Apollo Munich Health Insurance

Accidents can happen anytime and diseases are unwelcome guests in everyone’s life. Therefore, preparing yourself to tackle unforeseen situations is always a good idea. With Apollo Munich, a reliable name in the health insurance space, insurers can invest in a plethora of health insurance plans that suit their need.

Considered as one of the most trustworthy insurance brands in India

Plans like Easy Health, Optima Restore, Optima Vital and Optima Plus, cater to individual health needs to ensure all you have to worry about is your well-being and of those who matter to you.

Features of Apollo Munich Health Insurance

  • No. of members- The plan covers maximum 6 members of your family with up to 4 children and 2 adults.
  • 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.
  • Wide Sum Insured Options – offers varied choice of Sum Insured beginning at Rs. 1 lakh up to Rs. 15 lakhs at affordable premium.
  • Pre & Post hospitalization cover- The plan covers medical expenses for 60 days prior to hospitalization and 90 days post hospitalization only for related medical expenses.
  • Health Check-ups – The policy offers up to 1% of the sum insured under individual plan per insured person and also up to 1% of the sum insured per policy under family plans.
  • Pre-existing diseases- Pre-existing diseases are covered after 3 years of waiting period.
  • Co-payment- The plan has no co-payment policy.
  • 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.

Benefits of Buying Health Insurance from Apollo Munich

Apollo Munich is one of the top rated health insurance companies in the country. The insurance provider has made a place in the market as it provides the following benefits:

  • Competitively priced products
  • Great customer service post sales
  • Dedicated claim handler to make the claim settlement process smooth & easy.
  • The incurred claim settlement ratio of Apollo Munich Health Insurance for F.Y. 2017 - 18 is 62.47%.

Apollo Munich Health Insurance Plans

What is Covered in Apollo Munich Health Insurance?

Apollo Munich offers the following Health Insurance Plans that cover medical costs in case of hospitalization, right from accidents to critical illnesses. They are as follows:

Apollo Munich Easy Health Plan

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 policy or family floater basis.

Apollo Munich Easy Health Standard Plan

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 Rs.1 lakh and Rs.5 lakh 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 Rs.2 lakh to Rs.5 lakh 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.

Apollo Munich Easy Health Exclusive Plan

Individual Coverage

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

Family Floater Coverage

  • This plan offers coverage to entire family in the range of Rs.3 lakh and Rs.50 lakh 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 checkup after every 4 years and covers maternity benefits. It also has the option of choosing recovery benefit and additional critical illness.

Apollo Munich Easy Health Premium Plan

Individual Coverage

  • This plan is a variant of easy health plan, which offers coverage in range of Rs.4 lakh and Rs.50 lakh 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 Rs.4 lakh and Rs.50 lakh 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.

Apollo Munich Optima Restore Plan

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 Rs.3 lakh and Rs.50 lakh 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 50 % of sum insured up to a maximum of 100%, 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 Rs.3 lakh and Rs.50 lakh for adults up to age 65 years and dependent children between ages 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 50 % of sum insured up to a maximum of 100%, 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.

Apollo Munich Maxima Plan

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

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

Apollo Munich Energy Plan

This plan is designed especially 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 Rs.2 lakh to Rs.10 lakh 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.

Apollo Munich Optima Vital Plan

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 Rs.1 lakh and Rs.50 lakh 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 this policy.

Apollo Munich 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 Rs.5 lakh and 5 crore.
  • The sum insured after age of 70 years (for existing policy holders) is only Rs.5 lakh.
  • 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.

Apollo Munich Optima Plus Plan

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 coverage of Rs.5 lakh with a deductible in range of Rs.1 lakh and Rs.5 lakh.

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

Apollo Munich Optima Super Plan

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

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 Rs.5 lakh to Rs.10 lakh with deductible in range of Rs.1 lakh and Rs.10 lakh.
  • 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 Rs.5 lakh to Rs.10 lakh. Along with benefit to opt for zero deductible after retirement this plan also offers flexibility to customers to choose their own combination of deductible and coverage.

Apollo Munich Optima Cash Plan- (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 hospitalization 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 onwards.
  • Benefits like E-opinion, Cumulative Bonus, Domiciliary Treatment, etc. are available under this policy.

Apollo Munich Dengue Care Plan

  • 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 hospitalization cover with no sub-limits/co-payment, cover for OPD expenses up to Rs.10000/- and only 15 days of waiting period.
  • Lifelong renewable.

What is Not Covered in Apollo Munich Health Insurance?

Some of the main exclusions of a health policy offered by Apollo Munich are as follows:

  • Hospitalization due to war or any act of war due to nuclear, chemical and biological weapons or radiations of any kind.
  • Any Insured Person committing or attempting to commit a criminal or illegal act, or self injury or attempted suicide while sane or insane.
  • Any Insured Person’s participation or involvement in naval, military or air force operations, racing, diving, aviation, scuba diving, parachuting, rock or mountain climbing.
  • Abuse or the consequences of the abuse of intoxicants or hallucinogenic substances.
  • Expenses arising from sexually transmitted diseases, like AIDS.
  • Non-allopathy treatment, congenital diseases, mental disorders etc.
  • Items of personal comfort and convenience.

Another main factor that as a policyholder, you should consider is the concept of waiting period. Until the waiting period lapses, no coverage is offered. For instance, if a pre-existing disease coverage comes with a waiting period of 3 years, it means that since the day the policy has been issued, there would be no coverage for those disease and its related expenses for the first three years. Similarly, the waiting period for some other disease might be different.

