + Pharmacy Expenses + Diagnostics + Dental treatment + Spectacles, Contact lenses + Health Check-ups + Inpatient Treatment + Flexibility+ Tax benefits More often than not we visit hospitals for small health problems like sore throat, fever stomach ache etc than big ones, yet very few plan cover these small illnesses. Our Maxima plan offers unique out-patient benefits to take care of your regular illnesses and little niggles.

 Eligibility

  • This policy covers persons in the age group 91 days onwards. The maximum entry age is 65 years.
  • There is no maximum cover ceasing age in this policy.
  • The policy will be issued for a period of 1 year.
  • This policy can be issued to an individual and/or family. The family coverage in on floater basis and the coverage will be available for two members & two adults + upto 2 children.
  • The family includes spouse, dependent children and dependent parents.
  • The premium under floater coverage will be charged on the age of the eldest insured member
 Benefit

Outpatient Benefits

  • Doctor Consultation

    4/6/8 consultations as per plan opted for you and your family.
  • Pharmacy Expenses

    Your pharmacy bills are covered.
  • Diagnostics

    Cost of diagnostic tests taken by you or any of your covered family members is covered.
  • Specialist Services

    Coverage for specific dental treatments, spectacles & contact lenses upto a certain limit
  • Health Check-up Benefit

    Any person above the age of 18 years can undergo an annual health check-up (Person above 45 years can avail this benefit from second year)

Other Benefits

  • Renewal Benefits for Inpatient Treatment  Maxima offers a cumulative bonus of 10% for every claim free year accumulating to a maximum of 50% of your in-patient sum insured. In the event of a claim, the cumulative bonus is reduced by 10% on the next renewal.
  • Renewal Benefit for Out-Patient Treatment

    Maxima offers the advantage of carrying forward 50% of any unutilized entitlement certificates to the next policy year. This excludes the Annual Health Check-up.
  • Cashless Service

    You need to obtain a pre-authorization for all planned admissions atleast 48 hours prior to actual admission or regularize any emergency admission within 24 hours post the admission. The details of the process and the documentation requirements are given in the guide-book sent along with the policy.
  • Portability

    If you are insured with some other company’s health insurance and you want to shift to us on renewal, you can. Our portability policy is customer friendly and aims to achieve the transfer of most of the accrued benefits and makes due allowances for waiting periods etc.
  • Tax Benefits

    With our Maxima Plan you can presently avail tax benefits for the premium amount under Section 80D of the Income Tax Act.
 
 Stay Healthy Package

With increasing stress levels and work pressure, we help you take care of your wealth by managing your health! We bring to you our “Stay Healthy” Program that offers

  • Online health assessment.
  • Customized diet & exercise plan from our experts.
  • E- storage facilities to store your medical reports for 24X7 access.
  • Great offers & discounts on heath products & services.
  • Set alerts to track your health appointments and medicinal intake.
  • Exclusive health newsletter & helpline services.
And lots more…
In addition, Health Line Services & Discounts at our listed partners network are provided in all sum insured – You just need to call us and quote your customer ID to reach our experts and avail their help in primary consultation, health-related counseling, individual referrals, health information, nutrition and diet.

 Renewal Policies
  • Our Maxima policy offers lifelong renewability i.e there is no maximum cover ceasing age in this policy
  • Grace Period of 30 days for renewing the policy is provided under this policy.
  • Waiting periods as mentioned in the policy wording gets reduced by 1 year on every continuous renewal of your Maxima Insurance policy.
  • Renewal premium are subject to change with prior approval from IRDA. Any change in benefits or premium (other than due to change in age) will be done with the approval of the IRDA and will be intimated atleast 3 months in advance.
 Exclusions
  • All treatments within the first 30 days of cover except any accidental injury.
  • Any pre-existing condition will be covered after a waiting period of 3 years.
  • 2 years waiting period for specific diseases like cataract, hernia, joint replacement surgeries, surgery of hydrocele etc.
  • Expenses arising from HIV or AIDS and related diseases.
  • Congenital diseases, mental disorder or insanity, cosmetic surgery and weight control treatments.
  • Abuse of intoxicant or hallucinogenic substances like intoxicating drugs and alcohol.
  • Hospitalization due to war or an act of war or due to a nuclear, chemical or biological weapon and radiation of any kind.
  • Items of personal comfort and convenience.
  • Experimental, investigative and unproven treatment devices and pharmacological regimens
 
 Optima Super – Aggregate Top up Plan

Inpatient Treatment + Pre-hospitalization + Post-hospitalization + Day-care Procedures + Expenses for Organ Donor + Emergency Ambulance Our Top up Plan Optima Super is an aggregate plan that offers you varied sum insured & deductible combinations to choose so you can opt for the optimum coverage as per your needs. In addition, it is the only plan that gives you an option to convert to a Fully Nil Deductible plan near your retirement.

