Apollo Munich Health Wallet- Eligibility, Features & Benefits

Updated: 06-05-2019 07:54:39 AM

Apollo Munich Health Wallet is a health insurance plan for individuals offered by Apollo Munich. With uncertainties arising in today’s world relating to one’s health, one must plan for any such events in life caused by bad health that results in huge personal expense borne by the individuals. This plan is available for individuals aged between 3 months to 65 years. Some of the interesting features of this plan include OPD expenses, cost of treatment city-wise, and rider options. It also offers numerous benefits to individuals like Reserve Benefit, Restore Benefit, Multiplier Benefit, and Critical Advantage Rider Benefit.

Eligibility Criteria of Apollo Munich Health Wallet

Parameters	Minimum & Maximum
Individuals	Min. 91 days and Max. 65 years
For Adults	Min. 18 years and Max. 65 years
Children between 91 days and 5 years	Either of parents must be covered under this policy
For renewals	Life-long renewals as no age limit is specified for renewals
Policy Period	1 year

Features of Apollo Munich Health Wallet

This plan offered by Apollo Munich has some great features. Let’s look at some of them below:

• Sum Assured under this plan can range from Rs. 3 lakh to Rs. 50 lakh. However, with the help of Multiplier Benefit offered under this plan, the sum assured keeps increasing upon renewal if no claim has been filed in the previous year.
• Various in-policy benefits and rider options available to increase the benefits received under this plan that includes Reserve Benefit, Restore Benefit, Critical Advantage Rider Benefit, and Preventive Health Check-up Benefit.
• Health Wallet by Apollo Munich provides a portability option that allows individuals to transfer their benefits from health policy provided by another insurance service provider.
• Free-look period of 15 days to try out this plan and Grace Period of 30 days for policy renewals is provided to the individuals.
• Initial Waiting Period of 30 days and exclusion for 2 years for diseases like Cataract, Hernia, and Joint Replacement is provided. Pre-existing diseases have a waiting period of 3 years.

Benefits under Apollo Munich Health Wallet

This health wallet plan by Apollo Munich offers loads of benefits to the customers. Some of the major benefits received under this plan are:

Reserve Benefit

• This benefit helps the individuals to carry forward their unused sum assured to the next year upon renewal
• This also offers bonus earnings at 6% at the time of renewal
• One can pay a consultation fee to the practitioner, physiotherapist, dietician, and speech therapists etc.
• An Individual can also purchase medicine, vaccinations, spectacles, and medical devices for BP and Sugar levels monitoring

Restore Benefit

This benefit helps individuals by automatically restoring the basic sum insured and Multiplier Benefit amount is utilized during the policy tenure. However, there are conditions applied by the insurance company for using this benefit which one must always check with the company.

Multiplier Benefit

This benefit offered under this plan provides the feature of increasing the basic sum insured upon renewal due to non-filing of insurance claims in the previous year. There could be an increment up to 50% of the basic sum insured under this plan.

Critical Advantage Rider Benefit

This rider benefit is provided as an optional to the policyholder under this plan. Some of the unique advantages of this rider are:

This rider helps the individuals or policyholders to avail best in the class medical treatment across the globe for medical situations like Cancer, Bypass Surgery, Neurosurgery, Liver Transplant, and Graft Surgery by paying up for hospital bills.

• It also covers the cost of post-hospitalization expenses and also the second opinion consultation from the other medical practitioner
• Covers the accommodation and travel expenditure incurred by the policyholder and one caretaker
• Global medical coverage is provided to the policyholder for emergency treatments incurred by illness or injury if traveling outside India

Preventive Health Check-up Benefit

This benefit helps the policyholder to avail preventive health check-up upon the renewal of the policy irrespective of claims status. However, it depends upon Reserve Benefit sum insured.

 Exclusions under Apollo Munich Health Wallet

The company does not pay any claims in certain scenarios which are mentioned below:

Non-Medical Exclusions

• War-Medical treatment arising out directly or indirectly from war, or similar acts
• If the policyholder commits or attempts to commit any breach of law with criminal intent
• Deliberate self-injury or attempt to suicide
• Dangerous acts including risky sports like racing, diving, parachuting, mountain climbing etc.

Medical Exclusions

• Treatment arising out of the usage of alcohol, tobacco, narcotic substances
• Treatment availed outside India not covered in the policy document
• Treatment at a facility that is not a recognized hospital

 How to buy Apollo Munich Health Wallet?

