Apollo Munich Health Insurance Company Limited

Apollo Munich Health Insurance

Apollo Munich Health Insurance, a standalone health insurance company, is a joint venture of Apollo Hospitals Group and Munich Health, the world leader in insurance. Since its inception in the year 2007, the company has earned the reputation of providing innovative yet simple health insurance policies.

A trusted and preferred brand in health insurance in India, Apollo Munich works on the principle - ‘Let’s uncomplicate’ and offers a wide array of health insurance plans to choose according to a person’s requirements.

Broad Overview and Benefits of Choosing Apollo Munich

• A wide option of sum assured - One may choose a sum assured ranging from Rs. 1 lakh to Rs. 15 lakhs.
• Cover for pre and post hospitalization expenses, besides admission charges.
• Quick and efficient method of processing claims.
• Portability from any insurance policy to Apollo Munich without loss of benefits.
• Lifelong renewal.
• Income Tax benefits under section 80-D.
• No-claim bonus.
• Access to health and wellness portal.

Advertisement

Common Exclusions

The policy document must be read carefully to know the exact exclusions. However, some exclusions are common to all. They are:

• War or any act of war.
• Abuse of intoxicants or hallucinogenic products.
• Treatment of psychiatric illnesses.
• Expenses arising from treatment of HIV, AIDS or related diseases.
• Infertility treatment expenses.
• Treatment of obesity / weight management programs.

• Cosmetic or plastic surgery, except in cases of burns or accidents.
• All illnesses require a waiting period as specified in the policy to be covered under the policy.
• Pre-existing illnesses may also be covered but after an initial waiting period.

Besides health insurance, the company also offers Apollo Munich Travel Insurance plan and Personal Accident Plan, thereby catering to all types of medical emergencies and health uncertainties.

Apollo Munich has rightfully been honored with awards like ‘Health Insurance Company of the Year’, ‘Product Innovation Award’ and many similar titles. Its insurance plans have been ranked as the best in industry by publications like ‘The Economic Times’ and ‘The Hindustan Times’.

Individual Health Insurance Plans

The individual health insurance plans from Apollo Munich are the most awarded ones and are popular because of features like cashless hospitalization, restore benefit with no-claim bonus and no additional loadings at renewal due to claims.

Family Health Insurance Plans

The family floater, health insurance plans, provide the option of covering the entire family under one policy, with the choice to choose a sum assured over a range of Rs. 3 lakhs to Rs. 15 lakhs. The benefits of no-claim bonus and no additional loading at renewal are available in these plans too.

The various policies available under individual and family health insurance plans are:

Easy Health Policies

Easy Health Standard

• Complete hospitalization cover.
• Sum insured may range from 1-5 lakhs.
• Add-on optional cover for listed critical illnesses

Eligibility

• Coverage from the age of 5 years to 65 years.
• Available as individual as well as floater policy.
• Cover for self, spouse, dependent children, either set of parents or grandparents is available.
• Policy period can be 1-2 years (7.5% discount on 2-year policy).

Benefits

• Hospitalization Expenses - In cases of hospitalization for more than 24 hours.
• Pre-Hospitalization and Post-Hospitalization Charges for a period of 60 days before and 90 days after hospitalization respectively.
• Domiciliary Treatment - Treatment at home for a condition which would otherwise require hospitalization.
• Day-Care Procedures - 144 listed day care procedures are covered in the policy.
• Ambulance Expenses - Up to Rs. 2000 in the case of an emergency.
• Organ Donor - Treatment expenses for the organ donor in case of organ transplant.

• Ayush Benefit - Expenses incurred on treatment under Ayurveda, Siddha, Unani, and Homeopathy.
• Health Check-up - A comprehensive health check-up after 4 continuous claim free years.
• Critical Illness Cover - An additional cover for critical illnesses can be opted for. It covers illnesses like cancer, heart attack, kidney failure, organ transplant, multiple sclerosis, paralysis, and stroke. The sum insured can be 50% to 100% of the basic sum insured, subject to a minimum amount of Rs. 1,00,000.

Easy Health Exclusive

• Complete hospitalization cover.
• High sum insured option up to Rs. 50 lakhs.
• Maternity benefits covered.
• Optional cover for critical illnesses.

Eligibility

• Coverage from the age of 5 years to 65 years.
• Available as individual as well as floater policy.
• Cover for self, spouse, dependent children, either set of parents or grandparents is available.
• Policy period can be 1-2 years (7.5% discount on 2-year policy).

