Apollo Munich Optima Senior Health Insurance Plan

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

Optima Senior:

Optima Senior isexclusively for Senior citizens offering comprehensive cover for medical treatment of illnesses and accidents requiring hospitalisation.

Eligibility:

  • Minimum age: 61 years.
  • Individual and spousecanbe covered and avail a discount of 5%.
  • Coverage on individual sum insured basis only.

Policy Benefits:

  • In-Patient Hospitalisation –It covers if hospitalisation is for more than 24 hours.
  • Post-Hospitalisation – It covers your expenses incur in the 90 days immediately after release from the hospital
  • Day-Care Procedures - It covers you even when you are not in the hospital but at the ease of your home (144 day-care procedures) and domiciliary treatment.
  • Organ Donor - It covers you and your donor.
  • Daily Cash for Choosing Shared Accommodation - A lump sum amount is paid if the insured chooses a shared room in a network hospital.
  • Domiciliary Treatment – The treatment expenses involved in getting a treatment done at home which otherwise would need hospitalization.
  • Emergency Ambulance - Expenses incurred if ambulance service is used on the way to hospital for hospitalization (up to Rs. 2000).

Additional Benefits:

  • E-Opinion in Case of Critical Illness - Consultation is available with medical practitioner at Apollo Munich panel (One opinion per policy year).
  • Cumulative Bonus -A cumulative bonus of 10% for every claim-free year up to 100% (in the event of a claim, cumulative bonus will be reduced by 10% of SI on next renewal).
  • Sum Insured Enhancement - Sum Insured can be enhanced only at the time of renewal if no claim has been lodged/ paid under the policy. However, the amount of increase shall be at the discretion of the company
  • Cashless Service - Pre-authorization is required for all planned admissions at least 48 hours prior to actual admission or regularize any ‘emergency’ admission within 24 hours post the admission.
  • Portability – Shifting to the policy from another company is hassle free and due allowances are provided for delay and transfer of most of the accrued benefits.
  • Tax Benefits - Avail tax benefits for the premium amount under Section 80D of the Income Tax Act.
  • Health Line Services & Discounts at listed partner’s network – Avail help in primary consultation, health-related counselling, individual referrals, health information, nutrition and diet.

Policy Details:

  • Policy period of 1 or 2 years (7.5% discount if premium is paid in advance).
  • The premium at renewal may change due to a change in age or change in the applicable tax rate.

Exclusions:

  • All treatments within the first 30 days of cover, excluding accidental injury.
  • Pre-existing condition is covered after a waiting period of 4 years and for specific diseases like cataract, hernia, joint replacement surgeries, surgery of hydrocele etc. a waiting period of 2 years.
  • Expenses arising from HIV or AIDS and related diseases/Congenital diseases, mental disorder or insanity, cosmetic surgery and weight control treatments.
  • Hospitalization due to war/related situations.
  • Pregnancy, dental treatment, external aids and appliances.
  • Experimental, investigative and unproven treatment devices and pharmacological regimens.

Renewal Policy:

  • Lifelong renewability:  No maximum cover ceasing age in this policy
  • Grace Period of 30 days for renewal.
  • Waiting period is reduced by 1 year on every continuous renewal.
  • To make any change in benefit or premium then IRDA approval is required.

Premium Details:

Age Group/ Sum Insured

200000

300000

500000

61-65 Years

11932

14615

22553

66-70 Years

15137

19201

30719

71-75 Years

18367

23986

39428

76-80 Years

24219

31629

52125

81-85 Years

32051

42433

70849

>85 Years

42497

57032

96402

 

*The above premium rates may change. Please refer the policy wordings for more information.