HDFC ERGO General insurance company provides different insurance services on Car Insurance, Two Wheeler Insurance, Health Insurance, E secure cyber insurance, Personal Accident Insurance, and Home Insurance, Travel Insurance, Critical illness insurance, Goods carrying vehicle insurance, Passenger carrying vehicle insurance, Commercial Insurance, and Rural Insurance, etc. The cost of HDFC ERGO health insurance varies depending on the type of policy that you choose to buy.
HDFC ERGO is a joint venture of HDFC Limited and ERGO International AG. HDFC ERGO Health Insurance Company is one of the top 5 health insurance companies in India which offers health insurance solutions to customers. HDFC ERGO Health Insurance was earlier known as Apollo Munich Health Insurance. HDFC ERGO Health insurance got its approval from the Insurance regulatory and development authority of India (IRDA) on 11th November 2020. It is the second-largest private insurer in the accident and health insurance business.
What is Health Insurance?
Health insurance is a type of insurance in which an insured person gets financial support in case of a medical emergency. Health insurance is a long-term contract between the customer and the insurance company. The people who have health insurance can get health insurance claims from the insurance company in case of hospitalization due to accident or illness and they will take care of medical expenses charged by the hospital.
Why HDFC ERGO Health Insurance?
Paperless process: No lengthy documentation process for buying HDFC ERGO Health insurance policy
Trust ensured: HDFC insurance policy is trusted by millions of people, over 75 Lakhs happy customers. HDFC ERGO health insurance has the highest claim settlement ratio. HDFC ERGO health insurance tries hard to make insurance easier, more affordable, and more dependable.
Support Assistance: HDFC ERGO gives 24/7 support assistance to avoid any discrepancies. Reach HDFC ERGO Customer Care Service Number: 022 - 62346234 / 0120 – 62346234.
Now you can get in touch with HDFC ERGO on WhatsApp-73045 24888
Technological Services: Nowadays everything is digital; HDFC ERGO health insurance has used robotic automatic and voice analytics for better customer experience and service. Customer service requests are operated by artificial intelligence (AI).
Features of HDFC ERGO Health Insurance Policy
- Cashless claim
- No Sub-Limits
- Online purchase
- Cashless Home Healthcare
- Day Care Procedures
- Covers Pre and Post Hospitalisation Expenses
- Free Preventive Health Check-ups
HDFC ERGO Health Insurance Plans
HDFC Health Insurance Company offers different health insurance plans.
1. Optima Secure Health Insurance Plan:
Optima secure health insurance plan provides coverage on additional charges. This plan also offers benefits such as no room rent capping, pre and post-hospitalization, unlimited day-care procedures and exciting discount options, etc.
Key Features and Benefits:
- Sum Insured: 5 lakhs to 2 Crores
- Age Limit: Minimum entry age is 91 days and maximum entry age is 65 years
- Tenure: 1 year to 3 years
- Policy Options: Individual, Family floater
- Room Rent: Sum Insured less than 50L: Up to single AC private room, Sum Insured 50L and above: All room types covered.
- Waiting Period: 30 days
- Pre-hospitalisation: 60 days
- Post-hospitalisation: 180 days
- Hospitalization Expenses: Up to Sum Insured
- Ayush treatment: Up to Sum Insured
- Home Healthcare: Up to Sum Insured
- Plus Benefit: 100% increase in coverage after 2 years
- Secure Benefit: 100% of base sum insured
- Protect Benefit: Zero deduction on non-medical expenses
- Restore Benefit: 100% of the base cover gets restored
- Emergency Ambulance: Up to Sum Insured
- Tax Benefits: Get income tax benefits under section 80D of the Income Tax Act 1961.
Exclusions:
- Investigation and evaluation purposes
- Obesity control
- Cosmetic surgery
- Hazardous sports
- Breach of Law
- Alcoholism, drug or substance abuse
- Unproven treatments
- Sterility and infertility
- Maternity
2. Optima Restore Family Health Insurance Plan:
Optimal restore health family health insurance plan covers all family members It offers completely cashless treatments at network hospitals.
