Apollo Munich Optima Cash Plan

Entry Age

5 years- 65 years. A dependent child is covered from the 91st day if one of the parent is covered under this policy.

Policy Period

1 or 2 years.

Renewability

1. Lifelong renewability.
2. 30 day grace period is provided for renewing the policy.
3. Renewal premium is subject to change with approval from IRDA, this change will be intimidated 3 months in advance to the policy holder.
4. Waiting period gets reduced by one year on the continuous renewal of Optima policy.

Basis

1. Individual and their family members are eligible for the cover. Family members include their spouse, dependent children, dependent parents, parents-in-law, grandparents and grandchildren.
2. A 10% family discount is applicable if 2 members of the family are covered.

Sum Insured

Daily Cash plan of Rs.1000, Rs.2000 and Rs.3000.

Plan Benefits

1. Sickness Hospital Cash covers the daily cash amount flow for up to 90 days per policy year.
2. Sickness ICU Cash is twice the daily cash given to the insured admitted in ICU for a maximum of 15 days per policy year.
3. Accident Hospital Cash covers daily cash if the insured is hospitalised due to an accident for up to 90 days per policy year.
4. Accident ICU Cash is twice the daily cash amount provided to the insured who is admitted in the ICU due to accident for a maximum of up to 15 days per policy year.
5. Day Care Procedure Cash covers 50% of the daily cash amount if the insurer is going through any of the 10 identified procedure that does not require the insured to be hospitalised. A maximum of up to 6 day care procedures are covered every policy year.
6. Joint Hospitalisation due to an accident covers twice the daily cash to the two or more insured persons who are simultaneously hospitalised due to an accident. Coverage is for a maximum of 10 days per policy year.
7. Convalescence Cash is a lump sum amount paid to the insured if he is hospitalised beyond 7 continuous days. This is covered once per policy year.
8. Child birth benefit is covered under platinum plan it provides a lump sum amount twice the amount of Sickness Daily Cash for maternity for female insured. It is payable twice during the life time.
9. Parent Accommodation is given in case the insured child who is aged 12 years or less is hospitalised for more than 72 hours. Coverage is for a maximum of 30 days per policy year.

Add-on Covers

1. Policy holder can obtain cashless service. They need get a pre-authorization for the planned admissions. It needs to be obtained 48 hours prior to the admission. Any emergency admission should be notified within 24 hours.
2. Sum insured can be enhanced at the time of renewal provided that there was no claim lodged and paid.
3. On renewal, the policy holder can shift from other company's health insurance to Apollo Munich.

Tax Benefits

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

Exclusions

1. Treatments within the first 30 days are not covered except accidental injury.
2. Pre-existing conditions will be covered after the 4 year waiting period.
3. There is a 2 year waiting period for cataract, hernia, joint replacement surgery, surgery of hydrocele etc. to be covered.
4. Expenses rising from AIDS and HIV related diseases are excluded.
5. Insanity, cosmetic surgery, congenital diseases and weight control treatments are not covered.
6. Abuse of drugs and alcohol and the expenses incurred from them are not covered.
7. The policy excludes coverage on hospitalization due to war or act of war.
8. Pregnancy, dental treatment, external aids and appliances are not covered unless specified in the policy.
9. Items of personal comfort and convenience is excluded from this policy.
10. Treatment through experimental and unproven treatment devices are not covered.