Apollo Munich Health wallet is an extended version of Apollo Munich Optima Restore. The Insurer calls it Reserve Benefit.
The reserve benefit is fixed and depends on the Sum assured you have opted for. It comes in Multiples of Rs 5000 and ranges to Rs 25000. This reserve benefit will be charged to your premium and will be deposited in a health wallet where you will get Interest @6% p.a.
Why am I saying “charged to you”, if it is a benefit is a reason I call it an extended version of Optima Restore. The features of Apollo Munich health wallet is more or less similar with to that of Apollo Munich Optima Restore with a few exotic changes, but the extra premium they charge in health wallet is the one that goes into reserve benefit.
Below is the calculation of premium for both of the products for an Individual with 40 years of age
What is the benefit of this reserve?
This is mainly to take care of your Out of Pocket expenses which no health insurance policy generally covers. Like OPD expenses, diagnostic tests, non-allopathic treatments, Purchase of medicines, vaccinations, dental expenses, spectacles, contact lenses, a medical device like blood pressure, sugar monitors etc.
The accrued reserve benefit may also be used to pay 50% of the renewal premium post 5 continuous renewals.
The amount that is carried forward also earns 6% bonus at the time of renewal
The below table shows the basic working of the reserve benefit.
In case of cancellation or health wallet policy is not renewed, the reserve benefit at the end of the year would be available for next 12 months from the date of cancellation or expiry.
Who is eligible to take Apollo Munich Health Wallet Health Insurance Plan?
1) Minimum age of entry is 91 days.
2) Maximum age of entry is 65 years.
3) Children < 5 years can be insured only if parents are insured.
4) There is no maximum cover ceasing age on renewals.
5) Policy would be issued only for 1 year and can be renewed year on year.
6) This health insurance plan is available for individual or for family. The family indicated here includes spouse, dependent children and dependent parents and dependent in laws. However, in family floater the maximum number is restricted to 6 members.
7) Option available to convert health insurance plan to family floater policy.
8) In a family floater the age of the eldest member will be considered while computing premium for the family.
What are the major benefits available in Apollo Munich Health Wallet Health Insurance Plan?
Here are the major benefits available in this health insurance plan.
1) Reserve Benefit: This is the unique feature of this health insurance plan. This plan provides a separate sum insured which can be used for OPD expenses, any non-payable items under health insurance claim or to pay up to 50% of your renewal premium. Such Reserve Benefit would increase every year and any unutilized balance will be carried forward to next year with 6% bonus.
2) Restore Benefit: If your sum insured is exhausted due to earlier hospitalization, this health insurance plan offers automatic restoration benefit where sum insured would be restored. However, this benefit is available only once in a policy year.
3) Health Check-up: This is being offered by some of the health insurance plans now. This plan too offers reimbursement of expenses incurred on preventive health check-up.
4) Optional Coverage for Critical Advantage Rider: This plan provides optional benefit of coverage of 8 major illnesses which includes Cancer, Coronary Artery by-pass surgery, Heart Valve replacement / repair, Neurosurgery, Live Donor Organ Transplant, Bone Marrow Transplant, Pulmonary artery graft surgery and Aorta Graft Surgery. The unique part is that the rider not only offers best healthcare services world over but also covers all travel costs for the insured and accompanying relative, accommodation expenses, second opinion & post hospitalization expenses. This rider will be offered where base policy Sum Insured is Rs.10 lakhs & above. This rider can be issued to an individual and/or family only on individual Sum Insured basis.
5) Multiplier Benefit: You get a bonus of 50% of the basic sum insured for every claim free year accumulating up to 100%. (In the event of a claim, the bonus shall be reduced by 50% of the Basic Sum Insured at the time of renewal).
6) Continuation of Cover: Option to pay up to 50% of renewal premium from Reserve Benefit. Benefit is available after 5 continuous renewals.
7) In-Patient Hospitalization: Policy covers medical expenses for in patient hospitalization of over 24 hours.
8) Pre-Hospitalization: Policy covers medical expenses for pre- hospitalization expense of 60 days before insured is hospitalized.
9) Post-Hospitalization: Policy covers medical expenses for post hospitalization expenses of 90 days from the date of discharge from the hospital.
10) Day-Care Procedures: Covers all day care procedures where hospitalization is not required
11) Domiciliary Treatment: Covers all day domiciliary treatment done at home without any hospitalization.
12) Organ Donor: Treatment expenses for the organ donor at the time of organ transplant.
13) Emergency Ambulance: Ambulance service expenses to bring patient to hospital for hospitalization up to Rs 2,000.
14) Recovery Benefit: Lump sum benefit of Rs 10,000, if hospitalized for more than 10 days.