 Eligibility
  • We offer coverage from the age of 5 years onwards with maximum entry age of 65 years. A dependent child can be covered from the 91st day (if either parent is covered under this policy).
  • You and/ or your family members namely spouse, dependent children, dependent parents are eligible for buying this cover (we offer a family discount of 10% if 2 or more family members are covered under the same policy)
  • The policy covers on individual sum insured basis & maximum 6 members can be added in a single policy.
  • In an individual policy, a maximum of 4 adults and a maximum of 5 children can be included in a single policy. The 4 adults can be Self, Spouse, father & Mother. 
  • Your premium at renewal may change due to a change in your age or changes in the applicable tax rate.
  • The policy period options include period of 1 or 2 years(s). (We offer 7.5% discount if you opt for a 2 year policy)
 Benefit

Plan Benefits
  • In-Patient Hospitalisation - The medical expenses covered for hospitalization of more than 24 hrs.
  • Pre-Hospitalisation - The medical expenses that you incur on consultations, investigations and medicines during 60 days before you are hospitalized.
  • Post-Hospitalisation - The medical expenses you incur on consultations, investigations and medicines in 90 days immediately after you are discharged from hospital.
  • Day-Care Procedures - The medical expenses for 144 day-care procedures, which do not require 24 hours hospitalization due to technological advancement, are covered.
  • Organ Donor - Treatment expenses for the organ donor at the time of organ transplant.
  • Ambulance Service-  Expenses incurred if ambulance service is used on the way to hospital for hospitalization (up to Rs. 2000).
Other Benefits
  • Waiver of Deductible benefit - The option to convert the plan to a fully fledged Indemnity Health Insurance plan with no underwriting or medicals is available only at renewal between 55-60 years provided you have enrolled with Us under this policy before the age of 50 years and have renewed with us continuously without a break.
  • Cashless Service - You need to obtain a pre-authorization for all planned admissions atleast 48 hours prior to actual admission or regularize any emergency admission within 24 hours post the admission. The details of the process and the documentation requirements are given in the guide-book sent along with the policy.
  • Portability - If you are insured with some other company’s health insurance and you want to shift to us on renewal, you can. Our portability policy is customer friendly and aims to achieve the transfer of most of the accrued benefits and makes due allowances for waiting periods etc.
  • Tax Benefits - With the Optima Super Health Insurance Plan you can presently avail tax benefits for the premium amount under Section 80D of the Income Tax Act. (Tax benefits are subject to changes in Tax Laws).
 
 Value Added Services

We offer you a range of value-added services to promote your well- being, prevent illnesses as well as make hospitalization stress-free for you and your family.

  • Healthline - Just ring us and quote your customer ID to reach our experts and avail their help in primary consultation, health-related counseling, individual referrals, health information, nutrition and diet. The services on the Healthline would be available at no extra cost to the customers. They will be constantly augmented to cover further areas of health and wellbeing to include personalized health and wellness solutions.
  • Health Risk Assessment - Every Apollo Munich Health Insurance customer will be provided with an access to a health risk assessment tool, which helps to profile each member’s health status through our website. Upon assessment, members will be offered personalized wellness recommendations on diet, lifestyle and nutrition regimen.
 Renewal Benefits
  • Our Optima Super policy offers lifelong renewability i.e there is no maximum cover ceasing age in this policy
  • Grace Period of 30 days for renewing the policy is provided under this policy.
  • Waiting periods as mentioned in the policy wording gets reduced by 1 year on every continuous renewal of your Optima Super Insurance policy.
  • Renewal premium are subject to change with prior approval from IRDA. Any change in benefits or premium (other than due to change in age) will be done with the approval of the IRDA and will be intimated atleast 3 months in advance.
 Exclusions
  • All treatments within the first 30 days of cover except any accidental injury.
  • Any pre-existing condition will be covered after a waiting period of 4 years.
  • 2 years waiting period for specific diseases like cataract, hernia, joint replacement surgeries, surgery of hydrocele etc.
  • Expenses arising from HIV or AIDS and related diseases.
  • Congenital diseases, mental disorder or insanity, cosmetic surgery and weight control treatments.
  • Abuse of intoxicant or hallucinogenic substances like intoxicating drugs and alcohol.
  • Hospitalization due to war or an act of war or due to a nuclear, chemical or biological weapon and radiation of any kind.
  • Pregnancy, dental treatment, external aids and appliances.
  • Items of personal comfort and convenience.
  • Experimental, investigative and unproven treatment devices and pharmacological regimens.
 
