Sehwag PX
Apollo Munich Health Insurance
  • Stay Active Benefits Option
  • Wide Range of Sum Insured
  • 98%* Claim Settlement Ratio
  • 4650+ Network Hospitals
  • Quick Claim Settlement Process
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Apollo Munich Health Insurance

Apollo Munich Health Insurance company is a consolidated collaboration between two healthcare and insurance sector giants namely, Apollo hospitals and Munich Health. Apollo Hospitals that are distributed all over the Indian subcontinent delivering wide range services and Munich Health, reinsurance company headquartered in Germany and one of the three business segments of Munich Re.

Apollo Munich Health Insurance is known for crafting contemporary health plans that cover pre and post hospitalization expenses, daily cash for hospital rooms, free health checkups, medical expert opinion, daycare procedures, worldwide emergency ambulance, special coverage for cancer, hypertension and diabetes, etc.

Apart from bestowing these benefits, Apollo Munich health insurance also offers comprehensive coverage with optional rider to make it more productive and efficient.

Everyone should aim for the best whether it is the best school, best doctor, best life partner or the best health insurance plan. Apollo Munich fulfills your desire for obtaining “the best” through various plans. With the support of this health cover, wipe out all your health-related anxieties and complexities towards the future expenses pertaining to health.

The company is appraised through number of awards for instituting innovative health insurance plans that cater to the prevailing health associated needs of current generation.

Highlights of Apollo Munich Health Insurance

Number of Network Hospitals 4,500+
Claim Settlement Ratio 95%
Portability Available
Renewability of the Policy Lifetime
Additional Rider Benefit available Available
Discounts and Rebates Available
Health Rewards 8% discount

success of Apollo Munich Health insurance

Apollo Munich health insurance company remained very active in streaming innovative health insurance plans by first analyzing ‘what the customers demand from a health cover’. Due to correct information about the target audience, the company is able to gain the honour of “Best Health Insurance Provider in the private sector 2019” and “Insurance Claims Excellence of the Year”.

The company has a diverse number of partners that provide financial support to their health insurance policies like Axis Bank, Indian Overseas Bank, HDFC Life, HDFC Bank, Canara Bank, Citi Bank.

Types of Apollo Munich Health Insurance Plans

1. Apollo Munich Health Wallet

The most preferred plan of Apollo Munich health insurance that includes coverage for hospitalization for major and minor diseases/ illness along with other benefits as discussed below.

Special Features:

  • Restore the basic sum assured up to 100% if all the benefits are drained.
  • Reserve benefit through which an extra sum assured is provided to pay OPD expenses or any other medical expenses that are generally excluded from the coverage. You can also choose to pay 50% of premium on renewal with this benefit.
  • Reimbursement of expenses incurred on health check-ups, in-patient treatment taken under Ayurveda, Unani, Siddha and Homeopathy, pre and post hospitalization for any listed illness.
  • Emergency ambulance cover for transferring the patient to the nearby network hospital and insured can avail a maximum coverage of Rs 2000 per hospitalization.
  • Organ donor expenses that may arise due to organ transplantation in favor of insured person.
  • Get bonus equivalent to a maximum of 100% of sum assured as the multiplier benefit for not making any claim during a year or more.
  • Cashless treatment of any nearby network hospitals by displaying a health card granted by the insurer.
  • Get 50% of Sum Insured and up to a maximum of Rs 20 lakhs for the expenses under Worldwide Emergency Care.
  • Optional Critical advantage rider available at a minimal price for sum assured of more than Rs 10 lakhs. Illnesses that are included into the rider are-
    1. Pulmonary artery graft surgery
    2. Coronary Artery by-pass surgery
    3. Neurosurgery
    4. Bone Marrow Transplant
    5. Cancer Treatment
    6. Live-donor organ transplant
    7. Heart Valve replacement or repair
    8. Aorta Graft Surgery
Minimum Age Of Entry 5 years
91 days (for dependent children)
Maximum Age Of Entry 65 years
25 years (for dependent child)
Sum insured amount Rs 3 lakhs to 50 lakhs
Policy Term One Year
Premium Paying Modes Annually/ Monthly
Number of members can be included Both Individuals and Family Floater: 6 members

2. Apollo Munich Optima Restore

A health insurance plan suitable for both individual and family healthcare needs and demands. The plan comes with multiple benefits such as restoration of sum assured on depletion, multiplier benefit which doubles the coverage amount on a no claim year, lower premiums and for policyholders who maintains a healthy lifestyle and a lot more.

Special Features:

  • Cashless treatment for any specified illness at 4,500+ network hospitals located nearby your location.
  • Compensation for the health check-ups up to a maximum of Rs 5000 and the basic sum assured must be equal to or above Rs 5 lakhs.
  • Reinstallment of the entire sum assured on the complete or partial consumption due to past claims.
  • Multiplies the sum assured and raise up to 100%, only possible when do not make any claim for two years.
  • Facility of treatment at home if the insured do not possess the physical strength to shift to a hospital on doctor’s suggestion or due to unavailability of accommodation.
  • 8% discount on every renewal if the insured accomplishes established step count target which can be calculated through Apollo Munich mobile application.
  • Optional Coverage for 8 major illnesses that include-
    1. Aorta Graft Surgery
    2. Bone Marrow Transplant
    3. Coronary Artery by-pass surgery
    4. Heart Valve replacement/ repair
    5. Organ Transplant
    6. Cancer
    7. Pulmonary artery graft surgery
    8. Neurosurgery
  • Includes coverage for pre and post hospitalization expenses, emergency ambulance, daily cash for hospital accommodation.
  • Expert opinion for any illness where insured is not satisfied with the opinion of a local doctor and wanted to consult a medical expert who has specialization in treating a particular illness.
  • All day care procedures are included in this Apollo health insurance plan that is completed within 24 hours.
  • Emergency Air Ambulance Cover for choosing a sum assured of more than Rs 10 lakhs where a maximum of Rs 2,50,000 can be claimed for each hospitalization in a policy year.
Minimum Age Of Entry 5 years
91 days (for dependent children)
Maximum Age Of Entry 65 years
25 years (for dependent child)
Sum insured amount Rs 3 lakhs to 50 lakhs
Policy Term One Year/Two Year
Premium Paying Modes Annually/Monthly
Number of members can be included Both Individuals and Family Floater: 6 members

