Health-related risks are uncertain in everybody’s life. You can be a healthy person, following the best diet and proper exercise routine and still find yourself in doctor’s company as there are external reasons too like pollution and adulterated food which can affect your health adversely. Apollo Munich Health Insurance offers a safeguard for medical expenses and treatment of diseases covered in the policy by providing financial assistance in such times.
Types of Apollo Munich Health Insurance Plans
There are basically three main categories under which all the health insurance plans are divided, viz.:
- Health Insurance for Individuals
- Health Insurance for Families
- Health Insurance for Senior Citizens
Eligibility Criteria for Apollo Munich Health Insurance
|Entry Age||Adults: 18 – 65 years|
Children: 91 days – 65 years
|Sum Insured||Rs. 3 lakh- Rs. 50 lakh|
|Policy Renewal Period||Lifetime|
|Maximum Members Permitted||6 members (including 2 adults and 4 children)|
Documents Required to Purchase
Make sure you have following documents ready with you when going to purchase any of the health insurance plans by this insurance provider:
- ID Proof (Aadhaar Card, PAN Card, etc.)
- Address Proof (Ration Card, Passport, Aadhar Card, etc.)
- Medical Reports
- Income Proof (Salary Slip, Employer’s Certificate, Form 16)
- Passport-sized Photographs
Apollo Munich Health Insurance Plans
Below mentioned are the details of all the 8 plans provided by Apollo Munich:
|Names of Plans||Entry Age||Sum Insured||Features|
|Optima Restore||Adult: 18 – 65 years|
Child: 91 days – 5 years
|Rs. 3 lakh – Rs. 50 lakh|
|Health Wallet||Adult: 18 – 65 years|
Child: 91 days – 5 years
|Rs. 3 lakh – Rs. 50 lakh|
|Easy Health||Individual: 5 – 65 years|
Family Floater: 91 days – 65 years
|Rs. 1 lakh – Rs. 50 lakh|
|Day 2 Day Care Silver||Adult: 18 – 65 years|
Child: 91 days – 25 years
|Optima Super||91 days – 65 years|
Dependent Child: 91 days – 5 years
|Rs. 5 lakh – Rs. 10 lakh|
|iCan Cancer Plan||18 years & above||Rs. 5 – Rs. 50 lakh|
|iCan Cancer Plan for Women||18 years & above||Rs. 5/10/15/20 lakh|
|Dengue Care Plan||Adult: 18 – 65 years|
Child: 91 days – 25 years
|Rs. 50,000 – Rs. 1 lakh|
|Optima Cash Daily Hospital Cash Plan||5 – 65 years||Daily cash of Rs. 1,000 – Rs. 3,000|
|Optima Plus Top Up Plan||5 – 65 years||Rs. 5 lakh|
|Maxima Health Plan||1 year policy: 18 years & above|
2 year policy: 46 years & above
|Rs. 3 lakh|
|Optima Vital Critical Illness Plan||Adult: 18 – 65 years|
Child: 18 – 25 years
|For entrants below 55 years: Rs. 1 lakh – 50 lakh|
For entrant above 55 years: Rs. 1 lakh – 20 lakh
|Energy Health Insurance Plan||18 – 65 years||Rs. 2 lakh – 50 lakh|
|Optima Senior Citizen Plan||61 years & above||Rs. 2 lakh – Rs. 5 lakh|
Apollo Munich Health Insurance Network Hospitals
The plan provides the policyholder with access to more than 4500 hospitals throughout the country. It gives policyholder an opportunity to avail the services of healthcare experts.
Apollo Munich Health Insurance Claim Process
- The policyholder has to inform the company as soon as possible by filling in the required form with the necessary information required
- The policyholder can contact the company via the customer service platform i.e. toll-free number (1800 – 102- 0333)
- A surveyor from the company inspects the claim
- After the inspection is over, the company pays the sum assured as per the approval by the surveyor within a specific time-frame
- In case of hospitalization, the company has to be informed within one day of the incident
- If the policyholder gets hospitalized with the planning of any treatment, the company has to be informed within 48 hours
- The doctor appointed for the treatment will have to fill the form and related documents have to be provided by the policyholder
- The cashless claim gets approval within 60 minutes after the process gets completed
Documents Required for the Claim Process
There is a list that needs to be ticked-off while filing a claim with Apollo Munich for health insurance plans. This list is:
- Claim form (duly filled & signed)
- Medical reports
- All the hospital bills along with pharmacy bills
- Hospital discharge certificate
- Death certificate (wherever applicable)
- Post Mortem/ Autopsy Report
- Copy of the FIR (in case of accident)
- ID proof and address proof (Aadhaar, Passport, Ration Card, etc.)