15) Waiver of Deductible benefit : The option to convert the plan to a full-fledged Indemnity Health Insurance plan with no underwriting or medicals is available only at renewal between 55:60 years provided you have enrolled with them under this policy before the age of 50 years and have renewed with us continuously without a break.
16) Sum Insured Enhancement: Sum Insured can be enhanced only at the time of renewal subject to no claim have been lodged / paid under the policy.
17) Tax Benefits: With the Health Wallet Insurance Plan you can avail tax benefits u/s 80D of the Income Tax Act.
18) Renewability: Health Wallet policy offers lifelong renewability i.e. there is no maximum cover ceasing age in this policy. However if you are not satisfied with this policy, there is Grace Period of 30 days is provided for renewing the policy.
What is Waiting Period in Apollo Munich Health Wallet Health Insurance Plan?
There is waiting period in this policy indicated here
1) Hospitalization treatments covered only after 30 days except for accident injury.
2) All pre-existing diseases will be covered after a waiting period of 3 years from the policy date.
3) In case of specific diseases like cataract, hernia, joint replacement surgeries, surgery of hydrocele etc. 2 years waiting period is applicable.
The reserve benefit is fixed and depends on the Sum assured you have opted for. It comes in Multiples of Rs 5000 and ranges to Rs 25000. This reserve benefit will be charged to your premium and will be deposited in a health wallet where you will get Interest @6% p.a.
Why am I saying “charged to you”, if it is a benefit is a reason I call it an extended version of Optima Restore. The features of Apollo Munich health wallet is more or less similar with to that of Apollo Munich Optima Restore with a few exotic changes, but the extra premium they charge in health wallet is the one that goes into reserve benefit.
Below is the calculation of premium for both of the products for an Individual with 40 years of age
What is the benefit of this reserve?
This is mainly to take care of your Out of Pocket expenses which no health insurance policy generally covers. Like OPD expenses, diagnostic tests, non-allopathic treatments, Purchase of medicines, vaccinations, dental expenses, spectacles, contact lenses, a medical device like blood pressure, sugar monitors etc.
The accrued reserve benefit may also be used to pay 50% of the renewal premium post 5 continuous renewals.
The amount that is carried forward also earns 6% bonus at the time of renewal
The below table shows the basic working of the reserve benefit.
In case of cancellation or health wallet policy is not renewed, the reserve benefit at the end of the year would be available for next 12 months from the date of cancellation or expiry.
Who is eligible to take Apollo Munich Health Wallet Health Insurance Plan?
1) Minimum age of entry is 91 days.
2) Maximum age of entry is 65 years.
3) Children < 5 years can be insured only if parents are insured.
4) There is no maximum cover ceasing age on renewals.
5) Policy would be issued only for 1 year and can be renewed year on year.
6) This health insurance plan is available for individual or for family. The family indicated here includes spouse, dependent children and dependent parents and dependent in laws. However, in family floater the maximum number is restricted to 6 members.
7) Option available to convert health insurance plan to family floater policy.
8) In a family floater the age of the eldest member will be considered while computing premium for the family.
What are the major benefits available in Apollo Munich Health Wallet Health Insurance Plan?
Here are the major benefits available in this health insurance plan.
1) Reserve Benefit: This is the unique feature of this health insurance plan. This plan provides a separate sum insured which can be used for OPD expenses, any non-payable items under health insurance claim or to pay up to 50% of your renewal premium. Such Reserve Benefit would increase every year and any unutilized balance will be carried forward to next year with 6% bonus.
2) Restore Benefit: If your sum insured is exhausted due to earlier hospitalization, this health insurance plan offers automatic restoration benefit where sum insured would be restored. However, this benefit is available only once in a policy year.
3) Health Check-up: This is being offered by some of the health insurance plans now. This plan too offers reimbursement of expenses incurred on preventive health check-up.
4) Optional Coverage for Critical Advantage Rider: This plan provides optional benefit of coverage of 8 major illnesses which includes Cancer, Coronary Artery by-pass surgery, Heart Valve replacement / repair, Neurosurgery, Live Donor Organ Transplant, Bone Marrow Transplant, Pulmonary artery graft surgery and Aorta Graft Surgery. The unique part is that the rider not only offers best healthcare services world over but also covers all travel costs for the insured and accompanying relative, accommodation expenses, second opinion & post hospitalization expenses. This rider will be offered where base policy Sum Insured is Rs.10 lakhs & above. This rider can be issued to an individual and/or family only on individual Sum Insured basis.
5) Multiplier Benefit: You get a bonus of 50% of the basic sum insured for every claim free year accumulating up to 100%. (In the event of a claim, the bonus shall be reduced by 50% of the Basic Sum Insured at the time of renewal).
