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Plans > Health Insurance

  • Most awarded health insurance plans
  • Cashless Hospitalisation
  • Restore benefit with 100% no claim bonus*
  • No additional loadings at renewal due to claims

  • Covers entire family under one plan
  • No additional loading at the time of renewal
  • 100% no claim bonus*
  • Sum Insured available: Rs 3 to 15 Lakhs

  • Lifelong cover for self and spouse
  • 5% discount for every claim free year
  • Cashless coverage across network hospitals
  • No claim based loadings on renewals

Health Insurance Plans

Thanks to sedentary lifestyle, health insurance has become a necessity for every individual in the last few years. This is also the reason ‘people are genuinely concerned about their health’. As a result, they give right amount of thoughts at the time when they are considering to buy health insurance policy.

To elaborate on the shift in mindset, an individual has started looking at the broader aspect of their life and its health care needs. And the best part is that they have started accepting the fact that they actually do need health insurance, however the reasons may vary from one person to another.

Apollo Munich Health Insurance offers the best health insurance plans in India today, for men and women of any age. Apollo Munich offers individual health insurance plans, family floater health insurance plans and group health insurance policies for corporates. Ranging from Easy Health to Optima Restore to Energy, these health insurance policies will not only guard you against the present and future spiraling healthcare costs, but will also guide you on the path to wellness for the long term. 

Apollo Munich has also come up with an outpatient health insurance plan called Day2Day Care that covers you for unlimited doctor consultations at network centres and outpatient medical costs including pharmacy, diagnostic tests, vaccination and physiotherapy.

Apollo Munich Health Insurance has received numerous positive reviews and ratings for its health insurance plans and policies, which have been ranked as the best plans in the health insurance industry by several of India’s most popular publications such as “The Economic Times” and “The Hindustan Times”. The company offers its products through a network of 50+ offices, well trained sales partners and directly through its call center, website and in-house sales force.

Why you should buy health insurance?
1. Increase in the incidence of lifestyle-related illnesses
Life expectancy has increased. Thanks to advancement in medicines, the average man is likely to live for around 84 years by 2040. And so has stress due to sedentary lifestyle.
This has also given rise to the early onset of chronic diseases like cancer, lung conditions and stroke, claiming younger lives. Health insurance mitigates the financial risk that may befall a person irrespective of age.
2. Health insurance coverage is more than just hospitalization
Most/Many health insurance plans give coverage for day care procedures and OPD, other than the treatments that involve serious hospitalization. Health insurance policies also cover pre and post-hospitalisation as a large amount of expense on doctor consultations, tests and medicines are borne during this period. There are also health plans that cover vector borne diseases like dengue.
Domiciliary treatments, Ayurveda, Unani, Sidha and Homeopathy are also covered by the best health insurance plans in India.
3. Increase in out-of-pocket expenses
With the healthcare industry in India witnessing double-digit inflation, it is getting extremely expensive to treat common ailments in India. As a result, this has put a dent in an individual’s pocket.
Buying health insurance can double up as your emergency financial fund while preparing you for the troubled times.
4. Your group health cover may not be sufficient
A group health plan may or may not cover all your family members. The sum insured limit in a group plan is also less, which may not be enough to meet all the medical expenses incurred.
Also, during the times when you are in the process of shifting to another job or are unemployed, you and your family will be exposed to the risk of unexpected medical expenses.

And then as you’ll grow older, you might need frequent medical attention. Before that you may not want to put yourself at the risk of being under-insured.

According to a survey report, nearly 95% of Indians are under-insured, with those above 45 in the highest risk group
Why should you consider buying health insurance from Apollo Munich?
1. Wide sum insured options
Choose from a wide sum insured options starting from INR 1 lakh to INR 15 lakhs and get innumerable health insurance benefits at affordable premium.
2. Protection against health emergencies
Medical emergencies comes unannounced. When you buy health insurance plan, you will be relieved of the stress that accompanies troubled times especially when funds are lacking.
You will be able to access quality treatment and will not need to compromise on your health. Your dreams and plans that rely on your hard-earned savings will remain in place while you get the treatment you need.
3. Get access to wide network of hospitals
With more than 4500+ hospitals empaneled with us, we bring best-in-class service and renowned healthcare experts in India.

