Apollo Munich Energy Health Insurance Plan

Apollo Munich is one of the few private companies in India that offer comprehensive medical and health insurance plans that cover a wide range of treatments and costs. These include the Easy Health Insurance Plans, Personal Accident Insurance, Travel Insurance, and much more.

The Energy Health Insurance Plan is an individual wellness program for Type 1 and Type 2 Diabetes Mellitus patients as well as individuals suffering from IFG (Impaired Fasting Glucose), IGT (Impaired Glucose Tolerance), and Hypertension.

The plan offers coverage for all treatment and hospitalisation related charges that arise out of Diabetes or Pre-diabetes from Day 1. In other words, there is no waiting period. This plan is offered based on individual sum insured.

All About Apollo Munich Energy Health Insurance Plan

About Apollo Munich

Apollo Munich Health Insurance Company Ltd. is a joint venture between the Apollo Hospitals Group and Munich Health, the largest business segment of the leading global reinsurance company based in Germany. Founded on 8 August 2007, Apollo Munich is a private-sector health insurance company that has over 180 physical offices and more than 4500 employees in India.

Eligibility

Any individual between the ages of 18 and 65 is eligible to apply if he or she is diagnosed with any of the following:

  • Type 1 Diabetes
  • Type II Diabetes Mellitus.
  • Impaired Glucose Tolerance (IGT).
  • Impaired Fasting Glucose (IFG).
  • Hypertension.

(The last three are also known as Pre-diabetes)

Features

The Apollo Munich Energy Health Insurance Policy can be taken for one year. Upon renewal, there may be a change in the premium amount, depending on whether there’s a change in your age or the tax rate applicable.

The policy comes in two variants:

  • Gold (Includes treatment costs and a wellness test).
  • Silver (Only treatment costs are included).

Both these plan options are available with co-payment options that bear about 20% of the claim amount. The plan can be taken out based on sum insured invariants of Rs. 2,00,000, 3,00,000, 5,00,000, 10,00,000, 15,00,000, 20,00,000, and 50,00,000.

Renewal Policies

Lifelong coverage

The policy can be renewed for life long coverage as long as the insured doesn’t act dishonestly or commit an act of fraud during the tenure of the policy.

  • Upon completion of the current policy year, a grace period of 30 days is provided for renewing the policy.
  • Some pre-existing illnesses and ailments apart from Diabetes Type II or Pre-diabetes are given a waiting period of two years before they get covered. However, with each continuous renewal of the insurance policy, the waiting period will be reduced by one year.

Advantages

Day one coverage

The unique insurance plan offers you comprehensive coverage from day one. It allows for instant treatment coverage for all complications arising out of Diabetes and Hypertension (with no waiting period) Inpatient hospitalisation coverage with no sub-limits, including coverage for pre and post hospitalisation.

Wellness Management Program

The policy comes with a comprehensive package of two wellness tests once every six months.

  • Medical check 1: It is a test administered to monitor your Blood pressure and Haemoglobin levels as well as your BMI (Body Mass Index).
  • Medical check 2: It includes a comprehensive check-up that involves determining your body’s Haemoglobin, BMI, Cholesterol, Bilirubin, etc.
  • It also covers Doctor consultation charges.
  • It is worth noting that with the Gold variant, any of the costs incurred upon medical tests will be entirely reimbursed if the said medical tests are done at any of Apollo Munich’s network centres.
  • If you do undergo any of the wellness tests at an approved but non-network centre, you will be reimbursed a sum up to Rs. 2000 at the end of the year in which the policy is taken out.

Additional Support

  • You will be given access to a personalised web portal that keeps a comprehensive and detailed record of all your test results, so that you can easily track all of your medical test values. It also provides you with special offers on medical products that you may need.
  • A highly trained, personal health coach will offer you guidance and help you create your diet and monitor your fitness plans and lifestyle, providing corrections to your routine wherever necessary.
  • You will also be provided with periodical newsletters on healthcare and wellness management as part of the Stay Healthy Package. Along with that, the Package also offers you digital storage facilities online for keeping your medical reports. These records can be accessed at any given time.
  • You will also be given access to a centralised helpline to address all of your health-related queries.