Benefits

• Hospitalization Expenses in cases of hospitalization for more than 24 hours.
• Pre-Hospitalization and Post-Hospitalization Charges for a period of 60 days before and 90 days after hospitalization respectively.
• Domiciliary Treatment - Treatment at home for a condition which would otherwise require hospitalization.
• Day-Care Procedures - 144 listed day care procedures are covered in the policy.
• Ambulance Expenses - Up to Rs.2000 in the case of an emergency.
• Organ Donor - Treatment expenses for the organ donor in case of organ transplant.
• Maternity Expenses - Incurred both before and after childbirth.
• Ayush Benefit - Expenses incurred on treatment under Ayurveda, Siddha, Unani, and Homeopathy.
• New-Born Baby Cover - Option to cover a new-born baby (1-90 days) under the policy.
• Recovery Benefit - A lump sum benefit of Rs. 10000 if the hospitalization exceeds 10 days (For sum insured above Rs. 15 lakhs).
• Daily Cash for Accompanying Minor Patient (<12 years) - A lump sum amount is paid if an adult accompanies a minor patient during hospitalization.
• Health Check-up - A comprehensive health check-up after 4 continuous claim free years.
• Critical Illness Cover - An additional cover for critical illnesses can be opted for. It covers illnesses like cancer, heart attack kidney failure, organ transplant, multiple sclerosis, paralysis, and stroke. The sum insured can be 50% to 100% of the basic sum insured, subject to a minimum amount of Rs. 1,00,000.

Advertisement

Easy Health Premium

• Complete hospitalization cover.
• High sum insured option up to Rs. 50 lakhs.
• Coverage for dental, optical and maternity benefits.
• Optional cover for critical illnesses.

Eligibility

• Coverage from the age of 5 years to 65 years.
• Available as individual as well as floater policy.
• Cover for self, spouse, dependent children, either set of parents or grandparents is available.
• Policy period can be 1-2 years (7.5% discount on 2-year policy).

Benefits

• Hospitalization Expenses - In cases of hospitalization for more than 24 hours.
• Pre-Hospitalization and Post-Hospitalization Charges - For a period of 60 days before and 90 days after hospitalization respectively.
• Domiciliary Treatment - Treatment at home for a condition which would otherwise require hospitalization.
• Day-Care Procedures - 144 listed day care procedures are covered in the policy.
• Ambulance Expenses - Up to Rs. 2000 in the case of an emergency.
• Organ Donor - Treatment expenses for the organ donor in case of organ transplant.
• Maternity Expenses - Incurred both before and after childbirth.
• Ayush Benefit - Expenses incurred on treatment under Ayurveda, Siddha, Unani, and Homeopathy.
• New-born Baby Cover - Option to cover a new-born baby (1-90 days) under the policy.
• Recovery Benefit - A lump sum benefit of Rs. 10000 if the hospitalization exceeds 10 days (For sum insured above Rs. 15 lakhs).
• Dental Treatment - Expenses on dental treatment in network hospitals.
• Contact lenses, Spectacles, Hearing aids - Cost of one pair of spectacles or contact lenses or a hearing aid.
• Daily Cash for Accompanying Minor Patient (<12 years) - A lump sum amount is paid if an adult accompanies a minor patient during hospitalization.
• Critical Illness Cover - An additional cover for critical illnesses can be opt. It covers diseases like cancer, heart attack, kidney failure, organ transplant, multiple sclerosis, paralysis, and stroke. The sum insured can be 50% to 100% of the basic sum insured, subject to a minimum amount of Rs. 1 lakh.
• Second Opinion in Critical Illness - The patient can avail e-opinion from another medical specialist on the empanelled list in case of a critical illness.
• Health Check-up - A comprehensive health check-up after 4 continuous claim free years.

Optima Plans

Optima Restore

This is a one-of-a-kind insurance plan offered by Apollo Munich with an automatic feature of reinstatement of the sum assured in case it is availed of in the policy year.

Eligibility

• Coverage from the age of 5 years to 65 years.
• Available as individual as well as floater policy.
• High sum insured option from Rs. 3 lakhs to Rs. 50 lakhs.
• Policy period can be 1-2 years (7.5% discount on 2-year policy).

Benefits

• Hospitalization Expenses in cases of hospitalization for more than 24 hours.
• Pre-Hospitalization and Post-Hospitalization Charges for a period of 60 days before and 180 days after hospitalization respectively.
• Domiciliary Treatment - Treatment at home for a condition which would otherwise require hospitalization.
• Day-care Procedures - 144 listed day care procedures are covered in the policy.
• Ambulance Expenses - Up to Rs. 2000 in the case of an emergency.
• Organ Donor - Treatment expenses for the organ donor in case of organ transplant.
• Recovery Benefit - A lump sum benefit of Rs. 10000 if the hospitalization exceeds 10 days (For sum insured above Rs. 15 lakhs).
• Restore Benefit - Automatic reinstatement of the sum assured in case the entire amount is exhausted in a policy year. This can be availed of only once in a policy year.
• E-opinion - The second opinion of another medical specialist may be sought for an illness, once a year.
• Multiplier Benefit - Bonus of 50% of the sum insured for every claim-free year up to 100%.