4. Cashless facility
Take advantage of quick and easy claims approval process and access world-class healthcare facilities pan-India.
You simply need to inform us 48 hours before hospitalisation or within 24 hours of emergency hospitalisation to avail the cashless claim facility at our network centres. Cashless claims are approved within 60 minutes in 90% cases.
5. Efficient claim process
Apollo Munich is one of the fastest insurers to honor every genuine claim with nearly 98% of our claims settled within 15 days. 
Since Inception, we’ve settled claims worth over INR 2,913 Crores claims till June, 2017.
6. Healthline
The toll-free Healthline is a free and confidential healthcare information service available with all sums insured. This service is managed by specially trained health personnel who will be your Health Coach. You can avail primary consultation, individual referrals, health, nutrition and diet related information, health-related counselling and much more.
You can also get guidance on what to do in case of minor illnesses or injuries. You may seek to understand conditions you have been diagnosed with or get knowledge on chronic diseases.
7. Stay Active benefit
Medical insurance plans are most useful when they help you stay healthy. Some of our plans offer the Stay Active benefit wherein you can avail up to 8% discount on premium at the time of renewal for the steps you take in a day.

You simply need to download our Health Jinn app on your phone, sync it with Google Fit or Apple Health and aim to walk 10,000+ steps every day to earn the complete 8% discount. Walking is one of the most beneficial things you can do for your health and fitness and we aim to encourage you to incorporate this into your daily routine.
8. Efficient, quick and transparent customer service
At Apollo Munich, we believe in fostering a relationship with our customers that is beyond transaction. The best health insurance experience is accompanied by absolute transparency, integrity and clear communication.

Our customer service representatives are armed with thorough knowledge of our policies, coverages, exclusions, etc. They are well-equipped to answer all your queries and guide you from the first step of buying a policy online to the process of making claims, renewing your policy and more.
9.Tax benefit
Avail tax exemption on the health insurance policy premium under the Income Tax Section 80D.

10. Lifelong Renewal
Enjoy the lifelong renewal benefit and get secured against medical expenses for the lifetime. Our health insurance plans are designed to mitigate the financial burden and anxiety that mark emergency medical situations.

11. Portability
Apollo Munich health insurance offers customer-friendly health insurance policies ensuring you avail most of the accrued benefits every time you choose to port your health insurance policy to one of the health plans offered by Apollo Munich. The waiting period or any another accumulated benefit will be carried forward without any trouble – That’s our promise to you!

12. Health and Wellness Portal
As a customer, you can get numerous benefits from our health and wellness Portal. The portal allows individuals to keep a track of their health like weight, BMS etc. You can also explore healthy living, improve your lifestyle, never miss an appointment, access reports 24X7 from anywhere in the world, chat with a health coach, and lots more.

13. Earn up to 100% No Claim Bonus*
If you have had a claim-free year, we increase your basic sum insured by 50% at no extra charge. If you do not claim even in the second year, we double the sum insured, making it 100% of the basic sum insured. For instance, if you have a Rs. 5 lakhs health insurance plan and you do not make any claim in the first year, we will increase your cover to Rs. 7.5 lakhs in the first year and Rs. 10 lakhs in the second claim free year. Which means, at the end of the second claim free year you would be paying for a Rs. 5 lakhs plan but receiving the benefits of a Rs. 10 lakhs plan.

14. RESTORE Benefit*
If you or your family member exhausts entire sum insured during the year, Apollo Munich will restore the full amount back for usage for any new illnesses without any paperwork or any extra charge!
*Applicable only for Optima Restore
Types of health insurance policies/cover?

1.Reimbursement (Indemnity) based health insurance plans
The most popular form of health insurance in the market, reimbursement based health insurance plans more commonly known as “mediclaim”. These plans reimburse you for any expenses incurred in the event of hospitalisation and also cover expenses associated with diagnostic or screening requirements before hospitalisation or post hospitalisation treatments. The plan will have an annual limit which cannot be exceeded in a given year and which is renewed every year you pay your premiums. The plan can be offered as an
a. Individual Health Insurance Plan – Individual health insurance covers a single person; it is usually a person who is paying the premium. Under this, the chosen sum insured covers only one individual insured under the plan against various disease and illnesses.

Moreover, one can also enroll family member(s) for coverage by choosing different sum insured to be applicable to each individual insured member. 

In individual health insurance policies, one member’s expenses do not impact the other family member’s cover. In the unfortunate incident of more than one member being hospitalised in a given policy year, their individual plan is bound to cover their expenses if they have selected an adequate sum insured.
b.Family Floater Health Insurance Plan – Tailor made for families, it acts as an umbrella to give coverage against the health risks.

Under this, a fixed sum insured is available for any or all the members insured for one or more claims during the tenure of the policy. Thus, if one of the insured member falls sick and needs hospitalization, the (total) sum insured of the policy can be utilised by him/her.