3. Apollo Munich Easy Health

This Apollo Munich health insurance plan ensures financial assistance for all the hospitalization cost incurred on the treatment of any defined illness by the company and other expenses related medical expenses of the insured.

Special Features:

  • Discount on the premium if the insured strives to complete the target of average step count which can be determined by using mobile application of the company. This benefit is known as Stay Active benefit whose objective is to promote the importance of sound health through regular exercises and eliminate unhealthy style of living.
  • A recovery benefit of Rs 10,000 maximum will be provided if the inpatient hospitalization is for a longer period or for more than 10 days. This benefit is applicable only on the sum assured above Rs 15 lakhs.
  • Reimbursement of the expenses incurred on the extraction of an organ from the organ donor for transplantation. Expenses will include in-patient treatment of the donor.
  • Expenses associated with Pre and post hospitalization, daily cash for hospital room, domiciliary treatment, Ayush treatment (Ayurveda, Siddha, Unani and Homeopathy).
  • Includes health checkup expenses up to 1% of sum assured and emergency ambulance expenses up to Rs 2000 per hospitalization.
  • Suitable for the needs of both the individual and the family.
  • Covers maternity expenses for both before and after the birth of the child.
  • Expenses incurred after reception of newborn baby in the family till the child attains the age of 90 days.
  • Optional Critical Illnesses rider coverage for which include diseases such as cancer, coronary artery (bypass) surgery, first heart attack, kidney failure, major organ transplantation, etc. On diagnosis of any of the illness, the insured will receive a lumpsum payment of the rider sum assured up to a maximum of Rs 10 lakhs.
  • Optional Critical Advantage Rider which gives coverage on the investigation of 8 major illnesses related to brain, lungs, liver, arteries, heart etc. This rider is applicable only for the sum assured above Rs 10 lakhs.
Minimum Age Of Entry 5 years
91 days (for dependent children)
Maximum Age Of Entry 65 years
25 years (for dependent child)
Sum insured amount Rs 4/ 5/ 7.5/ 10/ 15/ 50 lakhs
Policy Term One Year/Two Year
Premium Paying Modes Annually/Monthly
Number of members can be included Both Individuals and Family Floater: 6 members

4. Apollo Munich Day2Day Care - Silver

This plan will cover all day to day medical expenses which occur very frequently like a consultation for any fever or minor illness, medical examination and test expenses, diagnostic reports, pharmaceuticals, etc. It helps you in managing the daily medical expenses while conserving your savings.

Special Features:

  • Get compensation for getting outpatient consultation from a medical specialist from a network hospital (unlimited times of consultation) or non-network (up to 5 consultations).
  • Includes all your pharmacy expenses, vaccinations, radiology, physiotherapy and up to Rs 5,000 per year and for non-network a 20% co-payment is applicable.
  • Insured will get 100% cashless redemption for outpatient expenses at any network providers.
  • The plan is suitable for both individual and family. Anybody from 3 months of child to adult.
Minimum Age Of Entry 5 years
91 days (for dependent children)
Maximum Age Of Entry 65 years
25 years (for dependent child)
Sum insured amount Rs 3 lakhs to 50 lakhs
Policy Term One Year/Two Year
Premium Paying Modes Annually/Monthly
Number of members can be included Individual policy: 6 members
Family Floater: 4 members

5. Apollo Munich Optima Super

A plan that offers higher coverage options at an affordable rate of premiums which covers important medical cost common to every individual.

Special Features:

  • Cover 144 day-care procedures that are treated and can be rectified within 24 hours due to developments in the technology standards. Treatment processes such as cataracts, angiography, tonsillectomy, Ear operations, etc.
  • Cashless facility where all the cost of treatment will be borne by Apollo Munich and insured can enjoy zero cost hospitalization.
  • All the expenses occurred over in-patient hospitalization for treatment of an illness in any of the network hospitals are duly compensated with cashless service.
  • Covers both pre-hospitalization (before 60 days) and post-hospitalization (up to 90 days) expenses for the same illness where expenses are paid on a reimbursement basis. Expenses such as consultations fee, diagnosis reports, pharmacy, etc are generally included.
  • Get waiver of deductibles by maintaining consistency in the payment of the premium on every renewal date of the policy.
  • Includes expenses related to the treatment of organ donor for organ transplantation.
  • Ambulance cost in case of emergency transportation to the nearest network or non-network hospital.
Minimum Age Of Entry 5 years
91 days (for dependent children)
Maximum Age Of Entry 65 years
25 years (for dependent child)
Sum insured amount Rs 5/ 7/ 10 lakhs
Policy Term One Year/Two Year
Premium Paying Modes Annually/Monthly
Number of members can be included Both Individuals: 6 members
Family Floater: 4 members

6. Apollo Munich Optima Cash

An individual plan that is crafted to meet the increasing cost of healthcare sector and provides timely coverage for the treatment expenses at any of the 4,500 hospitals located in 800 cities.

