Easy Health Individual Standard Plan offers protection against unforeseen medical expenses. It is a comprehensive health insurance plan that covers the cost of medical treatment for certain diseases and in-patient hospitalization expenses including accidental cases. The sum insured is on an individual basis and there are various optional benefits for specific critical illnesses.
- Anyone between the age group of 5 years and 65 years can buy this plan. The coverage is extendible to a dependent child who is more than 91days old (if both the parents are covered under the same plan)
- The plan covers the insured and also the family members including the spouse, dependent parents, dependent children, grandparents, grandchildren, and parent-in-law are eligible to get coverage under this plan. There is a family discount ranging from 5 to 10 percent.
- The plan covers a maximum of 6 members under a single plan. 4 adults can be insured under the individual policy, a maximum of 5 children can be covered under a single plan. 4 adults can be a combination of Spouse, self and either set of grandparents, parents or parents in law.
- The renewal premium may vary as per your age or changes in the tax rate.
- You can buy a 1 year or 2-year plan. You will get a 7.5% discount on the purchase of a 2-year plan
Inclusions of HDFC ERGO Easy Health Individual Standard Plan (formerly known as Apollo Munich Easy Health Individual Standard Plan)
- In-Patient Hospitalization - Hospitalization expenses incurred on medical treatment requiring hospitalization more than 24 hrs.
- Pre-hospitalization - Expenses incurred on medical treatment before 60 days of hospitalization
- Post-hospitalization - Expenses incurred on medical treatment after 90 days of getting discharged from the hospital
- Organ Donor - Organ donor treatment expenses during organ transplantation
- Day-Care Procedures - Daycare medical procedures and surgeries that do not require 24 hours of hospitalization
- Emergency Ambulance - Cost of emergency ambulance services up to Rs.2000
- Domiciliary Treatment - The plan also covers the cost of medical treatment done at home where hospitalization is not possible
- Daily Cash Allowance for Shared Accommodation - The insurer pays a lump sum amount if a shared room is taken in a network hospital
- Health Check-up Facility - After 4 years of policy coverage the plan will cover comprehensive medical check-ups only once
- Ayush Benefit - The plan also covers in-patient treatment expenses incurred on Ayurveda, Unani, Homeopathy and Sidha treatment.
- Recovery Benefit - If hospitalization exceeds 10 days then there is a lump sum benefit of Rs. 10000 (the sum insured amount needs to be more than Rs. 15 lakh)
- Stay Active Benefit - With this feature, HDFC ERGO Health (formerly known as Apollo Munich) encourages insured members to maintain a healthy lifestyle. There are various other discounts at the time of renewal. For details, you can check the policy wordings.
Optional Covers Available in HDFC ERGO Easy Health Individual Standard (formerly known as Apollo Munich Easy Health Individual Standard)
Critical Illness Cover
The sum insured for Critical Illness ranges from 50% or 100% of the basic sum insured up to a maximum of Rs. 1 lakh. You can opt for an additional cover for Critical Illness which covers for
- First heart attack (myocardial infarction)
- coronary artery (bypass) surgery
- Kidney failure (end-stage renal disease)
- Major organ transplantation
- Multiple sclerosis
Critical Advantage Rider
This plan offers Critical Advantage Rider benefit for Sum Insured above Rs. 10 lakh. It is available to an individual or family but on individual Sum Insured basis. It allows worldwide coverage at the network hospitals for the listed 8 major illnesses:
- Heart Valve surgery
- Live Donor Organ Transplant
- Coronary Artery by-pass surgery
- Bone Marrow Transplant
- Pulmonary artery graft surgery
- Aorta Graft Surgery
It covers the cost of healthcare services worldwide and also the travel costs for the policyholder and accompanying relative. It also offers compensation for a second medical opinion, accommodation expenses, and post-hospitalization expenses.
Others Benefits of HDFC ERGO Easy Health Individual Standard Plan (formerly known as Apollo Munich Easy Health Individual Standard Plan)
- Cumulative Bonus - For every claim-free year you get a Cumulative Bonus (CB) of 10% which can be accumulated to 100% (CB will be reduced by 10% at the time renewal of the SI if a claim is made).
- Enhancement of Sum Insured - Sum Insured can only be enhanced at the time of renewal if no claim was filed during the policy period. (Subjected to terms and conditions)
- Cashless Treatment - For all the planned treatments the insured needs to obtain a pre-authorization at least 48 hours before the hospitalization. For emergency admission, the insured must regularize it within 24 hours of the hospitalization.
- Portability - You can switch to HDFC ERGO Health (formerly known as Apollo Munich) even if you have health insurance from some other insurance company. Most of the accrued benefits are also carried forward.
- Tax Benefits - The premium that you pay for Easy Health Individual Health Insurance Plan offers tax exemption benefits under Section 80D of the Income Tax Act.
Discounts Applicable in HDFC ERGO Easy Health Individual Standard Plan (formerly known as Apollo Munich Easy Health Individual Standard Plan)
The plan offers the following discounts to the insured/proposer:
- If 2 members are covered under the same plan then there is a 5% family discount under Easy Health Individual Health Insurance Plan
- If 3 or more members are covered under the same plan then there is a 10 % family discount.
- 5% Discount on purchase of a 2-year plan
Exclusions of HDFC ERGO Easy Health Individual Standard (formerly known as Apollo Munich Easy Health Individual Standard)
The insurance company will invalidate your claim under the following circumstances:
- Any illness that is diagnosed in the initial 30 days from the inception except for accidental injuries. Check policy wording for details.
- Claim made for any pre-existing diseases before completion of 3 years waiting period
- Congenital diseases
- Weight control treatments
- Specific ailments such as hernia, cataract, surgery of hydrocele, joint replacement surgeries, etc. which cannot be insured before two years
- Any illness, injury or hospitalization arising due to war conditions
- Cosmetic surgery
- Treatment for HIV and AIDS
- Mental disorder or insanity
- Overdose of intoxicating drugs and alcohol
- Perils related to war and war-conditions
- Expenses incurred on dental surgeries, pregnancy, external aids, and appliances unless specifically covered
Please refer to the Policy Wording for the complete list of exclusions.
Written By: PolicyBazaar - Updated: 21 January 2020