HDFC ERGO Health Insurance Plans

HDFC ERGO Health Insurance Plans

Health insurance intends to offer utmost financial security to policyholders and their families during the time of injuries or illnesses. HDFC ERGO Health Insurance Company embraces its policyholders with budget-friendly health insurance plans that give them protection and coverage against medical emergencies. Due to the inflation of medical expenses, these carefully designed health insurance plans will help you to manage your health expenses without stretching your financial condition.

This eminent insurer has more than 200 branches and offers multifarious health insurance plans, like individual health plans, family floater plans, senior citizen health plans, critical illness health insurance, personal accidents plan, and so on. Moreover, the company also offers a faster and simpler claim settlement process, so that policyholders can enjoy all the benefits of the policy wholeheartedly.

Health Insurance Plans offered by HDFC ERGO Insurance Company

HDFC ERGO insurance offers an array of health insurance plans that resonate with all the necessities of individuals, families, and corporate people. Let’s take a look at its health plans.

HDFC ERGO My Health Suraksha

  • This plan gives the utmost protection to individuals, families, and senior citizens.
  • This comprehensive health insurance covers in-patient treatment costs, pre-and post-hospitalization expenses with no sub-limits on disease, hospital room rents, doctor’s fees and hospital charges.
  • With this health insurance plan, you are eligible for cashless claims across 10,000+ network hospitals in India
  • The minimum sum assured is Rs.20 lakh
  • This plan offers health checkups only once at the end of the continuous four claim-free years.
  • You can enjoy this policy both as an individual and on a family floater basis.
  • You can avail of the Income Tax benefits under Section 80D of the Income Tax Act.       
  • If your policy is claim-free, you are eligible for a cumulative bonus
  • Anyone can opt for this plan without medical check-ups for up to 45 years.

HDFC ERGO Optima Restore

  • Optima Restore plan is available in two forms (Optima Restore individual and Optima Restore family)
  • Optima restore is an exclusive health plan that restores your sum insured on partial or complete utilization of your health cover, for your future needs.
  • With this plan, you are eligible for health check-ups up to Rs. 5,000 at the time of renewals.
  • If you don’t make any claim in a year, you will get renewal incentives.
  • With this health plan, you can get daily cash of up to Rs. 1,000 per day and a maximum of Rs. 6,000 per hospitalization.
  • You are eligible for a discount of 10% if 2 or more family members are covered under Optima restore individual sum insured plan.

Benefits of HDFC ERGO Health insurance plans

  • HDFC health insurance plans offer comprehensive financial assistance and coverage to policyholders against medical emergencies, critical illnesses, women’s health, and accidents.
  • This eminent insurance company is partnered with more than 10000 network hospitals. Thus, HDFC health insurance offers you convenient and hassle-free cashless treatment.
  • After the renewal of the policy, the policyholders are eligible for a free health check-up within 60 days
  • Free medical consultation (24X7) for policyholders
  • HDFC ERGO Health Insurance plans cover hospitalization expenses, medical check-ups, AYUSH treatments, daycare treatments, and critical illnesses. Now, this plan also offers coverage for Coronavirus treatment.
  • The insurer provides a lifetime renewal option without any constraint.
  • The claim settlement ratio of HDFC ERGO health insurance is 86.52%. With its facile, trustworthy, and affordable service, the insurer has a client base of more than 1 Crore.

HDFC ERGO Health Insurance Inclusions

  • In-patient Hospitalization expenses: HDFC ERGO Health insurance plans cover in-patient hospitalization for illnesses and injuries.
  • Pre and Post-hospitalization expenses: HDFC ERGO Health Insurance plans cover pre-and post-hospitalization expenses for up to 60 and 180 days, respectively.
  • AYUSH Treatments: These health insurance plans cover expenses related to AYUSH treatments (Ayurveda, Unani, Siddha, and Homeopathy).
  • Emergency Ambulance Cover: If you need to get admitted to a hospital in case of an emergency, then your ambulance costs are covered up to Rs. 2000 per hospitalization
  • Daycare Procedures: HDFC ERGO Health plans cover expenses for daycare treatment procedures such as cataract chemotherapy, radiation, and dialysis.
  • Organ Donor Expenses: Organ donor expenses are also covered under HDFC ERGO health insurance plans.
  • Advanced treatment: Advanced treatments like Robotic surgery are covered under HDFC ERGO Optima Restore.
  • Domiciliary treatment: If you need to opt for home-based treatment due to the unavailability of the beds of the hospital, HDFC ERGO My Suraksha plan will bear your medical expenses in this condition.

HDFC ERGO Health Insurance Exclusions

  • Self-Inflicted Injuries: HDFC ERGO health plans don’t cover self-harmed injuries like injuries resulting from the attempt of suicide.
  • Cosmetic Surgery: Cosmetic Surgery treatments are not covered under HDFC ERGO health insurance.
  • Obesity Control Treatments: If you are looking for obesity treatments like bariatric surgery or any other surgical procedures, then these are also not covered under HDFC ERGO Health Insurance plans.
  • Injuries due to adventure sports: If you suffered from injuries due to adventure activities like rafting, mountain climbing, paragliding, etc., then these are also not covered under HDFC ERGO Health Insurance plans.
  • Illness because of intoxicating substances: If you suffer illness or injuries due to intoxicating substances like drugs, alcohol, tobacco chewing, and smoking, then you won’t get any financial assistance from HDFC ERGO health insurance.



What are network and non-network hospitals for HDFC ERGO Health Insurance?

Network hospitals are those that are tied up with HDFC ERGO Health Insurance Company. These hospitals offer cashless treatment to policyholders. On the other hand, non-network hospitals are not partnered with HDFC ERGO and thus, you need to pay bills first once you get admitted there. Later your claim will be reimbursed by the insurer. HDFC ERGO has 10,000+ cashless hospital networks, so, for betterment, choose a network hospital.

What is the maximum cover given by HDFC ERGO Optima Restore?

This insurance plan covers up to Rs. 50 lakh.

What’s a restore benefit for HDFC ERGO Optima Restore?

Under any medical emergencies, you claim the insurance and your expenses are reimbursed. Now, the interesting part is that your covered amount gets restored as it was.

How many times can the restore benefit be claimed in a policy year or lifetime?

If you are renewing your policy on time, then you can use it once in every policy year for a lifetime.

What are the benefits under basic hospitalization of HDFC ERGO health insurance plans?

The health insurance plan of HDFC ERGO covers pre-and post-hospitalization expenses like your diagnostic tests, doctor’s consultations, medicine costs, ICU, bed charges, nursing charges and operation theatre expenses.

Do I need to send a request for activating the restore benefit?

No, the restore benefit is autonomous. Once a claim is settled, the amount is refilled automatically. You can use it once in every policy year for a lifetime if you keep renewing your policy.

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