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Apollo Munich Health Insurance

India's Apollo Hospitals are renowned for its superior medical practices and a reputed brand for years now. In August 2007, they joined forces with Munich Health internationally recognized insurance brand leading to some impressive leaps in this sector. Currently, Apollo Munich Health Insurance (IRDA Reg. No 131) is considered as one of the most trustworthy and favored health insurance brands in India.

Plans Offered by Apollo Munich

Easy Health

This is a basic health insurance plan which offers coverage for medical expenses in case of hospitalization. There are three different variants of this plan namely Standard, Exclusive and Premium, which vary in terms of benefits offered. Standard plan is the most basic of the three variants while Premium is the most advanced version. All the plans cover health expenses on individual or family floater basis. The details of each variant is given below:

Easy Health Standard

Individual Coverage

  • This is the basic plan offered by Apollo Munich which covers your hospitalization costs including pre and post hospitalization expenses.
  • The plan offers coverage in range of INR 1,00,000 and 5,00,000 for individuals between age 5 years and 65 years.

Family Floater Coverage

  • This is a family floater plan which offers coverage for health costs of the entire family in range of INR 2,00,000 to INR 5,00,000 for members between age 5 years to maximum of 65 years and dependent children from age 91 days on wards.
  • A maximum of 2 adults and 5 children can be covered under the floater.

Easy Health Exclusive

Individual Coverage

  • This plan offers coverage in the range of INR 3,00,000 and INR 50,00,000 for individuals between age 5 years to 65 years.
  • In addition to the features of Easy health - Standard, this plan provides health check up every 4 years; also maternity benefit.

Family Floater Coverage

  • This plan offers coverage to entire family in the range of INR 3,00,000 and INR 50,00,000 for members between age 5 years and a maximum of 65 years and dependent children from age 91 days onwards.
  • A maximum of 2 adults and 5 children can be covered under the floater.
  • This plan provides health check up after every 4 years; maternity benefits. It also has the option of choosing recovery benefit and additional critical illness.

Easy Health Premium

Individual Coverage

  • This plan is a variant of easy health plan which offers coverage in range of INR 4,00,000 and INR 50,00,000 for individuals between age 5 years and 65 years.
  • In addition to the coverage provided in other variants this plan covers dental treatments, spectacles and contact lens treatment, etc. The plan also has an E-opinion available in case of critical illnesses.

Family Floater Coverage

  • This plan offers coverage to entire family in the range of INR 4,00,000 and INR 50,00,000 for members between age 5 years and 65 years and a 91 days old dependent child.
  • A maximum of 2 adults and 5 children can be covered under the floater.
  • In addition to the coverage provided in other variants this plan would additionally cover dental treatments, spectacles and contact lens treatment, etc. the plan also has an e-opinion available in case of critical illnesses.

If want to buy Easy Health plan for yourself or your family on individual or family floater basis then more about the coverage offered and related terms and conditions, please click here for more details on individual coverage and click here for more details on family floater coverage.

Optima Restore

This is a health insurance plan with restore benefit offered by Apollo Munich. It offers coverage on individual or family floater basis given below are the details of each plan.

Individual Coverage

  • This plan offers coverage in range of INR 3,00,000 and INR 50,00,000 for individuals between age 5 years and 65 years.
  • Pre and post hospitalization expense cover, coverage for expenses on day care treatments, no-claim bonus equal to 10 % of sum insured up to a maximum of 50%, etc. are the benefits offered in this plan.
  • This health insurance policy specifically offers restore benefits up to 100 % of sum insured after the entire sum insured is exhausted. E-opinion (in case of critical illnesses) is of the additional benefits offered.

Family Floater Coverage

  • This family floater plan offers coverage to entire family in range of INR 3,00,000 and INR 50,00,000 for adults up to age 65 years and dependent children between age 3 months to 25 years.
  • A maximum of 2 adults and 5 children can be covered.
  • Pre and post hospitalization expense cover, coverage for expenses on day care treatments, no-claim bonus equal to 10 % of sum insured up to a maximum of 50%, etc. are the benefits offered in this plan.
  • This policy specifically offers restore benefits up to 100 % of sum insured after the entire sum insured is exhausted. E-opinion and multiplier benefit are some of the additional benefits offered.

