HDFC ERGO Health Insurance Plans
Founded in the year 2002, HDFC Ergo Health Insurance has served around 1.5 crore customers. With over 12,000 crore claims settled to date, HDFC Ergo exceeds customer expectations by settling one claim per minute. The health insurance company has a claim settlement ratio of 99.80%. HDFC Ergo Health Insurance boasts a network of over 13,000 healthcare providers. They offer coverage for both modern and traditional medical procedures and drugs. Because they offer AYUSH treatment, their policyholders have total financial stability and the flexibility to select the Nbest course of treatment for the customers.
As part of its unwavering commitment to providing excellent customer service, HDFC Ergo Health makes sure that every one of its health insurance policies is tailored to the specific requirements of each customer. Because of this, HDFC Ergo Health provides a range of plans to accommodate different age groups and lifestyles. These plans include individual and family health insurance as well as speciality plans like health insurance for seniors and pregnant women.[1]
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HDFC ERGO Health Insurance Plan List
- Individual (1)
- Family (2)
- Woman (2)
- Parents (2)
- Blood Pressure (2)
- Kids (2)
- Thyroid (2)
- Diabetes (2)
Optima Restore
Cover
5 Lakh
Cashless Hospital
11693
Starting From ₹ 1,391/month*
Optima secure
Cover
5 Lakh
Cashless Hospital
11693
Starting From ₹ 1,312/month*
Key Highlights
HDFC Ergo Health has a few standout characteristics, which are outlined below:
No. of Plans Offered | 8+ |
---|---|
Sum Insured | 12,000 crore |
Claim Settlement Ratio (CSR) | 99.80% |
No. of Products and Services | 8+ |
Network Hospitals | 13,000+ |
Types of Health Insurance Plans Offered by HDFC Ergo Health Insurance
To meet the demands and needs of different people, HDFC Ergo Health offers a range of health insurance plans, such as the following:[1]
- Family Health Insurance Plans: Your family's medical costs are combined into one all-inclusive policy with the help of HDFC Ergo family health insurance plans. This covers you, your spouse, and your kids in addition to your dependent parents. Family health insurance from HDFC Ergo Health covers the medical needs of your whole family without requiring you to purchase several policies.
- Individual Health Insurance: HDFC Ergo Health offers individual health insurance plans based on each person's unique medical needs. Medical costs resulting from disease, accidents, hospital stays, and other health-related problems are covered by these policies. Additionally, individual plans provide customised coverage according to the policyholder's age, health history, and other specifications.
- Senior Citizens Health Insurance: As the name implies, these plans are specifically made for individuals who are 60 years of age or older. The senior citizen's health insurance plans cover a range of healthcare needs, such as pre-existing medical diseases, chronic illnesses, and age-related issues, tailored to the specific needs of senior individuals.
- Group health insurance: It is offered to a variety of people by HDFC Ergo Health, including members of the public, workers at businesses, and members of organisations. All group members are fully covered by these group health insurance policies at a much-reduced cost as compared to individual plan premiums. Moreover, employer-sponsored health insurance frequently includes refunds and other perks.
- Maternity Health Insurance: Plans that cover certain costs include those related to prenatal care, delivery, postpartum care, and infant care. These maternity health insurance plans also pay for doctor visits, hospital stays, diagnostic testing, and birth control pill costs.
- Plans for Critical Illness Health Insurance: Critical illness insurance policies provide coverage against serious illnesses including cancer, heart attacks, and other ailments that could be fatal. If it is pre-determined that the policyholder is already covered for the identified critical illness, the insurance will pay a lump sum to cover treatment-related medical expenses according to the plan.
- Coverage for the Out-Patient Department (OPD): HDFC Ergo Health provides OPD coverage, a special kind of health insurance plan. Payment for non-hospitalised outpatient medical treatments, consultations, diagnostic tests, prescription drugs, and procedures is covered by the Out-Patient Department. It provides comprehensive medical coverage for both in and out-patient treatments.
- Plans for Top-Up Health Insurance: These top-up health insurance plans go above and beyond the benefits of your current policy to provide extra coverage. When medical costs surpass the base amount covered by your primary medical coverage, HDFC Ergo's top-up policy kicks in. With these plans, you can affordably expand the coverage of your health insurance without a major increase in costs.
