Apollo Munich Optima Plus Plan

Entry Age

5 years- 65 years. A dependent child is covered from the 91st day that is 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 the policy renewal.
3. Renewal premium is subject to change with approval from IRDA. The 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 Plus Insurance 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

Rs.5,00,000 per person per policy year.

Discounts

If you opt for a 2 year policy, you get 7.5% discount.

Deductible

The amount that the insured needs to pay for his medical expenses before he can use the benefits from this policy can be either Rs.1 lakh, Rs.2 lakh, Rs.3 lakh, Rs.4 lakh or Rs.5 lakh.

Pre Policy Check-up

No pre policy check-up is required for a person up to 45 years of age.

Plan Benefits

1. In-patient hospitalisation covers medical expenses for hospitalisation of more than 24 hours with no room rent limits.
2. Pre-hospitalisation covers medical expenses that are incurred due to illness 60 days immediately before being hospitalised.
3. All the medical expenses 90 days immediately after being discharged is covered.
4. Medical expenses incurred for the 140 enlisted day care procedures are covered.
5. Domiciliary treatment that can be done at home are covered.
6. At the time of organ transplant, the organ donor's treatment expenses are covered.
7. Emergency ambulance services up to Rs.2000 is covered.

Other Benefits

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. On renewal, the policy holder can shift from other company's health insurance to Apollo Munich.
3. There is an option to convert the plan to a fully-fledged Health Insurance Plan at retirement. The option is available at the renewal between 58-60 years provided the insured had enrolled before the age of 50 years and has been renewing the policy without a break.

Tax Benefits

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

Exclusion

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 arising 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.
11. Expenses for artificial limb and external devices are excluded.
12. Expenses for non-allopathic treatment are excluded.