APOLLO MUNICH HEALTH PLAN

Comprehensive Health Insurance plan with unbelievable benefits
Comprehensive Health Insurance plan with unbelievable benefits

Apollo Munich introduces a plan exclusively for Citibank customers offering unbelievable benefits such as an auto-reinstatement of the sum insured in a policy year, a 50% no claim bonus for every claim free year, coverage for outpatient treatment, an annual health Check benefit, a sublimit free inpatient hospitalisation coverage and lots more....

This product comes to you with a choice of Silver, Gold and Platinum variants, with options to avail an individual or family floater plan.

For further information on this product please contact your Relationship Manager.

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Top 3 reasons

  • Multiple sum insured options upto Rs.50 lacs and variants to choose from to suit your requirement
  • Outpatient treatment to cover your smaller medical expenses
  • Additional covers such as Restore benefit,Multiplier benefit,Annual Health Check up,Hospital daily cash etc
BENEFITS AND FEATURES

A renewal incentive that doubles your sum insured in 2 years! If you’ve had a claim free year, AMHI will increase your basic sum insured by 50% as a no claim bonus. If you don’t claim even in the second year,AMHI will double your basic sum insured as a no claim bonus i.e. maximum upto 100% of the basic Sum Insured. This benefit is available in Gold and Platinum Plan

Auto-reinstatment of sum insured in case it gets exhausted during the policy year, at no extra charge.The basic sum insured will be re-instated only once in a policy year.This benefit is applicable to sum insured Rs.3 lacs & above

Renew your cover lifelong and stay covered forever

With this health plan you can get the treatment you deserve without any sublimits or copays applicable on treatment taken in the hospital.

Cover for inpatient treatment

90 days pre hospitalisation coverage and 180 days post hospitalisation coverage.

Cover for 144 listed day care procedures

Daily cash for choosing shared accomodation in network hospitals for hospitalisations exceeding 48 hrs.

Coverage against expenses incurred, for medical treatment occurring outside the hospital such as doctor consultation, diagnostics etc supported by medical prescriptions (for eg, cost of spectacles, dental expenses, etc)

Reimbursement on expenses incurred towards health check up at the time of renewal irrespective of the claim status

Daily cash benefit to take care of small expenses not covered under inpatient benefit while hospitalised

Cover for expenses incurred on normal delivery or cesarean section. This benefit is available in gold plan only

Coverage for new born chiild from day 1 subject to acceptance of the proposal. This benefit is availble in gold plan only

Domicillary Treatment - Coverage for treatment taken at home subject to terms & conditions of the policy

Organ Donor-Expenses incurred on medical treatment of the organ donor for harvesting the organ.

E-Opinion for Critical illness-Second opinion for listed critical illness from our panel of doctors

AMHI will never load your renewal premium because you claimed or fell ill after taking our policy.

You can avail tax benefits for the premium amount under Section 80 D of the Income Tax Act. (Tax benefits are subject to changes in tax laws.)