Optima Plus

This is again a unique plan which covers higher hospitalization expenditure at a nominal premium. It is the only plan in India which offers an option to convert to a fully-fledged nil deductible health insurance plan on retirement.

Eligibility

• Coverage from the age of 5 years to 65 years.
• The policy covers on individual sum insured basis.
• Policy period can be 1-2 years (7.5% discount on 2-year policy).

Benefits

• Hospitalization Expenses in cases of hospitalization for more than 24 hours.
• Pre-Hospitalization and Post-Hospitalization charges for a period of 60 days before and 90 days after hospitalization respectively.
• Domiciliary Treatment - Treatment at home for a condition which would otherwise require hospitalization.
• Day-care Procedures - 140 listed day care procedures are covered in the policy.
• Ambulance Expenses - Up to Rs. 2000 in the case of an emergency.
• Organ Donor - Treatment expenses for the organ donor in case of organ transplant.
• Conversion to Nil Deductible Policy - There is an option to convert the policy into a fully-fledged health insurance plan at the time of retirement (58-60 years), provided the policyholder enrolled before the age of 50 years and the policy was renewed without a break.

Optima Super

It is a plan to supplement an existing plan with low sum insured and has the option of waiver of the deductible to enjoy full coverage when one chooses.

Eligibility

• Coverage from the age of 5 years to 65 years.
• The policy covers on individual and floater sum assured basis.
• Policy period can be 1-2 years (7.5% discount on 2-year policy).

Benefits

• Hospitalization Expenses in cases of hospitalization for more than 24 hours.
• Pre-Hospitalization and Post-Hospitalization Charges for a period of 60 days before and 90 days after hospitalization respectively.
• Day-care Procedures - 144 listed day care procedures are covered in the policy.
• Organ Donor - Treatment expenses for the organ donor in case of organ transplant.
• Waiver of Deductible Benefit - There is an option to convert the plan to a fully-fledged health insurance plan without underwriting or medical examination if the policy was initiated before 50 years of age and has been renewed without a break.
• Ambulance Expenses - Up to Rs. 2000 in the case of an emergency.

Optima Vital

It is a critical illness policy which covers treatment expenses owing to 37 critical illnesses.

Eligibility

• Coverage from 18 years to maximum entry age of 65 years.
• The policy is available on individual sum insured basis.
• Policy period can be 1-2 years (7.5% discount on 2-year policy).

Benefits

• Payment of lump sum amounts for identified and listed critical illnesses, medical conditions, and surgeries. It is payable after a confirmed diagnosis and defined severity of the critical illness and the insured surviving the said survival period.
• E-opinion - The second opinion of another empanelled medical specialist may be sought.

Optima Cash

It is a top-up plan which provides coverage of daily cash benefits in case of hospitalization.

Eligibility

• Coverage from the age of 5 years to 65 years.
• Policy period may be 1-2 years.

Benefits

• Sickness Hospital Cash - Daily cash amount, paid for each completed and continuous 24 hours of hospitalization due to sickness.
• Sickness ICU Cash - Twice the daily cash amount, paid for each completed and continuous 24 hours of hospitalization in ICU, due to sickness.
• Accident ICU Cash - Twice the daily cash amount, paid for each completed and continuous 24 hours of hospitalization in ICU, due to an accident.
• Day-care Procedure Cash - 50% of the daily cash amount, in the case of any of the 10 listed day care procedures.
• Joint Hospitalization due to an Accident - Twice the daily cash amount, paid for each completed and continuous 24 hours, where two or more insured are hospitalized together, due to an accident.
• Convalescence Cash - Lump sum amount is paid, if a person is hospitalized for more than 7 continuous days.
• Childbirth Cash - Lump sum cash, twice the daily sickness cash, as maternity benefit.

• Parent Accommodation - Daily cash amount for parent’s accommodation, where a patient less than 12 years of age is hospitalized for more than 72 hours.

Optima Senior

This is a plan meant exclusively for senior citizens.

Eligibility

• Coverage of age from 61 years and above.
• Self and spouse can be covered under individual sum insured basis.
• Policy period can be 1-2 years (7.5% discount on 2-year policy).

