Introduction
Does your health insurance policy cover treatment costs for things like sore throat, cracked lips, running nose, wisdom tooth, broken finger, itchy eyes etc????? Chances are not. Most of the policies issued by Health Insurance Companies do not cover the treatment costs for these small-small illness for which we consult a doctor or visit the Out Patient Department (OPD) of a hospital. Most of the policies issued by Health Insurance Companies cover treatment cost for major illness wherein a patient gets hospitalised. How about a Health Policy, which apart from major hospitalisation instances, also takes cares of treatment costs of small illness, visits to a doctor for consultation, pharmacy expenses, annual health check-up, dental treatment, spectacles etc????? Would you be interested in knowing more about this Health Policy ……. then read on ……….
Features of Apollo Munich Maxima
Apollo Munich Maxima is a health insurance policy that covers major hospitalisation events along with OPD expenses for small-small treatments.
- 3 Variants: The policy comes in 3 variants. The policy can be taken by
i. One Adult (Individual) or
ii. Two Adults (Family Floater) or
iii. Two Adults and Two Children (Family Floater)
- The policy comes with a cover of Rs 3,00,000 (sum insured) for an individual for in-patient hospitalisation, pre and post hospitalisation and 140 day care procedures. If 2 adults or 2 adults and 2 children have taken the policy then the cover of Rs 3,00,000 becomes a floater for them.
- Additional Critical Illness Cover: An individual can also opt for additional critical illness cover of Rs 3,00,000 against 8 specified critical illnesses if required. This is optional and comes with additional premium payment depending on the age of the insured. In case of a floater policy additional critical illness cover can be availed on an individual basis.
- Doctor Consultations: The policy offers 4/6/8 doctor consultations for the individual and the covered family members, based on the plan opted for and the number of family members covered.
- Maximum entry age is 75 Years
- Life Long Renewal: The individual can renew the policy year after year during his / her entire lifetime. There is no maximum age for maturity of the policy.
- No Claim Bonus: For every claim free year for in-patient treatment, the company offers 10% cumulative bonus on the in-patient sum insured. However the additional sum insured is limited to 50% of the in-patient sum insured.
- Income Tax Benefit: Under Section 80D of the Income Tax Act, the individual can avail deduction from taxable income for the premium paid for the policy. The deduction is upto Rs 15000 for individuals below 65 Years of age and upto Rs 20,000 for Senior Citizens.
- Maternity Expenses: Maternity Expenses are covered but there is a waiting period of 4 Years.
What all does Maxima Cover?
Apart from treatment costs for regular hospitalisation, there are a whole host of other things which Maxima health policy covers. Some of these are:
- Pharmacy Expenses: Your pharmacy bills are covered
- Diagnostics: Cost of diagnostic tests taken by you or anyone covered in your family are paid
- Specialist Services: Dental treatment, Spectacles and Contact Lenses are covered upto a certain limit.
- Health Check-up: The company provides an annual health check-up facility. A person above 45 years of age can avail this benefit from the second year.
- Pre-existing illnesses under OPD Benefits: Medicines or Doctor's consultation for any pre-existing illnesses are covered without any waiting period.
All the above benefits are available on a cashless basis in the Apollo Munich network and on reimbursement basis outside the network.
Policy Premium:
- If the policy with sum insured of Rs 3,00,000 is taken for 2 adults aged between 18 Years and 45 Years the premium comes to Rs 21,105 (inclusive of taxes).
- On this the individual can save net income tax of Rs 4635 under Section 80D of the Income Tax Act.
Rs 15000 premium * 0.309 (30% tax rate) = Rs 4635
- The individual also gets OPD Entitlement Certificates worth Rs 14,900 which he can use for things like Doctor Consultation, Diagnostic Tests, Pharmacy, Annual Health Check-up, Dental Treatment, Spectacles, Contact Lenses etc.
- So effectively the cover of Rs 3,00,000 comes only for Rs 1570.
Rs 21,105 (Premium) – Rs 4635 (Net Tax Savings) – Rs 14,900 (OPD Entitlement Certificates) = Rs 1,570 (Net Effective Premium)
Things to Remember
- During the first 30 days the policy covers only medical expenses arising out of accidental emergency conditions
- Cataract and some other specific diseases are covered after two consecutive years
- Pre-existing illnesses will be covered from the 4th year onwards
- HIV AIDS and related diseases are not covered. Non-allopathic treatments and cosmetic treatments are not covered.
- For other finer details about the policy please refer the company website or get in touch with the company personnel.
About Apollo Munich Health Insurance
Apollo Munich Health Insurance Company Limited is a joint venture between the Apollo Hospital Group and Munich Health. Apollo Hospitals has 50 Hospitals, 8000 Doctors, 1068 Pharmacies spread over India. Munich Health has 5000 Experts across 26 locations worldwide and Customers spread across 100 Countries. For its Health Insurance venture Apollo Munich has tied up with 4500 Network Hospitals across 800 cities for offering cashless treatment facility for its customers.
For more details please read the policy wordings available on the company website on what is covered and what is not covered.
The company Toll Free Number is 1800-103-0555.
Note: Readers please note that all the above information has been sourced from the company website. So please make sure you refer the company website or company contact person before deciding on whether to take the policy or not.
