Apollo Munich Maxima Health Insurance

• This policy covers persons from 91 days onwards to the maximum entry age of 65 years.
• No maximum cover ceasing age in this policy.
• The policy is issued for a period of 1 year
• This policy can be issued to an individual and/or family. The family coverage in on floater basis and the coverage will be available for two adults & two adults + upto 2 children.
• The family includes spouse, dependent children and dependent parents.
• The premium under floater coverage will be charged on the age of the oldest insured member.

Outpatient Module

Entitlement Certificate is issued to the Insured Person for availing Outpatient benefits within the Network service provider.

• Out-patient consultations- Outpatient consultations (in Network or Non-Network) by a general Medical Practitioner(s) or a specialist Medical Practitioner(s).
• Diagnostic Tests within specified Network- Out-patient diagnostic tests taken by the Insured Person from a network diagnostic centre
• Pharmacy within specified Network – Medicines purchased by the Insured Person from a Network pharmacy, provided that such medicines have been prescribed in writing by a Medical Practitioner
• Out-patient Dental Treatment within specified Network – Any necessary dental treatment taken by an Insured Person from a Network Dentist provided. No payment would be made for any dental treatment that comprises cosmetic treatment.
• Spectacles, Contact lenses within specified Network – Either one pair of spectacles or contact lenses, provided that these have been prescribed for the Insured Person by an Eye specialist network Medical Practitioner(s).
• Annual Health Check-Up within specified Network – A health check-up for the Insured Person in a Network Hospital.
• If an Entitlement Certificate has been used and results in treatment to which In-patient Module responds, they would be refunding the Entitlement Certificate used for pre-hospitalisation by issuing fresh Entitlement Certificate.

Inpatient Module

• In-patient Treatment – It Covers hospitalization expenses due to an illness or accident. Get coverage for the medical expenses for Room rent, Boarding expenses, Nursing, Intensive care unit, Medical Practitioner(s), Anesthesia, Blood, Oxygen, Operation theatre charges, Surgical appliances, Medicines, Drugs and consumables, Diagnostic procedures, Cost of prosthetic & other devices or equipments if implanted internally during a Surgical Procedure
• Pre- Hospitalization – Medical Expenses incurred in 30 days immediately before the Insured Person was hospitalized. It can be increased to 60 days if claim is intimated 5 days before Hospitalization.
• Post-Hospitalization – Medical Expenses incurred in 60 days immediately after the Insured Person was discharged post hospitalization. It can be increased to 90 days if claim is intimated 5 days before Hospitalization.
• Daycare procedures – Get coverage for Medical Expenses for 140 Daycare procedures which do not require 24 hours hospitalization due to technological advancement.
• Domiciliary Treatment – The Medical Expenses incurred by Insured Person for availing medical treatment at his/her home which would otherwise have required Hospitalization.
• Organ Donor – Get coverage for Medical Expenses for an organ donor’s treatment in the event of organ transplantation.
• Emergency Ambulance – Get coverage for ambulance charges upto Rs. 2,000 per Hospitalization in case of an emergency.
• Maternity Expenses – Medical Expenses for maternity including pre-natal and post-natal expenses after a waiting period of 4 years.
• Newborn baby – Optional Coverage for newborn from birth (day 1 – 90) for In-patient treatment benefit, subject to acceptance of proposal and premium payment in full.
• Daily cash for Choosing Shared Accommodation- Daily cash amount per day if the Insured Person is hospitalized in shared accommodation in a Network Hospital and hospitalization exceeds 48 hrs.
• Daily Cash for Accompanying an Insured Child- Daily cash amount for 1 accompanying adult if Insured child under 12 years is hospitalized for more than 72 hrs.