A family may include individual, spouse, dependent children and in some cases, parents and parents-in-law. 
In a family floater policy, the sum insured is shared by all the family members. Thus, if one member ends up using a large portion of the sum insured, the other member may fall short of cover when needed.
Our Optima Restore plan offers a Restore Benefit wherein your basic sum insured is restored in case the entire sum insured gets exhausted in a policy year. This way, your family can still get coverage even if one member has used up the sum insured.

Who should buy
A reimbursement-based health insurance policy is the base coverage that everybody must have in order to ensure that you are protected against the less frequent but most immense expenses of hospitalisation.  

2.Fixed benefit hospitalisation plans
A new breed of health insurance plan first offered by Life Insurance companies and later offered by all insurance companies, these plans offer fixed benefit payouts on the occurrence of some well-defined diseases/illnesses or hospitalisation occurring. These plans not only attempt to partly cover costs associated with hospitalizations but also in some cases act as an income substitute.

The biggest advantage of these plans is that they offer coverage or payout even if you have claimed from any other health insurance plan (you can consider it as an additional payout for the same illness).

 However one must always consider these plans as a top-up or add on cover to your current plan and never mistake these for complete solutions due to the following reasons
  • As the payout is not related to your actual health expenses incurred it may be lower or higher than the actual cost
  • As the coverage is offered for set of defined benefits it may or may not cover all the illnesses or diseases
The variants to the fixed benefits hospitalization health insurance plans include
a.Critical illness plans These plans offer a fixed lump sum benefit in case of a critical illness occurring, the critical illness or disease covered would be as the list defined under the plan. Today critical illness plans covering 6 t0 39 critical illnesses depending upon the product offering them. The lump sum benefit offered by this plan covers not only cost but also acts as an income supplement or takes care of out of hospital treatment. 
b. Hospital Cash/Surgical benefit plans These plans offer fixed payouts in case of defined hospitalization events which may include admittance to the hospital, daily stay- recuperating benefit in case of prolonged stay and also lump sum payouts for a listed surgery. As the payout is a defined payout depending upon the listed event occurring the plan accepts copies of bills. 
Who should buy?
All such plans be it critical illness plans or fixed benefit hospitalisation plans are top-up plans or add on plans which can be used to supplement your base coverage and in no way substitutes the need for a reimbursement based hospitalization health insurance plan. Hence this plan should be bought by someone who would like to enhance his current coverage and would like to provision oneself for expenses not covered by reimbursement based hospitalisation health insurance or intangible expenses such as loss of income or chronic care.
How to select the best health insurance plan?
How do I know which is the best health insurance plan? Should I go for individual plan or a family floater policy? These are few of the first questions that come to people who are looking to buy a health insurance policy.

Before we tell you what you should consider to select the best health insurance plan, let us share how a health insurance buyer can perform a quick quality and choose to buy one of the best health insurance policy available in the market.

So, look for a plan that:
  • Has high ratings from industry experts. You can also check customer reviews.
  • Remember, a quality health insurance plan does a good job of helping policyholder stay well as well as get better after the treatment/surgery.
  • Check if the plan offers a wellness program.
  • Has the widest network of doctors and hospitals in the list. Remember, to check network-hospitals in your area.
  • Offers a wide range of sum insured options
  • Does not have sub-limits or co-payments so that you get complete coverage
  • Offers services as and when needed by the customers while meeting their budget.
  • Has easy claim authorization and settlement process
While you perform the quality check on the health insurance plans, look for reasons why do you think buying health insurance is important for you?

Here are few factors that can help you decide how to select the best health insurance plan-

1. Buy health insurance when young and healthy

It is common practice among young individuals to avoid buying health insurance as they think they do not need it. But the health landscape is fast-changing. With the increase in the incidence of lifestyle diseases and infections rising to epidemic proportions like the swine flu and dengue outbreaks, it becomes vital to protect yourself even at a young age.

Benefits of buying medical insurance at a young age
·        You are covered against health contingencies
·        You have to pay a lower premium
·        You can ride over the waiting periods while you are healthy
·        You avoid the risk of your proposal being rejected by health insurance companies on account of your health condition
Younger you are, lesser will be the amount of premium- An individual’s age is the major deciding factor for the calculation of health insurance premium.

2. Take advantage of the waiting period
Nearly all health insurance policies has a waiting period for 2-3 years for certain pre-existing diseases.