What Medical Expenses Does It Cover?

  • Gives you a daily cash limit up to Rs 3000
  • Get reimbursement of expenses on giving birth to a child and is valid for once in whole policy term.
  • Convalescence cash for hospitalization extending beyond 7 days.
  • Get regular cash limit for the cost of various types hospitalization-
    1. Cash for availing ICU facility for any illness or accident applicable only for 15 days of hospitalization.
    2. Cash compensation for a maximum of 6 daycare procedures whose treatment do not consume more than one day.
    3. Daily cash limit for accidental hospitalization up to 90 days per policy year.
    4. Cash for joint hospitalization occurred solely due to accident and is given for a maximum of 10 days per policy year.
Minimum Age Of Entry 5 years
91 days (for dependent children)
Maximum Age Of Entry 65 years
25 years (for dependent child)
Sum insured Amount Available Rs 1000/ 2000/ 3000
Policy Term One Year/Two Year
Premium Paying Modes Annually/Monthly
Number of members can be included Individual policy: 6 members

7. Apollo Munich Optima Plus

This plan covers all the necessary medical costs that are crucial for sane health of the insured and becomes effective at the time of retirement.

What Medical Expenses Does It Cover?

  • One sum assured that cover all the major critical illnesses when the insured reaches the retirement age.
  • No waiting period for any specific diseases and insured will receive a guaranteed sum assured on retirement.
  • Lesser and cheaper premiums for taking Optima Plus health insurance plan at the age between 91 days to 45 years.
  • There are no sub-limits imposed on choosing the type of room for day care treatment.
  • 140 day care processes are covered under the plan especially for the minor ailments or injuries whose treatment can be completed in 24 hours.
  • 10% discount on including family members equal to or more than 2.
  • Get full-time coverage till 100 years of age with respect to regular renewals.
Minimum Age Of Entry 5 years
91 days (for dependent children)
Maximum Age Of Entry 65 years
25 years (for dependent child)
Sum insured Amount Available Rs 5 lakhs
Policy Term One Year/Two Year
Premium Paying Modes Annually/Monthly
Number of members can be included Individual policy: 6 members

8. Apollo Munich Optima Vital

A uniquely designed health insurance that basically covers critical diseases whose treatment are way too extravagant that may leave you bankrupt at a point of time. The motive behind introducing this plan is to safeguard the savings of insured and create an additional reserve of money for medical expenses.

What Medical Expenses and Benefits Does It Cover?

  • Gives you financial assistance if insured get diagnosed with any critical diseases such as Alzheimer’s Disease, End-stage Lung Disease, Brain Surgery, Permanent Paralysis of Limbs, Cancer, kidney failure, Anaemia, coma, etc.
  • Lowers the financial burden over the family by providing prompt coverage on request with an accurate declaration of the critical disease caused.
  • Second Expert Opinion for any critical illness from the medical specialist registered in the penal of the company.
  • Increased sum assured when the insured does not exercise any claim during a year or for consecutive years. Assured must apply for renewal after every policy year to get this benefit.
  • Cashless treatment facility at 4,500 network hospitals with 10,000 specialized and proficient doctors.
Minimum Age Of Entry 5 years
91 days (for dependent children)
Maximum Age Of Entry 65 years
25 years (for dependent child)
Sum insured Amount Available Rs 1 lakhs to 50 lakhs
Policy Term One Year/Two Years
Premium Paying Modes Annually/Monthly
Number of members can be included Individual policy: 6 members

9. Apollo Munich Energy Plan

An exclusive health insurance plan to deal with widespread diseases called diabetes whether it is type 1 & 2. This gives financial energy to combat and treat the complicated illness of diabetes.

What Medical Expenses Does It Cover?

  • A health insurance product by Apollo Munich fabricated to meet the treatment expenses sprouting out of diabetes and hypertension.
  • Freedom from the hustle of waiting periods to receive the coverage for a specific treatment.
  • 25% discount is given on the premium amount on the policy renewal through participation in the wellness management program. Insured can earn points based on the health standard acknowledged through annual health checkups for Type 2 Diabetes Mellitus, Impaired Fasting Glucose (IFG), Impaired Glucose Tolerance (IGT) and/or Hypertension.
  • Renewal Incentives on the wellness test conducted where the insured will obtain reimbursement of medical tests on the amount of premium on renewal after discount.
  • The plan has two variants according to which wellness tests are offered yearly or half-yearly:
    1. Silver Plan: If you opt this plan, wellness test or medical checkups are not covered and you have to pay for the medical tests expenses conducted for wellness.
    2. Gold Plan: On opting this variant, all your medical tests expenses for better health will be borne by the company and will be treated by the empanelled medical practitioners.
  • Reimbursement will be provided only on expenses like consultation charges, medicines and drugs, diagnostic reports, dental treatments, and other miscellaneous medical charges barely given any coverage.
  • Consists of coverage for inpatient treatment that involves intensive treatment of a disease taking more than a day. The factor that form inpatient treatment expenses is hospital room rent or boarding expenses, nursing, Intensive Care Unit charges, Medical Practitioner’s charges, anesthesia, blood, oxygen, operation theatre charges, etc.
  • Pre-Hospitalisation expenses for 30 days before admission to hospital and post-hospitalization expenses for up to 60 days after insured is released o discharged or hospital supervision.
  • 182 day care procedures are included to ensure utmost health benefits of the policyholders.
  • Emergency ambulance, organ donor expenses, shared accommodation are some of the common features that are given due importance in the plan.
Minimum Age Of Entry 5 years
91 days (for dependent children)
Maximum Age Of Entry 65 years
25 years (for dependent child)
Sum insured amount Rs 2/ 3/ 5/ 10. 15/ 20/ 25/ 50 lakhs
Policy Term One Year
Premium Paying Modes Annually/Monthly
Number of members can be included For an individual only