- Health Insurance for Women: Finally, but just as importantly, HDFC Ergo Health offers health insurance plans customised to meet the particular medical requirements of women. These women's health insurance plans cover gynaecological procedures as well as pregnancy and other disorders that are special to women. Additional benefits like health activities and preventive exams could be included in these programs.
List of all HDFC Ergo Health Insurance Plans
The table below provides a summary of every HDFC Ergo Health Insurance plan:
Plan Name | Plan Type | Age | Sum Insured |
Individual, Family Floater | 91 days old and above | 5 lakh To 2 crore | |
Optima Secure Global | Individual, Family Floater | 91 days old- 65 years old | 5 lakh To 2 crore |
Senior Citizen, Family Floater | Adult: 70 years and above Child: 90 days old- 25 years | 5- 10 Lakh | |
Individual, Family Floater | Adult: 18 years- 65 years old Child: 91 days old- 23 years old | 2- 20 lakh | |
Family Floater | Adult: 18 years- 65 years old Child: 91 days old- 25 years old | 5 lakh - 1 crore | |
Health Suraksha Silver | Individual, Family Floater, Senior Citizen | 91 days old and above | 1- 50 lakh |
Womer CI | Women | 91 days old above | 1 lakh- 5 crore |
Individual, Family Floater | 18 years- 65 years old | 2- 50 lakh |
HDFC ERGO Health Insurance Top Up List
- Top-up (4)
- Family (1)
- Individual (1)
Name of Plan | Sum Insured | |
Optima PlusMin: 91 Days; Max: 65 Years | 5 Lakh | Check Premium |
my: Health Medisure Super Top-upMin: 3 Months; Max: 65 Years | 3 Lakh | Check Premium |
Optima SuperMin: 91 Days; Max: 65 Years | 5 Lakh | Check Premium |
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Let's Explore Each Plan in Detail
The following are the specifics of each of the plans listed above:
1. Optima Secure
The HDFC ERGO Optima Secure plan is a comprehensive health insurance plan that offers substantial medical coverage. It covers hospitalisation expenses, including lodging, ICU fees, and physician bills. The plan offers additional benefits such as pre- and post-hospitalisation costs, home treatment, and daycare procedures. The benefits include Secure, Plus, Protect, and Restore. The Secure benefit doubles the basic sum insured, the Plus benefit increases coverage annually, Protect covers non-medical expenses not covered by other plans, and the Restore benefit restores the full sum insured. The plan is available to both individuals and families and offers a cashless facility at network hospitals throughout India. This ensures strong financial protection against medical bills and helps manage medical costs without financial strain.[2]
Riders | Secure Benefit, Restore Benefit, No Cost Instalment Option, Aggregate Deductible |
Key Features | Early discharge cashless approval, Cashless approval for chronic diseases, etc. |
Inclusions | Hospitalisation Expenses, Day Care Treatments, Home Treatments, AYUSH Treatment, Organ Donor Expenses, etc. |
Exclusions | Adventure Sport Injuries, Venereal Or Sexually Transmitted Diseases, Treatment Of Obesity Or Cosmetic Surgery, War, Self-Inflicted Injuries, Participation In Defence Operations, etc. |
2. Optima Secure Global
The HDFC ERGO Optima Secure Global plan is a comprehensive health insurance plan that covers a wide range of medical costs, including hospital stays, doctor visits, lodging, ICU fees, and surgeries. The plan offers automatic coverage growth and covers pre- and post-hospitalisation costs, home therapy, and daycare procedures. It features the Secure Benefit, which doubles the base amount covered on the first day of coverage, and the Restore Benefit, which restores the entire insured amount in case of claims. The plan is ideal for frequent travellers, providing full coverage for planned treatments and emergencies abroad. The coverage for HDFC Ergo Optima Secure Global is offered to Indians aged 91 days and above globally. In a network hospital policyholders are provided with cashless claim options worldwide. The Optima Secure Global plan provides financial security and peace of mind for individuals and families. [2]
Riders | NA |
Key Features | Protect Benefit, Plus Benefit, Opinion for Critical Illness, etc. |
Inclusions | Hospitalisation Expenses, AYUSH Treatment, Pre-Hospitalization cover, Post-Hospitalization cover, Organ Donor Expenses, Emergency Air Ambulance, etc. |
Exclusions | Any Planned treatments, Treatment for any condition which is not life-threatening, Medical treatment taken outside India, if that is the sole or one of the reasons for the journey, Oncological (Cancer) diseases, etc. |
3. Health Suraksha
The goal of the HDFC ERGO Health Suraksha Plan is to provide financial security and medical expense coverage in the event of an illness or accident. The expenditures associated with being hospitalised are covered by this plan, including lodging, medical treatments, doctor visits, and surgery. Additionally, it helps with expenditures paid both before and after your hospital stay by covering pre- and post-hospitalisation charges. The plan also covers day-care procedures such as cataract surgery that don't need to be overnight stays. It covers things like ambulance fees, free physicals, and cashless care at network hospitals, you don't have to pay for medical services upfront at these facilities.