- Any other detail asked by the claims department of Apollo Munich
Time Taken to Settle Claims
For cashless claims, it takes 1 – 3 hours at most. For reimbursement cases, this period does not extend beyond the period of 30 days post receipt of complete set of required documents.
Exclusions under Apollo Munich Health Insurance Plans
Following cases fall out of the scope of coverage under any of the plans extended under Apollo Munich Health Insurance:
- Diseases like cataract, hernia, hysterectomy, joint replacement, etc. during the first 2 years of the Health Insurance Policy period
- Pre-existing diseases for the first 3 years from the initiation date of the Health Insurance Policy
- Hospitalization of war-affected person
- Hospitalization caused due to any illegal or criminal act
- Emergency arising due to participation in defence services, racing, or other similar activities
- Treatment of diseases arising out of sexual contacts
- Treatment of mental disorders
- All treatments within the first 30 days of commencement of the policy except accident cases
- Any pre-existing disease before the waiting period of 3 years
Note: This is not an all-inclusive list thus may have further additions.
Renewal Process of Apollo Munich Health Insurance
The process for Apollo Munich Health Insurance renewal is:
- Visit the official website of Apollo Munich
- Enter your Apollo Munich login details to access the renewal page
- Enter the policy number in the required space and submit
- Fill in all the details asked in the form thus produced
- Renewal quotes for the premium will be generated
- Make the payment
Advantages of Buying Apollo Munich Health Insurance Plans
- Health Emergencies’ Protection– The plan gives financial assistance in a time when one needs funds for medical emergencies. One doesn’t have to comprise with the quality and timely treatment of illnesses
- Facility of cashless treatment – One can avail cashless facility for emergency hospitalization and planned hospitalization. The policyholder has to inform the insurance company 2 days in advance if the policyholder needs to be hospitalized for treatment. For emergency hospitalization, the company must be informed within a period of 24 hours
- Process for Claiming is Efficient – The claims that come for settlement are paid within 15 days. Up to 98% of the genuine claimed amount can be availed
- Wide Sum Insured Options– The policyholder can choose policy sum insured between Rs. 1, 00,000 to Rs. 50, 00,000
- Tax Benefits: The premiums paid towards the policy along with the benefits received are both exempt from tax (up to a specified limit)
Customer Care Details
If policyholder wants to inquire about any renewal/claim or any related issues, they can contact Apollo Munich customer care using any of the following methods:
- Email: email@example.com
- Sales Toll Free: 1800-103-0555
- Fax: +91-124-4584111
- Support Toll-Free: 1800-102-0333
- Office Address: 2nd & 3rd floor, iLABS Center, Plot No. 404-405, Udyog Vihar, Phase-3, Gurgaon-122016
- Website– www.apollomunichinsurance.com
Q1. What is a free look period?
The insurance company provides a maximum period of 15 days to the customer after the initiation of the policy. This period is called a free look period. During this period, the policyholder is expected to go through all the terms and conditions in the policy documents. If the customer disagrees to any of the terms, he/she can cancel the policy.
Q2. Is the premium I pay eligible for tax benefits?
The premium paid for any policy is eligible for tax benefits under section 80 D of Indian Tax Law.
Q3. If I get diagnosed with hernia after 30 days of purchasing the policy, will the treatment for the same be covered?
No. For such diseases, there is a waiting period of 2 years from the date of purchase of the policy. Before this period, no claims can be made for such diseases.
Q4. How many times can I avail the Restore Benefit in the Optima Restore plan?
This benefit can be triggered only once in a policy period.
Q5. Can I convert my existing individual health plan into family floater plan?
Yes. If you got married post-purchase of the plan or have a new-born baby, then this change can be done in the mid-term, otherwise the conversion is available at the time of renewal.
Q6. Is the restoration of sum insured done only for the proposer or for other members of the plan too?
100% restoration is available no matter who used up the policy amount.
Q7. Can I increase the sum insured in my current health plan?
Yes. You can upgrade your plan but only at the time of renewal.
Q8. What happens if the hospital I’m getting treated is not covered in the network list of Apollo Munich?
In such a case, you can apply for reimbursement as the cashless claims will not work in a non-network hospital.