Apollo Munich Optima Plus Top up

Product Overview

Apollo Munich Optima Plus Top up health insurance plan is a unique type of health insurance cover which offers (the insured) an additional coverage, which is beyond the “threshold limit” (or) the maximum limit of the existing health insurance policies, admission as an inpatient for a minimum period of 24hrs is required.

Unique Features - Apollo Munich Optima Plus Top-up

• Life Time Renewal
• Pre and Post hospitalisation 60 days and 90 days
• No Co-payment.

Critical Features - Apollo Munich Optima Plus Top up

• Room rent:
  Limits imposed towards room and ICU rent expenses
  This plan does not have any limits specified over room rent expenses
• Co-Pay:
  Specific % of admissible claim amount to be borne by Insured
  This plan does not have co-payment clause
• No Claim Bonus:
  This Plan does not have no claim bonus benefits
• Pre- Existing Diseases:
  Means any condition, ailment or injury or related condition(s) for which you had signs or symptoms, and / or were diagnosed, and / or received medical advice/ treatment, within 48 months prior to the first policy issued by the insurer
  This plans has a waiting period of 4 years is case of pre-existing diseases.

Eligibility Criteria

• Minimum Age of Entry:- Children-91 days to 5 years
• Maximum age of Entry:- 65 years
• Renewal Age:- Life Long Renewal
• Policy Tenure:- 1 & 2yrs
• Family Defination:- Self, Spouse, Dependent Children and Dependent Parents
• Premium Calculated on Basis of:- Age, (i.e. sum Insured Choosen)

 

Deductible	Sum Insured
1 Lakh	5 Lakhs
2 Lakhs	5 Lakhs
3 Lakhs	5 Lakhs
4 Lakhs	5 Lakhs
5 Lakhs	5 Lakhs

Additional Discounts

• 7.5 % Discount on premium if insured person is opting for a 2 years policy.
• Family discount of 10 % if 2 or more family members are covered under the same policy.

Waiting Period

• Covered from Day 1:
  Accidental Injuries.
• Covered after 30 Days:
  All incidences apart from specified surgeries & Pre existing diseases (if any)
• Covered after 2 Years:
  Cataract, hernia, joint replacement surgeries, surgery of hydrocele etc.

Exclusions

• War or any act of war, invasion.
• Any Insured Person committing or attempting to commit a breach of law with criminal intent, or intentional self injury or attempted suicide while sane or insane.
• Any Insured Person’s participation or involvement in naval, military or air force operation, racing, diving, aviation, scuba diving, parachuting, hanggliding, rock or mountain climbing.
• Treatment of Obesity and any weight control program.
• Venereal disease, sexually transmitted disease or Illness; Psychiatric, mental disorders, Pregnancy (including voluntary termination), miscarriage (except as a result of an Accident or Illness).
• Dental treatment and surgery of any kind, unless requiring Hospitalisation.
• Experimental, investigational or unproven treatment, devices and pharmacological regimens

Tax Benefits

• You can claim tax deduction benefit u/s 80D as per IT Act 1961 for premium paid towards this policy.
• Self, Spouse, Childrens- Up to Rs 20,000/-
• Parents-Up to Rs 25,000/-
• Parents (Senior Citizens)-Up to Rs 30,000/-

Claim Process

Insurer has to be intimated 48 hrs before hospitalization in a planned event and within 24 hrs in case of an emergency hospitalization. For reimbursement claims the final claim documents have to reach the insurers office within 30 days of discharge from the hospital.

Claims Intimate at toll free - 1800-102-0333 & Email Id - customerservice@apollomunichinsurance.com

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