You can select the appropriate level of coverage by using flexible sum insured options. The plan is appropriate for both people and families, providing financial security for unexpected medical expenses and a sense of peace of mind.[3]
Riders | Newborn baby, Maternity Expenses, Outpatient Dental Treatment, Spectacles, Contact Lenses, Hearing Aid, E-Opinion in respect of a Critical Illness, Convalescence Benefit, etc. |
Key Features | In-patient Treatment, Organ Donor, etc. |
Inclusions | Pre- Pre-hospitalisation, Post-Hospitalisation, Day care procedures, Domiciliary Treatment, Emergency Ambulance, AYUSH, etc. |
Exclusions | Breach of law, War, Participation or involvement in naval, military or air force operations, Adventure sports, Abuse of intoxicants or hallucinogenic substances, Treatment of Obesity, etc. |
4. Medisure Super Top-Up
After a certain amount of money is paid out of pocket as a deductible, the HDFC ERGO Medisure Super Top-Up Plan is a supplemental health insurance policy that offers additional coverage once the limitations of your primary health insurance are reached. It is an affordable method to make sure you have enough protection against huge medical bills because it provides significant additional coverage at a reduced fee. This is a flexible plan that may be used by individuals or families, with a range of deductible options to pick from. Because of this, it's the perfect option for people who want to improve their health insurance coverage without having to pay huge premiums.[4]
Riders | Guaranteed Renewal for Life, No Claims Experience Loading on Renewal, Free-Look Period, etc. |
Key Features | 6 Hours response guarantee on every cashless claim or we pay a penalty, It can be renewed annually or for a period of 2 years throughout your lifetime, pre and post-hospitalisation expenses and daycare procedures without any sub-limits |
Inclusions | In-patient hospitalisation expenses, Pre and Post-hospitalisation medical expenses, Inpatient Hospitalisation, Expenses for Pre-existing diseases, etc. |
Exclusions | Breach of the law, War, Treatment of Obesity, Congenital external diseases, Adventure sports, Self-harm, etc. |
5. Optima Restore
A health insurance plan called HDFC ERGO Optima Restore is made to provide broad coverage and has a special feature that replaces the entire amount covered if it is depleted during the policy year. This implies that if you spend the entire amount of your insurance on medical bills, the policy will automatically refill the amount at no additional cost, guaranteeing that you will have coverage for additional medical requirements that year. A wide range of medical costs are also covered by the plan, including hospital stays, pre- and post-hospital stays, daycare visits, and even complementary therapies like Ayurveda. It also provides a multiplier benefit that rewards you for maintaining your health by doubling the amount insured after two years of no claims.
