Apollo Munich Easy Health Individual Plan

Apollo Munich Easy Health Insurance Individual policy is a basic plan offered by Apollo Munich Health Insurance with no sub limits and offering basic coverage. The plan is available in three variants namely Standard, Exclusive and Premium. The Standard variant has minimum benefits compared to other variants while the Exclusive has maximum number of benefits available.

Please Note: Apollo Munich Health Insurance is now HDFC ERGO Health (formerly Apollo Munich Health Insurance)

Main Highlight of the plan

Medical treatments, illnesses, accidents along with additional optional cover for critical illness are provided in this plan. There are three variants of this plan such that most of all the benefits are provided. The Standard plan is basic of all the variants followed by Exclusive and Premium.

Scope of cover

Coverage: Benefits & Features

Most Important

ROOM RENT/ ROOM CATEGORY

This plan does not have any limit on room expenses.

CO-PAYMENT

This plan does not have co-payment clause.

NO-CLAIM BENEFITS

In this plan no-claim bonus equal to 10% of basic sum insured up to a maximum of 100 % is available for each unclaimed year. However, the cumulative bonus is reduced by 10 % of sum insured once a claim is made.

Note: After any claim, only the cumulative bonus would be reduced at the time of renewal. However, the basic sum insured will not be affected.

Good to have

STAY ACTIVE BENEFIT

By downloading the stay active mobile app, you can count the number of steps you take each day and earn up to 8% renewal discount on policy in case of floater plans and per person in case of individual plans.

PRE/POST HOSPITALIZATION

60 days of pre hospitalization and 90 days of post hospitalization are provided in this health insurance plan.

RESTORE BENEFITS

This plan does not offer restore benefit.

HEALTH CHECK-UP

This plan offers health check-up benefit equal to

Standard Plan: 1% of sum insured, for every 4 claim free years.

Exclusive Plan: 1% of sum insured, up to a maximum of INR 5000 per insured person for every 3 policy years

Premium Plan: 1% of sum insured, up to a maximum of INR 5000 per insured person for every 2 policy years.

Value Adds

AMBULANCE CHARGES

This plan provides coverage for emergency ambulance expense up to INR 2000 per hospitalization.

EYE COVER

The eye cover benefit is provided in the Premium variant of this plan as mentioned in outpatient benefits.

DOMICILIARY HOSPITALIZATION

Domiciliary coverage up to sum insured is offered in this plan only if the hospitalization exceeds 3 days.

OUTPATIENT BENEFITS

The Premium variant of this plan, covers only for spectacles, contact lenses and hearing aids every third year up to- INR 5,000 for sum insured in the range of INR 4,00,000 to INR 10,00,000. INR 7,500 for sum insured in the range of INR 15,00,000 and INR 50,00,000.

CRITICAL ILLNESS COVERAGE-

This plan has an option to opt for additional coverage for some listed critical illnesses mentioned in policy wording. This additional cover may be equal to 50% or 100% of sum insured, for a minimum of INR 1,00,000 and a maximum up to INR 10,00,000 . The Premium variant of this plan has an e-opinion (second opinion) once in a policy year in case of diagnosis of a critical illness.

Note: This benefit is applicable after 30 days of survival and will not be applicable for the same critical illness or if 3 or more claims are made in the year.

ALTERNATIVE PRACTICE

This plan offers coverage for in-patient Ayurveda, Unani, Sidha and Homeopathy treatment. The maximum limits up to which these treatments are covered-

INR 20,000 for Standard variant. INR 25,000 and INR 50,000 (depending on sum insured) for Exclusive and Premium variant.

Note: The above mentioned treatments should be with government hospital, hospital or institute recognized by government or accredited by Quality Council of India/ National Accreditation board on health.

DENTAL COVER

After a waiting period of three years, the Premium variant of Easy Health Insurance offers coverage for dental expenses: Equal to 1% of sum insured up to a maximum of INR 5000 for sum insured in the range of INR 4,00,000 to INR 10,00,000. Equal to 1 % of sum insured up to a maximum of INR 7,500 for sum insured in range of INR 15,00,000 to INR 50,00,000.

DAILY CASH

Daily cash benefit is applicable only after choosing shared accommodation and 48 hours of hospitalization. For each variant, the limit for daily cash is as follows-

INR 500 per day up to maximum of INR 3000 for Standard variant

In the range of INR 300 to INR 1000 per day up to a maximum in the range of INR 3,000 to INR 6,000 for Exclusive and Premium variant depending on the sum insured opted.

In the range of INR 300 to INR 800 per day up to a maximum in the range of INR 9,000 to INR 24,000 for accompanying an insured child (less than 12 years of age) for Exclusive and Premium variant depending on the sum insured opted. Note: The standard variant does not provide daily cash benefit for accompanying insured child.

ORGAN DONOR COVER

All the variants of this plan, offers coverage for medical expenses up to sum insured, on harvesting organ from the donor, for the insured.

CONVALESCENCE BENEFIT

The convalescence benefit of INR 10,000 is available after more than 10 days of hospitalization, only for Exclusive and Premium variants of this plan and for sum insured of INR 15,00,000 and above.

MATERNITY COVER

Only the Premium and Exclusive variants of this plan covers maternity expenses after a waiting period of 6 years for sum insured up to INR 10,00,000 and the waiting period of 4 years for sum insured INR 15,00,000 and above. The limit up to which the expenses are covered is as follows:

For sum insured up to INR 5,00,000 normal delivery would be covered up to INR 15,000 and caesarean delivery would be covered up to INR 25,000.

For sum insured of INR 7,50,000 and INR 10,00,000 normal delivery would be covered for INR 25,000 and caesarean delivery would be covered up to INR 40,000.

For sum insured in the range of INR 15,00,000 to INR 50,00,000 normal delivery would be covered up to INR 30,000 and caesarean delivery would be covered up to INR 50,000.

Note: The maternity expenses also include pre and post natal expenses.

New born baby cover (coverage from day 1 to 90 days for inpatient treatment) up to limits specified in the document is optional for Premium and Exclusive variant on payment of additional premium.

Exclusions

A cooling off period of 30 days is applicable on buying a policy for the first year. No claims (other than claims related to an accident) can be made in this cooling off period. There is no cooling off period applicable on renewal of this policy. Waiting period of 2 years is applicable for specified ailments. Refer to the policy wordings for the list of these specified ailments. Waiting period of 3 years is applicable for pre-existing diseases.

PERMANENT EXCLUSIONS

Cosmetic surgery, Lasik eye treatments, drugs or alcohol abuse, genetic disorders, self inflicted injuries, war related injuries, etc are some of the permanent exclusions. For the detailed list of please refer the policy document.

Review of Apollo Munich Easy Health Individual Plan

This is the vanilla version health insurance plan from Apollo Munich. A very clean health plan that comes with no capping on Room Rent or any kind of copay. It provides No Claim Bonus of up to 100%. Though the plan is good, it lost its relevance when Apollo introduced Apollo Munich Restore Health Insurance plan, with many more added features at an approximate additional premium of just 20%.

"Reviews and ratings are based only on Benefits and Conditions. Things like Claim Settlement Ratio, Hospital Network have not been covered under product ratings. These are covered under Company ratings."