Individual Plan

Silver Gold Platinum
Basic Sum Insured per Insured Person per Policy Year (Rs. in Lakh) 2.00,3.00,4.00,5.00 7.00, 10.00 15.00,20.00,25.00.50.00
1a) In-patient Treatment Covered Covered Covered
1b) Pre-Hospitalization Covered, up to 90 Days Covered, up to 90 Days Covered, up to 90 Days
1c) Post-Hospitalization Covered, up to 180 Days Covered, up to 180 Days Covered, up to 180 Days
1d) Day Care Procedures Covered Covered Covered
1e) Domiciliary Treatment Covered Covered Covered
1f) Organ Donor Covered Covered Covered
1g) Daily cash for choosing shared accommodation Rs.500 per day maximum upto Rs.3,000 Rs.800 per day maximum upto Rs.4,800 Rs.800 per day maximum upto Rs.4,800
1e) Emergency Ambulance Up to Rs.2,000 per Hospitalization Up to Rs.2,000 per Hospitalization Up to Rs.2,000 per Hospitalization for SI up to 15 Lacs and up to 5000 per hospitalization for SI 20 Lacs & above
2) Restore Benefit Auto reinstatement of basic sum insured if your existing cover is exhausted during the policy year. Available only on sum insured of Rs.3 Lacs and above Auto reinstatement of basic sum insured if your existing cover is exhausted during the policy year. Auto reinstatement of basic sum insured if your existing cover is exhausted during the policy year.
3) Multiplier Benefit Not Covered Bonus of 50% of the Basic Sum Insured for every claim free year, maximum up to 100%. In case of claim bonus will be reduced by 50% of the basic sum insured However this reduction will not reduce the Sum Insured below the basic Sum Insured of the policy. Bonus of 50% of the Basic Sum Insured for every claim free year, maximum up to 100%. In case of claim bonus will be reduced by 50% of the basic sum insured However this reduction will not reduce the Sum Insured below the basic Sum Insured of the policy.
4) e-opinion in respect to a critical illness Yes Yes Yes
5) Health Checkup Benefit Not Covered Upto 1% of Sum Insured subject to a Maximum of Rs.5,000 per Insured person, at the end of every policy Year For SI of 15 Lacs- Upto 1% of Sum Insured subject to a Maximum of Rs.7,500 per Insured Person, at the end of every Policy Year.
For SI of 20 lacs and above- Upto 1% of Sum Insured subject to a Maximum of Rs.10,000 per Insured Person, at the end of every Policy Year
6) Outpatient Benefit Rs.5,000 per individual post waiting period of 2 years Rs.10,000 per individual post waiting period of 2 years Rs.25000 per individual post waiting period of 2 years
7) Hospital Daily Cash Rs. 500 per day up to a maximum of 30 days on individual basis Rs. 1000 per day up to a maximum of 30 days on individual basis Rs. 2000 per day upto a maximum of 90 days on individual basis
8) Maternity benefit Not covered Normal or Caesarean delivery upto Rs.50,000 ( including pre/post natal limit of Rs.3500 and new born limit of Rs.4500) after a waiting period of 3 years Not covered
9) New Born Baby cover Not covered Covered Not covered

Family Floater Plan

Silver Gold Platinum
Basic Sum Insured per Insured Person per Policy Year (Rs. in Lakh) 2.00,3.00,4.00,5.00 7.00, 10.00 15.00,20.00,25.00.50.00
1a) In-patient Treatment Covered Covered Covered
1b) Pre-Hospitalization Covered, up to 90 Days Covered, up to 90 Days Covered, up to 90 Days
1c) Post-Hospitalization Covered, up to 180 Days Covered, up to 180 Days Covered, up to 180 Days
1d) Day Care Procedures Covered Covered Covered
1e) Domiciliary Treatment Covered Covered Covered
1f) Organ Donor Covered Covered Covered
1g) Daily cash for choosing shared accommodation Rs.500 per day maximum upto Rs.3,000 Rs.800 per day maximum upto Rs.4,800 Rs.800 per day maximum upto Rs.4,800
1e) Emergency Ambulance Up to Rs.2,000 per Hospitalization Up to Rs.2,000 per Hospitalization Up to Rs.2,000 per Hospitalization for SI up to 15 Lacs and up to 5000 per hospitalization for SI 20 Lacs & above
2) Restore Benefit Auto reinstatement of basic sum insured if your existing cover is exhausted during the policy year. Available only on sum insured of Rs.3 Lacs and above. Auto reinstatement of basic sum insured if your existing cover is exhausted during the policy year. Auto reinstatement of basic sum insured if your existing cover is exhausted during the policy year.
3) Multiplier Benefit Not Covered Bonus of 50% of the Basic Sum Insured for every claim free year, maximum up to 100%. In case of claim bonus will be reduced by 50% of the basic sum insured However this reduction will not reduce the Sum Insured below the basic Sum Insured of the policy. Bonus of 50% of the Basic Sum Insured for every claim free year, maximum up to 100%. In case of claim bonus will be reduced by 50% of the basic sum insured However this reduction will not reduce the Sum Insured below the basic Sum Insured of the policy.
4) e-opinion in respect to a critical illness Yes Yes Yes
5) Health Checkup Benefit Not Covered Upto 1% of sum insured per Policy subject to a maximum of Rs.5000 per insured person, at the end of every Policy year For SI of 15 lacs- Upto 1% of sum insured per Policy subject to a maximum of Rs. 7,500 per insured person, at the end of every Policy year.
For SI of 20 Lacs and above: Upto 1% of sum insured per Policy subject to a maximum of Rs.10,000 per insured person, at the end of every Policy year
6) Outpatient Benefit Rs.5,000 per family post waiting period of 2 years Rs.10,000 per post waiting period of 2 years Rs.25000 per family post waiting period of 2 years
7) Hospital Daily Cash Rs. 500 per day up to a maximum of 30 days on individual basis Rs. 1000 per day up to a maximum of 30 days on individual basis Rs. 2000 per day upto a maximum of 90 days on individual basis
8) Maternity benefit Not covered Normal or Caesarean delivery upto Rs.50,000 ( including pre/post natal limit of Rs.3500 and new born limit of Rs.4500) after a waiting period of 3 years Not covered
9) New Born Baby cover Not covered Covered Not covered
FAQs

