• Apollo Munich Optima Restore

    Health 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**

    As a standalone health insurance service provider, Apollo Munich aims to provide health insurance service for people with all kinds of insurance requirements. The company offers health insurance plans for individuals, families, senior citizens, etc. There are many comprehensive covers available in the company’s product lineup. Among the comprehensive plans offered by the company, Optima Restore stands out as a one of a kind policy. As the name implies, this cover ‘restores’ the sum insured amount at no extra cost once it gets exhausted within a policy year. This policy is available in both individual and family floater variants.

    Eligibility for Apollo Munich Optima Restore

    The eligibility criteria set forth by the company for enrolling in this medical insurance policy can be given as follows:

    • Anyone between the age of 5 years and 65 years can be enrolled in this policy.
    • The proposer of this policy must be at least 18 years of age.
    • Dependent children can be covered from the age of 91 days provided at least one of the parent is covered simultaneously.
    • Lifelong renewability option is available with this policy cover.
    • A maximum of 6 family members can be enrolled in a single policy.
    • The family floater cover can be taken for self, spouse, dependent children, dependent parents, and dependent parents-in-law.

    Features of Apollo Munich Optima Restore

    Apollo Munich Optima Restore comes with a lot of attractive features that can be listed as follows:

    • This policy is available in multiple sum insured options ranging from Rs.3 lakh to Rs.50 lakh.
    • All pre-existing diseases have a waiting period of 36 months.
    • There is a general waiting period of 30 days for all illnesses (does not apply for accidental hospitalisation).
    • Pre-hospitalisation medical expenses are covered for up to 60 days before hospitalisation.
    • Post hospitalisation medical expenses are covered for up to 180 days after discharge from the hospital.
    • This policy is available in 1 or 2-year terms. A premium discount of 7.5% is available for 2-year policy terms.
    • Based on the age of the applicant, pre-insurance medical examination may be required for enrolling in the policy. The company will reimburse 100% of the examination costs upon acceptance of the policy.
    • This policy can be ported to other insurance companies in the market. In case of portability, the company must be notified at least 45 days in advance.
    • People who follow a healthy lifestyle are rewarded through premium discounts in this policy cover. Up to 8% discount is available through the ‘Stay Active’ health benefit.
    • Reimbursement for preventive health checkup is available in this policy. For sum insured over Rs.10 lakh, this benefit is available annually. For sum insured between Rs.5 lakh and Rs.10 lakh, this benefit is available once in 2 years.
    • There is a grace period of 30 days from the date of expiry for policyholders to renew this cover.
    • The premium amount paid towards this policy is eligible for income tax relief as per section 80D of the Income Tax Act.

    Benefits of Apollo Munich Optima Restore

    In-patient hospitalisation Up to the maximum sum insured limit
    Restoration benefit 100% sum insured restoration following exhaustion after a claim
    Day care treatment Coverage for all procedures
    Daily cash for choosing shared accommodation Rs.800 per day (max. Rs.4,800) for sum insured up to Rs.15 lakh Rs.1,000 per day (max. Rs.6,000) for sum insured Rs.20 lakh and above
    Health checkup Up to Rs.10,000 (for sum insured Rs.20 lakh and above)
    Emergency ambulance cover Up to Rs.2,000 per hospitalisation
    Emergency air ambulance cover Up to Rs.2.5 lakh per hospitalisation (only for sum insured Rs.10 lakh and above)
    E-opinion for critical illness Available
    Multiplier benefit 50% additional sum insured per claim-free year subject to a maximum of 100%
    Coverage for organ donor expenses Available
    Domiciliary hospitalisation Available
    Critical advantage rider (optional only for sum insured Rs.10 lakh and above) Worldwide cover at the company’s network centers for 8 major illnesses including cancer

    Exclusions of Apollo Munich Optima Restore

    Some of the exclusions listed under Apollo Munich Optima Restore can be given as follows:

    • Injuries or illnesses arising out of war or warlike activities
    • Intentional self injuries and attempted suicide
    • Injuries sustained while breaching the law with criminal intent
    • Expenses related to the treatment of AIDS, HIV, and sexually transmitted diseases
    • Congenital disorders, birth defects, anomalies, and mental disorders
    • Any kind of cosmetic or aesthetic treatments
    • Injuries or illnesses related to the abuse of alcohol or drugs
    • Any treatment related to pregnancy and childbirth
    • Treatment for obesity and weight control programs
    • Expenses related to external accessories and aids
    • Hospitalisation only for the purpose of diagnosis and investigation
    • Any treatments taken outside India
    • Any kinds of non allopathic treatment
    • Convalescence, general debility, and run down condition
    • Stem cell therapy and growth hormone treatment
    • Any kinds of non-medical expenses
    • Any other exclusions noted in the policy wordings

    Claim Procedure

    Apollo Munich operates a well-equipped customer service department that could guide you through the claim procedure. It is better to contact the company at least 7 days in case of planned hospitalisation. In case of unexpected emergencies, the insurer must be intimated within 24 hours of hospitalisation.

    Cashless treatment: Cashless treatment facility is available with Apollo Munich. For availing this benefit, the company’s customer service can be contacted. The customer care will guide you on the documents to be submitted to obtain the pre authorisation for cashless treatment. Cashless treatment facility is available only in the company’s network hospitals.

    Reimbursement claim: For reimbursement claims, the claim form along with the list of documents required must be submitted within 15 days after the completion of treatment. Once the documents are submitted, the company will initiate the claim process and provide the settlement amount within a maximum of 30 days.

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