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Apollo Munich Optima Restore Individual Plan

What is the Plan all About?

Optima Restore Plan is more than just a traditional health plan. Apart from covering hospitalization expenses, this health plan offers a unique Restore benefit. It also rewards you a multiplier benefit in case of claim free policy years.

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Key Features

  • Individual health cover
  • No sub-limit on hospital room rent
  • Treatment in any hospital without any co-pay
  • Grab family discount
  • Get Cashless Hospitalization across 4000 network hospitals
  • Quick Claim Assistance
  • Enjoy Tax Benefits

Policy Benefits

  • In-patient hospitalization expenses such as OT charges, medicines, blood, oxygen, etc. are covered.
  • Pre hospitalization that occurs prior hospitalization is covered up to 60 days.
  • Post hospitalization that occurs post 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 (shared accommodation) is payable as mentioned in the policy.
  • Avail worldwide coverage for 8 major illnesses with Critical advantage rider.

Value Added Benefits

  • Get Multiplier Benefit/ 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.
  • Sum Insured can be enhanced at the time of policy renewal.
  • Sum Insured can be restored automatically up to 100% of the basic sum insured, in case of its exhaustion in a policy year.
  • Emergency ambulance charges are covered.
  • E-opinion for critical illness can be availed once in a policy year.
  • Health check-up is covered after every 2 continuous claim free policy years .
  • Get ‘Stay Healthy’ package for SI 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.
  • 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.
  • Health check-up is covered upto 1% of the sum insured, to a maximum of Rs 10,000 per policy. This benefit is not applicable for SI 3/5/10/15 Lacs cover.

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 -
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
  • Intentional self injury
  • Participation in dangerous acts
  • Cosmetic treatment
  • Dental treatment
  • STDs
  • Pregnancy related expenses,etc.