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HDFC ERGO Health Wallet Plan

HDFC ERGO Health Wallet (formerly known as Apollo Munich Health Wallet) is first of its kind health plan offered by the insurer, which comes with unique features and benefits. The Reserve Benefit under this plan can be utilised in paying of the additional expenses to be incurred during OPD or any non-payable items. You can also pay up to 50% of your health insurance renewal premiums using this benefit. Let’s know a little more about this policy and how does it function.

Key Features of HDFC ERGO Health Wallet Plan (formerly known as Apollo Munich Health Wallet Plan)

The salient features HDFC ERGO Health Wallet plan (formerly known as Apollo Munich Health Wallet plan) that make the policy worth buying are:

  • The reserve benefit under this policy keeps increasing every passing year
  • 6% of the bonus is offered for non-utilization of balance under this policy
  • This policy can be converted to a full-fledged policy without much hassle
  • The policy comes with restore benefit where the basic sum insured gets restored automatically in case it’s exhausted.
  • The multiplier benefit of this plan enables you to earn rewards for not claiming the insurance.
  • Experience fast and smooth claim settlement
  • Cashless claim services at 5000+ network hospitals across India
  • 100% lifelong renewability
  • Tax benefit to be availed under Section 80D of Income Tax Act.

Key Benefits under HDFC ERGO Health Wallet (formerly known as Apollo Munich Health Wallet)

There are four main benefits apart from the basic coverage offered under HDFC ERGO Health Wallet (formerly known as Apollo Munich Health Wallet) policy. These are:

  • Reserve Benefit - This benefit keeps increasing every policy year if not utilised and can be used to cushion the impact of spiralling medical costs even in the retirement age. A 6& bonus is offered for not claiming the policy, which can be further utilised to pay the premiums up to 50%, post 5 claim-free renewals.
  • Restore Benefit - With this benefit, the basic sum insured of the policy is restored by 100% in case you claim the policy or even exhaust it partially. Let’s say if you have Rs. 5 lakh cover and you claim Rs. 2 lakh. In this case, you SI would be restored up to Rs. 5 lakh. Now you’ll have Rs. 5 lakh (basic cover) minus Rs. 2 lakh(claimed amount) i. e Rs 3 lakh (remaining cover) +Rs 5 lakh (restored cover)= Rs. 8 lakh.
  • Multiplier Benefit - This policy comes with an amazing benefit in which sum insured increases for every claim-free year. The basic sum insured gets increased up to 50% at the time of renewal. So, if you don’t claim your policy even in the second year, the policy sum insured gets doubled.
  • Recovery Benefit - Under this benefit a lump sum of Rs. 10,000 is offered in case of accidental hospitalisation and is the duration of stay exceeds 10 days.
  • Deductible Benefit (optional) - Usually deductible is shared by the insured person, anything beyond that is covered by the insurance company. If this cover has opted, the deductible will be applied to all insured person(s).

Eligibility Criteria

Minimum entry age

Children: 91 days to 5 years

Adult 18 years

Maximum entry age

65 years

Policy ceasing age

No

Policy Tenure

1 year

Member covered

6 members

 

Waiting Period Clause

  • All claims related to illnesses will be entertained after a waiting period of 30 days
  • Pre-existing health conditions will be entertained only after a waiting period of 36 months
  • Specific illnesses such as Cataract, Hernia, specific surgeries are to be covered after 2-years waiting period.

Scope of Cover under HDFC ERGO Health Wallet Policy (formerly known as Apollo Munich Health Wallet Policy)

