Apollo Munich Optima Senior Health Insurance Plan

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:

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