Apollo Munich 360-Degree Health Plan For 2 Adults Plus 2 Children

APOLLO MUNICH HEALTH INSURANCE CO. LTD.

Apollo Munich 360-Degree Health Plan For 2 Adults Plus 2 Children

Another Apollo Maxima 360-degree health plan is for 2 adultsplus 2 children with the floater option.

This plan has the FOLLOWING FEATURES:

  • Sum insured per policy per year is Rs.3lacs
  • In patient treatment
  • Pre-hospitalization
  • Post-hospitalization
  • Day care procedures
  • Domiciliary treatment
  • Organ donor
  • Emergency ambulance for up to Rs.2000 per hospitalization
  • Daily cash for choosing shared accommodationof Rs.500 subject to a maximum of Rs.5000
  • Daily cash of Rs.300 subject to a maximum of Rs.9000 for accompanying an insured child
  • Maternity expenses with waiting period of 4 years. For normal delivery expenses up to Rs.15000 are covered and for caesarean delivery the expenses up to Rs.25000 are covered. This includes pre/post natal limit of Rs.1500 and infant baby limit of Rs.2000
  • Newborn baby coverage is optional
  • 50% or 100% additional of sum insured for additional cover for critical illness

EXCLUSIVE MAXIMA 360-DEGREE BENEFITS (these are applicable to Outpatient coverage):

  • 6 consultations with general practitioner, physician or gynecologist. But if consultation is not within the specified network then the reimbursement will be the lower of the actual expense or Rs.350
  • 2 consultations with any other specialization not mentioned above. But if consultation is not within the specified network then the reimbursement will be the lower of the actual expense or Rs.500
  • Diagnostic tests worth Rs.2000 within a specified network
  • Pharmacy worth Rs.3000 within a specified network
  • Outpatient dental treatment worth Rs.1000 within a specified network
  • Cover for spectacles and contact lenses worth Rs.1000 within a specified network
  • 2 entitlement certificates of annual health check up within a specified network

ADDITIONAL BENEFITS:

  • Medical expenses that are incurred due to illness during the 30 days immediately before being hospitalized will be increased to 60 days if Apollo is informed 5 days prior to hospitalization
  • The medical expenses that are incurred in 60 days immediately after the patient is discharged from the hospital will be increased to 90 days if Apollo is informed 5 days prior to hospitalization
  • Medical expenses for 140 day-care procedures that do not require 24 hours hospitalization due to technological advancement
  • A policyholder gets a cumulative bonus of 10% for every claim-free year accumulating up to 50%. In the event of a claim this bonus will be reduced to 20% of sum insured on the next renewal. This is applicable for Inpatient treatment
  • For Outpatient treatment, Maxima offers the advantage of carry forward benefits of 50% of any unutilized entitlements to next policy year except for the annual health check up
  • If one is insured with some other company’s health insurance they can shift to Apollo on renewal. Apollo aims to achieve the transfer of most of the accrued benefits and makes due allowances for waiting periods

EXCLUSIONS (these exclusions are only applicable to any Inpatient coverage):

  • All treatments within the first 30 days of cover except any accidental injury
  • 2 years exclusion for specific diseases
  • Any pre-existing condition will be covered after a waiting period of 3 years
  • Expenses arising from HIV or AIDS and related diseases
  • Non-allopathic treatments, congenital diseases, mental disorder or insanity, cosmetic surgery and weight control treatments
  • Abuse of intoxicant or hallucinogenic substances like drugs and alcohol
  • Hospitalization due to war or an act of war or due to a nuclear, chemical or biological weapon and radiation of any kind
  • Pregnancy, dental and external aids and appliances unless covered under the specific Easy Health Individual Insurance plan

PREMIUMS:

AGE PREMIUM
18 – 45 25810/-
46 – 60 30705/-
>60 42720/-

PREMIUMS FOR ADDITIONAL COVERAGE FOR CRITICAL ILLNESS:

AGE PREMIUM
0 – 17 92/-
18 – 45 785/-
46 – 60 3741/-

The premium amount is the base amount. Service tax is levied separately @10.3%.

And this is not all. With these insurance plans one can presently avail tax benefits for the premium amount under Section 80D of the Income Tax Act.

You can buy Apollo Munich policies either online from their website www.apollomunichinsurance.com or call their toll free number 1800-102-0333 or they can also be picked up from companies dealing with Apollo products.

TERMS OF RENEWAL:

  • Apollo offers life-long renewal unless the insured person or any one on her/his behalf has acted in a dishonest or fraudulent manner
  • There is no maximum cover ceasing age. For additional cover of Critical Illness the maximum cover ceasing age would be 70 years.
  • The Waiting Periods mentioned in the policy get reduced by 1 year on every continuous renewal of the plan

The ADVANTAGESof buying this particular health insurance from Apollo Munich are:

  1. The two companies involved in the business, Apollo and Munich, are known and established business houses in the medical sector
  2. Their tie-ups are with more than 4000 hospitals across the country including the best hospitals also in any city
  3. Their claim settlement service is excellent
  4. Apollo does not have any sub limit for room rent, ICU and Operation Theatre
  5. Clients get cashless claim settlement service. A policyholder only needs to obtain a pre-approval for all planned admissions at least 48 hours prior to actual admission or within 24 hours post the admission in cases of emergency
  6. This is the first company in India that is covering the Outpatient expenses of pre-existing diseases as well

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