Optima Vital- The critical Illness Plan

Sum Insured starting from 1Lac to 50 Lacs+ Lumpsum payment for 37 defined critical illness+ E-opinion for diagnosed critical illness Today we live in a fast paced and progressive world. Along with development our modern life is also accompanied with increasing stress, lack of diet or proper exercise. Owing to this we are now more vulnerable to non-communicable diseases; these critical illnesses are always associated with an increased cost of treatment along with a long and expensive recovery process. This financial burden needs to be supported by a special financial protection plan, Optima Vital is our unique Critical Illness insurance policy that protects you financially in the event of any of the listed critical illnesses occurring.

 Eligibility
  • We offer coverage from the age of 18 years onwards with maximum entry age of 65 years. A dependent child can be covered from 18 years upto 25 years provided both parents are covered in a critical illness plan of an Indian Insurer.
  • You and/ or your family members namely spouse, dependent children, dependent parents are eligible for buying this cover on individual sum insured basis.
  • Maximum 6 members can be added in a single policy. In an individual policy, a maximum of 4 adults and a maximum of 5 children can be included in a single policy.
  • Your premium at renewal may change due to a change in your age or changes in the applicable tax rate.
  • The policy period options include period of 1 or 2 years(s). (We offer 7.5% discount if you opt for a 2 year policy)
 Benefits

Plan Benefits
  • Optima Vital Insurance will pay you a lump sum amount for the identified critical illness, medical events or surgical procedures. This amount is payable on confirmed diagnosis with defined severity of the illness or the date of undergoing specified surgery in respect of that Critical Illness  and the insured surviving the defined survival period.
Other Benefits
  • E-opinion - On request of the Insured person diagnosed with a crticial illness, We will arrange for a second opinion from a medical practitioner selected by the insured person from Our panel. This benefit can be availed once in a policy year.
  • Portability - If you are insured with some other company’s health insurance and you want to shift to us on renewal, you can. Our Portability Policy is customer friendly and aims to achieve the transfer of most of the accrued benefits and makes due allowances for waiting periods etc.
  • Tax Benefit - With the Critical Illness Insurance Plan you can currently avail tax benefits for the premium amount under Section 80D of the Income Tax Act. (Tax benefits are subject to changes in Tax Laws).
  • Sum Insured Enhancement - Sum Insured can be enhanced only at the time of renewal subject to no claim have been lodged/ paid under the policy. If the insured increases the sum insured the case shall be subject to medicals. In case of increase in the sum insured waiting period will apply afresh in relation to the amount by which the sum insured has been enhanced. However, the quantum of increase shall be at the discretion of the company.
 Renewal Policies
  • Our Optima Vital policy offers lifelong renewability i.e there is no maximum cover ceasing age in this policy
  • Grace Period of 30 days for renewing the policy is provided under this policy.
  • Waiting periods as mentioned in the policy wording gets reduced by 1 year on every continuous renewal of your Optima Vital Insurance policy.
  • Renewal premium are subject to change with prior approval from IRDA. Any change in benefits or premium (other than due to change in age) will be done with the approval of the IRDA and will be intimated atleast 3 months in advance.
 Exclusions
  • All illnesses & treatments within the first 90 days of the cover
  • Any pre-existing condition will be covered after a waiting period of 48 months
  • Any critical illness in presence of HIV infection and / or any AIDS
  • Congenital internal and external diseases, defects or anomalies.
  • Abuse of intoxicant or hallucinogenic substances like intoxicating drugs and alcohol
  • War or an act of war or due to a nuclear, chemical or biological weapon and radiation of any kind
  • Any treatment arising from pregnancy (including voluntary termination), miscarriage, maternity or birth (including caesarean section)
 
Energy – The Sweetest Thing for people living with Diabetes

Sum Insured from 2- 50 lacs + Hospitalization+ Pre-hospitalization + Post-hospitalization+ 182 Day-care procedures + Restore Benefit + Cumulative Bonus + Expenses for HbA1c Checkup + Benefits on Shared Accommodation + Expenses for Organ Donor + Emergency Ambulance + No sublimit + lifelong renewal + No additional loadings at renewal due to claims +Personalized disease management portal + Wellness discount & Incentives + Doctors consultation Energy is our Wellness management program for individuals with Type 1 Diabetes, Type 2 Diabetes Mellitus, Impaired Fasting Glucose (IFG), Impaired Glucose Tolerance (IGT) and/or Hypertension. It is a unique plan that offers Day 1 coverage for all hospitalisation arising out of Diabetes and Hypertension (with no waiting period). The plan is a combined package providing coverage for Inpatient hospitalisation expenses along with an ecosystem of wellness program & health rewards that help you monitor your health. The plan offers coverage on individual sum insured basis.