10. Apollo Munich Maxima Plan

A special plan dedicated to providing coverage for minor illnesses that are excluded from the coverage portion of many health insurance plans. This plan takes care of all the minor injuries to illness such as a normal stomach infection, allergies, sore throat, eyesight weakness, dental treatment, etc.

What Medical Expenses Does It Cover?

  • Covers In-patient treatment
  • Covers all your small pharmacy or medicine bills which may be insignificant for other health insurance companies.
  • Diagnostic test taken for the investigation of a particular illness is also given coverage to all the family members included in the plan.
  • No sub-limits on the medical expenses where the policyholder is free from following any cost limitation. Policyholder can avail OPD vouchers in accordance with the necessities without being anxious about the limitations.
  • If you are suffering from any illness before the policy purchase and when you buy Maxima Plan, then you will receive coverage for pre-existing diseases from the first day of policy commencement.
  • Facility of annual health check-ups for any age between 18 years to 44 years from the first day of the policy inception. While person above 45 years can use this benefit after the completion of the first year.
  • Out-patient treatment cover where there is no requirement of bed and illness can be attended conveniently.
  • Outpatient consultations up to a maximum of 6 doctor consultation based on the number of members included in the policy.
  • Cumulative bonus of up to a maximum of 50% of the sum assured is credited to accumulated benefit reserve of insured.
  • Covers the maternity expenses for normal delivery to cesarean delivery. Also, get coverage for newborn baby which covers expenses occurred during the first 90 days after the birth came out of the womb of the mother. Coverage newborn baby is optional.
  • Additional critical illness cover for treating major illnesses that are pernicious to the health in the long run.
Minimum Age Of Entry 5 years
91 days (for dependent children)
Maximum Age Of Entry 65 years
25 years (for dependent child)
Sum insured amount Rs 3 lakhs
Policy Term One Year
Premium Paying Modes Annually/Monthly
Number of members can be included Only Individual policy: 4 members

11. Apollo Munich iCan Cancer Insurance

The name of the plan resonates the purpose for which it was formed by Apollo Munich. This plan will give you advanced protection from cancer which has rapidly built its home in the human body and is poisonous like a snake. In order to eradicate the roots of cancer, this plan ensures complete coverage for the treatment without any limitations.

The plan is divided into two variants-

  • iCan Essential: It covers all the necessary medical expenses rising through
  • iCan Enhance: It contains all benefits under Essential variant plus extra benefits like two lumpsum payments, CritiCare benefit, family care benefit.

What Medical Expenses Does It Cover?

  • Covers all varieties of cancers under both the variant.
  • Cashless treatment of cancer at any network hospitals on requesting the preauthorization from the company.
  • Advance cover for ordinary treatment that contains Chemotherapy, Radiotherapy, Organ transplantation(part of Cancer treatment), Surgeries for excision of cancerous tissue or removal of organs/ tissues (Onco-surgery).
  • All the inpatient hospitalization, daycare procedures and outpatient treatment for the cure of cancer are covered through payment of sum assured.
  • Pre and Post- hospitalization cost that may arise before and after the real operation of the disease carried on in a hospital under medical practitioner surveillance.
  • Compensation will be promised for expenses coming through usage of the emergency ambulance for transportation to the hospital.
  • Even if the medical expert has found no traces of cancer in the body of insured and have advised to discontinue the treatment for at least 6 months, the company will still pay for the medical tests administered for investigation of same. Insured will receive a reimbursement up to Rs.3000 twice a year.

For Enhance Plan Only:

  • In addition to the essential plan, this will also cover treatments such as proton beam therapy, immunotherapy including immunology agents (e.g. Interferon, TNF), personalized & targeted therapy, hormonal therapy or endocrine manipulation, stem cell transplantation
  • Lumpsum payment of 100% of the Sum Insured as Family Care Benefit over and above the basic Sum Insured for the happening of any of the two cancer conditions-
    1. Advanced metastatic Cancer (Stage IV)
    2. Recurrence of Cancer
  • CritiCare Benefit which promises 60% of sum insured over and above the basic sum insured on the detection of cancer of specified seriousness. Please mark that this benefit is not applicable to Essential variant.
Minimum Age Of Entry 5 years
Maximum Age Of Entry Whole of the life
Sum insured Amount Available Rs 5/ 10/ 15/ 20/ 25/ 50 lakhs
Policy Term One Year
Premium Paying Modes Annually/Monthly
Number of members can be included Individual policy: 6 members only

12. Apollo Munich iCan Cancer Insurance for Women

Apollo Munich concern towards growing cancer cases mostly in women population has given birth to iCan Cancer Insurance which takes care of the women specialized cancer mainly cancer.

