Apollo Munich Energy for Diabetes Health Insurance Policy

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

Introduction/Overview

Apollo Munich’s Energy is a specialized policy that covers diabetes and related ailments (Type 2 Diabetes Mellitus, Impaired Fasting Glucose (IFG), Impaired Glucose Tolerance (IGT) and/or Hypertension) specially and also takes care of regular hospitalization with no waiting period.

Key Features

  • The plan offers coverage on individual sum insured basis.
  • The policy will be issued for 1 year.
  • With 2 variant plans – Gold (cost of wellness test included) & Silver (cost of wellness test excluded), this policy ia available with/without the copayment option of 20%.
  • There is no maximum cover ceasing age in this policy.
  • There will be no general waiting period of 30 days applicable in this product.

Benefits

S.No.

BENEFIT

COVERAGE

 

Basic Sum Insured Per Person Per Policy Year

2 lacs, 3 lacs, 5 lacs, 10 lacs

1

In Patient Hospitalization

Covered

2

Pre- Hospitalization

Covered, 30 days

3

Post- Hospitalization

Covered, 60 days

4

Day Care Procedures

144 day care procedures

5

Organ Donor

Covered

6

Emergency Ambulance

Up to Rs.2,000 per Hospitalization

7

Wellness discount

Up to 25% of Renewal Premium

 

Details about Premium

Silver Plan (Base Module)

 

No Copayment Applicable

20% Copayment Applicable

Age band

2,00,000

3,00,000

5,00,000

10,00,000

Age band

2,00,000

3,00,000

5,00,000

10,00,000

18-35

8,060

9,962

13,853

17,114

18-35

6,567

8,045

11,121

13,700

36-45

9,618

11,707

17,578

21,714

36-45

7,887

9,493

14,138

17,391

46-50

14,717

17,318

24,176

29,865

46-50

12,123

14,085

19,475

23,930

51-55

17,871

21,517

31,238

38,589

51-55

14,770

17,542

25,196

30,932

56-60

23,071

27,420

36,671

45,301

56-60

19,118

22,397

29,609

36,323

61-65

31,661

38,426

52,138

64,407

61-65

26,294

31,438

42,136

51,660

66-70

42,421

51,755

70,695

87,332

66-70

35,297

42,400

57,179

70,066

71-75

50,477

62,097

85,941

1,06,166

71-75

42,068

50,935

69,559

85,196

76-80

65,551

80,640

1,11,818

1,38,132

76-80

54,709

66,217

90,562

1,10,874

>80

79,370

97,641

1,35,710

1,67,647

>80

66,328

80,254

1,09,975

1,34,595

 

Gold Plan (Base Module + Wellness Programme)

No Copayment Applicable

20% Copayment Applicable

Age band

2,00,000

3,00,000

5,00,000

10,00,000

Age band

2,00,000

3,00,000

5,00,000

10,00,000

18-35

12,766

14,668

18,559

21,820

18-35

11,273

12,751

15,827

18,406

36-45

14,324

16,413

22,284

26,420

36-45

12,593

14,199

18,844

22,097

46-50

19,423

22,024

28,882

34,571

46-50

16,829

18,791

24,181

28,636

51-55

22,577

26,223

35,944

43,295

51-55

19,476

22,248

29,902

35,638

56-60

27,777

32,126

41,377

50,007

56-60

23,824

27,103

34,215

41,029

61-65

36,367

43,132

56,844

69,113

61-65

31,000

36,144

46,842

56,366

66-70

47,127

56,460

75,401

92,038

66-70

40,003

47,106

61,885

74,772

71-75

55,183

66,803

90,647

1,10,872

71-75

46,774

55,641

74,265

89,902

76-80

70,257

85,346

1,16,534

1,42,838

76-80

59,415

70,923

95,268

1,15,580

>80

84,076

1,02,347

1,40,416

1,72,353

>80

71,034

84,960

1,14,681

1,39,301

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

 

Policy Details

Sum Insured: Rs.2,00,000; 3,00,000; 5,00,000 and 10,00,000.

Coverage type: Individual

Waiting Period - The Waiting Periods mentioned in the policy wording will get reduced by 1 year on every continuous renewal of your Energy insurance Policy.

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

Policy termination: You may terminate the policy at any time by giving us a written notice. The cancellation shall be from the date of receipt of such written notice. Premium shall be refunded as per table below IF AND ONLY no claim has been made under the Policy

Length of time Policy in force

% of premium refunded

Up to 1 month

75%

Up to 3 months

50%

Up to 6 months

25%

Exceeding 6 months

nil

 

Free look period: A period of 15 days after date of receipt of policy to review terms and conditions during which insured can cancel it with due refunds.

Additional features or riders

  • Sum Insured Enhancement - Sum Insured can be enhanced only at the time of renewal subject to no claim have been lodged under the policy. In cases where the sum insured increase is more than one grid up, the case shall be subject to medicals, the cost of such medicals would be borne by you.
  • Tax Benefits - you can presently avail tax benefits for the premium amount under Section 80D of the Income Tax Act. (Tax benefits are subject to changes in Tax Laws)
  • Wellness Discount- Up to 25 % discount as indicated in Wellness Programme on renewal premium for better management of health condition.

Exclusions

  • War or any act of war, nuclear weapons/materials, chemical and biological weapons, radiation of any kind.
  • Insured Person committing or attempting to commit a breach of law with criminal intent, or intentional self-injury or attempted suicide while sane or insane.
  • Abuse or the consequences of the abuse of intoxicants or hallucinogenic substances such as intoxicating drugs and alcohol.
  • Treatment of Obesity and any weight control program.
  • Psychiatric, mental disorders; congenital internal or external diseases, stem cell implantation or surgery; sleep-apnoea.
  • Conditions related to or arising out of HIV/AIDS.
  • Pregnancy, miscarriage (except as a result of an Accident or Illness), maternity or birth (including caesarean section) except in the case of ectopic pregnancy.
  • Dental treatment and surgery of any kind, unless requiring Hospitalisation.

Documents Required

  • Our claim form, duly completed and signed for on behalf of the Insured person
  • Original bills with detailed breakup of charges (including but not limited to pharmacy purchase bill, consultation bill, and diagnostic bill) and any attachments like receipts or prescriptions in support of any amount claimed.
  • Original payment receipts
  • All reports, including but not limited to all medical reports, case histories, investigation reports, treatment papers, discharge summaries.
  • Discharge Summary containing details of date of admission and discharge.
  • Invoice/Sticker of the Implants.
  • 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.
  • Prescriptions that name the Insured Person and in the case of drugs: the drugs prescribed, their price and a receipt for payment.
  • Previous treatment record along with reports, if any
  • Treating doctor’s certificate regarding the duration.
  • MLC/ FIR copy/ certificate regarding abuse of Alcohol/intoxicating agent, in case of Accidental injury

Eligibility

  • Minimum Age- 18 years
  • Maximum Age- 65 years
  • For individuals with type 3 Diabetes Mellitus, Impaired Fasting Glucose (IFG), Impaired Glucose Tolerance (IGT) and/or Hypertension.