When you buy a health insurance cover early in life, you can easily take advantage of the waiting period rather than serving it at a later stage when your health risks may have increased substantially. 
3. Understand limits and exclusions

  • Sub-limits: Most health plans have sub-limits on room rent, surgeries, ICU charges, operating charges and other medical procedures. Opt for policy without sub-limits; it may have a higher premium; it is much better option in a long run.
  • Co-payment: Under co-payment, the policyholder bears a pre-defined percentage of the claim amount while the rest will be settled by the insurance company. While you may find the insurance plan to be quite cheap, it may not offer you compete coverage.
4. Choose a policy with no sub-limits
When you opt for a health insurance plan, you should be sure that the plan has no disease specific or expenditure specific sub-limit. In few cases, you may find such plans to be expensive but they will help you to evade greater financial risks as well as provide you with the freedom to opt for efficient medical treatment, that too at the best health care provider. A policy with no sub-limits will help you avoid unpleasant situations at the time of claims.

5. Choose adequate sum insured

According to a study we conducted among Apollo Munich policyholders across India, 51% of people were underinsured! Underinsurance is a widely prevalent concern across the nation. People opt for a lower sum insured to save on premium, not realising that they are keeping the gates open for a potential financial crisis in the future.

Consider all your personal priorities and liabilities, before you buy a health insurance policy to make an informed choice.

Choose the policy that is in line to your by giving due consideration to factors like your age, age of all your family members, increased health care costs, etc.
Also, when choosing a sum insured for your health insurance policy, keep in mind the increasing occurrence of lifestyle diseases among the youth.

6. Fill up the proposal form yourself
Most questions asked in a proposal form personal in nature. Thus, in order to give the right piece of information, one should fill up the proposal form first-hand.

Furthermore, for the insurer to be able to underwrite the policy in an appropriate manner, it is required all the details furnished are correct and true. You should never hide any information or overwrite on the proposal form. Inadequate information or exclusion of medical conditions during the proposal time can lead to issues of delayed or non-payment of claims during times of need. 

7. Hospital network of the insurance company
While selecting the right health insurance plan, review the list & details of the hospital network of the insurance company. An insurer with an extensive list of hospitals in its network across cities should be your prime criteria of selection.

8. Understand your health insurance need well
Consider if you want to buy individual policies for all family members or a family floater policy for all.

For a young nuclear family, it is better to opt for a family floater policy that extents coverage to two adults and two children.  Compared to individual plans, family floater come at a marginally incremental premium. 

9. Claim limitation related to treatment
Carefully note the treatment-respective limits in your health insurance plan. Certain policies cap the amount you can claim for a particular surgery. Such limits would restrict your claim, even if there is a large sum insured under your policy.

10. Opt for additional coverage
Add on covers like Maternity Cover, Critical Illness Rider can be bought along with standard health insurance plans to give additional coverage for your specific needs.

11. Clearly read and understand the policy wordings 
It is of utmost importance that you read the policy wordings and other documents carefully so as to reap maximum benefits from your respective health insurance policy. Every health insurer provides a policy wording document that contains details about the policy. It will help you gain a thorough understanding of the claim process, document requirements, payment options, special conditions, coverage and exclusions.
12. Gradual increase in sum insured 
In the present days, when medical inflation is rising at a rapid scale, as a precautionary measure, it would be best to keep on enhancing the sum insured of your health insurance plan from time to time. You should also compare various policies available from an insurer. You can also speak to your insurance advisor to know what is the apt sum assured for you and your family.
13. Clear all your doubts before taking the final decision 
Before making the final decision of buying a health insurance policy, you should read all your policy documents once again. Turn to your insurance advisor or the insurance company and ask as many questions as you can to clarify all your apprehensions. It will clear any confusion or doubts that may exist. 

This is only a summary of the product features. The actual benefits available are described in each policy document, and will be subject to the policy terms, conditions and exclusions. Please seek the advice of your insurance advisor if you require any further information or clarification.
How to read the fine print of the policy document?
One thing most health insurance buyers should understand is that the ‘devil lies in details shared in a policy document’. You miss a detail and devil is there to thwart you – moreover, it could cost you a cancellation of claim.

So, what is policy document?

Well, the policy document outlines what the policy intends to do, the benefits/exclusions it has. It is the key source of information for new policyholders regarding the objective and fundamental attributes of the health insurance policy they have bought.

The policy document records all the scheme details and give a thorough understanding of the claim process (authorization/settlement), documents required, payment options etc.  

Importantly, one must pay attention to the coverage norms like-

1. Room rent limit
- The limit puts a cap on per day room rent policyholder can claim, which is linked to the sum insured (total coverage) h/she is entitled to.
- A fixed room type definition such as a “shared accommodation” only
Note: room restriction does not only limit the reimbursement on your room rent fees but also proportionately reduces your eligibility of payout for all other charges such as surgical fees, consultant charges, operation theatre charges etc.