  • In-Patient Hospitalisation - Hospitalisation expenses including room rent, nursing expenses, ICU cost, OT cost, doctor’s consultation, medicine, oxygen, X-ray, laboratory etc.
  • Pre-Hospitalisation - Expenses of treating an illness 60 days prior to the hospitalisation.
  • Post-Hospitalisation - The medical expenses incurred in 90 days immediately after discharge from the hospital.
  • Day-Care Procedures - Selected day-care procedures that don’t require 24 hours hospitalisation due to the advancement in medical science and technology.
  • Organ Donor - Treatment expenses for the organ donor at the time of organ transplant
  • Domiciliary Treatment - The treatment expenses incurred in availing treatment at home due to the health condition of the patient
  • Emergency Ambulance - Up toRs. 2000 is paid towards ambulance service availed in transporting the insured to hospital.
  • Ayush Benefit - Expenses for non-allopathic treatment taken under Ayurveda, Unani, Sidha and Homeopathy.
  • Worldwide Emergency Care - Covers emergency hospitalisation expenses outside the country up to a specified limit.
  • Health Check-up - Preventive health check-ups expense cover
  • Critical Illness Rider - It is a rider cover where 8 major critical illnesses are covered including Cancer, Live Donor Organ, Neurosurgery, Coronary Artery by-pass surgery, Heart Valve replacement, Pulmonary artery graft surgery, Bone Marrow Transplant, and Aorta Graft Surgery. You can avail coverage at network hospitals worldwide. Apart from availing quality health care, the coverage is extended to accommodation, cost of accompanying a relative, availing the second opinion and post hospitalisation expenses. This cover can be availed with a basic sum insured Rs. 10 or above.

Additional Benefits

The added benefits to be earned are:

  • Waiver of Deductible benefit - The policy can be converted to a full-fledged health insurance plan with no medical test, between the age 55 to 60 years. The only condition is that the insured has to be enrolled with the insurance company before the age of 50 years. Also, the policy has been renewed continuously throughout.
  • Cashless Service - Cashless services can be availed at more than 55000 hospitals across the country. A pre-authorisation from the insurer is required to avail cashless service. In case of planned hospitalisation, the process has to be initiated 48 hours before the hospitalisation by informing the insurer. In case of emergency, the insurer has to be notified within 24 hours post hospitalisation.
  • Sum Insured Enhancement - Policy sum insured can be enhanced if you feel it insufficient as per your growing requirements with time. This can be possible only at the time of renewal. No medical is required if the enhancement is up to one grid. But if it is more than one grid up, a fresh medical will be required. Also, depending on the increased sum insured amount, a fresh waiting period will be applied.
  • Portability - Under portability benefit, you can switch your existing policy to HDFC ERGO Health (formerly known as Apollo Munich). And this is possible without compromising on the accrued benefits with the existing insurer.
  • Tax Benefits - With the Health Wallet Insurance Plan you can avail tax benefits under Section 80D of Income Tax Act.

Exclusions of HDFC ERGO Health Wallet Policy (formerly known as Apollo Munich Health Wallet Policy)

The policy doesn’t cover the insured person during the below circumstances:

  • No claims are accepted arising from pre-existing illness before 3 years
  • Expenses incurred due to treating HIV/AIDS or other related illnesses
  • Mental disorder, congenital disease, expenses of cosmetic surgery, weight loss program etc. are excluded
  • Injury due to the abuse of drugs, alcohol or intoxicant
  • Injury leading to hospitalisation due to war or war-like situation, an act of a foreign enemy, use of the nuclear weapon
  • Pregnancy, dental treatment, external aids, and appliances
  • Items that are used for personal comfort and convenience
  • Experimental, investigative and unproven treatment devices

HDFC ERGO Health Wallet Claim Process (formerly known as Apollo Munich Health Wallet Claim)

Claiming HDFC ERGO Health (formerly known as Apollo Munich) is easy. If you want to claim cashless service at a network hospital, the following steps need to be ensured:

  • Avail a pre-authorisation letter from the TPA at the hospital. Sign the filled-in form and submit it along with an ID proof
  • The same will be submitted to the insurer for approval of cashless service.
  • If the insurer approves it the same will be coordinated to the hospital authority. If not, the insurer will notify the reason of rejection within a few hours.
  • On approval, you can avail cashless treatment, where the incurred bill will be settled by the insurer directly with the hospital authority.
  • In case your cashless request is rejected then pay the expenses initially and register a claim later.
  • Collect all the original bills, report and submit along with the filled-in claim form. The insurer will reimburse the amount after verifying the documents.