It's a good option for people and families searching for substantial health insurance because it's a comprehensive plan designed to offer financial protection during medical emergencies.[5]
Riders | Restore Benefit |
Key Features | Day Care Procedures, Daily Cash, E-Opinion in respect of a Critical Illness, etc. |
Inclusions | In-patient Treatment, AYUSH treatment, Pre-Hospitalisation, Post-Hospitalisation, Emergency Air Ambulance Cover, Domiciliary Treatment, Organ Donor, etc. |
Exclusions | Breach of the law, War, Participation or involvement in naval, military or air force operations, Adventure sports, Self-harm, etc. |
6. Health Suraksha Silver
A health insurance plan with minimal features that covers medical costs is HDFC ERGO Health Suraksha Silver. It assists in covering hospitalisation expenditures if you become ill or are involved in an accident, including lodging, medical fees, and surgery costs. Additionally, pre-hospitalisation costs up to 30 days before admission and post-hospitalisation costs up to 60 days following release are covered by the plan. It also has advantages including emergency ambulance services and day care operations that don't require an overnight stay. HDFC ERGO Health Suraksha Silver offers a dependable financial safety net for unforeseen medical emergencies, facilitating the management of healthcare expenses without draining your resources.[6]
Riders | Cumulative Bonus, Health Check-up |
Key Features | In-patient Treatment, Day Care Procedures, Organ Donor, etc. |
Inclusions | Emergency Ambulance, Ayush Benefit, Domiciliary Treatment, Post-hospitalisation, Pre-Hospitalisation, etc. |
Exclusions | Breach of law, War, Participation or involvement in naval, military or air force operations, Adventure sports, Abuse of intoxicants or hallucinogenic substances, Treatment of Obesity, Congenital external diseases, etc. |
7. Women CI
A unique health insurance policy created specifically for women, the HDFC ERGO Women Critical Illness (CI) Plan provides financial help if a woman is diagnosed with any of the specified critical illnesses. After diagnosis, it offers a lump sum payout that can be applied to medical bills, hospital stays, or other requirements. This plan covers diseases including breast cancer, cervical cancer, and ovarian cancer, among others, that are more common in women. It seeks to relieve financial strain at difficult times so that women can concentrate on their healing without having to worry about money. It might also have elements that support general health and well-being, like wellness perks and routine health examinations.[7]
Riders | Newborn baby, Maternity Expenses, Outpatient Dental Treatment, Spectacles, Contact Lenses, Hearing Aid, E-Opinion in respect of a Critical Illness, Convalescence Benefit, Hospital Daily Cash, Regain Benefit, Enhanced Cumulative Bonus, etc. |
Key Features | In-patient Treatment, Organ Donor, etc. |
Inclusions | Pre-hospitalisation, Post-Hospitalisation, Day care procedures, Domiciliary Treatment, Emergency Ambulance, AYUSH, etc. |
Exclusions | Breach of law, War, Participation or involvement in naval, military or air force operations, Adventure sports, Abuse of intoxicants or hallucinogenic substances, Treatment of Obesity, Congenital external diseases, Psychiatric, mental disorders, etc. |
8. HDFC Ergo Energy Plan
A health insurance plan called the HDFC ERGO Energy Plan is intended for people who have been diagnosed with hypertension or diabetes. The medical costs associated with managing and treating certain illnesses are covered by this plan. It provides coverage for hospital stays, including pre- and post-hospitalization expenses, daycare services, and inpatient care. Regular check-ups, doctor consultations, and diagnostic tests are also included in the plan. Furthermore, it gives policyholders access to wellness programs designed to efficiently manage their hypertension and diabetes, assisting them in maintaining their health. For people coping with these frequent health conditions, it's a simple and supportive choice that doesn't require a medical test before purchase.[8]
Riders | Restore Benefit, Cumulative Bonus |
Key Features | HbA1C Checkup benefit, Day one coverage for all hospitalisation arising out of Diabetes and Hypertension (No waiting period) |
Inclusions | In-patient hospitalisation, Pre and post-hospitalisation cover 30 and 60 days respectively, 182 daycare procedures, Emergency ambulance coverage, Organ donor expenses, Shared Accommodation benefit |
Exclusions | Adventure Sport Injuries, Venereal Or Sexually Transmitted Diseases, Treatment Of Obesity Or Cosmetic Surgery, War, Self-Inflicted Injuries, Participation In Defence Operations, etc. |
Eligibility Criteria to Purchase Plan
To be qualified to acquire a health insurance plan from HDFC Ergo, you must meet certain requirements:[1]
1. Age Requirements
- The proposer needs to be 18 years old.
- The age at which a child must be covered under a family floater policy, which unites multiple family members under one plan, varies according to the plan offered by HDFC Ergo Insurance.
2. Waiting Period
- Before using the coverage, there is a 30-day waiting period. In the event of an emergency, however, this waiting period is waived.
