Apollo Munich Optima Senior Plan

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Apollo Munich Optima Senior

	Objective			This is a special health insurance policy designed to provide lifelong coverage to senior citizens.
Suited for			Anyone who fulfills the eligibility criteria can buy this policy.
What does it do?			Anyone proposing to buy this policy will be required to go through a medical check up. In certain cases mentioned, co-payment clause applies which means that total claim amount will be shared among policyholder and insurance company in a pre-specified ratio. Apart from hospitalization benefit, it also covers pre and post hospitalization expenses, domiciliary treatment, day care procedures, and hospitalization expenses of organ donor in case of transplant.
Pros			It offers lifelong renewal. It offers a 5 per cent discount on premium on including spouse. It allows 7.5 per cent discount for opting a 2-year policy. The policy assures of no claim based premium loading. There are no sub-limits on inpatient hospitalisation cover. Premium paid under this policy enjoys a tax benefit under Section 80D.
Cons			Co-payment in certain cases acts as a limitation.
Our View			There is no escape from co-payment clause when looking a policy for a senior citizen. USP of the policy is that it assures of no claim based loading and it covers inpatient hospitalisation expenses without any sub-limits. This policy is a perfect balance between the benefits and cost. If you can afford the premiums, this is a recommended plan. But if you are looking for a cheaper policy, you would be required to compromise on the scope of cover as well.
Eligibility
Maximum Policy Renewal Age (years)		Lifelong renewal
Coverage Type		Individual
Policy Term (years)		1/2
Sum Insured (Rs)
Maximum		5 lakh
Minimum		2 lakh
Discount		5% on renewal for each claim free year. 5% if spouse also buys this policy. 7.5% on selecting a 2 year policy term
Pre Policy Medical Check Up		Required (insurer would reimburse 50% of cost on acceptance of insurance proposal)
Grace Period for Policy Renewal		30 days
Co Payment Clause		15% on accomodation in a twin sharin room or lower room type. 30% on accomodation in a single room or higher room type (15% in case of an emergency). 30% on specific illnesses such as cataract(each eye), hysterectomy, joint replacement etc. 15% to all day care procedures
Policy Termination		Policyholder is allowed to cancel the policy at anytime by providing a notice. Insurer may also terminate the policy by giving a 30 days notice
Customer Service
Address		Apollo Munich Health Insurance Company Limited Corporate Office: 10th floor, Tower B, Building No. 10, DLF Cyber City, Phase -II, Gurgaon, Haryana-122002 Registered Office: Apollo Hospital Complex, Jubilee Hills, Hyderabad - 500033
Mail to		customerservice@apollomunichinsurance.com
Call to		1800-103-0555
SMS		HEALTH to 56767333
Network Hospitals		Http://www.apollomunichinsurance.com/our-hospital-network.aspx

 

	Scope of Cover
Cashless facility		available at network hospitals
Reimbursement facility		available if treatment taken in non-network hospitals
Pre and post hospitalisation		covered upto 30 days prior and 60 days post hospitalisation
Inpatient treatment		covered
Day care procedures		covers 140 listed day care treatment
Domiciliary treatment		covered only if treatment exceeds 3 days
Organ donor		covers medical treatment of organ donor
Emergency ambulance		pays upto Rs 2000 for each hospitalisation in case of an emergency
Second Opinion		allows to obtain an opinion from medical panel for listed critical illnesses once a policy year

 

	Exclusions and Waiting period
Pre-existing diseases		covered after 3 years of continuous policy renewal
No claim period		30 days from policy start date
Waiting period		2 years for specified illnesses like hernia, sinusitis, cataract, joint knee replacement etc.
Other exclusions		Non allopathic treatmentsHIV/AIDS and related conditions

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