Sum Insured starting from 3-15 lakhs + Restore benefit to auto-reinstate your sum insured + Multiplier benefit offers a no claim benefit of 50% every year + Pre& Post hospitalization coverage for 60 days & 180 days + 140 Day-care procedures + Domiciliary treatment + Expenses for Organ Donor + Emergency Ambulance + Lifelong renewal + No additional loadings at renewal due to claims+No sublimits + No co-payment Calculate & Buy
Health Insurance Plans for Individuals upto 65 years
- Comprehensive coverage for hospitalisation
- Sum insured options ranging from 3 lakhs to 15 lakhs
- Cashless hospitalization in more than 4000 hospitals across India
- Lifelong Renewal
- No Sub-Limits on room rent or Co-Payments
- No additional loadings at renewal due to claims
- First of its kind Restore benefit which restores entire sum insured with no extra charges
- Unique multiplier benefit that offers a bonus of 50% of sum insured for every claim free year
Our Unbelievable Plan
Sum Insured starting from 3-15 lakhs + Restore benefit to auto-reinstate your sum insured + Multiplier benefit offers a no claim benefit of 50% every year + Pre& Post hospitalization coverage for 60 days & 180 days + 140 Day-care procedures + Domiciliary treatment + Expenses for Organ Donor + Emergency Ambulance + Lifelong renewal + No additional loadings at renewal due to claims+No sublimits + No co-payment Calculate & BuyOur Most Popular Plan
Sum Insured starting from 2-5 Lakhs + Hospitalization + Pre-hospitalization + Post-hospitalization + 140 Day-care procedures + Domiciliary treatment + Daily Cash + Expenses for Organ Donor + Emergency Ambulance + Health Check-up Calculate & BuyOur Plan For Young Family
Sum Insured starting from 3-7.5 Lakhs + Hospitalization + Pre-hospitalization + Post-hospitalization + 140 Day-care procedures + Domiciliary treatment + Daily Cash + Expenses for Organ Donor + Emergency Ambulance + Health Check-up + Maternity expenses + Coverage for New Born Baby + Daily cash for accompanying an insured child Calculate & BuyOur Premium Plan
Sum Insured starting from 4-10 Lakhs+ Hospitalization + Pre-hospitalization + Post-hospitalization + 140 Day-care procedures + Domiciliary treatment + Daily Cash + Expenses for Organ Donor + Emergency Ambulance + Health Check-up + Maternity expenses + Coverage for New Born Baby + Daily cash for accompanying an insured child + Critical Illness + Dental Treatment + Spectacles, contact lenses Calculate & Buy Health Insurance Plans for Families
- Covers spouse, dependent children and dependent parents under one plan
- Sum insured options ranging from 3 lakhs to 15 lakhs
- Cashless hospitalization in more than 4000 hospitals across India
- Lifelong Renewal
- No Sub-Limits on room rent or Co-Payments
- No additional loadings at renewal due to claims
- First of its kind Restore benefit which restores entire sum insured with no extra charges
- Unique multiplier benefit that offers a bonus of 50% of sum insured for every claim free year
Our Unbelievable Plan
Sum Insured starting from 3-15 lakhs + Restore benefit to auto-reinstate your sum insured + Multiplier benefit offers a no claim benefit of 50% every year + Pre& Post hospitalization coverage for 60 days & 180 days + 140 Day-care procedures + Domiciliary treatment + Expenses for Organ Donor + Emergency Ambulance + Lifelong renewal + No additional loadings at renewal due to claims+No sublimits + No co-payment Calculate & BuyOur Most Popular Plan
Sum Insured starting from 2-5 Lakhs + Hospitalization + Pre-hospitalization + Post-hospitalization + 140 Day-care procedures + Domiciliary treatment + Daily Cash + Expenses for Organ Donor + Emergency Ambulance + Health Check-up Calculate & BuyOur Plan For Young Family
Sum Insured starting from 3-7.5 Lakhs + Hospitalization + Pre-hospitalization + Post-hospitalization + 140 Day-care procedures + Domiciliary treatment + Daily Cash + Expenses for Organ Donor + Emergency Ambulance + Health Check-up + Maternity expenses + Coverage for New Born Baby + Daily cash for accompanying an insured child Calculate & BuyOur Premium Plan
