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Apollo Munich Easy Health Insurance



Apollo Munich Easy Health Plan - Individual Health Insurance Plan


Key Features


  • Coverage cost between 1lakhs and 10lakhs
  • Coverage is offered with respect to individual sum insured basis
  • Lifetime renewal - The policy can be renewed for the entire life span


Eligibility


  • Individual alone or along with the family are eligible. Family members may be spouse, dependents like children or parents.
  • Proposer age should be 21 years
  • Dependants’ age above 91 days
  • Discount of 10% is provided if a single policy covers at least 3 family members.
  • For maximum age of 65 years, the existing sum insured choices are 1lakhs and 2 lakhs

Apollo Munich Easy Health Plan – Family Health Insurance Plan/Family Floater Health Insurance


The maximum sum insured can be shared among the members of the family.

Coverage is available for a maximum of 4 members in a family. This may include the following combinations:
  • 2 Adult
  • 1 Adult+1 Child
  • 1 Adult+2 Children
  • 2 Adults+1 Child
  • 2 Adults+2 Children
For example

If the Sum Insured is 5lakhs for a family floater plan bought by a family of 2 Adults and a child, the family in person or jointly can enjoy an insurance coverage of up to 5lakhs i.e. the family cannot claim more than 5lakhs.

Eligibility:

  • Proposer age should be 21 years
  • Child’s age should be at least 91 days and not more than 21 years
  • Discount of 10% is provided if a single policy covers at least 3 family members.

Coverage period:

  • Plan duration may be 1 or 2 years as per your requirements.
  • Discount of 7.5% if the policy is purchased for 2 years.
  • If you have chosen an option which has sum insured maximum of 2lakhs your age can be at most 65 years while for other sum insured options, your age should not be more than 60 years.

Apollo Munich Benefits Table


Benefits Easy Health Standard Easy Health Exclusive Easy Health Premium
Sum Insured per Insured Person per Policy Year (in lakhs) 1 lakhs, 2 lakhs, 3lakhs, 4 lakhs, 5 lakhs 3lakhs, 4 lakhs, 5 lakhs 7.5 lakhs 4 lakhs, 5 lakhs 7.5 lakhs, 10 lakhs
1 a) In-patient Treatment Covered
1 b) Pre-hospitalisation Covered
1 c) Post-hospitalisation Covered
1 d) Day Care Procedures Covered
1 e) Domiciliary Treatment Covered
2 a) Daily Cash for choosing Shared Accommodation Rs. 500 per day, Maximum Rs. 3,000 Rs. 500 per day, Maximum Rs. 3,000 Rs. 800 per day, Maximum Rs. 4,800 Rs. 500 per day, Maximum Rs. 3,000 Rs. 800 per day, Maximum Rs. 4,800
2 b) Organ Donor Covered
2 c) Emergency Ambulance Upto Rs. 2,000 per hospitalization
2 d) Daily Cash for accompanying an insured child Not Covered Rs. 300 per day, Maximum Rs. 9,000 Rs. 500 per day, Maximum Rs. 15,000 Rs. 300 per day, Maximum Rs. 9,000 Rs. 500 per day, Maximum Rs. 15,000
2 e) Newborn baby Not Covered Optional
3 a) Maternity Expenses with Waiting Period of 6 years Not Covered Normal Delivery Rs. 15,000* Caesarean Delivery Rs. 25,000* (* Including Pre/Post Natal limit of Rs.1,500 and New Born limit of Rs. 2,000) Normal Delivery Rs. 25,000* Caesarean Delivery Rs. 40,000* (* Including Pre/Post Natal limit of Rs.2,500 and New Born limit of Rs. 2,000) Normal Delivery Rs. 15,000* Caesarean Delivery Rs. 25,000* (* Including Pre/Post Natal limit of Rs.1,500 and New Born limit of Rs. 2,000) Normal Delivery Rs. 25,000* Caesarean Delivery Rs. 40,000* (* Including Pre/Post Natal limit of Rs.2,500 and New Born limit of Rs. 2,000)
3 b) Outpatient Dental Treatment with Waiting Period of 3 years Not Covered 50% of Admissible expenses, upto 1 % of Sum insured subject to a Maximum of Rs.5,000
3 c) Spectacles, Contact Lenses, Hearing Aid Every Third Year Not Covered 50% of Admissible expenses, max upto Rs.5,000
3 d) E-Opinion in respect of a Critical Illness Not Covered Covered, one opinion per policy year
4) Additional Cover for Critical Illness Not Covered Optional 50% or 100% of in-patient Sum Insured
5) Health Checkup Upto 1% of Sum Insured per Insured Person, only once at the end of a block of every continuous four claim free years. Upto 1% of Sum Insured subject to a Maximum of Rs.5,000 per Insured Person, only once at the end of a block of every continuous three claim free years. Upto 1% of Sum Insured subject to a Maximum of Rs.5,000 per Insured Person, only once at the end of a block of every continuous two claim free years.
Benefits under 3b), 3c), 3d) and 5) are subject to pre-authorisation by the TPA

Apollo Munich Unique Coverage Benefits


  1. Pre-hospitalization Coverage
    The medical expenses that you incur during the 30 days before you get hospitalized will be covered. If you inform Apollo Munich health insurance 5 days before you get hospitalized, the coverage for pre-hospitalization will be increased to 60 days.

