Apollo Munich Maxima Health Plan

Entry Age

91 days- 65 years.

Policy Period

Issued for a period of 1 year.

Renewability

1. Lifelong renewability.
2. Policy holder gets a grace period of 30 days for renewing the policy.
3. Renewal premium is subject to change with approval from IRDA. This change will be intimidated to the policy holder 3 month in advance.
4. Waiting period gets reduced by 1 year on every continuous renewal of the policy.
5. Renewal for optional benefit of critical illness is allowed till the age of 70 years.

Basis

1. You and your family members are eligible for the cover. Family members being spouse, dependent children and dependent parents.
2. The coverage is on a floater basis and two adults and 2 children's will be covered under this policy.
3. The premium is charges on the age of the eldest insured member.

Sum Insured

Rs.3 Lakhs per policy.

Plan Benefits

1. Medical expenses for hospitalization of more than 24 hours are covered.
2. Expenses incurred due to illness 30 days prior to hospitalization. It can be increased to 60days.
3. Medical expenses 60 days post the discharge. It can be increased to 90days.
4. 140 listed day care procedures which do not require the patient to be hospitalised are covered.
5. Domiciliary treatment that are done at home.
6. Treatment expenses for the organ donor at the time of the transplant.
7. Ambulance service coming up to Rs.2,000 that is used on the way to the hospital for hospitalization.
8. Daily cash is provided for the shared accommodation at the hospital. Maximum amount dispensed is Rs.3,000.
9. If the adult is accompanying the insured child during hospitalization, daily cash up to Rs.9,000 is paid.
10. Policy gives the policy holder an option to cover their new born baby from day 1 till the baby is 90 days old.
11. Both pre and post maternity expenses are covered.

Outpatient Benefits

1. As per the plan opted for you and your family, you get 4 or 6 or 8 Doctor Consultation.
2. Pharmacy bills are covered.
3. Diagnostic test taken by you or your family members are covered.
4. There is certain limit of coverage for dental treatments, spectacles and contact lenses.
5. Any person above 18 years of age can undergo annual health check-up. Policy holder above 45 years of age can avail this benefit from the second year only.

Cost Sharing

Not applicable for both outpatient and in-patient.

Add-on Covers

1. Critical illness such as cancer, first heart attack, kidney failure requiring daily dialysis, major organ or bone marrow transplant, paralysis of limbs etc. are covered on an optional basis. The benefit is applicable for the family members whose individual sum insured amounts to Rs.3,00,000.
2. Policy holder will get a 10% Cumulative Bonus for every claim-free year. 10% Cumulative Bonus will be reduced from the sum insured on the next renewal.
3. Policy holder can obtain cashless service. They need to get a pre-authorization for the planned admissions, they need to obtain it 48 hours prior to the admission. Any emergency admission can be notified within 24 hours.
4. On renewal the policy holder can shift from other to Apollo Munich.

Tax Benefits

Policy holder can avail tax benefits for the premium amount under the Section 80D of Income Tax Act.

Other Packages

1. Conduct online health assessment.
2. Policy holder can avail diet and exercise plan from experts.
3. Store your medical reports on an e-storage facility which is accessible for 24 hours.
4. Policy holder can enjoy discounts and offers on health products and services.
5. Help set alerts to track your medicinal intake and health appointments.
6. Subscribe to health newsletters and helpline services.

Exclusions

1. Except for accidental injury all the other treatments within the first 30 days are not covered.
2. Pre-existing conditions will be covered only after the 3 year waiting period.
3. There is a 2 year waiting period for cataract, hernia, joint replacement surgery, surgery of hydrocele etc.
4. Expenses rising from AIDS and HIV related diseases are excluded.
5. Mental disorder, cosmetic surgery, congenital diseases and weight control treatments are excluded.
6. Expenses from abuse of drugs and alcohol is excluded.
7. The policy excludes expenses occurred by hospitalization due to war or due to nuclear, chemical or biological weapon and radiation.
8. Experimental and use of unproven treatment devices for treating are not covered.
9. Items brought for personal comfort and convenience is not covered.