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Apollo Munich Optima Restore Health Insurance Plan

Apollo Munich Health Insurance

5/5

Apollo Munich's Optima Restore Health Insurance Plan is a comprehensive product with useful features like the Restore benefit that automatically restores the basic sum insured if you consume it during the policy year. It also remunerates you with a multiplier benefit for claim free years doubling your basic sum insured in 2 claim free years!

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Highlights of Apollo Munich Optima Restore Plan

  • Automatic restore of basic sum insured in case your cover is exhausted in policy year, at no extra cost
  • Lifelong renewability
  • No co-pay, sub-limits or additional loading on renewals
  • Cashless access to more than 10,000 medical specialists and over 4500 hospitals in more than 800 cities
  • Available in Individual and Family Floater option
  • Premium is charged basis the city of residence provided in the application form
  • Tax benefits on the premium paid as per the prevailing Income Tax rates
  • Discount on premium for adding more than two members and for longer policy term

Scope of cover

Indivdual Plan

Entry Age

For children : 91 days

Adults :

Minimum : 18 years

Maximum : 65 years

Number of Members Covered

Maximum Members : 6

Maximum Adults : 4

Maximum Children : 5

Sum Insured

3 lakh - 50 lakh


discount

For longer policy term

Family Discount


Policy Periods Available

1, 2 years


Pre-Policy Medical Check-up

Age 46 Years and above

Sum Insured 15L & above


Scope of cover

Family Floater Plan

Entry Age

For children : 91 days

Adults :

Minimum : 18 years

Maximum : 65 years

Number of Members Covered

Maximum Members : 6

Maximum Adults : 2

Maximum Children : 5

Sum Insured

3 lakh - 50 lakh


discount

For longer policy term

Family Discount


Policy Periods Available

1, 2 years


Pre-Policy Medical Check-up

Age 46 Years and above

Sum Insured 15L & above


Important Features

Day Care Treatments

The plan covers the expenses towards all day-care procedures that would otherwise require hospitalization of a minimum of 24 hours.

    No-Claim Benefits

    For every claim-free year, you will be entitled to 50% cumulative bonus for the next policy year up to a maximum of 100% of the sum insured.

      Organ Donor Cover

      Covers for the medical expenses for harvesting the organ from the donor for transplantation up to a limit of sum insured.

        Pre Hospitalization

        Compensates for the Pre-Hospitalisation expenses for consultations, investigations and medicines incurred up to 60 days before Hospitalisation

          Post Hospitalization

          Compensates for the Post-Hospitalization expenses for consultations, investigations and drugs incurred up to 180 days after discharge from Hospitalization.

            Restore Benefits

            Restore benefit that automatically reinstate the basic sum insured if you exhaust it in a policy year.

              Good to Have Benefits

              PORTABILITY

              If you are currently insured with a different insurer and wish to switch to Apollo Munich's Optima Restore Health Plan, you can do the same without losing your accrued benefits after the waiting periods.

                TAX BENEFITS

                You can avail tax benefits for the premium amount paid towards this plan under Section 80D of the Income Tax Act, 1961.

                  SUM ASSURED ENHANCEMENT

                  You can request for an increase in the Sum Insured at the time of renewal subject to no claim have been raised/paid under the Policy.

                    DAILY HOSPITALIZATION ALLOWANCE

                    Depending on the sum insured you have opted for, you can get a daily cash allowance for up to Rs. 1,000 for a maximum of six days. Date of admission and discharge is included for payout.

                      HEALTH CHECK-UP

                      The plan allows you for a complimentary health check at the block of every two policy years up to a 1% of sum insured or a maximum of Rs.10,000 depending on the sum insured. It is now extended for lower sum insured of 5 lacs and above.

                        Emergency Air Ambulance

                        Compensates you for hospitalization towards the emergency ambulance services for sum insured more than or equal to 10 lacs.

                          HOME HOSPITALIZATION/DOMICILIARY HOSPITALIZATION
                          Video

                          You can avail treatment at home up to the base sum insured. There are certain terms and conditions related to this privilege, and you can refer them in the policy wordings.

                            STAY ACTIVE BENEFIT

                            By downloading the stay active mobile app, you can count the number of steps you take each day and earn up to 8% renewal discount on policy in case of floater plans and per person in case of individual plans.

                              Health Advisory benefit
                              Video

                              By taking treatment in a network hospital suggested by AMHI you can get a lumpsum benefit of Rs.5000.

                                Value Adds

                                E-OPINION

                                The plan also provides one opinion post diagnosis of critical illness per policy year.

                                  FREE LOOK PERIOD

                                  For any reason, should you decide not to proceed with the policy, you can return the same and request for a refund within 15 days from the date of receipt of the policy document.

                                    Add-on Covers

                                    CRITICAL ADVANTAGE RIDER

                                    If you opt for a basic sum assured of Rs.10 lakhs and above, you can choose to cover yourself worldwide at the network centers of the company against treatment expenses for eight major illnesses. This rider offers you freedom to not only avail best healthcare services world over but also covers all travel costs for the insured and accompanying relative, accommodation expenses, second opinion & post hospitalization expenses.

                                      Terms & Conditions

                                      Co-Payment

                                      If the age of the policyholder or the eldest member on the policy is more than 61 years, you will have to bear the 20% co-payment charges at the time of claim.

                                        Sub-Limits

                                        If the age of the policyholder or the eldest member on the policy is more than 61 years, you will have to bear the 20% co-payment charges at the time of claim.

                                          Waiting Period

                                          Cooling Off Period

                                          A 30 days cooling off period for all claims except any arising out of accidental injuries.

                                            Specific Illnesses

                                            The policy covers some specific diseases/treatments only after 24 months.

                                              Pre-Existing Illnesses

                                              You can claim for any pre-existing conditions after 36 months from the policy start date.

                                                Permanent Exclusions

                                                The Plan will not cover any liabilities towards the treatments of following conditions-

                                                • Attempted suicide
                                                • Use of alcohol or drug
                                                • AIDS
                                                • Pregnancy, childbirth, miscarriage, and abortion
                                                • Congenital disease & non-allopathic treatment
                                                • Infertility and in vitro fertilization.
                                                • Hospitalization out of war, riot, strike and nuclear weapons

                                                The detailed list of what the policy does not cover is available in the policy wording.

                                                Review of Apollo Munich Optima Restore Health Insurance Plan

                                                Apollo Munich's Optima Restore Health Insurance is fitting for those who are explicitly looking for a benefit like a reinstatement of sum insured if it gets exhausted during the policy year. The plan also offers other valuable features like an attractive no-claim bonus, no limits on room category and an extensive network of hospitals for cashless treatment. Available in both, Individual and Family Floater choice, Optima Restore should be considered if you are looking to buy health insurance.

                                                **Reviews and ratings are based only on Benefits and Conditions. Things like Claim Settlement Ratio, Hospital Network have not been covered under product ratings. These are covered under Company ratings.

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