Apollo Munich Easy Health Premium- Family Floater Plan

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Apollo Munich Easy Health Premium- Family Floater

	Objective			This policy aims to provide complete health insurance for a family by including a comprehensive coverage for hospitalisation, outpatient treatment, maternity expenses, newborn baby cover, and other incidental expenses.
Suited for			This policy is most suitable for young couples who are planning to go the family way. Individuals looking to insure their spouse and dependent children can also buy this policy.
What does it do?			It is the third and most comprehensive variant of Easy Health policy from Apollo Munich. It is an all-inclusive policy that covers maternity expenses, newborn baby, out-patient dental treatment and provides daily cash benefit for an adult accompanying insured child. There is also an optional cover for Critical Illness which will pay a lump sum amount on confirmed diagnosis of any of the listed illnesses. Critical Illness cover will attract additional premium from policyholder. Maternity benefit and out-patient dental treatment will be covered only after the waiting period. Some other benefits such as external aids including spectacles, hearing machine and contact lenses and health check-up benefit will be allowed once after lapse of every certain number of claim free years.
Pros			There is no cover ceasing age. It offers a life long insurance. It offers a discount of 7.5 per cent on advance payment of 2-year premium. It gives a cumulative bonus of 10 per cent for every claim-free year up to a maximum of 50 per cent. This policy can be purchased online. It provides for homeopathic, ayurvedic, Unani and Sidha treatment. Premium paid under this policy qualifies for deduction under section 80D of Income Tax Act.
Cons			In case, cumulative bonus has been passed and a claim arises during that year, cumulative bonus would be reduced by 20 per cent in the following year. There is a waiting period before maternity expenses and out-patient dental treatment become eligible.
Our View			Shopping for insurance should be purely based on your needs and budget. Only if you think you require a comprehensive coverage, should you go for it. Or consider lower variants of 'Easy Health' policy which offer a coverage for lesser price. Ensure that you know the waiting period before taking this policy.
Eligibility
Entry Age (years)
Minimum		18; 3 months for children
Maximum		65
Maximum Policy Renewal Age (years)		No Limit
Policy Term (years)		1 or 2
Sum Insured (Rs)
Maximum		10 lakh
Minimum		4 lakh
Discount		Premium discount of 7.5% on advance premium payment for 2 year policy term.
No Claim Bonus		10% increase in your annual inpatient benefit sum insured for every claim free year, till it reaches 50% of the Sum insured. In case a claim is made during a policy year, the cumulative bonus would reduce by 20% in the following year
Grace Period for Policy Renewal		15 days
Policy Termination		Insurance company may terminate the policy by giving a written notice of 30 days. Policyholder is also allowed to terminate the policy at anytime by giving a written notice. In case no claim has been made under the policy, percentage of premium will be refunded
Customer Service
Address		Apollo Munich Health Insurance Company Limited Corporate Office: 10th floor, Tower B, Building No. 10, DLF Cyber City, Phase -II, Gurgaon, Haryana-122002 Registered Office: Apollo Hospital Complex, Jubilee Hills, Hyderabad - 500033
Mail to		customerservice@apollomunichinsurance.com
Call to		1800-102-0333
SMS		'easyhealth' to 56767333
Network Hospitals		Http://www.apollomunichinsurance.com/our-hospital-network.aspx

 

	Scope of Cover
		Sum Insured (in Rs)
		4 lakh and 5 lakh		7.50 lakh and 10 lakh
Cashless facility		Available if treatment taken in a network hospital
Re-imbursement Facility		Available if treatment taken in a non network hospital
Pre-hospitalisation		Covered for 30 days. 30 days extend to 60 days if informed 5 days in advance of hospitalisation
Post-hospitalisation		Covered from 60 days. 60 days extend upto 90 days if informed 5 days in advance of hospitalisation
In-patient Treatment		Covered
Day-Care Procedures		140 in number are covered
Domiciliary Treatment		Covered if the illness continues for atleast 3 consecutive days
Daily cash for choosing shared accommodation		Rs 500 per day, Maximum Rs 3,000		Rs 800 per day, maximum Rs 4800
Expenses for organ donor of transplant		Covered
Emergency Ambulance		Up to Rs 2,000 per hospitalisation
Ayush Benefit		covered upto Rs 25000
Daily Cash for 1 adult accompanying an insured child		Rs 300 per day, maximum Rs 9000		Rs 500 per day, maximum Rs 15000
Maternity Expenses		Normal Delivery Rs 15000Caesarean Delivery Rs 25000 (Sums are including pre/post natal limit of Rs 1500 and new born limit of Rs 2000)		Normal Delivery Rs 25000Caesarean Delivery Rs 40000 (Sums are including pre/post natal limit of Rs 2500 and new born limit of Rs 3500)
Newborn baby		Optional
Out-patient Dental Treatment		50% of reasonable cost, Upto 1% of Sum insured subject to a maximum of Rs 5000
Spectacles, Contact Lenses, Hearing Aid every third year		50% of the admissible expenses, maximum upto Rs 5000
E-Opinion in respect of a Critical Illness		Covered, one opinion per policy year (if no previous claim was made in current policy year) form any member of policyholder's choice from the insurance company's panel
Additional Cover for Critical Illness		Optional Optional 50% or 100% of in-patient Sum Insured
Health Check-up(after every 2 claim free years)		Upto 1% of Sum insured subject to a maximum of Rs 5000 per insured person

 

	Exclusions and Waiting Period
Pre-existing disease		covered after 36 months of continuous policy renewal
No claim period		30 days from policy start date
Waiting Period		4 years for maternity benefit24 months for treatment of certain illnesses as stated in the policy document.3 years for outpatient dental treatment
General exclusion		AIDS/ HIV or any related conditionTreatment of any mental disorder

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