FOR INTERNAL USE ONLY.

TO BE US
Product Name
Features
Entry Age (Adult)

Apollo Munich Optima Restore

Entry age - 18 years
Maximum entry age - 65 years

Lifetime
Renewal Age
Age of Dependent Child (Min & Max Child from 91 days to 5 years can be
covered if both parents are covered
Entry Age) for Floater
Dependent Parents Covered
Sum Insured Options
Tenure ( Years)
Policy type - (Individual / Floater)
Plan payout basis

Premium Band
Medical Test Requirement

Coverage
Hospitalisation

Pre Hospitalization
Post Hospitalisation
Day care Treatment
Domiciliary hospitalization
Ambulance Charges

Yes
3Lac, 5Lac, 10Lac, 15Lac
1 & 2 Years
Individual / Family Floater
Reimbursement of actual expenses

Age Band Wise

Based on Age and Sum Insured

Covered upto Full SI

60 days
180 days
Covered
Covered
2000 per hospitalisation in case of
emergency

Hospital Cash Allowance

Critical Illness

Not available
Not available

E Opinion

Not available

Recovery Grant/Convalescence
Organ Donor

Not available
Covered upto Full SI

Out Patient Expenses General

Out-patient dental treatment
Out Patients Pharmacy

Not available
Not available
Not available

Maternity

Pre - Existing Illness

Restoration

Worldwide Emergency Cover

Features
Claim Processing
Cumulative Bonus (No Claim)

Not available

After 3 years of waiting (36 months)

Restore available to re-instate the Basic
Sum Insured to 100% once in policy year
for all future claims once basic SI &
cumulative bonus SI is exhausted.
Restored SI to be
utilised in the same policy year.
Not available

TPA
50% of Basic SI on each renewal,
maximum upto 100% of Basic SI. If a
Claim is made CB is reduced by 50%

Long Term Discount on premium

Health Check up

Not available
Not available

Co-pay / Deductible/Sublimits

Not available

Renewal Special Features

No Special Renewal Feature

USE ONLY. TO BE USED FOR TRAINING PURPOSE. NOT TO BE CIRCULATED TO CUSTOMERS.

ProHealth Protect

ProHealth Plus
Min Entry Age: 18 Years

Lifetime

Max Entry Age: No limit

Lifetime
Min Entry Age: 91 days

Yes
Rs. 2.5 Lac/3.5 Lac/ 4.5 Lac

Yes
Rs. 4.5 Lac/5.5 Lac/7.5 Lac/10 Lac

1 year/2 year
Individual & Family Floater
Reimbursement of actual
expenses / Benefit payout for
Critical Illness

1 year/2 year
Individual & Family Floater
Reimbursement of actual expenses
/ Benefit payout for Critical Illness

Age and Zone Wise

Medicals required for insured
aged 46 years & above

Age and Zone Wise

SI 4.5 Lac/ 5.5 Lac/ 7.5 Lac Medicals required for insured aged
46 years & above
SI 10 Lac - Medicals
required for insured aged 41 years
and above

In-patient hospitalization
expenses as per actual.
Room rent (shared room) as
per actual

In-patient hospitalization expenses

as per actual.
Room
rent (single private room) as per
actual

60 days
90 days
171 listed procedures
Covered upto full Sum Insured

60 days
180 days
171 listed procedures
Covered upto full Sum Insured

Upto Rs.2000/- per

hospitalization event

Upto Rs.3000/- per hospitalization

event

Not available
Lump sum payment of full Sum
Insured if opted

Not available
Lump sum payment of full Sum
Insured if opted

Expert opinion available once

during policy year for each
insured

Expert opinion available once

during policy year for each insured

Not available
Covered upto full Sum Insured

Not available
Covered upto full Sum Insured

Rs.500/- available to redeem

against OPD expenses

Rs.2000/- available to redeem

against OPD expenses

Max Age: 23 years

Not available

Covered upto 15,000 for normal

delivery and 25,000 for CSection per event after a waiting
period of 48 months
New Born baby
cover also available Vaccination
expenses is covered over & above
Maternity SI

Pre-existing disease covered

after 48 months

Pre-existing disease covered after

36 months

When the basic SI & earned cumulative bonus is insufficient due to claims paid or accepted as pa
the same will be restored to 100% of basic SI. This does not require the Basic SI + CB to be exha
completely.

