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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.

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.

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.

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 lakh7.50 lakh
Cashless facilityAvailable 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-imbursementIn case policyholder opts for non empanelled hospital , expenses are re-imbursed within 14 working days from date of submission of all records
Pre-post hospitalisationRelevant medical expenses covered from 60 days prior and 90 days post hospitalisation
In-patient TreatmentCovered
Pre-hospitalisation
Post-hospitalisation
Day-Care Procedures140 in number are covered
Domiciliary TreatmentCovered
Daily cash for choosing shared accommodationRs 500 per day, Maximum Rs 3,000Rs 800 per day, maximum Rs 4800
Expenses for organ donor of transplantCovered
Emergency AmbulanceUp to Rs 2,000 per hospitalisation
Daily Cash for 1 adult accompanying an insured child upto 12 years of ageRs 300 per day, maximum Rs 9000Rs 500 per day, maximum Rs 15000
Newborn baby coverOptional if policyholder proposes the same to insurance company within 90 days of child birth
Maternity Expenses with waiting period of 6 yearsNormal 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 IllnessOptional, 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-upUpto 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 diseasecovered after a waiting period of three years
No claim period30 days from start date of the policy except any accidental injury
Waiting Period2 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 ExclusionsNaturopathy treatment and non allopathic treatmentCosmetic, beauty or slimming treatment.AIDS or any related illnessTreatment of any mental or related disease

Cost Details

Annual Premium
Age (in years)Sum Insured (in Rs )
3 lakh4 lakh5 lakh7.5 lakh
0-173623483052505565
18-354095504061437140
36-454410588072048820
46-50630077701134013999
51-558600115001378015988
56-6010900135001600018673
61-65*16868221442629232876
66-70*21665284543379342266
>70*24072316233756246984
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 lakh2 lakh2.5 lakh3 lakh3.75 lakh4 lakh5 lakh7.5 lakh10 lakh
0- 1746617692115122153229306
18-351732312893474334625788661155
36- 45531708885106213271415176926543538
46- 50116415521941232929113105388158227762
51- 551918255731973836479551146393959012786
56- 60303040405050606075758080101001515020200
61- 65*45176022752890331129212044150552258330111
66- 70*6412855010687128241603117099213743206142748
Premiums are exclusive of service tax and education cess
*Premium rates only for renewal