  2. Post hospitalization Coverage
    The medical expenses that you incur during a span of 60 days immediately after you are discharged from hospital. If you inform Apollo Munich health insurance 5 days before you get hospitalized, the coverage for post-hospitalization will be increased to 90 days.

  3. Coverage for Day-Care Procedures
    As technology has improved so much, there are some medical procedures that do not require 24 hrs hospitalization. The plan provides coverage for these enlisted 140 day care procedures.

  4. Cumulative Bonus
    For every claim-free year you will get a cumulative bonus of 10% which may sum up to 50%. If there is a claim, the CB will be decreased to 20% of SI on the following renewal.

  5. Portability
    The customer can shift to Apollo Munich Health Insurance if he has been insured by some other company’s health insurance. The portability policy is custom friendly and focuses on transferring of the most accrued benefits and makes due allowances for waiting period.

  6. Additional Coverage for critical illness
    By choosing the Exclusive and Premium options of the Easy Health insurance policy, you can enjoy an additional cover for critical illness which provides coverage for cancer, coronary artery (bypass) surgery, first heart attack (myocardial infarction), kidney failure (end-stage renal disease), major organ transplantation, multiple sclerosis, paralysis and stroke. This benefit is optional and can be chosen as per your requirement. The sum insured for critical illness will be either 50% or 100% of the basic sum insured.

  7. Tax Benefits
    Easy Health Individual Health Insurance Plan will allow you to avail tax benefits for the premium amount under Section 80D of the Income Tax Act. (Tax benefits are subject to changes in Tax Laws)

Apollo Munich Value Added Services


  1. Healthline – Provides free of cost service
    By providing the customer id to the Healthline of Apollo Munich Easy Health Insurance, you can acquire help in primary consultation, health-related counseling, individual referrals, health information, nutrition and diet.

  2. Cashless hospitalization
    Cashless Hospitalization Service is available in more than 4000 hospitals listed in the guide book which will accompany your policy sent.

  3. Health Risk Assessment The customer of Apollo Munich health insurance can access the health risk assessment tool which will maintain the health status of the customer on the website. Following the assessment, recommendations on diet, lifestyle and nutrition routine will be offered to the customer.

Apollo Munich Renewal


  1. Life-term renewal.
  2. Waiting Period specified in the policy wordings will be reduced by 1 year on every continuous renewal
  3. Enhancement of sum insured while renewing - The enhancement to the sum insured can be done only at the time of renewal as long as no claim has been done under the policy. If the sum insured has increased one grid up, no medical test is needed. If the increase in Sum Insured is more than one grid up, the insured should get medical test done. In case of increase in the Sum Insured, waiting period will apply afresh in relation to the amount by which the Sum Insured has been enhanced. However, the quantum of increase shall be at the discretion of the company.

Apollo Munich Exclusions


  1. Any treatment within the initial 30 days of coverage excluding injuries arising from accidents.
  2. Coverage for pre-existing conditions will be only after a waiting period of 3 years.
  3. Expenses incurred from AIDS or HIV and related diseases.
  4. Treatments from non-allopathic medicines.
  5. Expenses arising from treatment for congenital diseases, medical disorder or insanity, cosmetic surgery and control of weight treatments.
  6. Abuse of intoxicant or hallucinogenic substances like intoxicating drugs and alcohol.
  7. Hospitalization because of events like war, or because of a nuclear, chemical or biological weapon and any kind of radiation.
  8. Maternity, Dental treatment, External Aids and appliances unless covered under the specific Easy Health Family Health Insurance Plan.
  9. Waiting Period of 2 years for diseases like cataract, hernia, hysterectomy, joint replacement, etc.
  10. Items of personal comfort and convenience.
  11. Experimental, investigative and unproven treatment devices and pharmacological regimens.




With Easy Health Insurance Plans


Easy Health Insurance Plans are designed in a way to suit your need and fit your pocket. They will not only guard you against the spiraling medical costs but will also guide you on the path of wellness, providing you a double protection of prevention and cover. The Easy Health Insurance Plans are available for Individuals (Easy Health Individual Health Insurance Plan) and Families (Easy Health Family Health Insurance Plan). These Plans manage you and your families health-related needs right from consultation, hospitalisation to the post-hospitalisation.

These policies are available on a cashless basis in over 4000 hospitals thus managing your expenses and providing hassle-free transactions. To let you decide on what policy suits your needs they come in three variants, which gives you a choice to decide your premium.

The Easy Health Insurance policies are power-packed with unique features like cash credited on daily basis on choosing shared accommodation, daily cash for accompanying an insured child, maternity expenses*, health check-up, spectacles, contact lenses, etc. and out-patient dental treatment**.

*waiting period of 6 years
** waiting period of 3 years

Apollo Munich Health Insurance Plans


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