Optima Plus Plan
Optima Plus is a top-up plan which offers an option to convert into nil deductible. This feature of this plan is unique as with this benefit the plan can act as a regular health insurance plan post retirement.
Main Highlight of the plan
- This plan gives an option to convert to nil deductible thus making the plan as good as a normal health insurance policy with a lower premium.
- The plan has option to choose from 5 deductible while the sum insured remains constant.
Scope of cover
- Entry age:
- Individuals between age 3 months and 65 years can be covered under this plan. Children between age 3 months and 5 years can be covered only if one of the parents is also covered.
- This plan offers individual coverage only.
- Family Coverage is offered to proposer, spouse, dependent parents and dependent children.
- Total 6 members of the family can be covered.
- In case of individual plan maximum 4 adults and 5 children can be covered.
- This plan offers a discount of 10% after covering more than 2 members under the same plan.
- Sum Insured and deductible values:
- The plan offers a sum insured of INR 5,00,000 with deductible in the range of INR 1,00,000 to INR 5,00,000.
Coverage: Benefits & Features
Most Important
ROOM RENT/ ROOM CATEGORY
This plan does not have any limits specified over room rent expenses.
CO-PAYMENT
This plan does not have co-payment condition.
NO-CLAIM BENEFITS
This plan does not have benefit after claim free year.
Good to have
Good to have benefits offered in the Optima Plus plan are:
PRE/POST HOSPITALIZATION
60 days of pre hospitalization and 90 days of post hospitalization expenses is covered in this plan.
Value Adds
The benefits that add value to Optima Plus by Apollo are:
Exclusions
A cooling off period of 30 days is applicable for the first year after buying the policy. During this period, no claims (other than claims related to an accident) can be made.
Waiting period of 2 years is applicable for specified ailments. Refer the policy wordings for the complete list of ailments listed under each category.
Pre-existing diseases are covered after a waiting period of 4 years.
Pre and post hospitalization expenses are not covered under this plan.
PERMANENT EXCLUSIONS
Cosmetic surgery, Lasik eye treatments, drugs or Circumcision, genetic disorders, self-inflicted injuries, war related injuries, etc. are some of the exclusions. For the detailed list of please refer the policy document.