This plan is divided into two plans namely-

  • Standard Plan: It will cover all the necessary treatments, daycare processes and hospitalization related to cancer that are mandatory to get rid of the diseases.
  • Advanced Plan: This is an extension to the above plan that encompasses the benefits of standard plan and supplementary inclusion of advanced treatment procedures.

What Medical Expenses Does It Cover?

  • Expert opinion if the insured is skeptical upon the first diagnosis of cancer and wanted assistance from medically specialised doctors listed on the company’s panel. The doctors through the practice of artificial intelligence, deep analytics & cognitive software will generate genuine tests results that will confirm the presence of disease.
  • All commonly known conventional treatments are covered such as Chemotherapy, Radiotherapy, Organ transplantation(part of Cancer treatment), Surgeries for excision of cancerous tissue or removal of organs/ tissues (Onco-surgery).
  • Coverage for the expenses incurred before the reception of cancer infected insured into the hospital for inpatient treatment. Also called as pre-hospitalization expenses covered up to 30 days.
  • Post-hospitalization cost may live after the insured is operated for the illness and is discharged from the confines of the hospital. Coverage for up to 60 days after the insured is issued a discharge letter or summary is given.
  • Emergency service of an ambulance for the transportation of insured from home to the nearby hospital. A maximum payment of Rs 2000 per hospitalization is determined for this benefit.
  • A compensation of Rs 300 twice a year will be provided for the medical health checkups organized to check whether there are any manifestations of cancer in the body. This expense will be paid even if the doctor has recommended ceasing the treatment of cancer for at least 6 months as “No evidence of disease (NED)” are found.

For Advanced Plan:

  • Covers all the latest treatments that are developed to treat cancer from roots and are labeled proven solutions.
  • In addition to the standard plan, this will also cover treatments such as-
    1. Bone marrow transplantation
    2. Hormonal therapy or endocrine manipulation
    3. Personalized & targeted therapy
    4. Stem cell transplantation
    5. Proton beam therapy, immunotherapy including immunology agents (e.g. Interferon, TNF)
Minimum Age Of Entry 18 years
Maximum Age Of Entry Whole of the life
Sum insured Amount Available Rs 5/ 10. 15/ 20 lakhs
Policy Term One Year/Two Years
Premium Paying Modes Annually/Monthly
Number of members can be included Individual policy: 6 female members only

13. Apollo Munich Dengue Care Plan

A dengue specific plan that covers the expenses arising from hospitalization whether in-patient or outpatient treatment. Anybody from a child to an adult person can easily purchase the plan as there are no age limitations.

What Medical Expenses and Benefits Does It Cover?

  • No Medical examination is demanded by Apollo Munich for the purchase health policy.
  • Freedom from submitting co-payments or sharing the cost of the claim.
  • No defined sub-limits which mostly makes the policyholder feel constrained.
  • Covers room rent expense where insured can enjoy the facility of single private A/c room.
  • OPD expenses up to Rs 10,000 on detection of Dengue.
  • Treatment facility at home where all the medical procedures for Dengue like consultations, diagnostic tests, and nursing are operated at home under the advice medical professional.
  • No waiting period to obtain coverage for the specified illness.
  • Pharmaceutical bills, diagnostic tests, doctor consultations, etc may arise on an outpatient treatment basis are duly covered.
  • Shared accommodation in any of the network hospitals is waived off.
  • Same premium amount for all the ages i.e Rs 444 for sum assured of Rs 50,000 and Rs 578 for sum assured of Rs 1,00,000.
  • Non-medical expenses are also covered if the shared accommodation benefit has been chosen by the insurer.
  • Pre-hospitalization and post-hospitalization costs are covered for 15 days in both cases after and before the in-patient treatment of disease.
Minimum Age Of Entry 5 years
91 days (for dependent children)
Maximum Age Of Entry 65 years
25 years (for dependent child)
Sum insured Amount Available Rs 5/ 7/ 10 lakhs
Policy Term One Year
Premium Paying Modes Annually/Monthly
Number of members can be included Individuals Policy: 6 members

Health Insurance Plans for Senior Citizen

Apollo Munich Optima Senior

A simple health insurance that guarantees coverage for medical expenses occurred over the treatment and hospitalization of senior citizens. Anybody who is above the age of 61 years can buy this plan and can live the rest of life tension free.

What Medical expenses and benefits does it cover?

  • Inpatient treatment taken for a specified illness will be covered and a cashless facility is given if treatment is operated at network hospitals.
  • Second E-Opinion for receiving expert analysis on a serious illness directly coming from the medical practitioners registered on company’s panel that possess wisdom and years of experience.
  • Expenses related to domiciliary treatment, emergency ambulance, and organ donor are fully covered.
  • 140 day care procedures that include ailments that require lesser time like cataract, coronary angiography, chemotherapy, fractures, ear operations, etc.
  • Pre-hospitalisation up to 30 days before admission to hospital and post-hospitalization up to 60 days after the issue of discharge.
  • No increase in premium on renewal and the premium will remain the same throughout the policy tenure.
  • 7.5% discount on premium by selecting a two-year health policy instead of one-year.
  • No claim discount of 5% on a claim free year. Insured should apply for regular renewals to avail this benefit.
Minimum Age Of Entry 61 years
Maximum Age Of Entry No Limitations
Sum insured Amount Available Rs 2/ 3/ 5 lakhs
Policy Term One Year
Premium Paying Modes Annually/Monthly
Number of members can be included Individuals Policy: 6 members

