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Apollo Munich Easy Health Individual Plan

What is the Plan all About?

Easy Health Individual Plan provides you a cover against spiraling medical costs. This health plan covers in-patient hospitalization expenses and it also has an optional critical illness cover. Coverage under this plan is available on the individual sum insured basis.

3 plan variants can be opted under this plan:

  • Standard Plan
  • Exclusive Plan
  • Premium Plan

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Key Features

  • Comprehensive Health Plan
  • Flexible Sum Insured options
  • Avail AYUSH Benefit
  • Grab Family Discount
  • Avail Cashless Hospitalization across 4000+ network hospitals
  • Lifetime Renewability

Policy Benefits

  • In-patient hospitalization for which insured need to be hospitalized for a minimum duration of 24 hours is covered.
  • Pre hospitalization expenses that are incurred before hospitalization is covered up to 60 days.
  • Post hospitalization expenses that are incurred after hospitalization is covered for 90 days.
  • 144 day care procedures/surgeries that requires hospitalization for less than 24 hours are covered.
  • Domiciliary treatment is covered as specified under the plan.
  • Organ donor expenses incurred are covered as specified.
  • Recovery benefit is payable for Exclusive and Premium plan, up to limits specified.
  • Daily hospital cash for choosing shared accommodation is payable as provided in the policy schedule.
  • Daily hospital cash for accompanying an insured child is applicable for Exclusive and Premium Plan.
  • Get coverage for critical illnesses with an Add-on cover for Critical Illness.
  • Maternity expenses, including pre & post natal are covered. This benefit is applicable for Exclusive and Premium Plan.
  • New born baby cover is available as an add-on. This benefit is applicable for Exclusive and Premium Plan.
  • Outpatient dental treatment is applicable only for Premium Plan.
  • Cost of spectacles, contact lenses & hearing aids is covered for Premium Plan, up to the limits specified.

Value Added Benefits

  • Grab Cumulative Bonus. 10% of the sum insured is increased for every claim free policy year, subject to a maximum of 100%.
  • E-opinion for critical illness is applicable only for Premium Plan.
  • Sum Insured Enhancement can be availed at the policy renewal.
  • AYUSH benefit under this plan can be availed as an in-patient treatment.
  • Emergency ambulance charges are payable up to Rs 2000 per hospitalization.
  • Healthline service helps you reach experts to get primary consultation & counselling.
  • Health Risk Assessment tool helps you get an idea about the health status.
  • Health check-up is covered after every 4,3,2 continuous claim free policy years for Standard Plan ,Exclusive Plan Premium Plan respectively.
  • Avail tax benefits u/s 80D as per IT Act, 1961 for premium paid for this plan.

Sub Limits

  • No room rent limit is specified under this plan.
  • AYUSH benefit ranges from Rs 20,000 to Rs 50,000 depending on the plan chosen.
  • Daily hospital cash (shared accommodation) ranges from Rs 500 to Rs 1000, to a maximum of Rs 6000 as per plan chosen.
  • Daily hospital cash (accompanying an insured child) ranges from Rs 300 to Rs 800, to a maximum of Rs 24000 as per plan opted.
  • Recovery benefit is capped up to Rs 10,000, when hospitalization exceeds 10 continuous days.
  • Under maternity expenses, normal delivery charges are covered from Rs 15,000 to Rs 30,000, Caesarean delivery charges are covered from Rs 25,000 to Rs 50,000, depending on the plan opted for.
  • Outpatient dental treatment is capped up to 1% of SI, to a maximum of Rs 7,500.
  • For Standard Plan, health check-up is covered up to 1% of the sum insured after every 4 continuous claim free policy years. For Exclusive Plan, health check-up is covered up to 1% of the sum insured to a maximum of Rs 5,000 at the end of every 3 continuous claim free policy years. For Premium Plan, health check-up is covered up to 1% of the sum insured, subject to a maximum of Rs 5,000 after every 2 continuous claim free policy years.

Waiting Period Clause

  • Initial Waiting Period: A waiting period of 30 days from the inception date for all hospitalization claims except in case of accidents.
  • Specific Waiting Period: Specific illnesses such as Cataract, Pancreatitis, Sinusitis, Tonsillitis, etc are covered after 24 months of policy coverage.
  • Pre existing Disease Waiting Period: Any pre-existing ailment/injury is covered after a continuous policy coverage for 36 months.
  • Maternity Waiting Period: Maternity expenses incurred are covered after a waiting period of 6 years. This waiting period is reduced to 4 years upon choosing SI 15/20/25/50 Lacs under Exclusive and Premium Plan.

Who can Buy the Plan?

Factor Minimum Maximum
Age (as on last birthday) Adult: 18 Years, Children: 91 Days Adult: 65 Years, Children: 25 Years
Sum Assured 1 Lac 50 Lacs
Cover Type Individual -
Policy Tenure 1 Year 2 Years
Grace Period 30 Days -
Free Look Period 15 Days -
Riders Critical Illness -

Exclusions

  • War or similar situations
  • Self inflicted injury
  • Obesity and other weight control program
  • Cosmetic treatment
  • Experimental/Unproven treatment
  • Congenital internal/external diseases
  • Genetic disorders
  • HIV/AIDS & related diseases