Know About HDFC Optima Secure Health Insurance Plan

HDFC ERGO Optima Secure is the newest product in the category from HDFC Ergo General Insurance. The plan is offered in two flavors: individual and family floater. Regardless of claims filed under the plan, your base cover is automatically enhanced by 50% after one year and by 100% after two years. Another important feature of the plan is the Restoration Benefit, which ensures that if you make a claim throughout the year, 100 percent of your basic coverage is instantly restored at no additional expense.

The plan's built-in Protection Benefit also ensures payment of consumables such as gloves and masks. My Health Critical Illness Cover and My Health Hospital Cash Benefits Cover are two possible add-ons that may be used to customise the plan. The HDFC ERGO Optima Secure provides a variety of benefits, including loyalty discounts, family discounts, and long-term discounts. The plan's sum promised varies from Rs. 5 lakh to Rs. 2 crore. To know more about HDFC Optima Secure Health Insurance Plan, read on.

HDFC ERGO Optima Secure

Optima Secure emerges as an exceptional policy choice. HDFC ERGO Health Insurance provides the flexibility to select any room category, offers a generous loyalty benefit (with a 50% annual increase in the sum insured up to 100%), and features the much-discussed Secure benefit – granting you three times the coverage amount. 

Advantages of HDFC ERGO Optima Secure

• You'll never have to split the bill

The complete expense of treatment, up to the sum insured, is borne by the insurer. Not a single rupee needs to be paid by you. This signifies that the health insurance policy doesn't involve any co-payment.

• You can pick any room you like

Whether you opt for a shared room, single room, deluxe room, or any available room type, the insurer won't fuss over your room preference due to the absence of room rent restrictions.

• You always have full cover irrespective of the disease

No tricky dealings here. If your insurer hasn't explicitly excluded coverage for a particular ailment, you can claim the entire amount up to the sum insured, regardless of the specific disease you're facing. This means the policy doesn't enforce bothersome disease-wise sub-limits.

• Pre & Post hospitalisation expenses covered

You need not worry if your doctor orders a series of diagnostic tests before or after your hospital stay. The insurer has your interests covered. They will fully cover these expenses for a reasonably extended duration—60 days prior to hospitalisation and 180 days after discharge. This also includes medication costs.

• Good Restoration Benefit

Even if you make a claim for a portion of the coverage on one occasion, the complete coverage amount is reinstated. This ensures you can avail of this benefit in case you experience multiple hospitalisations.

• Day Care treatments covered

In instances of hospitalisation lasting less than 24 hours due to minor procedures like dialysis, chemotherapy, or minor surgeries, the insurer will also take care of these expenses.

• Special bonus for renewing the policy

Your sum insured grows by 50% each year, regardless of your claim history in the current year. However, this increase continues as long as the Loyalty Benefit sum insured reaches 100% of the initial sum insured.

• Free Health Checkups every year

If you intend to undergo an annual full body checkup to ensure your overall health, the insurer will cover the expenses.

• Covers Alternative Medicine

Considering Ayurvedic, Homoeopathic, or other alternative treatments for curing an illness? Your insurer will provide full coverage up to the sum insured.

Add-ons Included in HDFC ERGO Optima Secure

Hospital Daily Cash

The insurer disburses a lump sum by incorporating a fixed amount (daily cash) every day until discharge, aiding you in managing potential income loss during this period. Upon submitting the required documents after discharge, the reimbursement will be issued. While this appears to be a valuable benefit, we advise caution as it might not offset the additional premium expenditure.

Critical Illness

You become eligible for full cxoverage upon diagnosis of any of the 50 critical illnesses specified in the policy brochure. However, given that premiums fluctuate with age, securing a critical illness cover with term plans at more favourable rates could be more financially prudent.

Unlimited Restore

With Unlimited Restore, your coverage is completely reinstated with each settled claim. Regrettably, this enhancement is solely accessible through offline channels.

Aggregate Deductible

In the event of a claim, you'll be responsible for a payment before the insurance company finalises the settlement—the deductible. Opting for a higher deductible can lead to lower premiums, facilitating the purchase of a policy at a better cost.

Individual Personal Accident

The add-on disburses a segment of the coverage amount to policyholders who have faced fatalities, injuries, or partial or total disabilities arising from accidents.