- The four years are dedicated to maternity waiting time.
- A 48-month waiting period is also in place for those with pre-existing conditions.
3. Additional Conditions
- From 5 lakh to 5 crore, there is a broad variety of insured amounts available.
- The two additional benefits provided by HDFC Ergo Insurance plans are OPD and COVID coverage.
- Every customer's health insurance plan is tailored to meet their unique needs thanks to HDFC Ergo's efforts.
How To Purchase an HDFC Ergo Insurance Plan?
Depending on what works best for you, you can buy the HDFC Ergo Insurance plan online or offline. The following provides the two option specifics:[9]
Online Process
You can visit the InsuranceDekho website or the insurer's website to purchase the HDFC Ergo Insurance plan online:
Purchase Medical Insurance With InsuranceDekho
To acquire your health insurance policy on the official InsuranceDekho website, take the following actions:
Step 1: Fill out the InsuranceDekho website with your details.
First, fill out this form with your name and phone number on the InsuranceDekho health insurance page.
Step 2: Select the Best Scheme
Next, choose from the available options the best HDFC Ergo insurance plan. Make sure the items you select fit your needs and are within your limits.
Step 3: Cost of Coverage
Next, provide your details on two forms and respond to a few health-related questions. In addition, you will need to pay the price and provide a few documents.
Step 4: After Making a Payment, Receive Assistance
An InsuranceDekho manager will get in touch with you after you've paid the premium for the HDFC Ergo insurance of your choosing to assist with any policy-related issues.
Get a Health Insurance Policy on the Provider's Website
The easiest and fastest ways to purchase HDFC Ergo insurance directly from the insurer's website are as follows:
Step 1: Go to the website of the insurer
To HDFC Ergot the application procedure and submit the necessary information, visit the official HDFC Ergo Insurance website.[1]
Step 2: Take the Above Steps.
Follow the instructions in the “Use InsuranceDekho To Purchase Medical Insurance” section of the page Complete the process on the official HDFC Ergo Health Insurance website to obtain your coverage.
Offline Process
Take the following steps to get personalised help from the InsuranceDekho relationship manager when you purchase your HDFC Ergo health insurance policy:[9]
Step 1: Fill the Website with Content
Fill out the necessary information at www.insurancedekho.com, including your phone number, pin code, and age.
Step 2: Comparing the Available Plans
You will receive a list of the best HDFC Ergo health insurance plans after submitting your information.
Step 3: Ask for a Callback
You can edit your inquiry and request a callback on the plan page if you require any additional assistance. If you need further help, a personalised support visit from an InsuranceDekho relationship manager can be scheduled.
Required Documents
The following records must be obtained to get HDFC Ergo Health Insurance:
- A completed and signed proposal form identification such as a driver's licence, voter card, passport, PAN card, or 10th or 12th grade report
- Evidence of residency, such as a voter card, electricity bill, passport, driving licence, or Aadhaar card
- Any medical records required by the insurance provider
- passport-sized pictures
Comparing HDFC Ergo Health Insurance Plan Variants
The differences between the three Optima variants are highlighted in the table below:
Features | Optima Secure | Optima Restore | Optima Global |
Sum Insured | 5 lakh- 2 crore | 5 lakh- 2 crore | 5 lakh- 2 crore |
Plan Type | Individual, Family Floater | Individual, Family Floater | Individual, Family Floater |
Maternity | Not Covered | Not Covered | Not Covered |
Organ Donor | Covered | Covered | Covered |
Day Care Treatments | Covered | Covered | Covered |
Global Coverage | Not Covered | Not Covered | Covered |
Note: There may be variations amongst HDFC Ergo health insurance plans. The Optima Plan, the most popular HDFC Ergo Health plan, has its versions compared in the table above.
How to Upgrade Your HDFC Ergo Health Insurance Plan?
Here's how to quickly upgrade your plan with InsuranceDekho if you want to improve your health insurance coverage with HDFC Ergo Health Insurance:
At the Time of Renewal
When it's time to renew your HDFC Ergo health insurance policy, you have a fantastic chance to increase your coverage. Your HDFC Ergo medical insurance coverage can be enhanced in two ways with InsuranceDekho, by adding more riders or by raising the maximum amount insured. You are welcome to evaluate your current coverage and talk with us about any adjustments that would better meet your current medical needs throughout the renewal process.
