Leave your Details
CLAIMS SETTLED Rupees 2,913 Crores Claims Settled from Inception till June 2017.
Claim Board
Plans > Health Insurance Plans > Senior Citizen

Optima Senior is our plan exclusively for Senior citizens. The plan offers comprehensive cover for medical treatment of illnesses and accidents requiring in-patient hospitalisation.


Eligibility
  • We offer coverage from the age of 61 years above.
  • You and/or your spouse can be covered under the policy on individual sum insured basis. (we offer a family discount of 5% if both you & spouse are covered)
  • Your premium at renewal may change due to a change in your age or changes in the applicable tax rate.
  • The policy period options include period of 1 or 2 years(s). (We offer 7.5% discount if you opt for a 2 year policy)
Benefit

Plan Benefits

  • In-Patient Hospitalisation - Covers medical expenses for hospitalisation for more than 24 hrs.
  • Pre-Hospitalisation - The medical expenses that you incur due to illness during 30 days immediately before you are hospitalised.
  • Post-Hospitalisation - The medical expenses you incur in the 60 days immediately after you are discharged from hospital.
  • Day-Care Procedures - The medical expenses for enlisted 140 day-care procedures, which do not require 24 hours hospitalization due to technological advancement, are covered.
  • Domiciliary Treatment - The treatment expenses involved in getting a treatment done at home which otherwise would need hospitalization.
  • Organ Donor - Treatment expenses for the organ donor at the time of organ transplant.
  • Emergency Ambulance - Expenses incurred if ambulance service is used on the way to hospital for hospitalization (up to Rs. 2000).
  • E-Opinion in Case of Critical Illness(optional) - A second opinion will be arranged from a medical practitioner who is in the Apollo Munich panel (One opinion per policy year).

Copayment applicable on room rent type & specific illness & surgeries.

Others Benefits

  • Cumulative Bonus - You get a Cumulative Bonus (CB) of 5% for every claim-free policy year provided policy is renewed with us without a break.
  • Cashless Service - You need to obtain a pre-authorization for all planned admissions atleast 48 hours prior to actual admission or regularize any emergency admission within 24 hours post the admission. The details of the process and the documentation requirements are given in the guide-book sent along with the policy.
  • Sum Insured Enhancement - Sum Insured can be enhanced only at the time of renewal subject to no claim have been lodged/ paid under the policy. If the insured increases the sum insured one grid up, no fresh medicals shall be required. In cases where the sum insured increase is more than one grid up, the case shall be subject to medicals. In case of increase in the sum insured waiting period will apply afresh in relation to the amount by which the sum insured has been enhanced. However, the quantum of increase shall be at the discretion of the company.
  • Portability - If you are insured with some other company’s health insurance and you want to shift to us on renewal, you can. Our portability policy is customer friendly and aims to achieve the transfer of most of the accrued benefits and makes due allowances for waiting periods etc.
  • Tax Benefits - With Optima Senior Plan, you can presently avail tax benefits for the premium amount under Section 80D of the Income Tax Act. (Tax benefits are subject to changes in Tax Laws)
Health Line Services & Discounts

We provide Health Line Services & Discounts at our listed partner’s network – You just need to call us and quote your customer ID to reach our experts and avail their help in primary consultation, health-related counseling, individual referrals, health information, nutrition and diet.

Renewal Policies
  • Optima senior offers lifelong renewability i.e there is no maximum cover ceasing age in this policy.
  • Grace Period of 30 days for renewing the policy is provided under this policy.
  • Waiting periods as mentioned in the policy wordings gets reduced by 1 year on every continuous renewal of your Optima senior policy.
  • Renewal premium are subject to change with prior approval from IRDA. Any change in benefits or premium (other than due to change in age) will be done with the approval of the IRDA and will be intimated atleast 3 months in advance.
Exclusions
  • All treatments within the first 30 days of cover except any accidental injury.
  • Any pre-existing condition will be covered after a waiting period of 3 years.
  • 2 years waiting period for specific diseases like cataract, hernia, joint replacement surgeries, surgery of hydrocele etc.
  • Expenses arising from HIV or AIDS and related diseases.
  • Congenital diseases, mental disorder or insanity, cosmetic surgery and weight control treatments.
  • Abuse of intoxicant or hallucinogenic substances like intoxicating drugs and alcohol.
  • Hospitalisation due to war or an act of war or due to a nuclear, chemical or biological weapon and radiation of any kind.
  • Pregnancy, dental treatment, external aids and appliances unless covered under the Plan.
  • Items of personal comfort and convenience.
  • Experimental, investigative and unproven treatment devices and pharmacological regimens

Please refer to the Policy Wording for the complete list of exclusions.


Request A Call Back
 I have read and agree to the Terms & Conditions. I authorize Apollo Munich Health Insurance and associate partners to contact me via email or phone or SMS. 

AN ISO 9001:2008 CERTIFIED HEALTH INSURANCE COMPANY