Objective

Easy Health Premium is the third variant of Apollo Munich Easy Health Policy. The objective of this policy is to provide protection against financial loss arising due to illness or accident. It also covers maternity expenses, out-patient dental cover, cost of spectacles and hearing aids. There is an add-on cover for critical illness and provision of taking second opinion from doctors on Insurer's panel, in case of critical illness.

Suited for

This policy is suitable for any person seeking a wide coverage for medical uncertainties. It can be taken by any person up to 60 years of age and it is renewable lifelong.

What does it do?

It covers maternity expenses. On acceptance of maternity claim, this policy offers to include the new born under same policy. Other benefits include daily cash amount to compensate the expenses for one adult accompanying insured child to the hospital, day care procedure which do not require a 24-hour stay in hospital due to technological upgradation, treatment taken at home on doctor's advice and daily cash for choosing 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 ambit. Free health check up at end of two consecutive claim free years is allowed.
To widen the scope of cover, you can take an additional cover for eight critical illnesses upon payment of extra premium. This add on cover is available till 70 years of age and not beyond that.
Other benefits such as out-patient dental treatment, cost of external instruments to support vision and hearing are capped to sum insured. Moreover, these benefits become active only after their respective waiting periods have elapsed. This policy also arranges for a second opinion from any doctor of policyholder's choice from the insurance company's panel, in case of critical illness.

Pros

There is no cover ceasing age. It offers a life long insurance.
It provides a flat discount of 7.5 per cent on advance payment of 2-year premium.
Family discount of 10 per cent is applicable 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 two continuous claim free years.
This policy can be purchased online.
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.
Maternity benefit can be availed only after a waiting period of six years.
Waiting period of three years applies to out-patient dental treatment.
Sub-limits in one way or the other are imposed on each expense.

Our View

Buy this policy only if you need a big health insurance covering all such benefits as under this policy. Else, choose among the 'Standard' or 'Exclusive' variants that offer lower benefits at less price. Your insurance purchase should be purely based on your requirements and budget.

Eligibility

Entry Age (years)

Minimum

18; 3 months for children

Maximum

60

Maximum Policy Renewal Age (years)

No Limit

Policy Term (years)

1 or 2

Sum Insured (Rs)

Maximum

10 lakh

Minimum

4 lakh

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 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 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 (Rs)

4 lakh and Rs 5 lakh

7.50 lakh and 10 lakh

Cashless facility

Available

Re-imbursement Facility

In-patient Treatment

Covered

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

Day-Care Procedures

140 in number are covered

Domiciliary Treatment

Covered

Daily cash for chossing shared accomodation

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

Rs 300 per day, maximum Rs 9000

Rs 500 per day, maximum Rs 15000

Newborn baby

Optional

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)

Out-patient Treatment

Out-patient dental treatment is covered at 50% of the admissible expenses Upto 1% of Sum insured subject to a maximum of Rs 5000, after a waiting period of 3 years.

Spectacles, Contact Lenses, Hearing Aid every third year

50% of the admissible expenses, maximum upto Rs 5000, only once after every three years.

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, 50% or 100% of in patient Sum insured. It covers 8 critical illnesse namely: 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 2 claim free years

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

Certain diseases such as hernia, piles, cataract , sinusitis shall be covered after a waiting period of 2 years.Maternity cover will be available after a waiting period of 6 policy years.Expenses for Domiciliary treatment will be covered only if the illness continues for atleast 3 consecutive days.Out Patient dental treatment will be covered after a waiting period of three years.

General Exclusions

AIDS/ HIV or related treatmentTreatment of any mental or related disease.