Key Features and Benefits:
- Sum Insured: 3 lakhs to 50 Lakhs
- Age Limit: Minimum entry age is 91 days and maximum entry age is 65 years
- Policy Options: Individual, Family floater
- Pre-hospitalisation: 60 days
- Post-hospitalisation: 180 days
- In-patient Treatment: Up to sum insured
- Day Care Procedures: All Day Care Treatments Covered
- Hospitalization Expenses: Up to Sum Insured
- Domiciliary Treatment: Up to sum insured
- Organ Donor: Up to sum insured
- Daily Cash for Choosing Shared Accommodation: 800/- day
- Restore Benefit: 100% of the base cover gets restored
- Emergency Ambulance: Not covered
- Health Check-ups: Not Applicable
- Multiplier Benefit: Bonus of 50% of the Basic Sum Insured for every claim-free year, maximum up to 100%
- Tax Benefits: Get income tax benefits under section 80D of the Income Tax Act 1961.
Exclusions:
- Alcoholism, drug or substance abuse.
- Pregnancy, dental treatment, external aids, and appliances.
- Any treatment within the first 30 days of cover except any accidental injury.
- Any Pre-existing diseases/conditions will be covered after a waiting period of 3 years.
- 2 years exclusion for Specific diseases like cataract, hernia, hysterectomy, joint replacement, etc.
- Hospitalization due to war.
- Non-allopathic treatment, cosmetic surgery.
3. Optima Restore Individual Health Insurance Plan:
Optima Restore individual health insurance plan covers only one person that is who insured. It fulfills all future needs have insured. Optima Restore individual health insurance plan offers a lot of restore benefits and it gives financial security to its customer.
Key Features and Benefits:
- Sum Insured: 3 lakhs to 50 Lakhs
- Age Limit: Minimum entry age is 91 days and maximum entry age is 65 years
- Policy Options: Individual, Family floater
- Pre-hospitalisation: 60 days
- Post-hospitalisation: 180 days
- In-patient Treatment: Up to sum insured
- Day Care Procedures: All Day Care Treatments Covered
- Hospitalization Expenses: Up to Sum Insured
- Domiciliary Treatment: Up to sum insured
- Organ Donor: Up to sum insured
- Daily Cash for Choosing Shared Accommodation: 800/- day
- Restore Benefit: 100% of the base cover gets restored
- Emergency Ambulance: Not covered
- Health Check-ups: Not Applicable
- Multiplier Benefit: Bonus of 50% of the Basic Sum Insured for every claim-free year, maximum up to 100%
- Tax Benefits: Get income tax benefits under section 80D of the Income Tax Act 1961.
Exclusions:
- Alcoholism, drug or substance abuse.
- Pregnancy, dental treatment, external aids, and appliances.
- Any treatment within the first 30 days of cover except any accidental injury.
- Any Pre-existing diseases/conditions will be covered after a waiting period of 3 years.
- 2 years exclusion for Specific diseases like cataract, hernia, hysterectomy, joint replacement, etc.
- Hospitalization due to war.
- Non-allopathic treatment, cosmetic surgery.
4. Health Suraksha Insurance-Silver Smart Plan:
Health Suraksha Insurance-Silver smart plan is one of the best policy provides complete protection of individuals, families, senior citizens. It gives the best coverage. In this plan, there is no capping on room rent.
Key Features and Benefits:
- Sum Insured: 3 lakhs to 5 lakhs
- Age Limit: No age limit
- Policy Options: Individual, Family floater
- Pre-hospitalisation: 60 days
- Post-hospitalisation: 180 days
- Medical Expenses: Covered Up to sum insured
- Room Rent/ ICU Rent: No
- Mental Health Care: Covered Up to sum insured
- Home Health Care: Covered Up to sum insured
- Day Care Procedures: All Day Care Treatments Covered
- Maternity Expenses: Covered
- Domiciliary Treatment: Up to sum insured
- Organ Donor: Up to sum insured
- Recovery Benefit: 5000/-
- Road Ambulance: 2000/-
- Sum Insured Rebound: Covered
- Waiting Period: 3 years
- Tax Benefits: Get income tax benefits under section 80D of the Income Tax Act 1961.
5. Health Suraksha Insurance-Gold Smart Plan
Health Suraksha Insurance-Gold smart plan covers individuals, families, senior citizens. Mental health treatment hospitalization expenses are also covered in this plan. In this plan, there is no capping on room rent It provides cashless care facilities at home, Pre and post-hospitalization charges, and maternity expenses, emergency ambulance Ayush treatment, etc.