HDFC ERGO Health Wallet Renewal Process (formerly known as Apollo Munich Health Wallet Renewal)

Health wallet policy comes with lifelong renewal feature which means there is no maximum cover ceasing age. However, the policy requires timely renewal. The insurer provides 30 days grace period, in case you miss the renewal due date.

The applicable waiting period gets reduced by 1 year with every continuous renewal of HDFC ERGO Health Wallet plan (formerly known as Apollo Munich Health Health Wallet plan). Renewal premiums are subject to change as per the prior notice of IRDA. However, the insured has to be informed at least 3 months prior to any change to be made.

Written By: PolicyBazaar - Updated: 23 March 2020
Average Rating
(Based on 29 Reviews)
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HDFC ERGO Health Wallet Plan Reviews & Ratings
4.6 / 5 (Based on 29 Reviews)
(Showing Newest 15 reviews)
Pramod
Lohara, October 20, 2016
Great Service
Apollo munich general insurance company is well known insurers. I have took health insurance plan from them which is really very nice and the services are the best which is given by the executives of the company.
Manoj
Deodar, October 05, 2016
In Budget With Big Benefits Plans
Really good health insurance, it comes in low budget and premium is also less. Service provided by apollo munich insurance company is quick and they work 24X7. Large number of hospitals provided great service which facilitates the ambulance services also for free.
Bharat
Muktsar, October 03, 2016
Have A Good Health Policy
Really have a very good one insurance policy from apollo munich general insurance company ltd. The policy covers maximum expenditure and the claims are easy to get due to fast service provided by the executives. Renewals are easy and updates are mailed regularly to my email address.
Tamanna
Panaji, September 28, 2016
Apollo Health Insurance
Apollo munich general insurance is the biggest platform for buy an amazing insurance policies. I took health insurance policy at very low price. Service given by you guys is superb at all the time. Policy coverage and claims are easy to get and the percentage is also high of the benefits.
Jyotsna
Hamirpur, August 30, 2016
"Good"
The apollo munich health insurance game the best service and it's terms and conditions are very flexible. Policy coverage is high approx. 90% and the claiming process is very easy because the executives and staff members facilitated good service.
Abhishek
Kutch_(bhuj), August 26, 2016
Health is Wealth
My apollo munich health insurance policy is fantastic which give me many benefits. Policy premium is less and claims are high. This cover's maximum expenditures and the ambulance is provided for free of cost. Large number of hospitals makes easy and fast treatment.
Gaurav
Kherwara, August 23, 2016
Health Insurance
Finally got health insurance plan of my choice from apollo munich general insurance. The policy coverage is high and claiming is become more easy because of quick services given by the company executives and staff members.
Yamanpreet
Ahmedabad, May 24, 2016
Fantastic Policy
I purchase apollo munich health insurance plan. The policy coverage is high and premium is low. The claims are even better and easily sanctioned because of fast service facilitate by the executives and staff members. Ambulance is given for free of any charges. Good investment, I like the policy.
MUKESH
Mumbai, March 03, 2016
Claim rejection ratio very high
I request you to all customers, dont take this health insurance policy from Apollo Munich. They are always declined / reject your Claim in any case of reason. I was hospitalized more than 24hr in hospital because of bike accident, no reason to admit.
Raj
Delhi, February 25, 2016
Good Insurance Policy.
Apollo munich general insurance provides me great services in less installments. Coverage is huge ~95% and big number of hospitals are working with them. Claims are very easy to get due to there services. Great work guys.
Plan Name: OptimaRESTORE
Agent Code: BPW01119
Mr
Sonipat, February 25, 2016
Nice Policy Plan.
My frnd suggested me apollo munich health insurance plan and i took it without taking any time because the benefits are really very good. Claims,Policy coverage are high with low investments. Service is also quick.
Plan Name: Easy Health Individual Standard