Apollo Munich Health Insurance Eligibility Criteria

Name of the product Minimum Age of entry Maximum Age of entry Sum Insured/ Daily Cash Number members can be included Premium Paying Modes Policy Term
For Individuals and Family:
Health Wallet 5 years/ 91 days (for children) 65 years Rs 3 lakhs to Rs 50 lakhs Individuals and Family Floater: 6 members Annually/ Monthly One Year/Two Year
Optima Restore 5 years/ 91 days (for children) 65 years Rs 3 lakhs to Rs 50 lakhs Individual: 6 members Family Floater: 6 members (2 adults & 5 children) Annually/ Monthly One Year/ Two Year
Easy Health 5 years/ 91 days (for children) 65 years For Individual: Rs 1 to 15 lakhs For family: Rs 3 lakhs to Rs 50 lakhs Individual: 6 members (4 adults & 5 children) Family Floater: 6 members (maximum of 5 adults and 2 children) Annually/ Monthly One Year/ Two Year
Day2Day Care- Silver For children: 91 days to 25 years For Adults: 18 years 65 years Not Specified Individual: 6 members Family Floater: 4 members Annually/ Monthly One Year/ Two Year
Optima Super 5 years/ 91 days (For children) 65 years Rs 5 lakhs/ 7 lakhs/ 10 lakhs Individual: 6 members Family Floater: 4 members (maximum of 2 adults and 2 children) Annually/ Monthly One Year/ Two Year
For Individuals Only
Optima Cash 5 years/ 91 days (for children) 65 years Rs 1000/ 2000/ 3000 Not Applicable Annually/ Monthly One Year/ Two Year
Optima Plus 5 years/ 91 days (for children) 65 years Rs 5 lakhs 6 members (maximum of 4 adults and 5 children) Annually/ Monthly One Year/ Two Year
Optima Vital 18 years 65 years Rs 1 lakhs to Rs 50 lakhs 6 members (maximum of 4 adults and 5 children) Annually/ Monthly One Year/ Two Year
Energy Plan 18 years 65 years Rs 2/ 3/ 5/ 10/ 15/ 20/ 25/ 50 lakhs Only for one member Annually/ Monthly One Year/ Two Year
Maxima Plan 5 years/ 90 days (for children) 65 years Rs 3 lakhs Only for one individual Annually/ Monthly One Year/ Two Year
iCan Cancer Insurance 5 years Whole of the life Rs 5/ 10/ 15/ 20/ 25/ 50 lakhs Only for one individual Annually/ Monthly One Year/ Two Year
iCan Cancer Insurance for Women 18 years Whole of the life Rs 5/ 10/ 15/ 20 lakhs Only for one female individual Annually/ Monthly One Year/ Two Year
Dengue plan 91 days to 25 years (for children 18 years (for adults) 65 years Rs 50,000 to 1 lakh 6 members (Maximum of 4 adults and a maximum of 5 children) Annually/ Monthly One Year/ Two Year
For Senior Citizens:
Optima Senior 61 years No maximum age limitations Rs 2/ 3/ 5 lakhs

Apollo Munich Health Insurance Optional Riders

1. Apollo Munich Critical Advantage Rider

By choosing this additional cover, the insured can enjoy never-ending benefits attached. This cover gives you a treatment facility at network hospital present globally. In addition, it also gives coverage transportation expenses of insured and the attending member, accommodation expenses, post-hospitalization, and second opinion expenses.

The illnesses covered under this rider are-

  • Neurosurgery
  • Pulmonary Artery
  • Aorta Graft Surgery
  • Bone Marrow Transplant
  • Live Donor Organ Transplant
  • Cancer
  • Coronary Artery bypass Surgery
  • Heart Valve Replacement/repair

Benefits Offered:

  • Includes In-patient Treatment of the disease for a maximum term of 5 days. This includes the cost of room rent, boarding, nursing, Intensive Care Unit (ICU), Anaesthesia, blood, oxygen, operation theatre charges, surgical appliances, medicines, drugs and consumables, diagnostic reports, air ambulance etc.
  • Post-hospitalization Expenses occurring after the treatment of the illness so that the illness get completely erased from the body of insured.
  • Travel expenses taking shape solely because of treatment of Insured Person where expenses of traveling companion and the living donor, if accompanying for organ transplant are also covered.
  • Second opinion from Our panel of Medical Practitioners, if the Insured get confirmed by the doctor of being affected with any of the listed major illnesses.
  • Accommodation Expenses for insured who is taking treatment as well as the person accompanying and the living donor in the case of transplant.

2. Apollo Munich Critical Illness Benefit Rider

If this rider is attached to the base health policy, then the policyholder can get protection from 8 major diseases that can degrade the health of the insured if not treated timely.

What illnesses are covered?

