Family Health Insurance Plans

APOLLO MUNICH HEALTH INSURANCE CO. LTD.

FAMILY HEALTH INSURANCE PLANS – EXCLUSIVE

In the health insurance policies for familiesApollo Munich Insurance Co. Ltd. also has the Easy Health ExclusiveFamily Insurance Plan.

It includes theFOLLOWING FEATURES:

  • Sum insured per policy per year ranges can be Rs.3lacs, Rs.4 lacs, Rs.5 lacs and Rs.7.5 lacs
  • In patient treatment
  • Pre-hospitalization
  • Post-hospitalization
  • Day care procedures
  • Domiciliary treatment
  • Organ donor
  • Emergency ambulance for up to Rs.2000
  • Daily cash for choosing shared accommodation worth Rs.500 per day subject to a maximum of Rs.3000 is available for sum insured range of Rs.3 lacs to Rs.5 lacs
  • The daily cash for choosing shared accommodation for a sum insured of Rs.7.5 lacs is Rs.800 subject to a maximum of Rs.4800
  • Daily cash of Rs.300 subject to a maximum of Rs.9000 is available for accompanying an insured child for sum insured from Rs.3 lacs to Rs.5 lacs
  • Daily cash of Rs.500 subject to a maximum of Rs.15000 is available for accompanying an insured child for sum insured of Rs.7.5 lacs
  • Health check up to 1% of sum insured per policy only once at the end of a block of every continuous 4 claim free years
  • Cover for newborn baby is available but is optional
  • Maternity expenses with waiting period of 4 years. For sum insured of Rs.3 lacs to Rs.5 lacs the amount is Rs.15000 for normal delivery. For Caesarean delivery it is Rs.25000. Both these include pre/post natal limit of Rs.1500 and newborn limit of Rs.2000.
  • For a sum insured of Rs.7.5 lacs the maternity expense for normal delivery is available for Rs.25000 and for caesarean delivery it is Rs.40000. Both these include pre/post natal limit of Rs.2500 and newborn limit of Rs.3500.
  • 50% or 100% additional of sum insured for additional cover for critical illness

The features bulleted below are NOT COVERED under this policy:

  • Out patient dental treatment with waiting period of 3 years
  • Spectacles, contact lenses, hearing aid every 3rd year

The minimum entry age for this policy is 5 years and the maximum entry age is 60 years. But children from the age of 91 days can get this policy only if their parents already have this policy.

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
  • 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:

  • All treatments within the first 30 days of cover except any accidental injury
  • 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
  • 2 years exclusion for specific diseases like cataract, hernia, hysterectomy, joint replacement
  • Items of personal comfort and convenience
  • Experimental, investigative and unproven treatment devices and pharmacological regimens

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.

PREMIUMS:

SUM INSURED/FAMILY SIZE 3 LACS (PREMIUM RANGE) 4 LACS (PREMIUM RANGE) 5 LACS (PREMIUM RANGE) 7.5 LACS (PREMIUM RANGE)
1A+1C 4500/- TO 9255/- 5400/- TO 10999/- 7279/- TO 17184/- 9094/- TO 16514/-
1A+2C 5999/- TO 11200/- 6999/- TO 13999/- 8424/- TO 18141/- 10358/- TO 19728/-
1A+3C 7399/- TO 12572/- 8500/- TO 16256/- 11994/- TO 23295/- 14610/- TO 29251/-
2A+0C 5325/- TO 14951/- 6600/- TO 18688/- 8018/- TO 22898/- 10344/- TO 28602/-
2A+1C 6700/- TO 16445/- 8150/- TO 20556/- 10235/- TO 24150/- 12949/- TO 30243/-
2A+2C 8050/- TO 18170/- 9660/- TO 22713/- 11499/- TO 26450/- 14363/- TO 33156/-

PREMIUMS FOR ADDITIONAL COVER FOR CRITICAL ILLNESS:

SUM INSURED/AGE 1.5 LACS 2 LACS 2.5 LACS 3 LACS 3.75 LACS 4 LACS 5 LACS 7.5 LACS
0-17 46 61 76 92 115 122 153 229
18-35 173 231 289 347 433 462 578 866
36-44 531 708 885 1062 1327 1415 1769 2654
45-50 1164 1552 1941 2329 2911 3105 3881 5822
51-55 1918 2557 3197 3836 4795 5114 6393 9590
56-60 3030 4040 5050 6060 7575 8080 10100 15150

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

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
  • Sum Insured can be enhanced only at the time of renewal subject to no claim lodged/paid under the policy. If the sum insured is increased by one grid then do fresh medicals will be done, however if the sum insured is more than one grid up then that is subject to medicals.

The ADVANTAGESof buying a 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. All customers are given a customer ID through which they get help in primary consultation, health related counseling, individual referrals, health information, nutrition and diet
  7. Every Apollo Munich health insurance customer is provided with an access to a health risk management tool that helps profile each member’s health status through the website

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