Benefits of Apollo Munich Health Wallet Plan

  • The health coverage has no waiting period. All hospitalisation and medical charges are covered from Day one itself.
  • The plan comes with a reward points system that offers you incentives that motivate you to stay healthy. It includes reimbursing up to 25% of your premium amount for health condition management and covering medical expenses that weren’t previously covered under the insurance upon renewal.
  • Inpatient hospitalisation: It covers expenses related to hospitalisation if the patient has been hospitalised as a result of an illness or an accident for a period longer than 24 hours. The charges covered under this category include Nursing, Hospital room rent, ICU, Doctor’s practitioner fee, etc.
  • Pre-hospitalisation coverage: All medical expenses incurred up to 30 days before hospitalisation will be covered. It includes fees such as consultation charges and medication.
  • Post-hospitalisation coverage: All medical expenses incurred up to 60 days after the patient is discharged from the hospital are also covered.
  • The Energy Insurance Plan also covers up to 182 day-care procedures.

What is a day-care procedure?

Any medical or surgical treatment that takes less than 24 hours to complete owing to the advanced technological facilities available at the hospital is known as a day-care procedure.

As long as the procedure is undertaken while the patient is under General Anaesthesia or Local Anaesthesia and the process would’ve otherwise required the patient to be hospitalised for more than 24 hours, it qualifies as a day-care procedure.

These procedures include treatments such as Chemotherapy, Coronary Angiography, Cataract Operation, Haemodialysis, etc.

  • Emergency ambulance coverage : In case of an emergency or a complication that arises out of the illness or an accident during the policy period, any emergency ambulance charge is also covered.

  • Organ donor expenses: The plan covers the cost of the transplant surgery should it be required.

  • Shared Accommodation: If the insured is admitted to a Network Hospital in shared accommodation, specific general non-medical exclusions are waived off.
  • Haemoglobin Check-up: Up to Rs.750 is reimbursed on each HbA1C test, provided the original receipt of payment is submitted. This benefit can be availed as long as the following conditions are met:

    • The date of the tests should be within the current policy year.
    • Only two such claims can be made in a single policy period
    • There should be a minimum of 3 months gap between the two tests.

Additionally, it is worth noting that the HbA1C tests done as part of the wellness checkup (Gold variant) will not be considered when availing this benefit.

  • Restoration Benefit: The Basic Sum will be restored in full to the insured upon complete or partial utilisation of the existing insurance money during the current policy year. This benefit can be availed by the insured as long as the claim of the current policy year hasn’t exceeded the Basic sum insured and the cumulative bonus.

  • Cumulative Bonus : If the policy is claim free and the policy is renewed without a break, a 10% cumulative bonus is added along with your Basic insurance sum for the refurbished policy year.

The insured is also eligible for any tax deduction under Section 80D of the Income Tax Act, 1961, for the premium amount paid under the policy.

  • Cashless service: The insured can avail cashless facilities in the case of emergency hospitalisation provided the TPA (IRDA) is informed within 24 hours of admission.

If the hospitalisation is planned, you must seek authorisation from your TPA at least 48 hours before being hospitalised. If you are eligible for such a service, your TPA will send an authorisation letter to your provider.

  • Portability Policy: Let’s say you already have an existing insurance plan with another company and would like to shift to Apollo Munich’s Plan upon renewal. This is made possible, thereby allowing you to transfer any of the pending benefits.

Why is Apollo Munich Energy Insurance Plan so Important?

  • Almost 50 million people are estimated to have been diagnosed with diabetes in India. It also tends to appear in much earlier stages of life, which results in much more long term complications.

  • The changing lifestyles which involve long hours of work, lack of exercise, insufficient rest, and unhealthy food habits are certainly taking a toll on the health of the average person. A recent survey conducted by Nielsen India indicates that one out of every five workers is said to be diagnosed with diabetes or similar pre-diabetes ailments, such as hypertension.

