HDFC ERGO Health Formerly Apollo Munich Mediclaim Insurance

AMHI’s Easy Health Individual Plan protects the individual insured from any unplanned emergency medical expenses and also offers a coverage for treatment of inpatient hospitalisation following illnesses and accidents. The Plan offers more than 10 variants of individual sum insured basis & also offers an add-on optional cover for listed Critical Illnesses.

The Exclusive plan includes Maternity Expenses while the Premium Plan covers Maternity expenses, Outpatient dental cover, Recovery benefit and Cost of Spectacles & Hearing aids etc apart from letting the insured avail health check-up benefit every three years irrespective of claims. The eligibility is as follows:

• Entry age is 5 years onwards with maximum entry age of 65 years. A dependent child can be covered from the 91st day (if either parents are covered under this policy).
• In an individual policy, a maximum of 4 adults and a maximum of 5 children can be included in a single policy.
• The policy period options include period of 1 or 2 years(s). (We offer 7.5% discount if you opt for a 2 year policy)

This is a unique product in the market launched by which comes with seven sum insured variants from Rs.3 lacs to Rs.50 lacs and this plan coves Pre & Post Hospitalisation, Day Care procedures, Organ Donor, Emergency Ambulance and Ayush Treatment benefit. There is also a Restore facility of 100% of the Sum insured, a Multiplier benefit for every claim free year apart from a Critical Illness Rider and Health Check up as part of the plan offering.

The unique feature of this plan is the Reserve Benefit which can be used for OPD expenses, any non-payable items under the chosen health insurance plan or to pay upto 50% of your renewal premium. The Reserve Benefit will keep on increasing every year and any unutilized balance under this benefit will be carried forward to next year with 6% bonus.

The eligibility under the plan is as follows:

• Policy is available for an individual between 91 days and 65 years. The maximum entry age is restricted to 65 years.
• The Minimum entry age for Adult Dependent is 18 years and Maximum entry age is 65 years.
• Children between 91 days and 5 years can be insured provided either parent is getting insured under this Policy.
• The policy will be issued for a period of 1 year period and the sum insured & benefits will applicable on Policy Year basis.

Another unique plan from AMHI is their Health plan specifically for Cancer called iCan. There are two variants called iCan Essential and iCan Enhanced with sum insured options of Rs.5, Rs.10, Rs.15, Rs.20, Rs.25 and Rs.50 lacs. The features of this plan are as follows:

• The entry age under the plan is 5 and maximum entry age is 65 years.
• Covers all types of Cancer and at all stages
• Lumpsum payouts as well covering all Actual Treatment costs through Cashless/Reimbursement possible which can amount of 160% of the sum insured.
• Lifelong Renewal, Even After Claims are paid
• No Pre-policy Medical Check-up required
• Advanced Treatments like proton beam therapy, immunotherapy, personalized & targeted therapy, stem cell transplantation, bone marrow transplantation also covered.
• Waiting Period under the plan is 4 months (120 days)

The plan also has the regular coverages of Pre & Post Hospitalisation, Day Care procedures, Emergency Ambulance apart from Second Opinion benefit and Follow-up Care cover.

Another unique plan from AMHI is a coverage specific for Dengue.The plan offers coverage for any medical expenses incurred on inpatient or outpatient treatment for dengue. Other eligibility criteria include:

• This policy can cover individuals in the age group 91 days to 65 years. The maximum entry age is restricted upto 65 years.
• The Minimum entry age for Adult is 18 years and maximum is 65 years. The minimum entry age for child is 91 days and the maximum is 25 years
• The individual is not required to undergo any medicals before taking the policy.

Optima Cash is a top up plan that provides coverage to the insured under a daily cash benefit in case of hospitalisation due to illness or accidents. In addition to the hospital cash benefit, the plan also offers covers such as Parent’s hospitalization, Day care procedures, Child Birth, Convalescence benefit, etc. The eligibility criteria for this plan includes:

• Coverage available between the ages of 5 years and 65 years. A dependent child can be covered from the 91st day (if either parent is covered under this policy).
• The policy period options include period of 1 or 2 years(s).