Sum Insured starting from 4-10 Lakhs+ Hospitalization + Pre-hospitalization + Post-hospitalization + 140 Day-care procedures + Domiciliary treatment + Daily Cash + Expenses for Organ Donor + Emergency Ambulance + Health Check-up + Maternity expenses + Coverage for New Born Baby + Daily cash for accompanying an insured child + Critical Illness + Dental Treatment + Spectacles, contact lenses Calculate & BuyWhat We OFFER & Others DON’T
| Offerings | Apollo Munich | Majority of others |
|---|---|---|
| Restore Benefit | Offered | Not available |
| Multiplier benefit | Offered | Not available |
| Pre/Post Hospitalisation | 60/180 days coverage | Most Insurers offers 30/60 days coverage |
| 100% Life Long Policy Renewal | Offered | Offer cover around 75 years only |
| No Sub-limits on Room Rent | Offered | Sublimits on room rent |
| No geography based sublimits | Offered | Co-pay/Sublimit based on geography |
| No claim based loading | Offered | Most Insurers don’t offer |
| Health Line Support for any time Medical Assistance | Offered | Most Insurers don’t offer |
Do You Know?
- What is a 'cashless' claim?
In cashless claim the insured is required to intimate TPA to avail cashless facility. On authorisation by the TPA, the TPA directly settles the claim to the network hospital and insured is not required to pay any charges except non-medical and expenses not covered under the policy. Insured person is entitled for cashless only in our network hospitals.
- What is a reimbursement claim?
In a reimbursement claim the insured has to pay upfront for the services of the provider and seek reimbursement from the Insurer for the covered services
- What is Pre-Authorization?
In a pre-authorization process, the insured or the service provider seeks an approval and guarantee of payment from the insurer or it’s TPA for the covered services before the Hospitalization / service for planned treatment and during the course of Hospitalization / service for emergency treatment
- How to avail cashless facility?
For any emergency Hospitalisation, your designated TPA must be informed no later than 24 hours after hospitalization. For any planned hospitalization, kindly seek cashless authorization from your designated TPA atleast 48 hours prior to the hospitalization. TPA will check your coverage as per the eligibility and send an authorization letter to the provider. In case there is any deficiency in the documents sent, the same shall be communicated to the hospital within 6 hours of receipt of documents. Please pay the non-medical and expenses not covered to the hospital prior to the discharge. In case the ailment /treatment is not covered under the policy a rejection letter would be sent to the provider within 6 hours. Rejection of cashless in no way indicates rejection of the claim.
- How to make intimation?
You can make claim intimation by informing us on our / TPA’s toll-free number or in writing to us / TPA at any of our offices. You will be entitled for the benefit of 60 days pre hospitalisation and 90 days of post hospitalization, if you intimate us/TPA 5 days in advance of the treatment and provide medical documents with all details about the Illness and the date and the place of the proposed hospitalisation.
- If there are any charges by the hospital, which are not reimbursable and hence have to be paid even after "Cashless Service" has been authorized for treatment in the network hospitals?
Yes, there are quite a few charges, which are not reimbursable and have to be paid by you even though you have been authorized for "Cashless Service" at the Network Hospitals. Some of those charges are enumerated below:
Registration/Admission charges.
Attendant/Visitor pass charges.
Special nursing charges not authorized by the attending doctor.
Service charges not forming a part of the room rent.
Charges for extra bed for attendant etc.
Bed retaining charges.
Charges for TV, Laundry etc.
Telephone/Fax charges.
