Objective

This is a special health insurance policy designed to provide lifelong coverage to senior citizens.

Suited for

Anyone who fulfills the eligibility criteria can buy this policy.

What does it do?

Anyone proposing to buy this policy will be required to go through a medical check up. In certain cases mentioned, co-payment clause applies which means that total claim amount will be shared among policyholder and insurance company in a pre-specified ratio. Apart from hospitalization benefit, it also covers pre and post hospitalization expenses, domiciliary treatment, day care procedures, and hospitalization expenses of organ donor in case of transplant.

Pros

It offers lifelong renewal.
It offers a 5 per cent discount on premium on including spouse.
It allows 7.5 per cent discount for opting a 2-year policy.
The policy assures of no claim based premium loading.
There are no sub-limits on inpatient hospitalisation cover.
Premium paid under this policy enjoys a tax benefit under Section 80D.

Cons

Co-payment in certain cases acts as a limitation.

Our View

There is no escape from co-payment clause when looking a policy for a senior citizen. USP of the policy is that it assures of no claim based loading and it covers inpatient hospitalisation expenses without any sub-limits. This policy is a perfect balance between the benefits and cost. If you can afford the premiums, this is a recommended plan. But if you are looking for a cheaper policy, you would be required to compromise on the scope of cover as well.

Eligibility

Maximum Policy Renewal Age (years)

Lifelong renewal

Coverage Type

Individual

Policy Term (years)

1/2

Sum Insured (Rs)

Maximum

5 lakh

Minimum

2 lakh

Discount

5% on renewal for each claim free year.
5% if spouse also buys this policy.
7.5% on selecting a 2 year policy term

Pre Policy Medical Check Up

Required (insurer would reimburse 50% of cost on acceptance of insurance proposal)

Grace Period for Policy Renewal

30 days

Co Payment Clause

15% on accomodation in a twin sharin room or lower room type.
30% on accomodation in a single room or higher room type (15% in case of an emergency).
30% on specific illnesses such as cataract(each eye), hysterectomy, joint replacement etc.
15% to all day care procedures

Policy Termination

Policyholder is allowed to cancel the policy at anytime by providing a notice. Insurer may also terminate the policy by giving a 30 days notice

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

1800-103-0555

SMS

HEALTH to 56767333

Network Hospitals

Http://www.apollomunichinsurance.com/our-hospital-network.aspx

Scope of Cover

Cashless facility

available at network hospitals

Reimbursement facility

available if treatment taken in non-network hospitals

Pre and post hospitalisation

covered upto 30 days prior and 60 days post hospitalisation

Inpatient treatment

covered

Day care procedures

covers 140 listed day care treatment

Domiciliary treatment

covered only if treatment exceeds 3 days

Organ donor

covers medical treatment of organ donor

Emergency ambulance

pays upto Rs 2000 for each hospitalisation in case of an emergency

Second Opinion

allows to obtain an opinion from medical panel for listed critical illnesses once a policy year

Exclusions and Waiting period

Pre-existing diseases

covered after 3 years of continuous policy renewal

No claim period

30 days from policy start date

Waiting period

2 years for specified illnesses like hernia, sinusitis, cataract, joint knee replacement etc.

Other exclusions

Non allopathic treatmentsHIV/AIDS and related conditions