The Optima Super plan is an aggregate plan that offers the insured varied sum insured & deductible combinations to choose so they can opt for the optimum coverage as per their requirements. There are three sum insured options to choose from which are 5 lacs, ₹7 lacs and ₹10 lacs with deductible options ranging from ₹1 lac to ₹10 lacs. The plan also coves Pre & Post Hospitalisation, 144 Day Care procedures, Organ Donor and Emergency Ambulance cover. The plan also gives the insured an option to convert to a Fully Nil Deductible plan near your retirement. Eligibility criteria is:

• The insured age is from 5 years upto the age of 65 years. A dependent child can be covered from the 91st day (if either parent is covered under this policy).
• The policy covers on individual sum insured basis & maximum of 6 members can be added in a single policy
• The policy period options include period of 1 or 2 years(s).

Optima Vital from AMHI is an insurance plan which covers Critical Illness and will pay the insured a lump sum amount for the identified critical illness, medical events or surgical procedures incurred by the insured. This amount is payable on a confirmed diagnosis with defined severity of the illness or the date of undergoing specified surgery in respect of that Critical Illness and the insured surviving the defined survival period. The survival period under this particular plan is 30 days, which means the insured will need to survive for 30 days after diagnosis to be eligible for coverage under the policy. The plan also covers an E-opinion which is actually a second opinion with the insurer’s panel of medical specialists. The eligibility for this plan include:

• Coverage is available to an individual from the age of 18 years onwards with maximum entry age of 65 years.
• A dependent child can be covered from 18 years upto 25 years provided both parents are covered in a critical illness plan of any Indian Insurer.
• Policy Period can be 1 or 2 years(s) depending on the insured’s choice and requirement
• The list of Critical Illnesses are named and in the table below for an immediate perusal.

Energy is another unique product from the AMHI stable and is a plan tailormade for Diabetes patients. It is essentially a wellness management program for individuals with Type 1 Diabetes, Type 2 Diabetes Mellitus, Impaired Fasting Glucose (IFG), Impaired Glucose Tolerance (IGT) and/or Hypertension. It offers Day 1 coverage for all hospitalisation arising out of Diabetes and Hypertension (with no waiting period). The plan is also a combined package providing coverage for Inpatient hospitalisation expenses along with an availability of wellness solutions & health rewards for monitoring your health and earning rewards accordingly. The plan covers:

• Individuals from the age of 18 years to 65 years for individuals with Type 1 Diabetes, Type 2 Diabetes Mellitus, Impaired Fasting Glucose (IFG), Impaired Glucose Tolerance (IGT) and/or Hypertension.
• There are 8 sum insured options from ₹2 lacs upto ₹50 lacs
• The plan has 2 variants – Gold (cost of wellness test included) & Silver (cost of wellness test excluded), both available with/ without the co-payment option of 20%.
• The policy will be issued for 1 year.

The plan coves Pre & Post Hospitalisation, 182 Day Care procedures, Organ Donor, Emergency Ambulance and Shared Accommodation benefit. There is also a Restore facility of 100% of the Sum insured, a Cumulative Bonus benefit for every claim free year

Optima Plus Top Up plan from AMHI offers to cover the insured for higher hospitalization expenditures at nominal premium. This is where the insured typically has another base health policy which has limited sum insured provided by another individual policy or a corporate plan provided by the employer. It is the only plan in India that provides the insured an option to convert to a fully fledged nil deductible health insurance plan on retirement. It is a plan which offers additional sum insured at a reasonable premium and also remains active if the insured is shifting jobs etc. While the primary sum insured is fixed at ₹5 lacs, the insured has an opportunity of choosing for the deductible options available from ₹1lac to ₹5 lac. The eligibility criteria are:

• Coverage for individuals from the age of 5 years onwards with maximum entry age of 65 years. A dependent child can be covered from the 91st day (if either parent is covered under this policy).
• The policy period options include period of 1 or 2 years(s)

The plan coves Pre & Post Hospitalisation, 140 Day Care procedures, Organ Donor, Emergency Ambulance and Domiciliary Treatment benefit.

