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Apollo Munich Easy Health Premium Plan

Apollo Munich’s Easy Health is a group of health insurance plans and Premium is one such variant. Easy Health Premium plan provides a comprehensive scope of coverage with multiple coverage benefits and the premiums are also affordable. The plan is available both as an individual basis and on a family floater basis.

Key features of the plan

  • The plan has a Stay Active Benefit which allows premium discounts if the insured member takes specified number of walking steps during the plan tenure.
  • A critical illness rider can be taken with the plan if the Sum Insured is Rs.10 lakhs and above. The rider pays an additional lump sum benefit in case of being diagnosed with any critical illness.
  • Cover for new born baby can also be chosen by paying an additional premium.
  • Outpatient dental treatments and cost of spectacles, hearing aids or contact lenses are also covered by the plan.

How does the plan work?

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.

Example

Rohit and his wife buy Apollo Munich Easy Health Premium for a Sum Insured of Rs.10 lakhs. The plan duration is 2 years.

Option 1 – Rohit’s wife becomes pregnant after 3 years of buying the plan. Since the waiting period for maternity benefits has elapsed, Rohit’s health plan pays Rs.25, 000 for normal delivery and Rs.40, 000 for Cesarean delivery. It also includes pre and post-natal expenses of Rs.2500. Since Rohit does not opt for new born baby cover, no new born benefit is available.

Option 2 – if the plan matures and Rohit or his wife doesn’t suffer any medical emergency, no benefit is paid.

Plan benefits

  • Medical benefits – the list of medical expenses covered by the plan and their extent is as follows:
  • Coverages Sum Insured Rs.4,5 lakhs Sum Insured Rs.7.5,10 lakhs Sum Insured Rs.15,20,25 or 50 lakhs
    Room rent, Boarding expenses, nursing charges Covered Covered Covered
    Day care treatments Covered Covered Covered
    Pre-hospitalization 60 days 60 days 60 days
    Post hospitalization 90 days 90 days 90 days
    Domiciliary hospitalization Covered Covered Covered
    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
    Outpatient dental treatment Up to 1% of Sum Insured to a maximum of Rs.5000 Up to 1% of Sum Insured to a maximum of Rs.5000 Up to 1% of Sum Insured to a maximum of Rs.10,000 for family floater and Rs.7500 for individual plans
    Spectacles, contact lenses, hearing aids Up to Rs.5000 Up to Rs.5000 Up to Rs.10,000
    e-opinion for critical illness Covered Covered Covered
    Health check-ups Up to 1% of Sum Insured to a maximum of Rs.5000 once every 2 years Up to 1% of Sum Insured to a maximum of Rs.5000 once every 2 years Up to 1% of Sum Insured to a maximum of Rs.5000 once every 2 years
  • No Claim Bonus – if the policyholder does not make a claim in any policy year he earns a cumulative bonus of 10% increase in the Sun Insured subject to a maximum of 100%.
  • Premium discounts – premium is discounted by 7.5% if a 2-year policy term is chosen. A family discount is also available which is 5% for 2 members and 10% for 3 or more members
  • Stay Active Benefit – this benefit also discounts the premium if the insured takes a specified number of steps during a policy year. If the insured has walked 5001 to 8000 steps, the discount is 2%, for 8001 to 10, 000 steps, the discount is 5% and for steps above 10, 001, the discount is 8%.
  • Value Added Services – the plan has three types of Value Added Services which include:
  • Health line which allows policyholders to seek medical consultation and advise for their illnesses.
  • Cashless Hospitalization which allows the facility of cashless claim settlement across 4000+ hospitals in India.
  • Health Risk Assessment which is a tool to assess the health of the policyholder.

Eligibility Criteria

  Minimum Maximum
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.4 lakhs Rs.50 lakhs

What is not covered by the plan?

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 4 years. If the Sum Insured is Rs.15 lakhs and above the waiting period is 3 years.

Outpatient dental treatments have a waiting period of 3 years. Spectacles, lenses and hearing aids are covered in the 3rd year.

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.

Premium Illustration

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.

FAQs