• Apollo Munich Optima Super Health Insurance

    Car Insurance
    • Premiums as low as Rs12/day for coverage of Rs.4 Lakhs*
    • 10,000+ hospitals for cashless treatment
    • Claim up to Rs. 55,000 deduction under section 80D**

    Optima Super is one of the top up policies available in the product lineup of standalone health insurance service provider Apollo Munich. A top up policy is something that will provide you the extra coverage when your regular health insurance cover gets exhausted. This may come in handy during emergency situations where the medical expenses go overboard in an unexpected manner. Apollo Munich Optima Super is affordably priced and comes with flexible sum insured options. A certain level of deductible must be exhausted before this top up health insurance plan gets activated.

    Eligibility for Apollo Munich Optima Super

    Apollo Munich Optima Super can be the taken by people who meet the following eligibility criteria:

    • The maximum entry age under this policy cover is 65 years.
    • Dependent children between the age of 91 days and 5 years can be covered provided at least one of their parents are covered.
    • A maximum of 6 family members can be enrolled under a single policy cover.
    • Lifelong renewability option is available under this medical insurance plan.
     

    Features of Apollo Munich Optima Super

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

    • This top up health insurance policy is available in three different sum insured options: Rs.5 lakh, Rs.7 lakh, and Rs.10 lakh.
    • The deductible options available with this policy ranges from Rs.1 lakh to Rs.10 lakh.
    • This policy is available in 1 or 2-year policy terms. There is a 7.5% discount available on the premium charges if this policy is chosen for a 2-year term.
    • A family discount of 10% is applicable if 2 or more members of a family are enrolled in the same policy cover.
    • For sickness hospitalisation, there is a waiting period of 30 days from the date of commencement of the policy.
    • There is a waiting period of 4 years for all kinds of pre-existing diseases.
    • There is a 2-year waiting period for certain conditions like cataract, hernia, joint replacement surgery, hydrocele, etc. The complete list of these conditions can be taken from the policy document.
    • This policy covers pre-hospitalisation medical expenses for up to 60 days prior to the date of admission in a hospital.
    • It covers post-hospitalisation medical expenses for up to 90 days after discharge from the hospital.
    • This policy can be converted into a regular health insurance plan without any deductible only between the ages of 55 and 60. This benefit can be availed only if the policy is taken before the age of 50.
    • There is a free look period of 15 days available with this policy. The policyholder can review the terms during this period and cancel it if they are not satisfied.
    • A grace period of 30 days is available from the date of expiry to renew this policy cover.
    • The sum insured amount chosen at the time of signing up for this policy can enhanced during the time of renewal.
    • Income tax relief under Section 80D of the Income Tax Act is applicable to the premiums paid on this policy cover.

    Benefits of Apollo Munich Optima Super

    This policy comes with a range of benefits to provide adequate financial support to policyholders during a medical emergency:

    Benefits Extent of Cover
    In-patient hospitalisation expenses Up to the sum insured limit (after the exhaustion of the deductible amount)
    Day care treatment Covered for up to 144 procedures
    Organ donor Covered (including the treatment expenses related to harvesting the organ)
    Emergency ambulance cover Up to Rs.2,000

    Exclusions of Apollo Munich Optima Super

    Some of the key exclusions applicable to Apollo Munich Optima Super can be listed as follows:

    • Intentional injuries or self-inflicted injuries
    • Expenses related to cosmetic or aesthetic treatments
    • Sexually transmitted diseases including AIDS and HIV
    • Expenses related to weight management or obesity treatments
    • Expenses incurred for external medical aids and appliances
    • Any kind of non-medical expenses incurred during hospital stay
    • Hospitalisation due to war or invasion
    • Hospitalisation due to drug or alcohol abuse
    • Experimental or unproven treatment methods
    • Treatment for pregnancy, childbirth, and related complications
    • Expenses related to treatment for mental disorder and insanity
    • Congenital anomalies and birth defects

    Claim Procedure

    The customer service team of Apollo Munich can help you with the claim process. Following an event, you may contact the company’s customer service team and intimate them about it. When you contact the customer service, make sure that you have the policy number and other related details with you. It is better to inform planned hospitalisation 48 hours ahead and emergency hospitalisation within 24 hours of admission in a hospital.

    For cashless treatment, you can send an authorisation request from the hospital by filling out the pre authorisation form. Once the request is sent, the company will verify the request and provide the authorisation. The authorisation for cashless treatment is usually provided within a matter of hours. Following the acceptance of the request, you can continue with cashless treatment for all medical expenses.

    For reimbursement claims, you must file the claim within 15 days after your discharge from the hospital. The claim request must include various documents such as medical bills, diagnostic reports, physician certificate, cash receipts, prescriptions, discharge summary, etc. The company will verify the documents to ensure that the claim is valid. Once the request is processed, the company will provide the reimbursement amount to the insured person.

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