  • While diabetes may not be as worry-inducing as cancer or cardiac diseases, the treatment is still quite expensive, costing up to Rs. 9000 per month in most cases. Further complications can cause this amount to go up as high as Rs. 20,000.

  • There is a 20% chance that a person past the age of 45 will have diabetes. The odds worsen to an unfavourable 50% once you hit 55.

  • Considering how damaging diabetes can be to the heart, blood vessels, kidneys, the nervous system, and the entire body as a whole, it seems wise to get a comprehensive health insurance package early on. It makes sense to opt for a plan that comes with fewer restrictions, covers the expensive treatment costs, and comes with additional benefits that can help you on your way to a speedy recovery.

  • While most packages have a waiting period of about 1 to 2 years, the Apollo Munich Energy Insurance Plan differs in this regard. There is no waiting period, and treatment costs are covered from day one itself.

  • There is also a co-payment option that covers 20% of the claim amount. It covers up to 182 day-care procedures. It also includes a comprehensive wellness program that covers a half-yearly medical test, offers web portals and newsletters, appoints a personalised health coach to help you recover, etc.

  • It covers a lot of additional costs incurred and comes with further benefits such as restoration and cumulative bonuses that make it one of the best diabetes insurance plans you could opt for in the country.

  • It is also one of the most dedicated insurance plans that covers many types of hospitalisation and treatment costs.

How to Buy the Apollo Munich Energy Insurance Plan

There are two ways in which the insurance plan can be availed: Online and offline.

  • Here’s how you do it online-
  • First, visit the Apollo Munich official website.
  • Open the Energy plan page.
  • A form will be provided for you to fill online. The fields include details regarding your personal information and your relevant medical history.
  • Fill the application form and submit it online.
  • Select the premium option of your choice and proceed to pay using your preferred mode of payment.

The plan can also be bought through an authorised broker where the payment is made via a premium cheque.

Documents That Should Be Attached Along with the Proposal Form

  • ID proof : Any document relevant to proving your identity, such as a copy of your Passport, your driver’s license, your voter’s ID, or your Pan card will suffice.
  • Proof of Residence: : It could be your Telephone Bill, your Bank account statement, your Electricity bill, or anything similar.
  • Age Proof: Any documents such as your Birth certificate, school leaving certificate, etc. is enough.
  • In case your current policy has expired, and you seek to renew it, a copy of the Renewal notice must also be submitted.
  • Certification of your previous insurer detailing the settlement of your preceding claims.

Documents Required for Claiming the Insurance Amount

While submitting the claim form, you must ensure that the following documents are attached:

  • Original bills, including the medicine purchase receipts, the consultation bills, and the diagnostic bills. Original receipts and prescriptions that support the amount to be claimed are also included under this category.
  • Any medical reports and records such as case histories, treatment documentation, and discharge summaries should be included.
  • An accurate and precise diagnosis of the patient’s medical condition and the treatment availed.
  • All medical prescriptions related to the treatment and their respective payment receipts.
  • A certificate from the treating doctor about any information that is missing from the case history. These include the circumstances of any injury or accident.

Conclusion

When you consider the rising rate of diabetes cases in the country, it helps to be prepared for the worst. Diabetes is a severe condition that requires very specialised care and a plan that accounts for and covers multiple aspects of the treatment. Apollo Munich’s Energy plan offers much-needed relief in this regard. So, if you’re considering getting yourself or one of your family members specific diabetes insurance policy to be safe, it doesn’t hurt to go with one of the very best.

Frequently Asked Questions

How will my insurance claims be indemnified?

Your expenses will be covered, and your insurance claims repaid by way of reimbursement. You can also avail of cashless facilities from the network hospital.

Does the cashless facility cover all expenses incurred?

All medical expenses incurred will be covered up to the amount of the sum insured and terms and conditions mentioned in the policy document. However, you will be expected to pay non-medical bills and unrelated expenses if any, are incurred during your hospitalisation.

What is the maximum policy period?

The policy can be taken for a maximum of one year with the option to renew it every year.

Is the cashless facility available in all hospitals?

No, it can be availed only from a hospital that is a part of Apollo Munich’s Network hospitals.