Key Features and Benefits:
- Sum Insured: 7.5 lakhs to 15 lakhs
- Age Limit: No age limit
- Policy Options: Individual, Family floater
- Pre-hospitalization: 60 days
- Post-hospitalization: 180 days
- Medical Expenses: Covered Up to sum insured
- Room Rent/ ICU Rent: No
- Mental Health Care: Covered Up to sum insured
- Home Health Care: Covered Up to sum insured
- Day Care Procedures: All Day Care Treatments Covered
- Maternity Expenses: Covered
- Domiciliary Treatment: Up to sum insured
- Organ Donor: Up to sum insured
- Recovery Benefit: 15000/-
- Road Ambulance: 3500/-
- Sum Insured Rebound: Covered
- Waiting Period: 3 years
- Tax Benefits: Get income tax benefits under section 80D of the Income Tax Act 1961.
6. Health Suraksha Insurance-Platinum Smart Plan
Health Suraksha Insurance-Platinum smart plan provides benefits for families and individuals. In this plan, there is no capping on room rent. It provides cashless care facilities at home, Pre and post-hospitalization charges, and maternity expenses, emergency ambulance Ayush treatment, etc.
Key Features and Benefits:
- Sum Insured: 20 lakhs to 75 lakhs
- Age Limit: No age limit
- Policy Options: Individual, Family floater
- Pre-hospitalization: 60 days
- Post-hospitalization: 180 days
- Medical Expenses: Covered Up to sum insured
- Room Rent/ ICU Rent: No
- Mental Health Care: Covered Up to sum insured
- Home Health Care: Covered Up to sum insured
- Day Care Procedures: All Day Care Treatments Covered
- Maternity Expenses: Covered
- Domiciliary Treatment: Up to sum insured
- Organ Donor: Up to sum insured
- Recovery Benefit: 25000/-
- Road Ambulance: 3,500/- ( for 20 Lakhs to 50 Lakhs Sum Insured ), 15000/- (Above 50 Lakhs of the sum insured)
- Sum Insured Rebound: Covered
- Waiting Period: 3 years
- Tax Benefits: Get income tax benefits under section 80D of the Income Tax Act 1961.
7. Health Koti Suraksha Insurance-Platinum Plan
Health Koti Suraksha Insurance-Platinum plan provides benefits for families and individuals.
Key Features and Benefits:
- Sum Insured: 50 Lakhs and 1 Crore
- Age Limit: 18 years to 65 years
- Policy Options: Individual, Family floater
- Pre-hospitalisation: 60 days
- Post-hospitalisation: 180 days
- Medical Expenses: Covered Up to sum insured
- Room Rent: Single Standard AC Room
- ICU Rent: No
- Medical Expenses: Covered
- Disease Capping: Applicable
- Home Health Care: Covered Up to sum insured
- Day Care Procedures: All Day Care Treatments Covered
- Domiciliary Treatment: Up to sum insured
- Organ Donor: 5% of sum insured
- Road Ambulance: 2000/-
- Alternative Treatment: Rs. 50000/-
- Tax Benefits: Get income tax benefits under section 80D of the Income Tax Act 1961.
8. Health Koti Suraksha Insurance-Titanium Plan
Health Koti Suraksha Insurance-Titanium plan provides benefits for families and individuals.
Key Features and Benefits:
- Sum Insured: 50 Lakhs and 1 Crore
- Age Limit: 18 years to 65 years
- Policy Options: Individual, Family floater
- Pre-hospitalisation: 60 days
- Post-hospitalisation: 180 days
- Medical Expenses: Covered Up to sum insured
- Room Rent: No
- ICU Rent: No
- Medical Expenses: Covered
- Disease Capping: Applicable
- Home Health Care: Covered Up to sum insured
- Day Care Procedures: All Day Care Treatments Covered
- Domiciliary Treatment: Up to sum insured
- Organ Donor: At Actuals
- Road Ambulance: 10000/-
- Alternative Treatment: Actuals
- Tax Benefits: Get income tax benefits under section 80D of the Income Tax Act 1961.
9. Health Koti Suraksha Insurance-Super Top-Up
Health Koti Suraksha Insurance-Super top-up plan provides benefits for families and individuals.