If you want to buy a health insurance plan with restore benefit offered by Apollo Munich, please click here to know more about the coverage offered.

Maxima

This health insurance policy covers expense for treatment of regular illnesses along with hospitalization expenses and out patient expenses. The details of coverage offered are:

  • The plan is available for individuals between age 91 days and 65 years for life.

Energy

This plan is designed specially for people with type 2 diabetes and hypertension. It provides coverage for these illnesses right from day 1 of the policy period. The details of the coverage offered are:

  • The coverage amount is in range of INR 2,00,000 to INR 10,00,000 for individuals between age 18 years and 65 years.
  • The plan has two variants gold and silver. Silver plan excludes wellness test whereas Gold plan includes wellness test.

To know more about this plan, contact Coverfox.

Optima Vital

This is a critical illness benefit plan offered by Apollo which offers a lump sum amount equal to sum insured upon diagnosis of critical illness listed in the policy wording.

  • This plan specially offers coverage for critical illness in range of INR 1,00,000 and INR 50,00,000 for individuals between age 18 years and 65 years.
  • The plan provides a lump-sum amount in case of critical illnesses. Other benefits include e-opinion and sum insured enhancement.

If you are looking out for a benefit plan just like this one, contact Coverfox to know all about the terms and condition under ths policy.

Individual Personal Accidental Plan

This is a personal accident disability plan offered by Apollo which provides compensation in case of death or disability due to accident. The details of coverage offered are as follows:

  • This policy covers expenses in case of accidents for people between age 91 days and 69 years in the range of INR 5,00,000 and INR 5,00,00,000.
  • The sum insured after age of 70 years (for existing policy holders) is only INR 5,00,000.
  • This policy provides worldwide accidental coverage. Accidental death, complete or partial disability, emergency ambulance charges, etc. are covered in this policy.

Ensure that this plan is best suited for your needs, contact Coverfox to know all the terms and conditions under this policy.

Optima Plus

This is a top-up plan, a plan with an agreed upon deductible amount to be paid at the time of claim, here are the details of coverage offered:

  • The entry age for this plan is between 5 years and 65 years.
  • It can also cover a dependent child over the age of 91 days.
  • It has a coverage of INR 5,00,000 with a deductible in range of INR 1,00,000 and INR 5,00,000.

Before you buy this plan have a look at the terms and conditions, please click here.

Optima Super

This is an aggregate top-up plan which gives you flexibility to choose the deductible and coverage amount. The details are as folows:

Individual Coverage

  • This is a top up plan which covers anybody between age 5 years and 65 years. This plan can also cover a dependent child from the age of 91 days.
  • This plan offers coverage of INR 5,00,000 to INR 10,00,000 with deductible in range of INR 1,00,000 and INR 10,00,000.
  • In this plan, individuals have the flexibility of choosing the combination of coverage amount and deductible amount as per one's needs.
  • Like Optima plus, this also offers the option to convert to zero deductible after retirement.

Family Floater Coverage

  • This is a family floater plan which provides top up cover for entire family for members between age 5 years and 65 years and dependent children from age 91 days on wards.
  • A maximum of 2 adults and 2 children can be covered under this floater.
  • This plan offers coverage of INR 5,00,000 to INR 10,00,000. Along with benefit to opt for zero deductible after retirement this plan also offers flexibility to its customer to choose their own combination of deductible and coverage.

Optima Cash- (Daily Hospital Cash Plan)

  • This is another top up plan for anyone between age 5 years and 65 years. Is also available to dependent children after age 91 days.
  • This plan offers the benefit of daily cash allowance in case of hospitalisation and certain day procedures.
  • This policy also comes with a convalescent cash benefit.

Senior Citizen

  • This is an exclusive health insurance plan for senior citizens which provide coverage for both individual and/or their spouse from age 61 on wards.
  • Benefits like E-opinion, Cumulative bonus, Domiciliary treatment, etc. are available under this policy.

Dengue Care

  • This is an exclusive plan that covers you for inpatient & outpatient treatment for Dengue.
  • Offers benefits like one premium irrespective of age, no medicals, comprehensive in-patient hospitalisation cover with no sub-limits/co-payment, cover for OPD expenses up to Rs. 10000/- and only 15 days of waiting period.
  • Lifelong renewable.

