Plan Overview

Apollo Munich Optima Restore Family Floater is a health insurance plan covering the entire family. The plan boasts of Restore and Multiplier Benefits which are unique in their nature. The facility of E-Opinion is also available which helps individuals seek a second opinion for critical illnesses. Also, a gamut of other coverage benefits is extended under this health plan

Benefits included

Hospitalization means any impatient treatment (min. 24 hrs stay) as well as the named All day care procedures. .

  • Accident related hospitalisation are covered from day 1.
  • Other hospitalisations are covered after 30 days. Cover starts after 30 days, except accidents which are covered from day 1
  • Exceptions : Any pre-existing diseases (PED) which are covered after 3 years and some specified diseases which are covered after 2 years from the policy start date.

Other additional benefits :

  • 100% Cover restoration
  • No claim bonus
  • Free Health Check-up
  • Ambulance charges
  • Daily cash allowance
  • 60 days pre-hospitalisation
  • 180 days post hospitalisation
  • Organ donor expenses
  • Maternity
  • New-born treatment
  • Home treatment
  • Outpatient
  • Ayush treatments
  • Recovery allowance

Out of pocket expenses

  • You will bear all the expenses not covered by the policy. Refer to the list of such expenses in the Policy Exclusions section below
  • Besides, you will have to pay more if you stay in a room category above 10000

Policy Exculsion

  • Cosmetic surgery
  • Birth defects
  • Medical expenses due to drugs/alcohol abuse
  • Self-inflicted injury
  • Hazardous sports or war related injuries
  • HIV or AIDS
  • Sexually Transmitted Disease(STDs)
  • Consumables
  • Mental illness
  • Genetic disorders
  • Dental treatment / Surgery
  • Eye disorders & lasik laser treatment
  • Hospitalization for only diagnostic purpose
  • Diagnostic Charges
  • Hospital registration or admission fees
  • Administrative Charges
  • Non medical expenses

Claims settlement

  • If you go to a non-network hospital, you will have to get the claim settled on reimbursement basis by providing the original bills and documents to the insurer.
  • If you get admitted to a network hospital, you can get a cashless authorization from the insurer and then the insurer will settle the expenses directly with the hospital. See the list of the network hospitals near you below

Most frequently asked questions

Q. How many members can be covered under the plan?

A. A maximum of 6 members can be included in the cover comprising of a maximum of 5 children and a maximum of 2 adults.

Q. Is emergency air ambulance cover available at all coverage levels?

A. No, the coverage for emergency air ambulance is available for Sum Assured of Rs.10 lakhs and above.

Q. Can I increase the Sum Assured of the plan?

A. Yes, the Sum Assured can be increased to the next level at any policy renewal.

Q. Are pre-entrance health check-ups required?

A. The company might require pre-entrance medical check-ups based on the insured member’s age and the amount of cover opted for. 100% costs of such check-ups are reimbursed by the company when the policy is accepted.

Q. Are free health check-ups provided in the plan?

A. Yes, the plan allows free health check-ups once after every 2 years if the Sum Assured is up to Rs.5 lakhs. For coverage levels of Rs.10 lakhs and above, such check-ups are provided every policy year.

Apollo Munich Health Insurance