  1. Aorta Graft Surgery
  2. Heart Valve replacement or repair
  3. Neurosurgery
  4. Live Donor Organ Transplant
  5. Pulmonary artery graft surgery
  6. Coronary Artery by-pass surgery
  7. Cancer Treatment
  8. Bone Marrow Transplant

Benefits Offered:

  • In-patient Treatment for any of the above-listed illnesses up to a maximum period of 30 days. This mainly includes expenses like room rent, boarding expenses, nursing, Intensive Care Unit (ICU), Anaesthesia, blood, oxygen, operation theatre charges, surgical appliances, medicines, drugs and consumables, diagnostic reports, cost of prosthetic.
  • Post-Hospitalization expenses that enclose doctor consultations fee, medical diagnosis reports, and medicines, etc which are covered until the completion of 30 days after receiving a discharge from the attending hospital authorities.
  • Accommodation expenses for the treatment of insured operating in some foreign land far away from Indian borders. It also covers the traveling companion and the living donor accommodation expenses.
  • Covers repatriation expenses, if the insured or living donor meets his/ her death outside the peripheries of India. Here, the insured bodily remains will respectfully be transported to the home country.
  • Travel expenses of the insured, living donor and the traveling companion if the travel is for the purpose of receiving treatment for a specified illness.
  • Second medical opinion in favor of any major illness pointed above. The opinion should be taken from the medical practitioners mentioned in the company’s panel.

Apollo Munich Health Insurance Plans Benefits

1. Claim Settlement Ratio

Before taking a step towards buying health insurance, a person must check the company’s claim settlement ratio to get an idea about the credibility of the insurer. Apollo Munich Health insurance with 95% of settlement ratio has maintained a trustworthy image in the health insurance sector.

2. Number of Satisfied customers

The second most significant factor behind Apollo Munich’s success is the rate of customer satisfaction that ranks them first in preference hart of health insurers. The company records that 85% of their customers are enjoying their services related to health insurance policies and also apply for policy renewal after every one year. Presently, the Apollo Munich Health Insurance has millions of customers all around India that are holding their health insurance policies.

3. Brand Strength and Market Value

Apollo Munich is one legal entity that contains the power of two colossal brands namely Apollo Hospitals and Munich Health, recognized as a global player in the health insurance sector. Consequently, when a person buys their policy they get the benefit of domestic as well as international brand.

4. Quick Customer Care Service

While you purchase a health insurance policy, the factor of customer service should be taken into consideration. Apollo Munich customer care team strives to settle each and every claim within 15 to 30 days to keep the customer engaged with current policy and not switch to other health insurers.

5. Cashless Treatment Approvals in less than 2 hours

Cashless service at any network hospitals is like a blessing to policyholder and settlement of same is equally significant. Apollo Munich Health Insurance has statistics of establishing 90% cashless claim authorization within 2 hours if all the information regarding the claim is truly represented by the insured.

6. Monetary Bonuses of Remaining Healthy

When you buy Apollo Munich Health Insurance, you get rewards for staying healthy and keeping yourself miles away from consuming tobacco or smoking. The policyholder will get monetary rewards like lower rates of premiums. Also, if the policyholder does not make any claim for one year or more, then a bonus equal to 50% of the sum assured will be added to the basic coverage.

7. Rider Facility for Enhanced Health Coverage

Almost every health insurance plan formulated by Apollo Munich contains the rider benefit whose objective is to provide additional security to family and individuals. Through the inclusion of these riders, you can make your health plan super worthwhile.

8. Lifelong Renewability

Apollo Munich health insurance plans give you the feature of lifelong renewability where the policyholder can renew the health cover on every policy anniversary. On renewals, all the benefits scored in the previous year will be carried forward to the next year.

9. Tax Benefits

Insured after buying health insurance can receive huge amount of tax benefits up to Rs 25,000 per year. The tax exemption will be given on the annual Income Tax submitted every year on the annual salary or profit earned from a business.

10. Portability

The company also gives complete freedom to port your previous health insurance policy into Apollo Munich health insurance policy, if you are not satisfied. The insured has to submit an application 30 days before the renewal date by filing portability form and submitting previous policy details. Company will process the application after pre-policy check-up within 7 days and decision will be communicated within a time limit of 15 days.

Apollo Munich Health Insurance Exclusions

  • Diseases caused due to the transmission of AIDS/ HIV infection.
  • Congenital diseases, mental disorder or insanity, cosmetic surgery, aesthetic surgery, and weight control management programs.
  • Any injuries/ trauma resulted from wars, nuclear bomb explosion, chemical or biological weapon, and radioactivities.
  • Any drug or treatment taken without the consultation of the medical practitioner and intake of which resulted in serious side effects.
  • Illness formed due to regular consumption of alcohol, tobacco, hallucinogenic substance, sedatives, etc.

All these exclusions are common to all Apollo Munich Health Insurance. However, there are specific exclusions for some specific Apollo health plans and the policyholders are requested to check the particular plan page for which they are planning.

Apollo Munich Health Insurance Premium Calculation

  • Age of the policyholder: The prime factor that determines the amount of premium and calculate premium according to a certain age group. Usually, Apollo Munich sets lower premiums prices for younger ages for higher coverage. However, in Dengue Care Plan, the premiums are fixed and same for all age groups.
  • Smoking or Non-smoker/ Medical History: After knowing the age, the policyholder is requested to reveal the health condition during the purchase of policy. This is usually asked by Apollo Munich to ensure transparency and clarity about the policyholder so that it may not hinder the claim settlement process. Also, non-smokers are given priority in the rate of premium.
  • Number of members included in the plan: The quantity of members attached into Apollo Munich Health Insurance plan also changes the premiums values. Apollo Munich appreciates the inclusion of family members in the health policy, that is why they provide 10% discount on involving more than 2 members.
  • Sum Assured opted: Apollo Munich offers a wide range of sum assured from minimum Rs 1 lakh to Rs 50 lakhs on individual and family floater basis. As the sum assured increases, the premium also increases. But the increase in gap is very less as compared to the benefits it offers on happening of any medical issue. Choosing higher sum assured can assist you in fighting the soaring medical costs.
  • Male or Female: The premium also depends upon the gender of the policyholder whether female or male. The premiums for female policyholder is relatively cheaper than the male counterpart. This step was taken to boost the importance of health insurance among women and encourage them to purchase coverage at a lower rate.
  • Type of Apollo Health Plan: Apollo Munich has formulated a myriad of health insurance plans for every category whether it is for individuals, family members, and senior citizens. The premiums are different for different plans. For instance, if Ayush (34 years) purchases Apollo Munich Optima Restore Individual plan where he includes his wife (34 years) and the sum assured opted is Rs 5 lakhs each. The annual premium calculated for covering both the person is Rs 15,176. However, If Ayush purchases Optima Restore Family plan under the same coverage, the premium would be Rs 11,802.

