Apollo Munich Individual Easy Health Premium Insurance Policy

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Apollo Munich Easy Health Premium Plan Overview

 Apollo Munich Easy Health Premium plan offers comprehensive coverage for emergency medical conditions arising out of accident or illness. Apart from the regular in-patient coverage, the policy comes with additional features such as maternity expenses, recovery benefit, out-patient dental cover, cost of spectacles & hearing aids and coverage for listed critical illness (optional). The policy can be availed for individual sum insured basis, where up to 6 family members can be covered. The coverage can be extended to dependent parents, grandparents and parents-in-law as well.

Key Features of Apollo Munich Easy Health Premium Plan

The policy comes with unique features with maximum coverage. The basic features of Apollo Munich Easy Health Plan include:

  • The policy comes with maximum policy ceasing age
  • It offers lifelong renewability
  • The policy can be issued for individual/family floater sum insured basis
  • Add-on benefit offered for listed critical illnesses
  • The policy can be bought for 1 year. After that, it needs to be renewed to enjoy continuous benefits
  • Option to choose the sum insured from 3/4/5/7.5/10/15/20/25/50 lakhs
  • Avail tax benefits for the premiums paid towards Apollo Munich Easy Health plan
  • Cashless hospitalisation in 4500+ hospitals across India
  • Additional discounts under Stat Active Programme
  • Ayush treatment cover
  • Track your health appointments and medicinal intake through alerts
  • Exclusive health newsletter & helpline services
  • E-opinion in respect to critical illness
  • Annual health check-ups in every four claim-free year
  • Critical Advantage Rider in case of sum insured Rs. 10 lakh or above
  • Online health assessment
  • Customized diet plan & exercise plan from experts
  • Maternity benefit
  • Digitally stored medical reports for 24X7 access

Apollo Munich Easy Health Premium Plan Benefits

Coverage Sum Insured Options
4/5 lakhs 7.5/1o lakhs 15/20/25/50 lakhs
In-patient Cover- Expenses incurred due to hospitalisation including room rent, nursing cost, boarding, ICU cost, OT cost, medicine and drug cost, surgery, doctor’s consultation etc. Covered Covered Covered
Pre-hospitalisation Covered for 60 days Covered for 60 days Covered for 60 days
Post-hospitalization Covered for 90 days Covered for 90 days Covered for 90 days
Day Care Procedures Covered Covered Covered
Domiciliary Treatment Covered for the expenses incurred in availing treatment at home which would otherwise have required hospitalisation 
Organ Donor Treatment expenses while transplanting an organ
Emergency Ambulance Up to Rs.2000 per hospitalisation
Ayush Benefit Up to Rs 25,000   Up to Rs 50,000
Daily cash allowance for choosing Shared Accommodation Rs 500-3000 Rs 800-4800 Rs 1000-6000
Daily cash allowance for accompanying an insured child Rs 300-9000 Rs 500-15,000 Rs 800-24,000
Newborn baby Optional cover on payment of additional premium
Recovery Benefit Not covered   Rs. 10,000
Emergency Air Ambulance Not covered   up to Rs. 2.5 lakhs
Maternity Expenses Normal delivery: Rs. 15000Caesarean Delivery Rs. 25,000 Normal delivery: Rs. 25,000Caesarean Delivery Rs. 40,000 Normal delivery: Rs. 30,000Caesarean Delivery Rs. 50,000
Outpatient Dental Treatment (waiting period 3 years) 1% of sum insured up to a maximum of Rs. 5,000 1% of sum insured up to a maximum of Rs. 7,500
Spectacles, Hearing Aid, Contact Lenses (every third year) Up to Rs. 5000 Up to Rs. 7500
E-Opinion in respect of a Critical Illness Second opinion in case of critical illness from a medical practitioner form Apollo Munich Panel
Critical Illness  Rider 50% or 100% sum insured of in-patient SI (optional cover)   50% or 100% sum insured of in-patient SI, up to a maximum of Rs. 10 lakhs (optional cover)
Health Check-up An extensive health check-up including a number of health tests after four years of continuous renewal
Critical Advantage Rider Covered only for sum insured Rs. 10 lakh or above


Exclusions of Apollo Munich Easy Health Premium Plan

The policy doesn’t cover the insured under below conditions:

  • No claim will be entertained within the first 30 days of the policy period, except accidental claims
  • Complications arising out of a pre-existing illness will not be covered before 3 years of waiting period
  • No claim will be entertained for the expenses incurred in treating a specific illness such as hernia, joint replacement surgeries, cataract, surgery of hydrocele etc. without serving a waiting period of 2 years
  • Expenses towards HIV/AID or other related diseases that are permanently excluded
  • Expenses towards mental disorder, cosmetic surgery, congenital illness, weight loss treatment etc. are not covered
  • Any accident leading to hospitalisation while driving under the influence of alcohol or intoxicating substances.
  • Injury due to war, warlike situation, due to the use of nuclear weapon and radiation, riot, strike or malicious act
  • Expenses towards dental treatment, pregnancy, external aids, unless it is additionally covered by the plan
  • Maternity-related claims will not be accepted
  • For the complete list of exclusions, please refer to the Policy Fine Print

 Waiting periods Under Apollo Munich Easy Health Premium Plan

  • 30 Days: Initial waiting period for claiming the policy for any health issue. Only accidental injuries are covered
  • Covered after 2 years: specific illnesses
  • Covered after 3 years: Pre-existing illnesses
  • Cover after 3 years: out-patient dental treatment