Food and Beverages for attendants and visitors, toiletries etc.
Purchase of Medicines not related to the treatment.
Stationery, xerox or certifying charges.
The above list is only indicative and not exhaustive. - Whether cosmetic treatments or medical attention for cosmetic purposes are covered or not?
Plastic surgery or cosmetic surgery is excluded unless necessary as a part of medically necessary treatment certified by the attending medical practitioner for reconstruction following an accident, cancer or burns
- Whether Easy Health policy offers benefits if one suffers illness/disease or contracts injury through accident either in India or outside India?
Easy Health policy only covers medical treatment taken within India and payments under this policy shall only be made in Indian Rupees within India.
- How will the payment of claim be made?
All claims will be payable to policyholder in Indian Rupees within India currency by cheque/DD or through bank transfer.
- What is TPA?
TPA stands for Third Party Administrator.
TPA means the third party administrator that we appoint from time to time as specified in your schedule. All claims under the policy will be processed and settled by specified Third Party Administrator (TPA) licensed by IRDA. - How does one get reimbursement for pre- and post-hospitalization expenses under this scheme?
Your policy allows reimbursement of medical expenses incurred 30 days before and 60 days after discharge from hospitalisation towards pre and post hospitalisation expenses. The Insured is required to send all invoices in original with supporting documents/prescriptions along with a copy of the discharge summary to the respective TPA. TPA will scrutinize the claim and settle the invoices subject to the overall limit of the policy. The invoices must be sent to TPA within 15 days from the date of completion of treatment.
Pre and post hospitalisation benefit will be enhanced to 60 and 90 days respectively if we were provided with the following at least 5 days before the hospitalisation:
Medical documents with all details about the Illness; and the date and the place of the proposed Hospitalisation. - How does one get reimbursements in case of treatment in non-network hospitals?
The insured person or someone claiming on your behalf shall provide us with any documentation, medical records and information we or our TPA may request to establish the circumstances of the claim, its quantum or our liability for the claim within 15 days of the earlier of our request or the insured person’s discharge from hospitalisation or completion of treatment. Such documentation will include but is not limited to the following:
- Our claim form, duly completed and signed for on behalf of the insured person.
- Original bills (including but not limited to pharmacy purchase bill, consultation bill, diagnostic bill) and any attachments thereto like receipts or prescriptions in support of any amount claimed which will then become our property.
- All reports, including but not limited to all medical reports, case histories, investigation reports, treatment papers, discharge summaries.
- A precise diagnosis of the treatment for which a claim is made.
- A detailed list of the individual medical services and treatments provided and a unit price for each.
- Prescriptions that name the insured person and in the case of drugs: the drugs prescribed, their price and a receipt for payment. Prescriptions must be submitted with the corresponding doctor’s invoice.
- What are the benefits of your health card?
A health card mentions the contact details and the contact numbers of the TPA along with your policy details. In case of a medical emergency, you can call on these numbers for queries, clarifications and for seeking any kind of assistance. Moreover, you need to display your health card at the time of admission into the hospital.
- What if I also have or intends to buy a medical policy of any other insurance company?
It’s your choice, but you would have to intimate us of the same and the concerned insurance company.
- How to find out which Hospitals are part of a given insurance network?
You can refer to the list of empanelled hospitals on our website www.apollomunichinsurance.com or the list provided in the guidebook or welcome kit, alternatively you can also call our Toll Free Line at 1800-102-0333 or email us at customerservice@apollomunichinsurance.com or call you respective TPA.
- If the claims have to be submitted with the insurance company or with TPA?
Preferably with the TPA.
- Whether Health check up is covered under this policy or not?
Yes, at the end of a block of every continuous 2/3/4 claim free years (As per variant opted) during which you have been insured with us. Our maximum liability will be subject to 1% of the sum insured for this policy year or the subsequent policy years (whichever is lower).
- What are the Non payable items?
Click here for the list