Apollo Munich Easy Health Optima Plus Individual Insurance

*Please note that the quotes shown will be from our partners

Apollo Munich Easy Health Overview

Optima Plus is India’s only Top-up Health plan. It provides the insured person with an option of converting into a full-fledged nil deductible Health Insurance plan when he/she retires. It provides double benefits of a top up and a full-fledged plan.

As a top up:

a)    Covers for higher hospitalisation expenditure.

b)    The premium paid is nominal.

c)    Provides wide in-patient cover, after deductible.

d)    Renewable for life.

Option of converting to a full-fledged plan:

a)    Reduction in waiting periods.

b)    Deductible is waived off.

c)    Cashless hospitalisation and wide in-patient cover.

 

Key Features

  • The policy offers coverage on individual sum insured basis only.
  • The family includes self, spouse, dependent children and dependent parents.
  • There is no cover ceasing age under this policy.
  • Option to choose your policy period for 1 or 2 years.
  • Optima Plus gives you an option to opt for a full-fledged 5 lac Indemnity Health insurance policy provided that:
    • The insured person should enrol for first time under this policy before the age of 50 years and should have renewed continuously without interruption.
    • Opt for conversion between 58 - 60 years of age at the time of renewal only.

 

Benefits

a)    In-patient Treatment - Hospitalisation expenses due to an illness or accident.

b)    Pre-Hospitalisation medical expenses.

c)    Post-Hospitalisation medical expenses.

d)    Day care procedures - Coverage for enlisted 140 day care procedures which do not require 24 hours hospitalisation.

e)    Organ Donor - Medical expenses for harvesting of the organ donated to the Insured person.

f)     Emergency Ambulance - Expenses up to Rs.2000 per hospitalisation.

 

Details about Premium

Annual premium in Rupees

Sum Insured

500,000

500,000

500,000

500,000

500,000

Deductible

100,000

200,000

300,000

400,000

500,000

91 Days- 35 Years

1,999

1,049

899

799

699

36-45 years

2,750

1,500

1,400

1,300

1,200

46-60 years

4,813

2,925

2,170

2,015

1,860

61-75 years

10,106

5,704

3,472

2,519

2,325

>75 years

24,053

14,254

9,090

3,894

6,640

 

*The above rates may change. Please check the policy wordings for more details.

Policy Details

Sum Insured: 5 Lakhs

Coverage type: Individual/ family

Grace period: Grace Period of 30 days for renewing the policy is provided under this policy.

 Renewal Policies: Lifelong Renewal.

 Policy termination: The policy holder may terminate the policy at any time by giving the company a written notice. Premium shall be refunded as per the table below if no claim has been made. 

1 Year Policy

2 Year Policy

Length of Time Policy in force

Refund of premium

Length of Time Policy in force

Refund of premium

Up to 1 month

75%

Up to 1 month

87.5%

Up to 3 months

50%

Up to 3 months

75%

Up to 6 months

25%

Up to 6 months

62.5%

Exceeding 6 months

Nil

Up to 12 months

50%

 

 

Up to 15 months

37.5%

 

 

Up to 18 months

25%

 

 

Exceeding 18 months

Nil

 

*The above rates may vary. Please check the policy wordings for more details.

Free look period: 15 days

Additional Features or Riders

  • Discounts: Family discount of 10% if 2 or more family members are covered under the same Policy.

Exclusions

  • All treatments within the first 30 days of cover except incase of any accidental injury.
  • Pre-existing condition are covered after a waiting period of 4 years.
  • 2 years waiting period for specific diseases like cataract, hernia, joint replacement surgeries, surgery of hydrocele etc.
  • HIV or AIDS and related diseases.
  • Congenital diseases, mental disorder or insanity, cosmetic surgery and weight control treatments.
  • Abuse of intoxicant or hallucinogenic substances like drugs and alcohol.
  • Hospitalisation happens due to war or an act of war or due to a nuclear, chemical or biological weapon and radiation of any kind.
  • Pregnancy, dental treatment, external aids and appliances unless specifically covered under the Plan.
  • Items of personal comfort..

Documents Required

  • A duly filled company’s claim form which should be completed and signed for on behalf of the Insured Person.
  • Original Bills including pharmacy purchase bill, consultation bill, and diagnostic bill) and any attachments thereto like receipts or prescriptions in support of any amount claimed.
  • Medical reports, including case histories, investigation reports, treatment papers, discharge summaries.
  • A precise diagnosis of the treatment for which a claim is made.
  • A detailed list of the individual medical services and treatments provided and a unit price for each.

Eligibility

  • Minimum Age- 91 days
  • Maximum Age- 65 years
  • Child between 91 days to 5 years can be insured only when either parent is getting insured under this policy.