Pre- and Post-hospitalization expenses cover all medical expenses incurred within 90 days prior to hospitalization and expenses incurred within 180 days post hospitalization provided the expenses were incurred for the same condition for which the Insured Person’s hospitalisation was required.

For Example: A person may be required to undergo certain tests to confirm the disease for which he is eventually hospitalized. The Doctor's consultation fees for this, the expenses for tests and medicines 90 days prior to hospitalization for that particular disease are covered. Medical expenses for 180 days post-hospitalization after being discharged from the hospital, e.g. the subsequent follow-up consultations with specialists, medicines and test expenses are covered.

At the time of renewing an individual or floater policy you can add dependants to your existing policy subject to necessary approval from AMHI.

You cannot add dependants in the middle of a policy except in the case of a new born baby, a newly married spouse and child > 91 days not covered earlier. For product specific conditions kindly refer to the product brochures.

Sum insured can be enhanced only at the time of renewal subject to no claim have been lodged/ paid under the policy. If the insured increases the sum insured one grid up, no fresh medicals shall be required. In cases where the sum insured increase is more than one grid up, the case shall be subject to medicals. In case of increase in the sum insured waiting period will apply afresh in relation to the amount by which the sum insured has been enhanced. However the quantum of increase shall be at the discretion of the company.

Restore Benefit automatically re-instates the basic sum insured, if the basic sum insured and multiplier benefit has been exhausted during the policy year. Basic sum insured will be re-instated only once in a policy year. Restore Sum Insured can be used for only future claims made by the Insured Person and not against any claim for an illness/disease (including its complications) for which a claim has been paid in the current policy year. If the restore sum insured is not utilised in a policy year, it shall not be carried forward to any subsequent policy year.

AMHI will automatically reinstate basic sum insured once exhausted .An endorsement highlighting the same will be dispatched to the customer.

Basic sum insured will be re-instated only once in a policy year. The Restore benefit can be reinstated once every year and there would be no policy lifetime limit.

Multiplier Benefit is a no claim benefit and will be offered as renewal incentive. Under Multiplier benefit, a Bonus of 50% of the basic sum insured will be provided for every claim free year accumulating up to a maximum of 100%. In the event of a claim, the bonus will be reduced by 50% of the Basic Sum Insured at the time of renewal. However this reduction will not reduce the Sum Insured below the basic Sum Insured of the policy.