Maxima, as the name suggests is the plan offering Maximum coverage under the HDFC ERGO Health Formerly Apollo Munich banner. The basic difference between Maxima and most other plans in the market include the fact that this plan covers Outpatient expenses incurred by the insured and these expenses could be for something as simple as a fever, stomach pain, back ache, head ache etc. Maxima plan offers unique out-patient benefits to take care of your regular illnesses incurred by the insured individual. Other features include:

• Under the plan depending on the number of members covered, there are 4/6/8 consultations for the insured and their family
• Out patient treatments costs include Doctor Consultations, Pharmacy Expenses, Diagnostic Test Costs, Coverage for Spectacles, Contact Lenses, Dental Treatments etc are all covered.
• Annual Health Check up is included (for members above 18 years of age) with the insurer’s hospital network for the insured / or family member based on the option chosen
• Apart from the OPD treatments, the insured can also opt for inclusion of Part B, which is for Inpatient treatment and has coverages like Pre and Post Hospitalisation, Organ Donor, Day Care Procedures, Domiciliary Treatment, Ambulance Expenses etc.
• There is also a Maternity cover and Critical Illness available to be chosen by the insured on an optional basis.

Optima Restore Family Floater plan is designed specially to cover a family which can include your spouse, dependent children, parents and parents-in-law. The primary insured can choose from seven sum insured variants from ₹3 lacs, ₹5 lacs, ₹10 lacs, ₹15 lacs, ₹20 lacs, ₹25 lacs and ₹50 lacs. The plan also includes unique benefits such as Restore, Multiplier and Stay Active.

With Restore benefit even if any family member uses the sum insured partially or fully, instantly an additional 100% of the sum insured will be added to the insured’s policy, and the restored sum insured would be available to everyone covered under the plan. It is applicable once during a policy year. Similarly the Multiplier benefit rewards the insured with a 100% increase in sum insured for every two claim free years. The Stay Active benefit rewards customers who lead an active lifestyle, the benefit allows a customer to enjoy premium discounts simply by exercising.

The plan also covers Pre & Post Hospitalisation, Domiciliary Expenses, Day Care Treatments, Organ Donor, Daily Cash, E-Opinion (which is a second opinion), Emergency Ambulance Expenses (including Air Ambulance), Health Check-up and Critical Advantage Rider. Other criteria include:

• Coverage is offered from the age of 5 years till maximum entry age of 65 years. A dependent child can be covered from the 91st day (if either parents are covered under this policy).
• The Primary Insured you’re their family members namely spouse, dependent children, dependent parents / parents in law are eligible for buying this cover on floater sum insured basis.
• The policy period options include period of 1 or 2 years(s).

Easy Health Family Floater Plan protects the insured’s family from unforeseen emergency expenses following an illness or accident and also offers a comprehensive cover for medical treatment for in-patient hospitalisation. The Plan offers coverage on floater sum insured basis & offers an add-on optional cover for listed Critical Illnesses. The plan has seven sum insured options ranging from ₹2 lacs to ₹15 lacs. Eligibility criteria include:

• Insured age from 5 years till the maximum entry age of 65 years. A dependent child can be covered from the 91st day (if either parent is covered under this policy).
• Insured’s family members can include spouse, dependent children, dependent parents, parent-in-law, grandparents and grandchildren. Family discount between 5% and 10% is offered depending on the number of members of the family covered under the policy.
• The policy period can be for 1 or 2 year(s).

The plan also covers Pre & Post Hospitalisation, Domiciliary Expenses, Day Care Treatments, Organ Donor, Daily Cash, E-Opinion (which is a second opinion), Emergency Ambulance Expenses, Ayush Benefit, Health Check-up and Critical Illness Rider.

The Optima Super Aggregate Top Up plan offers the insured varied sum insured & deductible combinations to choose so they can opt for the optimum coverage as per their requirements. There are three sum insured options to choose from which are 5 lacs, ₹7 lacs and ₹10 lacs with deductible options ranging from ₹1 lac to ₹10 lacs.

The plan also coves Pre & Post Hospitalisation, 144 Day Care procedures, Organ Donor and Emergency Ambulance cover. The plan also gives the insured an option to convert to a Fully Nil Deductible plan near your retirement. Eligibility criteria is:

• The insured age is from 5 years upto the age of 65 years. A dependent child can be covered from the 91st day (if either parent is covered under this policy).
• The policy covers on individual sum insured basis & maximum of 6 members can be added in a single policy
• Insured and their family members namely spouse, dependent children, dependent parents are eligible for buying this cover on a floater sum insured basis.
• Maximum 4 members can be added in a floater policy with a maximum of 2 adults and a maximum of 2 children. The 2 adults can be a combination of Self, Spouse, Father or Mother.
• The policy period options include period of 1 or 2 years(s).