Apollo Munich Health Insurance Claim Process

Reimbursement claim process for Apollo Munich Health Insurance

  1. Submit duly filled and attested claim intimation form in combination with the required documents. All the documents must get deposited within 15 days after treatment has been accomplished.
  2. If you fail to submit complete documents, you will be issued a deficiency letter within 7 days of receipt of claim documents.
  3. After the submission of the required documents, the company will pay the requisite amount within 30 days.
  4. A settlement statement is also issued with the name of the proposer.

Cashless claim process-

  • Notify the company about the emergency (within 24 hours)/ planned hospitalization (48 hours prior to admission).
  • The claim request will be overlooked and an authorization letter will be provided to the network hospital stating cashless treatment of the patient.
  • If insufficient documents are submitted, the same will be conveyed to the hospital within 6 hours after the receipt of documents.

List of documents mandatory for settlement of claim

  1. Claim Intimation Form (attested and filled)
  2. Original Bills like diagnostic bills, consultation bills and attachments like prescriptions.
  3. Medical reports, history of the patient, investigation report, discharge summaries, etc.
  4. Medical Records of pre and post-hospitalization treatment like consultation notes, prescription bills, diagnosis reports, tests results etc
  5. ID proofs and address proof of the insured
  6. Settlement letter from TPA or insurance provider for cashless fac
  7. FIR and MLC (Medico-Legal Case) in case of an accident claim.

Apollo Munich Health Insurance Renewal Process

Online Renewal Process of Apollo Munich health insurance

  • After purchasing the policy from the company, you can renew when the policy anniversary arrives.
  • Insured can visit the website of Apollo Munich and can apply for a renewal by disclosing the 10 digit policy number as asked during the process.
  • If you have already applied for renewal in the past years, then you have to enter 12 digit policy number on date of renewal or completion of one year.

If you have already applied for renewal in the past years, then you have to enter 12 digit policy number on date of renewal or completion of one year.

Conditions to be followed-

  1. The company into responsible to give notices or reminder regarding the renewal of the policy.
  2. In most of Apollo health insurance policies, the premiums on renewal will get revised which will change the future amount of premium based on the age and medical conditions of the insured.
  3. There will be no extra loading on the premium on renewal as imposed by the company.
  4. If the insured fails to renew the policy on the given date, then Apollo Munich will provide a grace period of 30 days to renew and submit the premium.

Apollo Munich Health Insurance Review

Apollo Munich Health Insurance has been rated as the top most preferred company for ensuring financial protection from health insecurities through broad coverage from rising expenditure of medicare sector.

With connectivity to 4,650 hospitals spread across various zones of the country and faster settlement of claim proposals have earned them satisfied customers.

Due to this gesture of service, 80% of the customers are return back to renew their health insurance policy on the policy anniversaries. Also, the benefits which are covered in each Apollo Munich Health plan are duly paid as promised during the commencement of the policy.

Contact Address

Apollo Munich Health Insurance Co. Ltd

1st Floor, SCF-19, Sector-14, Gurgaon-122001, Haryana Email: customerservice(at)apollomunichinsurance(dot)com

FAQs

1. What is the intimation time period for claim?

For a planned hospitalization, Apollo Munich health insurance company must be informed within 7 days before the event takes place.

In case of emergencies, the company must be notified about the claim within 24 hours succeeding the happening of an event.

2. Is Pre-policy check-up are necessary before purchasing the policy?

Yes, Pre-Policy Check-up is necessary on the basis of age and sum insured value. The medical reports of the check-up are valid for 90 days from the date of check-up.

However, in some of the policies mentioned above, the requirement for pre-policy medical checkup is not compulsory.

3. Do we get reimbursement for Pre-policy check-ups?

Yes, some Apollo Munich Health Insurance plans contains 50% to 100% reimbursement of expenses incurred during the medical examination. Please read the policy wordings before purchasing a particular plan to get an idea about the reimbursement of pre-policy medical checkups cost.

4. If we have pre-existing diseases at the time of purchasing the policy, will it be covered?

Yes, pre-existing diseases will be covered after waiting period of 36 months or from the date of commencement of risk based on the type of health insurance policy chosen.

5. How much time is taken by the Apollo Munich to settle a claim?

A maximum period of 30 days is taken to settle the payment of the claim for which bank details of the insured are necessary to get electronic transfer of funds. The payment will be made through a cheque issued in the name of the person proposing the

6. What is Stay Active benefit in Optima Restore?

It allows the insured to gather health rewards in the form of discounts on the premium. The simple requirement to avail this benefit is to walk as far as possible to gain a healthy body and gain 8% discount on the premium paid on every renewal.

Last updated on 2-07-2019

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