6) Continuation of Cover: Option to pay up to 50% of renewal premium from Reserve Benefit. Benefit is available after 5 continuous renewals.
7) In-Patient Hospitalization: Policy covers medical expenses for in patient hospitalization of over 24 hours.
8) Pre-Hospitalization: Policy covers medical expenses for pre- hospitalization expense of 60 days before insured is hospitalized.
9) Post-Hospitalization: Policy covers medical expenses for post hospitalization expenses of 90 days from the date of discharge from the hospital.
10) Day-Care Procedures: Covers all day care procedures where hospitalization is not required
11) Domiciliary Treatment: Covers all day domiciliary treatment done at home without any hospitalization.
12) Organ Donor: Treatment expenses for the organ donor at the time of organ transplant.
13) Emergency Ambulance: Ambulance service expenses to bring patient to hospital for hospitalization up to Rs 2,000.
14) Recovery Benefit: Lump sum benefit of Rs 10,000, if hospitalized for more than 10 days.
15) Waiver of Deductible benefit : The option to convert the plan to a full-fledged Indemnity Health Insurance plan with no underwriting or medicals is available only at renewal between 55:60 years provided you have enrolled with them under this policy before the age of 50 years and have renewed with us continuously without a break.
16) Sum Insured Enhancement: Sum Insured can be enhanced only at the time of renewal subject to no claim have been lodged / paid under the policy.
17) Tax Benefits: With the Health Wallet Insurance Plan you can avail tax benefits u/s 80D of the Income Tax Act.
18) Renewability: Health Wallet policy offers lifelong renewability i.e. there is no maximum cover ceasing age in this policy. However if you are not satisfied with this policy, there is Grace Period of 30 days is provided for renewing the policy.
What is Waiting Period in Apollo Munich Health Wallet Health Insurance Plan?
There is waiting period in this policy indicated here
1) Hospitalization treatments covered only after 30 days except for accident injury.
2) All pre-existing diseases will be covered after a waiting period of 3 years from the policy date.
3) In case of specific diseases like cataract, hernia, joint replacement surgeries, surgery of hydrocele etc. 2 years waiting period is applicable.
What are the major exclusions in Apollo Munich Health Wallet Health Insurance Plan?
Here are the major exclusions.
1) Expenses arising from HIV or AIDS and related diseases.
2) Congenital diseases, mental disorder or insanity, cosmetic surgery and weight control treatments.
3) Abuse of intoxicant or hallucinogenic substances like intoxicating drugs and alcohol.
4) Hospitalization due to war or an act of war or due to a nuclear, chemical or biological weapon and radiation of any kind Pregnancy, dental treatment, external aids and appliances.
5) Items of personal comfort and convenience
6) Experimental, investigative and unproven treatment devices and pharmacological regimens. You can refer policy document for complete list of exclusions.
Should you opt for Apollo Munich Health Wallet Health Insurance Plan?
This health insurance plan comes with several unique features. However, one should really assess whether they need such benefits or not. As in this case, be ready to face hassles of claiming the health-related expenses every now and then from your Insurer. Alternatively, you can claim for either major expenses or let the money accumulate and set off your annual premium payments with the reserve amount.
If not, you can take plain vanilla health insurance plans by adding the base policy, plus Super top up
If you feel such features would fit to your life style, you should definitely consider such plans. You have to decide what suits you the best.
source:good moneying / my investment ideas
Here are the major exclusions.
1) Expenses arising from HIV or AIDS and related diseases.
2) Congenital diseases, mental disorder or insanity, cosmetic surgery and weight control treatments.
3) Abuse of intoxicant or hallucinogenic substances like intoxicating drugs and alcohol.
4) Hospitalization due to war or an act of war or due to a nuclear, chemical or biological weapon and radiation of any kind Pregnancy, dental treatment, external aids and appliances.
5) Items of personal comfort and convenience
6) Experimental, investigative and unproven treatment devices and pharmacological regimens. You can refer policy document for complete list of exclusions.
Should you opt for Apollo Munich Health Wallet Health Insurance Plan?
This health insurance plan comes with several unique features. However, one should really assess whether they need such benefits or not. As in this case, be ready to face hassles of claiming the health-related expenses every now and then from your Insurer. Alternatively, you can claim for either major expenses or let the money accumulate and set off your annual premium payments with the reserve amount.
If not, you can take plain vanilla health insurance plans by adding the base policy, plus Super top up
If you feel such features would fit to your life style, you should definitely consider such plans. You have to decide what suits you the best.
source:good moneying / my investment ideas
