Apollo Munich Optima Plus Health Insurance

• Enjoy options to cover yourself, your spouse, kids and even your parents
• Enjoy access to 10,000+ hospitals for cashless treatment
• Reduce your taxable income by up to Rs. 50,000 deduction under section 80D**

General insurance service provider Apollo Munich is a popular brand when it comes to health insurance in India. The company’s product lineup has a diverse range of plans suitable for people with different requirements. Apollo Munich Optima Plus is a top-policy that could provide you the much-needed extra coverage when your claims exceed the coverage offered by your regular health insurance plan. With an affordable pricing and flexible deductible options, Optima Plus could be the extra coverage that you might be looking for to cover you and your family.

Eligibility for Apollo Munich Optima Plus

Policyholders who wish to subscribe to Apollo Munich Optima Plus must meet the following eligibility criteria:

• The age of the proposer must be between 18 years and 65 years.
• Dependent children can be covered from their 91st day of birth.
• Dependent children between the age of 91 days and 5 years can be covered only if either one of their parents are covered.
• A maximum of 6 family members can be enrolled in the same policy. This coverage can be taken for self, spouse, dependent children, and dependent parents.
• Once entered, the Optima Plus policy can be renewed throughout one’s life.

Features of Apollo Munich Optima Plus

Some of the notable features of Apollo Munich Optima Plus can be listed as follows:

• The sum insured option available under this policy cover is Rs.5 lakh.
• This top-up policy is available with 5 different deductible options ranging from Rs.1 lakh to Rs.5 lakh.
• If more than 2 more members of a family are covered under the same policy, a family discount of 10% is available with this policy.
• This policy is available in 1 or 2-year policy terms. A 7.5% discount is available if the policy term is chosen for 2 years.
• There is an initial waiting period of 30 days from the date of inception of this coverage for sickness hospitalisation. This does not apply to hospitalisation due to accidental injuries.
• Pre-existing illnesses can be covered only after 4 years of continuous policy coverage.
• Certain conditions like cataract, hernia, hydrocele, joint replacement surgery, etc. can be covered only after 2 years of continuous policy coverage. The extensive list of these conditions can be found in the policy document.
• Pre-hospitalisation medical expenses are covered for up to 60 days before the date of hospitalisation.
• Post-hospitalisation medical expenses are covered for up to 90 days after discharge from the hospital.
• There is a free look period of 15 days to check the terms of the policy and cancel it if the terms are not satisfactory.
• The company offers a grace period of 30 days from the date of expiry to renew this medical insurance cover.
• As per the IRDAI regulations, Apollo Munich allows policyholders to port their policies without losing out on accrued benefits.
• The premium amount paid for this policy is eligible for tax relief as per Section 80D of the Income Tax Act.

Benefits of Apollo Munich Optima Plus

The benefits available for policyholders of Apollo Munich Optima Plus can be listed in the table below:

Exclusions of Apollo Munich Optima Plus

There are certain exclusions for which Apollo Munich Optima Plus is not liable to provide any coverage, and they are listed as follows:

• Hospitalisation due to self-inflicted injuries or suicide attempt
• Medical expenses related to HIV, AIDS, and other sexually transmitted diseases
• Treatment for mental conditions including stress, anxiety, depression, etc.
• Expenses incurred for weight management or obesity treatments
• Medical expenses related to drug or alcohol abuse
• Illness or injuries caused by war or warlike activities
• Expenses related to external aids such as crutches, hearing aids, eyeglasses, etc.
• Cosmetic, aesthetic, or elective surgeries
• Hospitalisation due to exposure to nuclear materials, toxic substances, or radiation
• Medical expenses incurred through experimental or unproven treatment methods
• Any kinds of non-medical expenses

Claim Procedure

Any information regarding the claim procedure, claim forms, network hospitals, etc. can be found in the company’s official website. To initiate the claim procedure, you must intimate the insurer regarding the hospitalisation well in advance. While emergency hospitalisation can be informed within 24 hours after admission in a hospital, it is better to intimate planned hospitalisation at least 48 hours in advance.

You can get cashless treatment in any of the company’s network hospital. Check the network hospital list in the official website to find out if there are any close to your residence. You can send the pre authorisation request from the hospital through fax or by any other means. The insurer will verify the request before providing the approval. Once you get the approval, you can proceed with the cashless treatment process.

Reimbursement claims can be made after discharge from the hospital. You can contact the customer care regarding this process if you have any doubts. Along with the claim form, you must also submit various documents like medical bills, cash receipts, diagnostic reports, physician certificate, discharge summary, etc. The company will verify these documents and provide the reimbursement amount upon acceptance.

FAQs on Apollo Munich Optima Plus Health Insurance

1. What is the premium payable for Optima Plus?

The premium payable towards Apollo Munich Optima Plus depends on various factors such as the sum insured amount chosen, the policy tenure opted for, the age of the policyholder, the age of the members of the policy, and so on. The deductibles opted for by the policyholder will also determine the premium payable. Health insurance applicants can check the premium amount payable online through the premium calculator available on the official website.

2. Can I port to a different health insurance plan?

Yes, the plan offers the portability option. The policyholder is required to apply for portability 30 days before the renewal date of the current policy. The portability form is available on the insurer’s website.

3. Is the lifetime renewability option available under Optima Plus?

Yes, Optima Plus offers the lifetime renewability option which allows policyholders to renew the policy throughout his/her lifetime.

4. Can I convert my plan to a fully fledged indemnity plan?

Yes, the health insurance plan offers the option to convert the plan to a fully-fledged indemnity plan at retirement. The policyholder can avail this benefit when he/she is between 58 years and 60 years. The condition to avail this option is that the policyholder should have enrolled in this policy before he/she has turned 50 years old and has renewed the policy without any breaks.

5. What are the customer care contact numbers of Apollo Munich?

If you want to buy an Apollo Munich health insurance plan, you can call 1800-103-0555. In case of any service-related queries, you can call 1800-102-0333.