Below are the steps to be followed if anyone is looking to buy the plan:

• The individuals must collect the application form and fill it correctly with personal information and health profile
• Then the application form must be submitted to the company representative along with the premium amount and other necessary documents
• The company then organizes a pre-policy check at the nearest network center on a cashless basis. If the proposal is declined by the company, then the premium amount will be refunded after deductions made against the cost for organizing the pre-policy check
• Based on the details submitted by the policyholder, the company can accept or revise the offer to suggest an optimal plan based on the individual’s profile. In case, the proposal is accepted for an individual, the finalized policy document and the Health Wallet Kit is sent to the individual

Filing Claim for Apollo Munich Health Wallet

The company settles claims on a cashless basis at network centers whereas, on non-network centers, the claims are settled on a reimbursement basis. Below are quick steps for claims procedure:

Intimation and Assistance

A prior 7 days notice should be given for any planned hospital events. In case of an emergency, the insurance company must be intimated within 24 hours.

Procedure for reimbursement

• Apollo Munich must be informed within seven days of completion of any medical treatment, practitioner consultation, or any medical procedure by filling the Claim Intimation Form provided by the company
• The policyholder must send the claim form duly signed with all the relevant claim documents within fifteen days of the incident
• In the absence of any other important documents, the company sends a deficiency letter within 7 days of the receipt of the claim documents
• On receipt of all claim documents, Apollo Munich team sends an admissible amount with a statement of settlement within thirty days
• All the claim payments are made in the name of the policyholder

Procedure of Cashless Facility

• Apollo Munich must be informed within 24 hours of hospitalization
• For any planned hospitalization by the policyholder for self or other dependents covered in the policy, Apollo Munich Health Insurance desk must be informed 48 hrs in advance to seek cashless authorization
• Apollo Munich checks the eligibility and the coverage. It then sends an authorization letter to the provider
• The policyholders are subjected to pay the non-medical expenses not covered at the hospital prior to the patient discharge at the time of billing clearance

In case the treatment is not covered under the plan, the company sends a Rejection Letter to the provider within 6 hours.

Note: Claim Procedure for availing claims under the Reserve Benefit is also mentioned on the company’s website or the policy document. The policyholder can also speak with the company representatives on toll-free or customer care e-mail id.

Renewal Process of Apollo Munich Health Wallet

Under Apollo Munich Health Wallet, policyholders are provided with lifelong renewability which means there is no bar ceasing age in the policy. Also, policyholders are provided grace period of 30 days for renewing the policy.

Surrender policy of Apollo Munich Health Wallet

Policyholders can surrender the policy anytime simply by giving written notice to the company. Cancellation will be processed from the date of receipt of written notice. Also, premium will be refunded only if no claim other than claim under Reserve Benefit has been made under the policy. 

Contact Details

Toll-free Number– 1800-103-0555

Website– www.apollomunichinsurance.com

Office Address:

2^nd & 3^rd floor, iLABS Center,

Plot No. 404-405, Udyog Vihar, Phase-3,

Gurgaon-122016, Haryana, India

E-mail: customerservice@apollomunichinsurance.com

Fax: +91-124-4584111

FAQs

Q1. Who all can be covered in the family for coverage under this plan?

Spouse, children, dependent parents, and dependent in-laws can be covered for coverage under this plan. But, the maximum number of people enrolled in a single policy is limited to six members only.

Q2 How many days of pre-hospitalization and post-hospitalization expenses are covered under this Apollo Munich Health Wallet?

60 days for pre-hospitalization and 90 days for post-hospitalization expenses are covered under this plan.

Q3. What is meant by Preventive Health check-up?

It is a set of medical tests to be performed for the general assessment of the health profile of an individual.

Q4. Are there any tax benefits that a policyholder can get if he/she has purchased this plan?

The premium amount paid against the purchase of this health insurance plan, the policyholder can enjoy income tax benefits under section 80D of the Income Tax Act of India.

Q5. If this policy is taken including the family floater cover, are ambulance charges covered?

Yes, ambulance charges up to Rs. 2,000 per hospitalization are covered in the policy for everyone included in the policy.

Features
Claim Type (In-House or TPA)	In-patient
Pre-Hospitalization	Up to 60 days
Network Hospital Count	3880
Post-Hospitalization	Up to 90 days
Room Eligibility	No limit
Share Claim Payments	No
Restoration of Cover	Yes
No Claim Bonus
Ambulance Charges	Up to Rs. 2,000 per hospitalization
Worldwide Coverage	Yes
Maternity Cover	No
Hospitalization at Home	Yes
Day Care Treatment	Yes
Non-Allopathic Treatment Coverage	No
Emergency Ambulance	Yes
Health Check-up	Yes