Discount Available under Apollo Munich Easy Health Premium Plan

  • Cumulative Bonus or NCB Benefit- the insurer offered a no claim bonus or cumulative bonus for not claiming the insurance policy. The NCB benefit can be availed up to 10% and a maximum of 100%. In case of a claim, the NCB will be reduced by 10%.
  • 5% Discount on Premium: 5% discount if 2 family members are covered
  • 10% Discount on Premium: 10% discount on premiums if 3 or more family members are covered

Additional Benefits Offered Under Apollo Munich Easy Health Premium Plan

  • Cashless Service – You can avail cashless services at more than 4500 network hospitals of the insurance provider. In order to avail cashless service, a cashless request letter and health card will be required. The process of applying for cashless services is mentioned in the policy document.
  • Tax Benefits - With Apollo Munich Easy Health Premium Plan, you can save on tax under Section 80D of Income Tax Act, for the premiums paid towards availing the plan benefits.
  • Renewal Benefits for Inpatient Treatment – No Claim Bonus of 10% is offered for every claim-free policy year. The bonus can be availed up to 100% for every consecutive year on renewal.
  • Stay Active Benefit: The insurer offers a discount on policy premiums to encourage health and fitness. A defined discount is offered to those who achieve the target of Stay Active programme. One can track progress through a mobile application.
  • Enhancement of Sum Insured: Sum insured can be enhanced at the time of renewal, subject to no claim has been made. However, medical test or waiting period may be applied a fresh depending on up to the amount the SI has been increased.
  • Portability – The insurer offers portability benefit as well, where you can switch to Apollo Munich without a hassle. If you are not satisfied with the existing insurance provider, you can check the plans of Apollo Munich and transfer your existing policy without losing the policy benefits such as accumulated NCB benefit or waiting period. You are not required to serve the waiting period again, as the previous one is considered.

Eligibility Criteria for Apollo Munich Easy Health Premium Plan

Minimum Entry Age

91 days- 5 years (if any of the parents is covered)

Maximum Entry Age

65 years

Policy Tenure

1 year

Members to be Covered

4 adults and a maximum of 5 children to be covered

Premium

based on the sum insured or other related factors

Policy Tenure

1 & 2 years


Apollo Munich Easy Health Premium Plan Renewal Process

Apollo Munich Easy Health Premium Plan requires timely renewal to avail the benefits continuously. However, the plan comes with lifelong renewability, where there is no maximum policy ceasing age for the insured. To renew the policy you can go either online or offline. Online renewal can be ensured in a smooth way by visiting the official website of Apollo Munich, click on the renewal option, mention the 10-digit or 12-digit policy number, calculate the premiums online and pay it online using credit/debit card or via net banking.

If you want to renew the policy offline, just visit the branch office and approach the concerned officer. You can approach an authorised agent as well who can help you complete the renewal formalities.

Renewal Terms:

The premiums are subject to change with due approval from IRDA, which can be applicable at the time of renewal. However, the insurer has to inform the policyholder at least 3 months prior to the renewal date. Also, if you want to increase or decrease the sum insured, the same can be raised at the time of renewal. The insurer may impose the waiting period clause or may ask to undergo the medical test again, depending the amount up to which, the sum insured has been increased.

Moreover, the insurer comes with an easy portability benefit where a person holding a policy from another insurer can switch to anyApollo Munich Health Insurance. And this can be ensured without losing the existing benefits such as NCB or waiting period.

Apollo Munich Easy Health Premium Plan Claim Process

In order to ensure a smooth claim process with Apollo Munich, just follow the below claim steps:

Intimation & Assistance: It is essential to intimate the insurers without a fail inform with 48 hours prior to hospitalisation, in case of a planned hospitalisation. You can contact through

  • 24x7 helpline number
  • Email
  • Post and courier to the nearest claim branch
  • The claim intimation form is required to register a claim

Procedure to Get Cashless Facility

 To avail cashless facility and in case of emergency hospitalisation, inform the insurer within 24 hours of hospitalisation.

  • For cashless services, seek pre-authorisation from the insurer approaching the hospital help-desk or TPA. Submit the form along with the documents to the insurer
  • The insurer will analyse the insurance coverage, check the eligibility, and convey its decision to the hospital authority
  • In case of any discrepancy in the documentation, the same will be informed to the hospital authority within 6 hours of receiving of the documents
  • The additional amount that is not covered by the insurer are to be borne by you, up to the deductible
  • In case the treatment is not covered by the insurance company, the expenses will be paid by you at the time of discharge. A letter of rejection will be sent accordingly within 6 hours
  • The cashless facility can be availed at network hospital only

Procedure to Reimburse the Medical Expense

In case of reimbursement claim, avail the treatment from a non-network hospital and register a claim later:

Send the duly completed claim form along with the supporting documents and bills within 15 days from the day of discharge

The insurance company will verify the document upon receiving. In case of any discrepancy, the same will be informed within 6 days with a discrepancy letter.

Apollo Munich will settle the claim once receiving the complete set of document and verifying everything. The admissible amount will be transferred within 30 working days from the receiving of the document.

The payment will be made in the name of the policyholder. Anything that is not covered by the insurance policy has to be borne by the insured.

Claiming for E-Opinion

In case of critical illness cover, the insured can avail the benefit of E-opinion. The claim process is as below:

  • The claim form has to be submitted along with medical reports
  • Documents such as investigation report, discharge letter have to be submitted
  • The next step is to select a panel doctor from Apollo Munich to take e-opinion.
  • Upon receiving a complete set of claim document, the same will be forwarded to the concerned doctor from the panel
  • The insurer will make all the arrangement regarding the same within 7 days from the date of receiving of the claim form and covers the expenses incurred.