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Apollo Munich’s Easy Health Exclusive gives a comprehensive coverage at very affordable premium rates. The plan allows individual as well as family floater cover for Sum Insured levels going up to Rs.50 lakhs. There is also a premium discount for maintaining a healthy lifestyle in the Stay Active benefit of the plan.
Step 1 – the policyholder chooses the Sum Assured, the term of the plan and the members covered.
Step 2 – If the covered member (s) face any medical contingency and the related expenses are covered by the plan the expenses incurred are paid by the plan.
Step 3 – if the plan matures and no medical contingencies occur, no benefit is paid.
Chintan buys the plan for a Sum Insured of Rs.7.5 lakhs. He gets married and adds his wife to the plan and converts it into a family floater plan.
Option 1 – To cover maternity related expenses, Chintan would have to wait for four years. Other hospitalization expenses would be paid as incurred.
Option 2 – if the plan matures and Chintan or his wife doesn’t suffer any medical emergency, no benefit is paid.
|Coverages||Sum Insured Rs.3,4,5 lakhs||Sum Insured Rs.7.5,10 lakhs||Sum Insured Rs.15,20,25 or 50 lakhs|
|Day care treatments||Covered||Covered||Covered|
|Pre-hospitalization||60 days||60 days||60 days|
|Post hospitalization||90 days||90 days||90 days|
|Organ Donor expenses||Covered||Covered||Covered|
|Daily Cash for Shared Accommodation||Rs.500/day up to Rs.3000||Rs.800/day up to Rs.4800||Rs.1000/day up to Rs.6000|
|Daily cash for accompanying insured child||Rs.300/day up to Rs.9000||Rs.500/day up to Rs.15,000||Rs.800/day up to Rs.24,000|
|AYUSH Coverage||Up to Rs.25,000||Up to Rs.25,000||Up to Rs.50,000|
|Recovery benefit||Not available||Not available||Rs.10,000 if hospitalization exceeds 10 days|
|Maternity benefit||Normal delivery – Rs.15,000
Cesarean – Rs.25,000
|Normal delivery – Rs.25,000
Cesarean – Rs.40,000
|Normal delivery – Rs.30,000
Cesarean – Rs.50,000
|Pre and post-natal expenses||Rs.1500 included in maternity benefit||Rs.2500 included in maternity benefit||Rs.5000 included in maternity benefit|
|New born baby cover (at an additional premium)||Rs.2000 included in maternity benefit||Rs.3500 included in maternity benefit||Rs.5000 included in maternity benefit|
|Ambulance cover||Up to Rs.2000||Up to Rs.2000||Up to Rs.2000|
|Air Ambulance Cover||Not covered||Not covered||Rs.2.5 lakhs per hospitalization up to a maximum of Sum Insured|
|Health check-ups||Up to 1% of Sum Insured to a maximum of Rs.5000 once every 3 years||Up to 1% of Sum Insured to a maximum of Rs.5000 once every 3 years||Up to 1% of Sum Insured to a maximum of Rs.5000 once every 3 years|
|Age at entry (in completed years)||5 years
Dependent Children - 3 months
|Adults - 65 years|
|Plan tenure||1 year||2 years|
|Premium paying options||Single pay|
|Sum Assured||Rs.3 lakhs||Rs.50 lakhs|
Illnesses suffered during the first 30 days of the plan commencement are not covered.
Critical Illnesses suffered during the first 90 days of the plan commencement are not covered.
Pre-existing illnesses or conditions are not covered by the plan in the first 3 years of the policy
Maternity related benefits have a waiting period of 6 years. If the Sum Insured is Rs.15 lakhs and above the waiting period is 4 years. For family floater plans, the waiting period is 4 years for Sum Insured up to Rs.15 lakhs and 3 years if Sum Insured is Rs.15 lakhs and above.
Specific illnesses are not covered in the first two years of the plan.
Illnesses or accidents caused due to genetic disorder or stem cell surgery, substance abuse, participation in adventure sports or hazardous activities, criminal acts, attempted suicide, war and hazardous substances, etc. are not covered.
Treatments like cosmetic treatments, artificial life support, weight loss treatments, non-allopathic treatments or due to HIV/AIDS, etc. are not covered.
Below are the sample rates of premium payable by a non-smoking male living in Mumbai for different combinations of age and members covered. The Sum Insured is Rs.10 lakhs and the policy is taken for 1 year.