Policy Review - Apollo Munich Optima Restore
Mar 18, 2014

Author: PersonalFN Content & Research Team

Some health insurance plans are gaining popularity these days and one such plan is the "Apollo Munich Optima Restore". So we thought why not review its features for the benefit of our avid PersonalFN readers.

Apollo Munich Optima Restore is a Health Insurance plan which not only takes care of your hospitalization bills in case of any accident or any illness, but also offers some additional or unique feature as well. Let's look at all the features of this health insurance plan in detail:
 

Apollo Munich Optima Restore
Sum Assured (SA) 3 lakh, 5 lakh, 10 lakh, 15 lakh
Pre-Hospitalisation 60 Days
Post-Hospitalisation 180 Days
Pre-Existing Diseases Covered after 36 months
Co-payment 0% Co-payment
Sub limits No sub-limits on Room Rent
Multiplier Benefit 50% of Basic SA (Max. upto 100%)
Restore Benefit Equal to 100% of Basic Sum Assured
 

Sum Assured

As you may know, Sum Assured is the amount of insurance cover you can buy under the policy. This policy has 4 available options to choose the Sum Assured, ranging between Rs 3 lakh to 15 lakh.

Pre-Hospitalisation

Pre-Hospitalisation expenses are those expenses which are incurred before you are hospitalized. They can include doctor's consultation fees, medical tests, medication, and related expenditures. This policy covers such expenses for upto 60 days.

Post-Hospitalisation

Post-Hospitalisation expenses are those expenses which are incurred once you are discharged from the hospital. They can include things such as doctor's consultation fees, medication, further tests (checkups), and even physiotherapy. This policy covers such expenses for upto 180 days.

Pre-Existing Diseases

Pre-Existing Diseases are those diseases which you are already diagnosed with before taking up the health insurance policy. Insurance companies do not cover such diseases for few years from the day you take up the new policy and in case of Apollo it is 36 months.

Co-Payment

Co-payment is a clause in health insurance plans that requires cost-sharing by the policyholder. Cost sharing is the specified percentage of the admissible claim amount. In case of Apollo there is no co-payment clause; so you do not have to bear any cost as full admissible amount will be borne by Apollo.

Sub Limits

Room Rent is one of the major expenses you have to bear if any member of your family gets hospitalized. Hence some insurance companies cap the maximum amount that they will pay under their health insurance plan. In case of Apollo, there is no maximum limit on room rent. (Also Read: The One Fact about Mediclaim That Your Agent Will Never Tell You to know how sub-limits affect your overall claim amount)

Multiplier Benefit

Multiplier Benefit is actually a 'No claim Bonus' paid in case you do not claim any amount in a policy year. In such a case the aforesaid policy from Apollo, will increase your Sum Assured by 50% of the Basic Sum Assured and maximum upto 100% of Sum Assured. So if you do not claim any amount for 2 consecutive years then your Sum Assured will double. But in case of any claim, your bonus will reduce by 50% of Basic Sum Assured.

Restore Benefit

Restore Benefit is an additional feature which otherwise rest of the health insurance policies do not offer. In this benefit if your entire Sum Assured is exhausted within a policy year then your Basic Sum Assured will be restored. For example, if you have a Sum Assured of Rs 5 lakh under this policy and due to an accident your entire limit is exhausted, then unlike a normal health insurance policy, Apollo Munich Optima Restore will restore your entire Basic Sum Assured of Rs 5 lakh and you will be eligible for any claim arising in case of further hospitalization within the same policy year.

But there are the 2 catches in this benefit. First, you are eligible for restore benefit only if your entire sum assured is exhausted. This means that if you have sum assured of Rs 5 lakh under the policy and you claim Rs 4.50 lakh then your next claim within the same policy year will be eligible for maximum of Rs 50,000 only and not Rs 5 lakh. The second catch in this policy is that, this benefit is not applicable in case of hospitalization for the same/related disease because of which you were admitted earlier within the same policy year. Further the premium charged for this policy is slightly higher than the normal health insurance policy.

Our verdict:
If you are looking out for a health insurance, then you may consider going for the above policy or any other that you come across. What matters the most is that, whichever policy you go for must suit your requirement. Having a good health insurance plan will ensure that you are prepared in advance to face the uncertainties of life.



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