Apollo Munich Easy Health Exclusive- Individual
Objective
This policy has three variants, of which 'Easy Health-Exclusive' is the second one. It is a basic health insurance policy that provides maternity cover and an optional cover for newly born child along with cover for inpatient hospitalisation. This policy can be purchased online. An add-on critical illness benefit to insure against eight chronic diseases is available as an optional benefit on payment of extra premium.
Suited for
This policy is most suitable for young females as the policy covers maternity related expenses after a 6-year waiting period. The policy allows life long renewals which makes it preferable over others.
What does it do?
It provides Maternity cover up to a specified amount. On acceptance of maternity claim, this policy offers to include the new born under same policy. Other allowances include daily compensation of expenses incurred by one adult in accompanying the insured child to the hospital, day care procedures which do not require a 24-hour stay in hospital due to technological upgradation, domiciliary treatment (treatment taken at home on doctor's advice) and specified daily compensation of shared accommodation in a network hospital.
Expenses incurred towards inpatient hospitalisation including diagnostic procedures, boarding and lodging, ICU, Operation theatre, Anesthesia, blood, oxygen, medicines, drugs, nursing and medical practitioner charges are covered. Relevant medical expenses incurred prior to and post hospitalisation and emergency ambulance also fall under the policy ambit. Free health check up is allowed at the end of 3 years that have been claim free consecutively.
To widen the scope of insurance cover, a policyholder can take an additional cover for 8 critical illnesses upon payment of extra premium. This add on cover is available till 70 years of age and not beyond that.
Pros
There is no cover ceasing age. It offers life long insurance.
The policy provides a flat discount of 7.5 percent on advance payment of 2-year premium.
Family discount of 10 per cent is available on including 3 or more family members under the same policy.
It gives a cumulative bonus of 10 per cent for every claim-free year up to a maximum of 50 per cent.
It provides for a free health check up at the end of 3 continuous claim free years.
This policy can be purchased online.
Premium paid towards the 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.
Maternity benefit can be availed only after a waiting period of 6 years which is the longest waiting period in industry.
Our View
The major advantage of this policy is that it covers a policyholder during golden years when healthcare costs are expected to be relatively higher. There is no ceiling on policy renewal age. So, the policy actually stands by the individual in later years when health cover is direly needed. If planned well in advance, it takes care of maternity expenses as well. This policy is recommended as it passes the benefit-to-cost test. Optional Critical Illness Cover is an another worthwhile feature and can be chosen for a wider coverage.
Eligibility
Entry Age (years) | |
Minimum | 18; 3 months for children |
Maximum | 60 |
Maximum Policy Renewal Age (years) | No Limit |
Coverage Type | Individual |
Sum Insured (Rs) | |
Maximum | 7.5 lakh |
Minimum | 3 lakh |
Policy Term (years) | 1 or 2 |
Tax Benefit | Premium paid is eligible for tax benefit under section 80D of the Income Tax Act |
Discount | Premium discount of 7.5% on advance premium payment for 2 year policy term. Family discount of 10% is applicable if 3 or more family members included. |
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 of a claim, the cumulative bonus reduces 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 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 | [email protected] |
Call to | 1800-102-0333 |
SMS | 'easyhealth' to 56767333 |