Features Of HDFC Optima Secure Health Insurance Plan

Health insurance has now become a requirement for all individuals and their families. However, the majority of us are unaware of the policy's fundamental aspects. After examining all of the features and coverage, we should purchase a health insurance plan. You will pay extra if you choose a plan that does not meet your needs

Following are some of the most important features of HDFC Optima Secure Health Insurance Plan -

• Assured Sum - There are many sum-insured alternatives available, including 3 lakh, 5 lakh, 10 lakh, 15 lakh, 20 lakh, 25 lakh, and 50 lakh. It provides free automatic restoration of the base sum assured if the cover is depleted within the policy year.
• Renewability - This health has the option of lifetime renewability.
• Cashless Facility - It provides cashless services to over 10,000 medical professionals and over 4500 network hospitals in over 800 locations, allowing the insured individual to avoid paying any money out of pocket in the event of hospitalisation or operation.
• Plan For All - This plan is available for everyone individuals as well as families.
• Pre-Policy Check-Up - Requires 46 years or more of age and an amount insured of 15 lakh or more.
• Waiting Periods -Tax Rebates - Due to the premium paid, there is a tax deduction benefit when paying income tax on the yearly salary under section 80 D of the Income Tax Act.
• Claim Settlement - In terms of adequate document representation, there is a 98 percent claim settlement percentage.
• Free Look Period - A timeline of 15 days is given to any individual to review the terms and conditions of the health plan.
• Discounts - It gives a reduction on premiums for adding more than two members as well as for keeping the insurance for a longer period of time.
• Waiting Period - After 24 months, just a few disorders and illnesses are covered. If pre-existing conditions are accepted at the time of application, they will be covered after 36 months of continuous renewals. Only accidental hospitalisations are covered for the first 30 days after the coverage is issued.

Benefits Of HDFC Optima Secure Health Insurance Plan

Following are the benefits of HDFC Optima Secure Health Insurance Plan -

• Daycare Treatment - Instead of requiring a minimum of 24 hours of hospitalisation, the Plan covers all day-care treatments. The list of possible therapies, such as radiation, chemotherapy, cataract surgery, dialysis, and so on, may be found in the Policy Documents as well as on the company's website.
• Claim Free Benefits - This is a fantastic advantage that may make a policyholder very happy. For each year you go without filing a claim, you'll be eligible for a 50% incentive. This incentive is available for the policy's next year, up to a maximum of 100% of the total covered.
• Restore Benefits - If you have exhausted or used your amount insured in a policy year, you can get the restore benefit, which instantly adds 100 percent of the sum insured.

Endnotes

Medical crises may strike at any time, leaving you financially burdened. Furthermore, when it comes to your family, you must have the appropriate health coverage to ensure the happiness and well-being of your loved ones. Individual health insurance programmes protect policyholders from a variety of diseases and illnesses, as well as accidental hospitalisation. It might be tough to pick the best strategy for yourself, therefore it's vital to make a list of factors to help you understand.

FAQs

Q. Does Optima Secure come with waiting periods?

A. Certainly, Optima Secure includes three types of waiting periods:

• A 30-day Waiting Period: During the initial 30 days of the policy, hospitalisations won't be covered, except in the case of accidents.
• Specific Illness Waiting Period: There's a mandatory 2-year waiting period for certain listed diseases before you can start making claims.
• Pre-Existing Disease Waiting Period: When purchasing the policy, there's a 3-year waiting period for any pre-existing diseases you might have.

Q. Does Optima Secure impose restrictions on room rent?

A. No, Optima Secure provides the flexibility to choose any available room type within the hospital, whether it's a Single Private Room, Shared Room, Deluxe Room, and so on.

Q. Does Optima Secure offer a restoration benefit?

A. Yes, Optima Secure does offer a restoration benefit. You will have your full coverage reinstated so that you can utilise this benefit in case of multiple hospitalisations within a policy year.

Q. Does Optima Secure cover AYUSH treatments?

A. Yes, Optima Secure does cover AYUSH treatments.

Q. Does Optima Secure provide a bonus?

A. Your sum insured increases by 50% each year, regardless of your claim status in the current year. However, this increase continues as long as the loyalty benefit sum insured reaches 100% of the initial sum insured.

Q. Does Optima Secure include maternity benefits?

A. No, Optima Secure does not include maternity benefits.

Q. Does Optima Secure extend international coverage?

A. No, Optima Secure does not offer international coverage.

Q. Does Optima Secure encompass dental protection?

A. Yes, HDFC Ergo - Optima Secure does cover dental treatments resulting from injuries or accidents.

Q. Does Optima Secure offer coverage for outpatient consultations?

A. No, Optima Secure does not provide coverage for outpatient consultations.

Q. Does Optima Secure have entry and exit restrictions?

A. Yes, Optima Secure is available for individuals aged between 18 and 65 years. For dependent children, the age range is from 91 days to 25 years.

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Disclaimer: This article is issued in the general public interest and is meant for general information purposes only. Readers are advised not to rely on the contents of the article as conclusive in nature and should research further or consult an expert in this regard.