Prescription is mandatory to claim for pharmacy expenses under OPD. The prescription should indicate the current requirement of usage for medicine. Eg in case of hypertension the medication is valid lifelong, medication for infection would be only for a time period.

To avoid administrative inconvenience, we would be requesting the customer to send us the bills for reimbursement under OPD once at the end of the year where along with the bills the customer can send us the prescription once.

If client opts for Apollo Munich Health Plan with 5 Lacs Sum Insured & does not make a claim during policy duration. Multiplier Benefit will be functional as follows-:

Year 1 Year 2 Year 3 Year 4
Base Sum Insured 5,00,000 5,00,000 5,00,000 5,00,000
Claim Status No Claim No Claim No Claim No Claim
Multiplier Benefit NA 2,50,000 5,00,000 5,00,000
Total Amount 7,50,000 10,00,000 10,00,000
(At beginning of the year)

If client opts for Apollo Munich Health Plan with 5 Lacs Sum Insured & claimed in 3th year. Multiplier Benefit will be functional as follows-:

Year 1 Year 2 Year 3 Year 4 Year 5
Base Sum Insured 500,000 500,000 500,000 500,000 500,000
Claim Status No Claim No Claim Claim No Claim No Claim
Multiplier Benefit NA 250,000 500,000 250,000 500,000
Total Amount 500,000 750,000 10,00,000 750,000 10,00,000
(At the beginning of the year)

Yes, when supported by medical prescription. In case of routine vaccination for children, it has to be supported by a copy of the vaccination chart.

You cannot select sum insured across the variants in one single application form. However within the variant selected , you may choose multiple sum insured options for your dependents.

OPD expenses are to be claimed on reimbursement basis. Please submit the original bills along with medical prescription once at the end of the year to Apollo Munich

ELIGIBILITY CRITERIA
  • This policy covers persons in the age group 91 days to 65 years. The maximum entry age is restricted to 65 years.
  • Child between 91 days and 5 years can be insured if either parent is getting insured under this Policy.
  • The policy will be issued for a period 1 or 2 years.
  • This policy can be issued to an individual and/or family.
  • The family includes spouse, dependent children and dependent parents or parents-in law
  • The policy offers option of covering on individual sum insured basis as well as on family floater basis.
  • The insured and his family cannot select different sum insured across variants in a single application form. (For eg. within the same policy members need to be insured across Silver or Gold variant only)
  • Enjoy up to Rs2,500 Bonus Reward Points* on your first spend with the Citibank Rewards Card.
  • IndianOil Citibank Platinum Credit Card.

Disclaimer:

Good Health Group Mediclaim Policy - IRDA/NL-HLT/NIA/P-H/V.I/342/13-14

Group Health Policy - UIN - IRDAI/NLHLT/RSAI/P-H/V.I/184/13-14

Health Forever - UIN-IRDAI/NL-HLT/RSAI/P-H/V.II/211/13-14

Lifeline - UIN-IRDAI/HLT/RSAI/P-H/V.II/32/15-16

Top-up - UIN-IRDAI/NL-HLT/RSAI/P-H/V.I/209/13-14

Smart Cash - UIN-IRDAI/HLT/RSAI/P-H/V.II/181/14-15

Personal Accident Care Platinum - UIN-IRDAI/NL-HLT/RSAI/P-P/V.I/187/13-14

Individual Personal Accident Insurance - UIN-IRDA/NL-HLT/RSAI/P-H/V.I/215/13-14

Apollo Munich Health Plan UIN: IRDA/NL-HLT /AMHI/P-H/V.1/15/13-14

Group Personal Accident Insurance UIN: IRDA/NL-HLT /AMHI/P-P/V.1/109/13-14

Optima Restore UIN - IRDAI/HLT/AMHI/P-H/V.III/1/2016-17

Insurance products are obligations only of the Insurance company. They are not bank deposits or obligations of or guaranteed by Citibank N.A, Citigroup Inc or any of its affiliates or subsidiaries or any Governmental agency. All claims under the policy will be solely decided upon by the Insurance Company. Citibank, Citigroup or any of their affiliates and group entities hold no warranty and do not make any representation about the insurance, the quality of claims processing and shall not be responsible for claims, recovery of claims, or for processing of or clearing of claims, in any manner whatsoever. This document does not constitute the distribution of any information or the making of any offer or solicitation by anyone in any jurisdiction in which such distribution or offer is not authorized or to any person to whom it is unlawful to distribute such a document or make such an offer or solicitation. Investment products are not available to US persons and may not be available in all jurisdictions.

Participation by the bank's customers in an insurance product is purely on a voluntary basis.

*IRS Circular 230 Disclosure: Citigroup, Inc., its affiliates, and its employees are not in the business of providing tax or legal advice to any taxpayer outside of Citigroup, Inc. and its affiliates. This document is not intended or written to be used, and cannot be used or relied upon, by any such taxpayer for the purpose of avoiding tax penalties. Tax benefits are subject to changes in the tax laws. Any such taxpayer should seek advice based on the taxpayer's particular circumstances from an independent tax advisor.

Citibank N.A. is a registered Corporate Agent of Tata AIA Life Insurance Company Limited, New India Assurance Company Limited, Royal Sundaram General Insurance Company Limited and Apollo Munich Health Insurance Company Limited under the composite license number CA0086 issued by IRDAI.

Life Insurance Policies: These policies are underwritten by Tata AIA Life Insurance Co. Limited (IRDAI Registration No. 110)
CIN: U66010MH2000PLC128403 with its registered office at 14th Floor, Tower A, Peninsula Business Park, Senapati Bapat Marg,
Lower Parel, Mumbai 400013.

All guaranteed benefits are payable only when all premiums are paid when due.

Investment risk in the investment portfolio is borne by the Policy Holder. The premium paid in Unit Linked Life Insurance policies are subject to investment risks associate with capital markets and the NAVs of the units may go up or down based on the performance of the fund and factors influencing the capital market and the insured is responsible for his or her decision. Tata AIA Life is only the name of the Insurance Company and the funds offered are only the names of the funds and does not in any way indicate the quality of the contract, its future prospects or returns.

Non-life Insurance Policies:

Policies are underwritten by New India Assurance Company Limited (IRDAI Registration No. 190) CIN: U99999MH1919GOI000526 with its registered office at No.87, Mahatma Gandhi Road, Fort, Mumbai – 400 001 or by Royal Sundaram General Insurance Company Limited (IRDAI Registration No. 102) CIN:U67200TN2000PLC045611 with its registered office at No. 21, Patullos Road,
Chennai 600 002.

Specialist Health Insurance Policies: These policies are underwritten by Apollo Munich Health Insurance Co. Limited
(IRDAI Registration No. 131) CIN: U66030AP2006PLC051760 with its registered office at Apollo Hospitals Complex, Jubilee Hills, Hyderabad - 33.

For more details on risk factors, terms and conditions please read the sales brochure carefully before concluding the sale.

For any queries with respect to your Insurance Policies bought through Citibank N.A., kindly contact 24 x 7 CitiPhone, The updated numbers are available on www.citibank.co.in

SECTION 41 OF THE INSURANCE ACT 1938 PROHIBITION OF REBATES
  1. No person shall allow or offer to allow, either directly or indirectly, as an inducement to any person to take out or renew or continue an Insurance in respect of any kind of risk relating to lives or property in India, any rebate of the whole or part of the commission payable or any rebate of the premium shown on the policy nor shall any person taking out or renewing or continuing a Policy accept any rebate, except such rebate as may be allowed in accordance with the published prospectus or tables of the Insurer.
  2. Any person making default in complying with the provisions of this section shall be liable for penalty which may extend to
    ten lakh rupees.