Key Features and Benefits:
- Sum Insured: 50 Lakhs and 1 Crore
- Age Limit: 18 years to 65 years
- Policy Options: Individual, Family floater
- Pre-hospitalisation: 60 days
- Post-hospitalisation: 180 days
- Medical Expenses: Covered Up to sum insured
- Room Rent: No
- ICU Rent: No
- Medical Expenses: Covered
- Disease Capping: Applicable
- Home Health Care: Covered Up to sum insured
- Day Care Procedures: All Day Care Treatments Covered
- Domiciliary Treatment: Up to sum insured
- Organ Donor: At Actuals
- Road Ambulance: 10000/-
- Alternative Treatment: Actuals
- Tax Benefits: Get income tax benefits under section 80D of the Income Tax Act 1961.
10. My: Health Women Suraksha Plan:
My Health Women Suraksha Plan provides 3 types of plans such as
- Women Cancer Plus Plan: It covers Major illness and Cancer
- Women CI Essentials: It covers Cancer, Major Illness, Surgical Procedures, Cardiac Ailments and procedures
- Women CI Comprehensive Plan: It Covers Cancer, Major Illness, Surgical Procedures, and Cardiac Ailments & procedures, 41 Critical Illness
Key Features and Benefits:
- Sum Insured: 1 Lakh to 1 Crore
- Age Limit: 18 years to 65 years
- Policy Options: Individual, Family floater
- Waiting Period: 90 days and 180 days as per specified illness, 1 year for pregnancy and newborn complications, 4 years for pre-existing diseases
- Survival Period: 7 days
- Illness Covered: 41 Listed Critical Illness, Cancer, Major Illness, Surgical Procedures, Cardiac Illness, etc.
- Policy Period: 1, 2, 3 years
- Premium Payment Option: yearly, half-yearly, quarterly and monthly
- Loss of Job Benefit: 50% of Monthly Salary, up to 6 months
- Preservative Health Check-Ups: Covered
- Pregnancy & Newborn Complications: 25% of SI, Max 5 lakhs
11. My: Health Medisure Super Top-Up Plan:
My: health Super Top-up Insurance plan provides an option of buying a top-up insurance cover that works alongside your current health insurance policy. It offers high sum insured at low premiums.
Key Features and Benefits:
- Age Limit: 18 years to 65 years
- Policy Options: Individual, Family floater
- Premium: Constant premium from 61 years and above
- Health Check-ups: No health check-ups up to 55 years
- In-patient Hospitalization: Covered
- Pre-hospitalisation: 60 days
- Post-hospitalisation: 180 days
- Day Care Procedures: Covered
- Policy Period: 2 years
- Expenses for Pre-existing diseases: Covered
Exclusions:
- Adventure sport injuries
- Self-inflicted injuries
- Participation in defense operations and war injuries
- Venereal or sexually transmitted diseases
- Treatment of obesity or cosmetic surgery
12. iCan- Cancer Insurance Plan
iCan- An Essential Cancer Insurance Plan covers all kinds and all stages of cancer. It provides lifelong renewals even after death, cashless cancer treatment, etc.
Key Features and Benefits:
- Age Limit: 18 years to 65 years
- Sum Insured: 5,10,15,20,25,50 Lakhs
- Policy Options: Individual, Family floater
- In-patient and Out-Patient Hospitalization: Covered
- Pre-hospitalisation: 30 days
- Post-hospitalisation: 60 days
- Cashless Treatment: 10000 plus network hospitals
- Criticare Benefit: 60% of SI Covered
- Family Care Benefit: 100% of SI
- Emergency Ambulance: 2000/-
- Follow Up care Post-treatment: 3000/-
- Tax Benefits: Get income tax benefits under section 80D of the Income Tax Act 1961.
Exclusions:
- Treatments other than Cancer
- Congenital external diseases, defects, or anomalies
- Pre-existing conditions
- AIDS/HIV
- Prosthetics and non-surgical devices
- Non-allopathic or international treatments
13. Critical Illness Insurance Plan
Critical Illness Insurance provides coverage against 8 life-threatening health conditions such as cancer, heart attack, kidney failure, major organ transplantation, stroke, multiple sclerosis, paralysis. It offers 2 plans such as silver plan, platinum plan.
Key Features and Benefits:
- Age Limit: 5 years to 65 years
- Sum Insured: 1 lakh to 50 Lakhs
- Policy Options: Individual, Family floater
- Survival Period: 15 days, 30days
- Plan Options: 1 and 2 years
- No medical check-ups: No medical check-ups up to the age of 45 years.