Benefits

• Hospitalization Expenses in cases of hospitalization for more than 24 hours.
• Pre-Hospitalization and Post-Hospitalization Charges for a period of 30 days before and 60 days after hospitalization respectively.
• Domiciliary Treatment - Treatment at home for a condition which would otherwise require hospitalization.
• Day-care Procedures - 144 listed day care procedures are covered in the policy.
• Ambulance Expenses - Up to Rs.2000 in the case of an emergency.
• Organ Donor - Treatment expenses for the organ donor in case of organ transplant.
• E-opinion - The second opinion from empanelled medical specialist may be sought in case of a critical illness.
• Cumulative Bonus of 5% for every claim-free year.

Disease Specific Plans

Apollo health insurance also offers plans which are specifically meant to provide cover for particular diseases.

Dengue Care

This is another unique product of Apollo Munich, which covers outpatient as well as inpatient treatment of Dengue.

Eligibility

• Coverage of age from 91 days to 65 years.
• Children - 91 days to 25 years.
• Adults - 18 years to 65 years.
• The policy is available on individual sum insured basis only.
• It is available for a term of one year.

Benefits

• Hospitalization Expenses in the case of hospitalization for more than 24 hours.
• Pre-Hospitalization and Post-Hospitalization Expenses for a period of 15 days before and after hospitalization respectively.
• Shared Accommodation Benefit - If the patient shares accommodation with another, the exclusion for non-payable items is waived off.
• Out-patient Consultations - Expenses are covered for Outpatients Department (OPD) visits in case of Dengue treatment.
• Investigations - Outpatient diagnostic tests are also covered.
• Pharmacy - Expenses on medications purchased on out-patient basis are covered.
• Home Nursing - In such cases, the expenses of an empanelled medical specialist are covered.

Energy

This plan is specifically for patients with type-2 Diabetes Mellitus.

Eligibility

• Coverage of age from 18 years to 65 years for individuals with type-2 Diabetes Mellitus, Impaired Glucose Tolerance, Impaired Fasting Glucose and/or Hypertension.

• It is an annual policy.
• It is available as an individual policy.
• It has two variants: Gold (cost of wellness tests included) and Silver (cost of wellness tests excluded).

Benefits

• Coverage of day 1 of hospitalization due to type-2 Diabetes and Hypertension.
• Sum insured - Rs.2 lakhs to Rs. 10 lakhs.
• Health monitoring and health reward program.
• A personalized health coach to guide and motivate towards diabetes control and fitness.

Maxima

This plan provides cover for out-patient expenses due to small illnesses.

Eligibility

• Coverage for age from 91 days to 65 years.
• It is available both as an individual and family floater policy.
• It is an annual policy.

Benefits

• Doctor Consultations - 4 or 6 or 8 OPD visits, as per opted plan.
• Pharmacy Expenses - The cost of medicines is covered.
• Diagnostic Tests - Expenses on diagnostic tests performed on OPD basis.
• Health check-up Benefit - Any person above 18 years of age can get an annual health check-up.
• Specialist Services - Cost of spectacles, contact lenses and hearing aids is covered up to a limit.

Inpatient benefits

• Hospitalization Expenses in cases of hospitalization for more than 24 hours.
• Pre-Hospitalization and Post-Hospitalization Charges for a period of 30 days before and 60 days after hospitalization respectively.
• Domiciliary Treatment - Treatment at home for a condition which would otherwise require hospitalization.
• Day-care Procedures - 140 listed day care procedures are covered in the policy.
• Ambulance Expenses - Up to Rs.2000 in the case of an emergency.
• Organ Donor - Treatment expenses for the organ donor in case of organ transplant.
• Maternity Expenses - Incurred both before and after childbirth.
• Ayush Benefit - Expenses incurred on treatment under Ayurveda, Siddha, Unani, and Homeopathy.

• New-born Baby Cover - Option to cover a new-born baby (1-90 days) under the policy.
• Critical Illness Cover - An additional cover for critical illnesses can be opt. It covers diseases like cancer, heart attack, kidney failure, organ transplant, multiple sclerosis, paralysis, and stroke. The benefit is applicable to all family members on individual sum insured basis equivalent to Rs. 3 lakhs.

Other Types Of Insurance

Apollo Munich not only provides a varied choice of health insurance products, but also offers travel insurance and personal accident insurance.

Travel Insurance

• Easy Travel - with plans for individual, family, senior citizens or multi-trips. The plans cater to medical and health emergencies while traveling.
• Educare - The plan covers medical expenses when an individual goes abroad for educational purposes.

Accident Insurance

The accident insurance plans provide financial stability to the family in the event of an accident along with covering the expenses incurred due to hospitalization on account of an accident. Apollo Munich offers two types of plans:

• Standard Plan - with an option of sum insured from Rs. 1 lakh to Rs. 50 lakhs.
• Premium Plan - with a higher range of sum insured from Rs. 5 lakhs to Rs. 5 crores.