In Between
You can make modifications to your HDFC Ergo health insurance plan at any time; you do not need to wait until it is time for your policy to renew. Contact the InsuranceDekho customer support team to discuss your possibilities for an upgrade if your healthcare needs change or you discover that your current coverage is insufficient.
Portability Benefits
If you're thinking about moving from another health insurance company to HDFC Ergo Health Insurance, you can use the portability function on InsuranceDekho to improve your coverage. With the use of this provision, policyholders can transfer their current health insurance policy to a new plan while keeping some benefits, like waiting period credit and coverage continuity.
References
[1]https://www.hdfcergo.com/campaigns/health-insurance-detail-new?&utm_source=google_search&utm_medium=cpc&utm_campaign=AIO_Search_Brand_Neev-Phrase&utm_adgroup=HDFC-ERGO&utm_adid=660499018279&utm_term=hdfc%20ergo&utm_network=g&utm_matchtype=p&utm_device=c&utm_location=1007765&utm_sitelink=&utm_placement=&ci=aiogsearch&SEM=1&gad_source=1&gclid=Cj0KCQjwxqayBhDFARIsAANWRnR-DQssqvfxcMSmdqULF43nBdSelqYjN2XNVPvVhEnee-O2UvU32m8aAhBVEALw_wcB
[2]https://www.hdfcergo.com/docs/default-source/downloads/prospectus/health/my-optima-secure-prospectus.pdf
[3]https://www.hdfcergo.com/documents/downloads/prospectus/HS_Prospectus.pdf
[4]https://www.hdfcergo.com/documents/crosslink/myhealth_medisure_super_top_up_insurance_brochure.pdf
[5]https://www.hdfcergo.com/docs/default-source/downloads/prospectus/health/optima-restore-prospectus.pdf
[6]https://www.hdfcbank.com/content/atom/723fb80a-2dde-42a3-9793-7ae1be57c87f/content?id=a7d8c08a-62e1-44bc-a27f-2ebd7bd7af92
[7]https://www.hdfcergo.com/documents/downloads/HEHI/myhealth-WS/Prospectus-my-health-Women-Suraksha-Ken.pdf
[8]https://d3h6xrw705p37u.cloudfront.net/policy/brochure/hdfc-ergo-health-energy-brochure.pdf
[9]https://www.insurancedekho.com/health-insurance?utm_campaign=SER-InsuanceDekho-Brand-CPC&utm_device=c&utm_term=insurancedekho&network=g&utm_medium=cpc&utm_source=google&agid=82439981411&ap=&aoi=&ci=2085133886&cre=567579836112&fid=&lop=1007765&ma=e&mo=&pl=&ti=kwd-615247392843&track=&gad_source=1&gclid=Cj0KCQjwjLGyBhCYARIsAPqTz180fkx5KkRZafqGHPKm8i-tMeq77YKKOQV4V8Y9dcExgnmfKhJItfQaAiCrEALw_wcB
FAQs
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Why should I buy health insurance by HDFC Ergo?
HDFC Ergo helps its customers ‘Take it easy. Experience the convenience.' To ensure the same, the company offers HDFC Ergo best health insurance plans that are specifically designed keeping the diverse health insurance needs of customers in mind. Moreover, HDFC health insurance policy offers benefits such as pre and post hospitalisation coverage, cashless claims, no sub-limits, tax benefits, day care procedures, domiciliary medical treatment, and others.
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How to apply for and buy health insurance plans offered by HDFC Ergo?
You can apply for and buy HDFC Medical Insurance plans online through the HDFC Ergo website www.hdfcergo.com or through www.insurancedekho.com. Remember, you can make use of net banking, debit card, or credit card to pay the premium of HDFC health insurance policy as the company allows flexible payment modes.
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Is there a limitation on the entry age for buying HDFC medical insurance plans?
The entry age for children is 91 days. However, there is no maximum entry age for adults to buy HDFC Ergo health insurance plans.
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What is the customer care number of HDFC Ergo?
The customer care number for HDFC Ergo is 022 6234 6234.