Eligibility
  • We offer coverage from the age of 18 years to 65 years for individuals with Type 1 Diabetes, Type 2 Diabetes Mellitus, Impaired Fasting Glucose (IFG), Impaired Glucose Tolerance (IGT) and/or Hypertension.
  • Your premium at renewal may change due to a change in your age or changes in the applicable tax rate.
  • The policy will be issued for 1 year.
  • The plan has 2 variants – Gold (cost of wellness test included) & Silver (cost of wellness test excluded), both available with/ without the copayment option of 20%.
 Benefit

Plan Benefits

Comprehensive health coverage
  • Day 1 coverage for all hospitalisation arising out of Diabetes and Hypertension (with no waiting period)
  • Inpatient hospitalisation coverage with no sublimits, including coverage for pre and post hospitalisation.
  • Sum insured options ranging from 2 lacs to 50 lacs.
  • Restore benefit
  • Cumulative bonus on a claim free year at renewals.
Health management with a health reward program
  • An optional diagnostic monitoring program which includes a doctor consultation, to monitor and manage your health.
  • Wellness incentives are offered on good health management through premium discounts and additional coverage for any health expenses
Support through a Health Eco-System
  • A personalised health coach to help guide you throughout your journey towards a healthy & active lifestyle and also support you with personalised diet and fitness plans.
  • An access to a wellness portal that conducts an HRA, tracks your medical values, stores medical records, provides offers for health service and products.
  • Access to a centralised helpline to answer any queries you may have.
  • A health market place which offers you healthy discounts on health merchandise, pharmacies, health foods, medical equipment’s like glucometers etc.
Others Benefits
  • Cashless Service - You need to obtain a pre-authorization for all planned admissions atleast 48 hours prior to actual admission or regularize any ‘emergency’ admission within 24 hours post the admission. The details of the process and the documentation requirements are given in the guide-book sent along with the policy
  • Sum Insured Enhancement - Sum Insured can be enhanced only at the time of renewal subject to no claim have been lodged/ paid under the policy. If the insured increases the sum insured one grid up, no fresh medicals shall be required. In cases where the sum insured increase is more than one grid up, the case shall be subject to medicals. In case of increase in the sum insured waiting period will apply afresh in relation to the amount by which the sum insured has been enhanced. However, the quantum of increase shall be at the discretion of the company.
  • Portability - If you are insured with some other company’s health insurance and you want to shift to us on renewal, you can. Our portability policy is customer friendly and aims to achieve the transfer of most of the accrued benefits and makes due allowances for waiting periods etc.
  • Tax Benefits - With Energy Plan, you can presently avail tax benefits for the premium amount under Section 80D of the Income Tax Act. (Tax benefits are subject to changes in Tax Laws)
 Stay Healthy Package

With increasing stress levels and work pressure, we help you take care of your wealth by managing your health! We bring to you our “Stay Healthy” Program that offers
  • Online health assessment.
  • Customized diet & exercise plan from our experts.
  • E-storage facilities to store your medical reports for 24X7 access.
  • Set alerts to track your health appointments and medicinal intake.
  • Exclusive health newsletter & helpline services.
 Renewal Policies
  • Energy offers lifelong renewability i.e there is no maximum cover ceasing age in this policy.
  • Grace Period of 30 days for renewing the policy is provided under this policy.
  • Waiting periods as mentioned in the policy wordings gets reduced by 1 year on every continuous renewal of your Energy policy.
  • Renewal premium are subject to change with prior approval from IRDA. Any change in benefits or premium (other than due to change in age) will be done with the approval of the IRDA and will be intimated atleast 3 months in advance.
 Exclusions
  • Any pre-existing condition will be covered after a waiting period of 2 years. Any condition or illness, complication or ailment arising out of or connected to the condition of Type 1 Diabetes, Type 2 Diabetes Mellitus or Impaired Fasting Glucose (IFG) or Impaired Glucose Tolerance (IGT) or Hypertension is not a part of this waiting period.
  • 2 years waiting period for specific diseases like cataract, hernia, joint replacement surgeries, surgery of hydrocele etc.
  • Expenses arising from HIV or AIDS and related diseases.
  • Congenital diseases, mental disorder or insanity, cosmetic surgery and weight control treatments.
  • Abuse of intoxicant or hallucinogenic substances like intoxicating drugs and alcohol.
  • Hospitalization due to war or an act of war or due to a nuclear, chemical or biological weapon and radiation of any kind.
  • Pregnancy, dental treatment, external aids and appliances unless covered under the Plan.
  • Items of personal comfort and convenience.
  • Experimental, investigative and unproven treatment devices and pharmacological regimens.
  • Please refer to the Policy Wording for the complete list of exclusions.