Covered upto full Sum Insured

Covered upto full Sum Insured

TPA
5 % increase in Sum Insured
maximum upto 50 %.
No reduction in SI in case of a
claim

TPA
10 % increase in Sum Insured maximum upto 50 %.
reduction in SI in case of a claim

7.5% for a 2 years policy term

Available once in a block of 3
Available at each renewal, to all
years for all Insured persons
insured persons who have
who have completed 18 years of completed 18 years of Age.
age.
Co-pay: Options to choose
between 10% and 20%
copayment for each and every
claim
Sum Insured - Deductible
options
2.5 Lac - Not Availble
3.5 Lac - 1 Lac
4.5 Lac - 1 Lac/ 2 lac
Mandatory
Co-pay of 20% for insured aged
65 years & above.

Co-pay: Options to choose between

10% and 20% copayment for each
and every claim
Sum Insured - Deductible options
4.5 Lac - 1 Lac/ 2 Lac
5.5 Lac - 2 Lac/ 3 Lac
7.5 Lac - 2 Lac/ 3 Lac
10 Lac - 3 Lac
Mandatory Copay of 20% for insured aged 65
years & above.

Reward Points to be earned for each year of premium paid and accumulated for 2 years. Rewards
completing Our Online Wellness Programs. These earned Reward Points can be used to get a disc
Premium OR they can be redeemed for equivalent value of Health Maintenance vouchers.

RCULATED TO CUSTOMERS.

18 Years

ProHealth Preferred

ProHealth Premier

Max Entry Age: No limit

Lifetime
e: 91 days
Max Age: 23 years

Lifetime

Yes
Rs. 15 Lac/30 Lac/ 50 Lac

Yes
Rs. 100 Lac

1 year/2 year
Individual & Family Floater
Reimbursement of actual
expenses / Benefit payout for
Critical Illness

1 year/2 year
Individual & Family Floater
Reimbursement of actual
expenses / Benefit payout for
Critical Illness

Age and Zone Wise

Medicals for all age group

Age and Zone Wise

Medicals for all age group

In-patient hospitalization expenses In-patient hospitalization

as per actual.
Room
expenses as per actual.
rent (single private room) as per
Room rent (single private room)
actual
as per actual
60 days
180 days
171 listed procedures
Covered upto full Sum Insured

60 days
180 days
171 listed procedures
Covered upto full Sum Insured

Actual expenses paid per

hospitalization event

Actual expenses paid per

hospitalization event

Not available
Lump sum payment of full Sum
Insured if opted

Not available
Not available

Expert opinion available once

Expert opinion available once
during policy year for each insured during policy year for each
insured
Not available
Covered upto full Sum Insured

Not available
Covered upto full Sum Insured

Covered upto 1% of Sum Insured subject to maximum of 15000 per

policy year

Covered upto 50,000 for normal

delivery and 100,000 for CSection per event after a waiting
Period of 48 months
New Born baby cover
also available Vaccination
expenses is covered over & above
Maternity SI

Covered upto 50,000 for

normal delivery and 100,000
for C-Section per event after a
waiting Period of 48 months
New Born baby cover also
available
Vaccination expenses is covered
over & above Maternity SI

Pre-existing disease covered after 24 months

due to claims paid or accepted as payable,

require the Basic SI + CB to be exhausted

Covered upto a maximum of Rs.10

Lac

TPA
red maximum upto 50 %.
a claim

No

for a 2 years policy term

Available at each renewal, to all
insured persons who have
completed 18 years of Age.

Not available

Covered upto a maximum of

Rs.10 Lac
TPA
Not available

Available at each renewal, to all

insured persons who have
completed 18 years of Age.

Co-pay/Deductible - Not available

Co-pay/Deductible - Not available

Mandatory Co-pay of 20% for

insured aged 65 years & above.

Mandatory Co-pay of 20% for

insured aged 65 years & above.

nd accumulated for 2 years. Rewards can also be earned for enrolling and
ward Points can be used to get a discount in premium from the 3rd Annual
Health Maintenance vouchers.