Eligibility Criteria to Buy Apollo Munich Health Insurance Plans

The eligibility criteria to buy Apollo Munich’s health insurance plan varies with each policy. The following table describes the criteria for each:

Health Insurance PlanMinimum Entry AgeMaximum Entry Age
Apollo Munich Optima Restore5 years (newborn: 91 days)65 years
Apollo Munich Energy18 years65 years
Apollo Munich Easy Health5 years (newborn: 91 days)65 years
Apollo Munich Easy Health- Premium5 years (newborn: 91 days)65 years
Apollo Munich Easy Health- Popular5 years (newborn: 91 days)65 years
Apollo Munich Optima Cash5 years (newborn: 91 days)65 years
Apollo Munich Optima Cash- Top-up5 years (newborn: 91 days)65 years
Apollo Munich Maxima5 years (newborn: 91 days)65 years
Apollo Munich Optima Super5 years (newborn: 91 days)65 years
Apollo Munich Optima Vital5 years (newborn: 91 days)65 years

Claims Process at Apollo Munich Health Insurance

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.

Apollo Munich Health Insurance Premium Calculator

The company’s website offers the facility of calculating your premium online with an online premium calculator. Using this calculator is simple as all you need to do is follow a few simple steps. Select the policy, choose the location from the drop down, provide the family size, the sum insured, age of the eldest member as well as the deductible amount. Now, this calculator will provide you with the base premium, gross premium and discounted premium amount per year. Based on this, you can take an informed decision of whether or not to buy the policy.

Apollo Munich Health Insurance Renewal Online

Apollo Munich offers lifetime renewability for all its health insurance policies. To renew the policy, you need to make a renewal payment atleast 60 days before the expiration date. The amount of renewal is based on the age of the policyholder at the time of renewal. In case you miss out on renewing the policy within the grace period, then you will have to buy a new policy altogether.

To renew the policy online, simply visit the official website of Apollo Munich Health insurance and login with your registered email id and password, pay the renewal premium and your policy will be renewed instantly. There is also a possibility to login with your policy number. However, the health insurance policy has a policy number that shall change every time during renewal.

Documents Required to buy Apollo Munich Health Insurance

The documents required to buy Apollo Munich’s health insurance policy is same as buying any other health insurance policy. The documents are as follows:

  • Age Proof- Birth certificate, 10th or 12th passing certificate, Passport, Aadhaar, etc.
  • Identity Proof- Aadhaar card, Passport, Driving License
  • Address Proof- Electricity bill, Ration Card, Driving License
  • Medical check-up for policyholders above the age of 45
  • Passport Size Photographs

Apollo Munich Health Insurance Network Hospitals

Apollo Munich has a highly acclaimed list of Apollo Munich Health Insurance Network Hospitals that provide world class service. The insurance provider is registered with 4650+ hospitals PAN India who are devoted to help patients with their cashless claim facility.

Apollo Munich Health Insurance Customer Care Support

Apollo Munich has a well-trained customer service staff and a robust website that answers all your queries. Simply log on to the official website and visit the ‘Customer Service’ tab. Following options shall be visible to you:

  • Contact Us: As a policyholder, you can either fill out a simple form on the website and get your queries answered or call on the toll free number- 1800-102-0333. Alternatively, you can reach out to the customer service team on customerservice@apollomunichinsurance.com
  • Branch Offices: You can also reach out to any of the offline branches of Apollo Munich Health Insurance and get your queries resolved in person.
  • Grievance Redressal: In case you want to reach out to the grievance redressal cell, you can walk in or write a letter to Apollo Munich Health Insurance Co. Ltd., iLABS Center, 2nd and 3rd floor, Udyog Vihar, Phase- 3, Gurgaon- 122016, Haryana

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.

Frequently Asked Questions On Apollo Munich Health Insurance

Does Apollo Munich Cover Pregnancy?

While Apollo Munich does not cover pregnancy in standard insurance plans, the Easy Health Family Floater Premium plan provides maternity benefits to the mother and the new born child.

How do I cancel my Apollo Munich Health Insurance?

If you want to cancel or terminate your policy, you can give a written notice at any Apollo Munich branch or call on 1800 102 0333.

Does Apollo Munich cover cancer?

Yes, Optima Vital, a health insurance plan by Apollo Munich covers 37 critical illnesses, including cancer.

How do I claim or indemnify the medical benefits under Apollo Munich Health Insurance?

The expenses or benefits can be claimed or indemnified by reimbursement or by availing cashless services at the hospitals.

Who is TPA of Apollo Munich Health Insurance?

For all retail policies, Apollo Munich has an in-house claim settlement team. For group policies, the company’s major TPA is Family Health Plan Limited (FHPL). However, the firm also uses some other TPAs depending on the company’s requirement.

What is a pre-existing disease or condition under Apollo Munich Health Insurance?

By Pre-existing Condition, Apollo Munich refers to any condition, injury or ailment etc. 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.

How do I avail cashless benefit under Apollo Munich health insurance?

To avail cashless benefit, you need to show the Apollo Munich Health Card to the treating doctor when you get hospitalized at the network hospital. The Network Hospital would contact the responsible TPA (Third Party Administrator mentioned on the card) and fill up the pre-authorization form. Then it would send the same to TPA with estimation and approval of expenses.

How can I add my family members to my existing Apollo Munich Health Insurance policy?

To add a family member to your existing policy, you will be required to fill the Change Request Form. Submit the form to Apollo Munich’s nearest branch along with the revised premium. Please note that a mid-policy term addition will be available only for a new born and a newly-wed spouse.

What is Restore Benefit in the Apollo Munich Health Plan?

A Restore benefit in Apollo Munich is a benefit that which reinstates your sum insured when it gets exhausted. This happens within a policy period and is dependent on the terms and conditions of the plan.

Leave a rating!
3.5 (33 votes)