Agent Code: BPW01119
Charu
Gurgaon, February 25, 2016
Average Policy Plan.
An average health insurance policy i have which is given by apollo munich general insurance. The service is bit slow with waiting in queue. Claims are normal with normal payback returns. Premiums are Rs.3999 thricely in a year.
Plan Name: OptimaRESTORE
Agent Code: BPW01119
Mr
Delhi, February 25, 2016
Awesome.
I own apollo munich health insurance. Policy coverage is high with low in premiums. Coverage is Rs.3 lakhs. Service is fast and even hospital send ambulance without taking any money. Good work whole team.
Plan Name: Easy Health Floater Exclusive
Agent Code: BPW01119
Harish
Bengaluru, February 25, 2016
Fantastic plan
My health insurance save my big bills last month which i took from apollo munich general insurance. All the bills and treatment is covered in the policy and even ambulance is for free of any charges. I really am happy.
Plan Name: OptimaRESTORE
Agent Code: BPW01119
Mr
Gurgaon, February 24, 2016
Nice Health Policy.
I own apollo munich health insurance policy plan which has low premiums and returns are high. Policy coverage is 80% and claims are Rs.3.2 lakhs. Ambulance is also there for free assistance. Nice policy.
Plan Name: OptimaRESTORE
Agent Code: BPW01119
Anil
Delhi, February 18, 2016
Average Policy.
My health policy plan has low premiums. The policy coverage is 80-90%. The claims are around Rs.2.7 lakh. Apollo munich general insurance has awesome services with on time facilities. Keep it up guys, i'm happy.
Plan Name: Easy Health Floater Standard
Agent Code: BPW01853
Mrs
Ghaziabad, February 18, 2016
Perfect Policy Plan.
I purchase policy plan of apollo munich general health insurance. The policy coverage is high with low premiums and claim is Rs.3 lakh. Ambulance is provided without taking any charges. Service is fast and number of hospitals are providing facilities.
Plan Name: OptimaRESTORE
Agent Code: BPW00177
Nikhil
Gurgaon, February 15, 2016
Nice Health Insurance.
My apollo munich health insurance plan is really very nice with great benefits. Premium is low with high policy coverage and claim is of fifty nine thousand. Ambulance is also provided without taking any charge.
Plan Name: OptimaRESTORE
Agent Code: BPW00750
SHYAM
Hyderabad, February 14, 2016
Health Care.
I have health insurance form last two years with apollo. Plan is good and service is super. Regular updates are mailed or texted to me. Premium is three thousand rupees, payback money is around four lakh. Overall, nice plan.
Plan Name: Easy Health Floater Standard
Agent Code: BPW00750
Rohidas
Mumbai, February 14, 2016
"Damn Good"
My health policy is with apollo munich. Policy is nice with premium of Rs.2500 per month. The policy cover full coverage of hospital bills. Claim is of Rs.3.1 with easily sanctioned without any paper work.
Plan Name: Easy Health Floater Standard
Agent Code: BPW00750
Syed
Meerut, February 13, 2016
"Standard health insurance"
The service is really nice rest is can't say because i don't have experience yet. Although it clear in future. Policy coverage is high with low premiums. Claim is Rs.4 lakh as shown in policy. Daily updates texted and mailed to me.
Plan Name: Easy Health Floater Standard
Agent Code: BPW00750
Ashish
Bengaluru, February 13, 2016
Good coverage.
Munich provides me health insurance with low premium benefit. Policy coverage is 90% of the treatment. Claim is high and the hospitals are very response each and every time. Great service, nice work, happy.
Plan Name: OptimaRESTORE
Agent Code: BPW00750
SUNITA
Bareilly, February 13, 2016
"Superb"
I have health insurance with apollo general. The plan i have is very beneficial with several plus point. The service is marvelous, claim is high and premium is low, policy coverage is 80-90% with ambulance facility. Nice work.
Plan Name: OptimaRESTORE
Agent Code: BPW00750
Umesh
Ludhiana, January 31, 2016
Good Plan
Last year, I had surgery at that point of time I don’t had any health insurance. So I planned to buy Apollo Munich Health Insurance as my family friend suggested. I have coverage of 27 lakh and it has good number of hospitals listed under the plan. I came to know that it does not cover pre-existing disease.
Saurabh
Delhi, January 23, 2016
good
good policy

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