Additions to the Plan
Scope of Cover | ||
Sum Insured (in Rs) | ||
3 lakh, Rs 4 lakh and Rs 5 lakh | 7.50 lakh | |
Cashless facility | Available at empanelled hospitals in India. The policyholder must inform and obtain pre-authorization in case of planned hospitalisation atleast 48 hours prior to actual admission or 24 hours after hospitalisation in case of an emergency admission | |
Re-imbursement | In case policyholder opts for non empanelled hospital , expenses are re-imbursed within 14 working days from date of submission of all records | |
Pre-post hospitalisation | Relevant medical expenses covered from 60 days prior and 90 days post hospitalisation | |
In-patient Treatment | Covered | |
Pre-hospitalisation | ||
Post-hospitalisation | ||
Day-Care Procedures | 140 in number are covered | |
Domiciliary Treatment | Covered | |
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 | |
Daily Cash for 1 adult accompanying an insured child upto 12 years of age | Rs 300 per day, maximum Rs 9000 | Rs 500 per day, maximum Rs 15000 |
Newborn baby cover | Optional if policyholder proposes the same to insurance company within 90 days of child birth | |
Maternity Expenses with waiting period of 6 years | 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) |
Additional Cover for Critical Illness | Optional, 50% or 100% of in patient Sum insured. It covers 8 critical illnesses namely: cancer, coronary artery (bypass) surgery, first heart attack (myocardial infarction), kidney failure (end stage renal disease), major organ transplantation, multiple sclerosis, paralysis and stroke after a waiting period of 30 days. Maximum cover ceasing age is 70 years. | |
Health Check-up | Upto 1% of Sum insured subject to a maximum of Rs 5000 per insured person, only at the end of a block of every continuous 3 claim free years |
Exclusions and Waiting Period | ||
Pre-existing disease | covered after a waiting period of three years | |
No claim period | 30 days from start date of the policy except any accidental injury | |
Waiting Period | 2 years for specific diseases such as cataract, hernia, joint replacement surgery etc.6 years for maternity benefits.Domiciliary Treatment will be covered only if illness continues for atleast 3 days consecutive days. | |
General Exclusions | Naturopathy treatment and non allopathic treatmentCosmetic, beauty or slimming treatment.AIDS or any related illnessTreatment of any mental or related disease |
Annual Premium | |||||
Age (in years) | Sum Insured (in Rs ) | ||||
3 lakh | 4 lakh | 5 lakh | 7.5 lakh | ||
0-17 | 3623 | 4830 | 5250 | 5565 | |
18-35 | 4095 | 5040 | 6143 | 7140 | |
36-45 | 4410 | 5880 | 7204 | 8820 | |
46-50 | 6300 | 7770 | 11340 | 13999 | |
51-55 | 8600 | 11500 | 13780 | 15988 | |
56-60 | 10900 | 13500 | 16000 | 18673 | |
61-65* | 16868 | 22144 | 26292 | 32876 | |
66-70* | 21665 | 28454 | 33793 | 42266 | |
>70* | 24072 | 31623 | 37562 | 46984 | |
Premiums are exclusive of service tax and education cess | |||||
*Premium rates only for renewal |
Annual Premium Option for Critical Illness Cover | ||||||||||
Age (in years) | Critical Illness Sum insured (in Rs) | |||||||||
1.5 lakh | 2 lakh | 2.5 lakh | 3 lakh | 3.75 lakh | 4 lakh | 5 lakh | 7.5 lakh | 10 lakh | ||
0- 17 | 46 | 61 | 76 | 92 | 115 | 122 | 153 | 229 | 306 | |
18-35 | 173 | 231 | 289 | 347 | 433 | 462 | 578 | 866 | 1155 | |
36- 45 | 531 | 708 | 885 | 1062 | 1327 | 1415 | 1769 | 2654 | 3538 | |
46- 50 | 1164 | 1552 | 1941 | 2329 | 2911 | 3105 | 3881 | 5822 | 7762 | |
51- 55 | 1918 | 2557 | 3197 | 3836 | 4795 | 5114 | 6393 | 9590 | 12786 | |
56- 60 | 3030 | 4040 | 5050 | 6060 | 7575 | 8080 | 10100 | 15150 | 20200 | |
61- 65* | 4517 | 6022 | 7528 | 9033 | 11292 | 12044 | 15055 | 22583 | 30111 | |
66- 70* | 6412 | 8550 | 10687 | 12824 | 16031 | 17099 | 21374 | 32061 | 42748 | |
Premiums are exclusive of service tax and education cess | ||||||||||
*Premium rates only for renewal |