2. Sublimit
- Applies to specific charges on coverage such as doctor fees or surgical fees.
- The sublimit may be applicable on listed illnesses/diseases, for example cataract would be covered only up to a certain amount irrespective of the total sum insured.
Note: such restriction may impact your payout at the time of claim.

3. Copay / deductibles
- Copayment is the percentage of the total claim amount i.e. payable by the insured out of the total claim submitted.
- Deductible is the rupee amount you would have to incur or pay from your pocket before the insurance plan would come into effect.

4. Waiting period
- Waiting period applicable on listed illnesses or diseases
- Waiting period applicable on pre-existing illnesses
- All policies apply a waiting period against treatment due to illnesses or diseases. Waiting period is restricted to 30 days post the first time issuance of the policy. In certain policies, waiting period can extend up to 90 days.There is no waiting period in case of claims due to an accident.

5. Lifelong renewal As per the latest guidelines, all health insurance policies are required to offer lifelong coverage. However, certain policies issued prior to the regulatory issuance of guidelines, still offer coverage only until a certain age of an individual.

No lifelong renewal in a policy may prove detrimental in the long run as the lack of health insurance may not be there to support you at an elderly age, which is when you require health insurance the most.
Top myths about health insurance?
For long, several myths about health insurance has persisted, which is quite a big challenge for industry people. It is because due to the prevailing misconceptions about health insurance, they leave people generally, apprehensive about their decision to buy the one.

Myths about Health Insurance have persisted for long, which is a challenge to clarify. But it is important to check the facts before relying on the information you might have heard from your friends or read somewhere. It is important to understand, who is asking and who is answering it.

During our survey, we found that 50 to 60% of working class population in India have Health Insurance, but there are very few who can comprehend its value.

So, before you set out to seek a fresh health insurance cover or assess your existing coverage, we help you shatter few of the health insurance myths.

1. Health insurance is for use in old age, which is also the right time to buy it. We are living at the peril of the sedentary lifestyle. The unpredictability of contracting cancer and other major illnesses at a young age has made it more than obvious that we just cannot ignore the health risks, which may befall us.

The reality is to wait for too long to buy health coverage is likely to make us face the risk of not being accepted into the insurance fold. In case you are accepted, you will have to pay a higher premium and would have to go through the waiting periods till all your pre-existing conditions and initially excluded diseases are covered.

2. All healthcare expenses will be covered under health insurance. Most health insurance plan have their own set of exclusions, inclusions and limits. Thus, it is important to look for all the details regarding what are the expenses covered in a health insurance policy you intend to buy.

3. I am covered under the group health insurance. So, there’s no need for individual cover. An employer-sponsored health insurance offers coverage to a group of people. However, complete reliance on this type of coverage is not a prudent move as it might not be enough to take care of all the medical expenses and may not cover all family members.
Also, in case you wait to apply for an independent health insurance plan till you retire, you would have to pay a much higher premium because of your age. Also, in case you counteract a chronic disease, your premium would be loaded.
In even the best health insurance policies in India, the maximum age for entry and the maximum sum insured at an older age are restricted.
Senior citizen plans come with a high premium tag.

Limitations under a group health plan- -Limit/restrictions on most vital elements of a health plan like hospital room rent, pre-  existing disease, copayment and sub-limits.
-Limited sum insured options-1 Lac to 3 Lac.
-Occurrence of factors like termination of employment, switching to another job, change in company policy will mean no insurance coverage at all.

4. My health insurance premiums will remain static.   Hospitalization expenses, cost of medication, and healthcare services are few things that directly impact the rise in medical inflation. This in turn, will affect the amount of premium at the time of renewal.
But keep in mind that, as per IRDAI regulations, no health insurance company is allowed to increase your premium because you made a claim in the previous policy year.

Health insurance plans may also offer you a cumulative bonus, i.e., a discount for not making any claims in a policy year. Apollo Munich’s Optima Restore offers up to 100% no claim discount in two claim-free years.

5. Pre-existing diseases are covered after the given waiting period. Thus, they need not be declared in the proposal form. One should never hide any information or overwrite on the proposal form. Thus, it is important to declare pre-existing diseases upfront at the time of buying health policy. 

Inadequate information or exclusion of medical conditions may lead to issues of delayed or non-payment of claims at the time of need. Declaring pre-existing medical conditions is a wise step as you can be assured of getting complete coverage after the waiting period is over, instead of being half-covered by your health insurance policy.


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