Talk to a Health Insurance Advisor

Understand all the benefits of Apollo Munich health plans

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Benefits

The collaboration of Asia's largest healthcare provider and major global insurance company offers a host of unique and comprehensive features.

  • Wide Sum Insured Options – offers varied choice of Sum Insured beginning at Rs. 1 lakh up to Rs. 15 lakhs at affordable premium.

  • RESTORE Benefit - In Optima Restore health plan, Restore benefit is offered if the sum insured is exhausted during the year. This amount can be used for any new illnesses without any paperwork or any extra charge.

  • Lifelong Renewal – The plans offered are lifelong renewable hence it saves you from the financial burden and stress caused by a medical emergency and keeps you well prepared to handle any situation.

  • No Sub-Limits on Room Rent - As sub-limits on room rent practically eat into your sum insured, Apollo Munich scores brownie points for their plans without any sub-limits on the room rent.

Claim Process at Apollo Munich

The Health Insurance Policy can be claimed through two ways: Cashless settlement at the network hospital and Re-imbursement after the treatment/hospitalization. However, in both scenarios, an early intimation to the insurance company is mandatory. A pre-approval needs to be in place for a planned hospitalization.

For Cashless Service:

  • At the time of hospitalization, submit the completed Pre-Authorization form at the TPA desk
  • The TPA representative will then forward the form to Apollo Munich for an approval along with necessary doctor’s report
  • The request is then reviewed by the Claim Experts at Apollo Munich and an approval is then issued. Please note that the insurance company can raise queries, if required
  • In case of rejection of the authorization, initiate the required treatment and claim for reimbursement later

For Re-imbursement of claim:

  • Post hospitalization, complete the claim form and submit the same to the insurance company along with other documents like Discharge Summary issued by the hospital, Prescriptions, Bills and Invoices for medicines/treatments, etc.
  • In case, insurance company needs any further clarification/information, it will be duly notified to you
  • Similarly, if the claim is rejected, a detailed rejection letter will be shared with you along with the reasons for denial

Apollo Munich takes pride in their claim settlement process. They claim to have settled 95% of the claims within 30 days.

Note: If you are a Coverfox customer, you can directly reach out to us for all your claim-related issues and queries.

Frequently Asked Questions

What are the benefits of your health card?

A health card indicates the contact details and the contact numbers of the TPA accompanied by your policy details. In case of a medical emergency, you can call on these numbers for enquiries, clarifications and for seeking any kind of support. In addition, you need to show your health card at the time of admission into the hospital.

Is Health check up offered by Apollo Munich?

Yes, at the end of a block of every continuous 2/3/4 years (As per variant opted) during which you have been insured with Apollo Munich. However, their maximum liability will be subject to 1% of the sum insured for the policy year or the succeeding policy years (whichever is lower).

Why should I buy a critical illness cover?

With speedily fluctuating demographics and lifestyles, incidence of critical illness is on the upsurge in India. With increase in life expectancy and prolonged nature of critical illness there is a necessity of surplus funds to meet the expenses of higher medical overheads for treating such critical illnesses. Apollo Munich policy protects against 8 most common critical illnesses where an insured is reimbursed by a lump sum payout.

How do I find out which Hospitals are part of a given insurance network?

You can refer to the list of empaneled hospitals on their website www.apollomunichinsurance.com or the list provided in the guidebook or welcome kit. Simultaneously, you can also call their Toll Free Line at 1800-102-0333 or email them at customerservice@apollomunichinsurance.com for any additional assistance you may need. To locate an Apollo Munich network hospital near you, click here.

Please note that, as an esteemed Coverfox customer, you are welcome to reach out to us as we are obliged to assist you in every possible scenario.

Review of Apollo Munich Health Insurance

  • 80% of Apollo Munich's prevailing customers renew their policies each year
  • Over 95% of the claims being settled within 30 days from the point of initiation of the claim with 15 days being the average claim settlement period
  • Cashless authorizations happening within 2 hours from the point of claim intimation

With such inspiring statistics, the company has the determination, the recognition and the assets to upraise itself on top of the health insurance domain in India. Do contact Coverfox at 1800-209-9970 if you are looking to buy a new Health Plan or considering porting from your current insurer.