- Tax Benefits: Get income tax benefits under section 80D of the Income Tax Act 1961.
Exclusions:
- Adventure Sport Injuries
- Self-Inflicted Injuries
- Participation in Defence Operations
- Injuries due to War
- Obesity or Cosmetic Surgery Treatment
How to Claim HDFC ERGO Health Insurance
HDFC ERGO Health Insurance Claim Process:
- Intimation: Fill up the HDFC ERGO health insurance claim form at the network hospital for cashless approval
- Status Update: Once the hospital intimates to the company the status will update
- Avail Cashless Hospitals: Avail cashless treatment at a network hospital
- Submission of Documents: Submit all the documents required
- Preauthorization: Hospitalisation can be done based on pre-auth approval
- Claim Settlement: At the time of discharge, we settle the claim directly with the hospital
How to select the best HDFC ERGO health insurance plan?
There is no best health insurance plan which fits for all. Each person has different requirements and the health insurance plan has to be chosen as per the requirements. The health insurance plans available from HDFC ERGO Company provide many options to customers which can sometimes lead to confusion. In that case below factors are to be considered before deciding on the best health insurance plan:-
Coverage/Premium:
Coverage in a health insurance is also known as Sum insured under the health insurance plan. Higher the coverage, higher would be the premium charged by the insurance company. The sum insured or coverage should be ideally decided by the customer keeping in mind different factors such as Age of the customer, family members in the policy, rising inflation costs, cost of treatments, affordability/premium paying capacity. Now-a-days insurance companies are providing EMI options to pay their health insurance premiums which provide a great relief to customer to select the higher sum insured plans.
Individual/ Floater:
It is important to decide whether the health insurance policy would be taken for an individual or for family. There are many options in a health insurance policy which cannot be utilised by an individual alone and availing these options would be of no use and the customer would end up paying high premium for the options he wouldn’t be using. The sum insured can be opted separately for each individual in the health insurance policy or everyone in the policy can use a single sum insured. Most of the health insurance plans include individual and floater sum insured options for the customer to select from.
Need for health insurance:
First of all, the need for health insurance should be identified by the customer before proceeding to the health insurance policy purchase. As there are different types of policies for different requirements, it is important to analyse the need for health insurance before taking one. For instance there are Covid health insurance plans, Maternity plans, senior citizen plans, Plans for customers with pre-existing diseases such as Heart attack, Hypertension etc.
Add-on/ Rider:
Add-on or Rider is the extra coverage that is available under the health insurance premium on payment of additional premium. The base coverage can be extended with the help of add-ons on payment of additional premium. There are so many add-ons available with the HDFC ERGO health insurance company with different health insurance plans. Careful analysis should be made before deciding an add-on as the riders are charged by the insurance company. Customer should identify the add-on which is necessary as including all the add-ons will only increase the premium with less scope for utilization of all the add-ons.
No Claim Bonus/ Renewal Bonus:
No claim bonus or the renewal bonus is the increase in sum insured at the time of renewal provided by the insurance company for no claims made in the previous policy year. The maximum renewal bonus or No claim bonus provided by the insurance companies would not exceed 100% of the basic sum insured. There are few plans which provide 10% to 50% renewal bonus for each claim free year. Higher the renewal bonus percentage each year, higher would be the sum insured at the time of renewal.
Network Hospitals:
Network or tie-up hospitals are the hospitals with which the insurance companies enter into an agreement to provide cashless treatment to its customers. In cashless medical treatment hospitalization the customer need not pay medical bills to the hospital. The insurance company tie-up with those hospitals and they take care about the medical expenses charged by the hospital.
Co-pay:
In Co pay the fixed amount of money is must pay each and every time when insured person need medication. Co-pay is the amount of claim which is to be borne by the insured customer at the time of claim settlement. Most of the health insurance policies have co-pay clause if there are senior citizens included in the policy. Higher the co-pay amount selected by the customer, lower would be the health insurance premium. Co-pay is the way of making customer liable and participating in the claim settlement process.
Pre-existing waiting period:
Any illness or disease which exists prior to the inception of the health insurance policy is known as pre-existing disease. Health insurance policies usually have a waiting period only after which the health insurance claim for the existing diseases would be paid. The pre-existing waiting period would normally range between 2 years to 4 years for different health insurance products available in the market. Higher the pre-existing waiting period, higher would be the time before the claim is settled for pre-existing conditions.