HDFC ERGO Health Insurance Plans

HDFC ERGO Health Insurance Plans

HDFC ERGO offers a comprehensive range of health insurance plans designed to meet different needs and budgets. Here’s a detailed look at their popular health insurance products.

1. Optima Secure

Overview

A comprehensive health insurance plan with advanced features and extensive coverage for individuals and families.

Key Features

• Sum Insured: ₹3 lakhs to ₹50 lakhs
• Restoration Benefit: Unlimited restoration of sum insured
• Coverage: Pre & post hospitalization, day care procedures, AYUSH treatment
• OPD Cover: Optional add-on available
• Room Rent: No room rent capping in base plan

Coverage Highlights

✅ Hospitalization: All medical expenses during hospitalization ✅ Pre-Hospitalization: 60 days before admission ✅ Post-Hospitalization: 180 days after discharge ✅ Day Care Procedures: 150+ procedures covered ✅ Ambulance Cover: Up to ₹5,000 per hospitalization ✅ AYUSH Treatment: Ayurveda, Yoga, Unani, Siddha, Homeopathy ✅ Organ Donor Expenses: Covered ✅ Maternity Cover: Available with suitable plans

Who Should Buy?

• Families looking for comprehensive coverage
• Those who want unlimited restoration benefits
• People seeking flexibility with add-ons

Premium Range

• Individual (30 years): ₹8,000 - ₹12,000 annually for ₹5 lakh cover
• Family Floater (2 adults): ₹12,000 - ₹18,000 annually for ₹5 lakh cover

Actual premiums vary based on age, location, and coverage selected

2. Energy

Overview

An affordable health insurance plan offering essential coverage for individuals and families on a budget.

Key Features

• Sum Insured: ₹2 lakhs to ₹6 lakhs
• Restoration Benefit: 100% restoration once per year
• Coverage: Basic hospitalization and medical expenses
• Affordability: Lower premiums for basic coverage

Coverage Highlights

✅ Hospitalization: Room rent, ICU charges, medical expenses ✅ Pre-Hospitalization: 30 days before admission ✅ Post-Hospitalization: 60 days after discharge ✅ Day Care Procedures: 100+ procedures covered ✅ Ambulance Cover: Up to ₹2,000 per hospitalization ✅ Health Check-up: After policy completion

Who Should Buy?

• Young professionals seeking basic coverage
• Budget-conscious families
• First-time health insurance buyers

Premium Range

• Individual (30 years): ₹5,000 - ₹7,000 annually for ₹3 lakh cover
• Family Floater (2 adults): ₹8,000 - ₹11,000 annually for ₹3 lakh cover

3. My:health Suraksha (Top-up Plan)

Overview

A top-up health insurance plan that provides additional coverage above your base policy’s deductible.

Key Features

• Sum Insured: ₹3 lakhs to ₹1 crore
• Deductible Options: ₹2 lakhs to ₹20 lakhs
• Cost-Effective: Lower premiums compared to increasing base cover
• Wide Coverage: Comprehensive hospitalization expenses

How It Works

1. You have a base health policy of ₹5 lakhs
2. Buy My:health Suraksha with ₹5 lakh deductible and ₹20 lakh cover
3. If hospitalization costs ₹8 lakhs:
   • Base policy pays first ₹5 lakhs
   • Top-up pays remaining ₹3 lakhs

Who Should Buy?

• Existing policyholders wanting additional coverage
• Those seeking cost-effective way to increase coverage
• People with specific high-value coverage needs

Premium Range

• ₹10 lakh cover (₹5 lakh deductible): ₹2,500 - ₹4,000 annually

4. Critical Illness Plan

Overview

Provides lump-sum payout on diagnosis of specified critical illnesses.

Covered Illnesses

• Cancer
• Heart Attack
• Stroke
• Kidney Failure
• Major Organ Transplant
• Paralysis
• Multiple Sclerosis
• And 10+ more conditions

Key Features

• Lump Sum Benefit: Immediate payout on diagnosis
• Use as You Wish: No restrictions on fund usage
• Independent Coverage: Can be bought with or without base health policy

5. Health Wallet

Overview

An optional add-on that provides coverage for OPD expenses.

What’s Covered

• Doctor consultations
• Diagnostic tests
• Pharmacy bills
• Dental treatments
• Eye check-ups
• Physiotherapy sessions

Benefit Amount

Up to ₹10,000 per year for OPD expenses

Optional Add-ons

Customize your plan with these riders:

1. Maternity Cover

• Pre & post-natal expenses
• Normal and C-section delivery
• New-born baby cover

2. Personal Accident Cover

• Accidental death benefit
• Permanent disability cover

3. International Coverage

• Emergency medical expenses abroad
• Medical evacuation

4. Consumables Cover

• PPE kits, gloves, syringes
• Other consumable items during hospitalization

Exclusions

Common exclusions across plans:

❌ Pre-existing diseases (waiting period applies) ❌ First 30 days waiting period (except accidents) ❌ Cosmetic surgery ❌ Dental treatment (unless due to accident) ❌ Self-inflicted injuries ❌ War and nuclear risks

How to Buy

Online

1. Visit HDFC ERGO website
2. Get instant quotes
3. Compare plans
4. Make online payment
5. Receive policy instantly

Through Agent

Contact HDFC ERGO authorized agents for personalized guidance

Through PolicyJack

Compare HDFC ERGO plans with other insurers and buy the best option for your needs

Claim Process

Cashless Claims

1. Visit network hospital
2. Show health card at admission desk
3. Hospital sends pre-authorization
4. HDFC ERGO approves (usually 2-6 hours)
5. Receive treatment
6. Settle directly with hospital

Reimbursement Claims

1. Pay hospital bills
2. Collect all documents
3. Submit claim via app/website within 30 days
4. Claim processed in 7-14 days
5. Amount credited to bank account

Tips for Choosing the Right Plan

1. Assess Your Needs: Consider age, health conditions, and family size
2. Compare Sum Insured: Ensure adequate coverage (minimum ₹5 lakhs recommended)
3. Check Network Hospitals: Verify your preferred hospitals are in network
4. Read Policy Document: Understand waiting periods and exclusions
5. Consider Add-ons: Choose riders based on specific needs

Premiums and features mentioned are indicative. Please check the official HDFC ERGO website for current pricing and terms.