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Apollo Munich Optima Restore Family Plan

What is the Plan all About?

Optima Restore Family Plan covers you and your family against in-patient hospitalization expenses. This health plan offers a unique restore benefit with which the sum insured is reinstated automatically, if gets exhausted in a policy year. The multiplier benefit under this plan doubles the basic sum insured in 2 continuous claim free policy years.

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Key Features

  • Cover for you & your family
  • No geography based sub-limits
  • No sub-limit on room rent
  • Avail family discount
  • Get Cashless Hospitalization across 4000 network hospitals
  • Quick Claims Settlement
  • Enjoy tax benefits

Policy Benefits

  • In-patient hospitalization expenses such as room rent, nursing, operation theater charges, medicines, etc are covered.
  • Pre hospitalization expenses that incur before hospitalization is covered for a maximum of 60 days.
  • Post hospitalization expenses that incur after hospitalization is covered for a maximum of 180 days.
  • Listed day care procedures or surgeries that requires the insured to get hospitalized for less than 24 hours are covered.
  • Domiciliary treatment expenses are covered under this plan.
  • Organ donor expenses incurred on harvesting the organ are covered.
  • Daily hospital cash for choosing shared accommodation is payable for a maximum of 6 days.
  • Critical advantage rider provides worldwide cover for treatment expenses incurred against 8 major critical illnesses.

Value Added Benefits

  • Sum Insured can be enhanced at the time of policy renewal.
  • E-opinion in case of critical illness is availed once during a policy year.
  • Get Multiplier Benefit or Cumulative Bonus. 50% of the basic sum insured is increased for each claim free policy year, up to a maximum of 100%. It doubles the sum insured in case of 2 continuous claim free policy years.
  • Emergency Ambulance charges are payable.
  • Automatic restoration of the Sum Insured up to 100% of the basic sum insured, in case of its exhaustion during a policy year.
  • Health check-up is covered after every 2 continuous claim free policy years. It is payable up to up to 1% of the sum insured, to a maximum of Rs 10,000 per policy. This benefit is applicable for SI 20/25/50 Lacs.
  • Get ‘Stay Healthy’ program for Sum Insured over 5 Lacs.
  • Avail tax benefits u/s 80D as per IT Act, 1961 for premium paid for this plan.

Sub Limits

  • No room rent limit is applicable under this plan.
  • No co-pay is applicable udner the plan.
  • Daily cash benefit of Rs 800 & Rs 1000 for SI 3/5/10/15 Lacs & SI 20/25/50 Lacs respectively.
  • Ambulance charges are payable up to Rs 2000 per hospitalization.

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, Hernia, Hydrocele, etc are covered after 24 months of policy coverage.
  • Pre existing Disease Waiting Period: Any pre-existing ailment/injury is covered after a waiting period of 36 months.

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 3 Lacs 50 Lacs
Cover Type Individual/Family Floater -
Policy Tenure 1 Year 2 Years
Grace Period 30 Days -
Free Look Period 15 Days -
Riders Critical Advantage Rider -

Exclusions

  • War, invasion, act of foreign enemy
  • Participation in dangerous acts
  • Cosmetic treatment
  • Intentional self injury
  • Dental treatment
  • Non allopathic treatment
  • STDs
  • Pregnancy related expenses,etc.