HDFC ERGO Health Insurance Plans – Features, Plans, Claims Process, Buy, Renew Policy, Quotes

What are the Key Features of HDFC ERGO Health Insurance Plans?

The Key Features of HDFC ERGO Health Insurance Plans are as follows:

1. Comprehensive Coverage: HDFC ERGO Health Insurance Plans provide comprehensive coverage for Hospitalisation Expenses, Pre- and Post-Hospitalisation Expenses, Daycare Procedures, organ donor expenses, AYUSH treatments (Ayurveda, Yoga, Unani, Siddha, Homeopathy) etc.
2. Wide Range of Plans: HDFC Ergo offers a wide range of plans across Individual Policies, Family Floater Policies, Senior Citizen Plans, critical illness Plans, Super top-up Policies, and dedicated disease-specific policies like diabetes or Cancer to cater to different requirements of customers.
3. Sum Insured Flexibility: Plans start from as low as Rs5 lakhs and can go up to Rs2 crores in premium offerings such as My:Optima Secure.
4. Cashless Hospitalization: HDFC Ergo 12,000+ network hospitals across India which facilitate cashless claim settlement for policyholders.
5. No-Claim Bonus: Some HDFC Ergo Health Insurance Plans a No-Claim Bonus of up to 200% for claim-free years.
6. Restoration Benefits: HDFC Health Insurance Plans provide Restoration Benefits which automatically restore the Policy Sum Insured if it gets exhausted in a Policy Year.
7. Lifetime renewability: All HDFC Ergo Health Insurance Plans offer lifetime renewal ensuring access to healthcare for life.
8. Minimal Room Rent Limits: HDFC Ergo Health Insurance Plans have minimal room rent limits ensuring that the Claim Settlement does not suffer from deductions
9. Tax Benefits: The Premium HDFC Ergo Health Insurance Plans are eligible for tax deductions under Section 80D of the Income Tax Act, 1961.

What are different Health Insurance Plans of HDFC Ergo General Insurance Company?

HDFC ERGO General Insurance Company offers various health insurance plans depending on the requirement of the Insured. Some of the Health Insurance Plans offered by HDFC Ergo are listed below:

HDFC Ergo My:Optima Secure Health Insurance

HDFC Ergo My:Optima Secure Health Insurance Plan provides a 4X increase in Health Insurance Coverage for no additional cost. The Policy provides various Sum Insured Options ranging from Rs5 lakhs to Rs2 Crores. HDFC Optima Secure Policy offers comprehensive coverage for Hospitalisation Expenses, Pre- and Post-Hospitalization expenses, Day Care Treatments, AYUSH Treatments etc.

Key Features of HDFC Ergo My:Optima Secure Health Insurance Policy

1. The Policy offers various Sum Insured Options available up to Rs2 Crores
2. HDFC Ergo My:Optima Secure Plan provides 2X Coverage from Day 1 under the Secure Benefit and the Plus Benefit under the Policy provides 100% increase in coverage after 2 years
3. The Policy provides a Restore Benefit, where any claim, partial or total, made at any time during the year, gets restored at 100% of the Base Cover automatically, at no additional cost. Additionally, the Policy also has an Unlimited Restore Add-On Cover where the Sum Insured can be restored Unlimited times during a Policy Year.
4. HDFC my:Optima Secure Policy Provides coverage for Consumable Expenses which are normally excluded under other health insurance policies
5. The Policy provides Pre and Post-Hospitalisation Expenses Coverage for 60 days and 180 Days
6. Waiting Period of 36 months for Pre-Existing Diseases
7. Waiting Period of 24 months for Specific Diseases
8. Policy provides coverage for Domiciliary Hospitalisation and Organ Donor Expenses
9. Lifelong Renewal

HDFC Ergo Optima Restore Health Insurance Policy

HDFC Ergo Optima Restore Health Insurance Plan is a comprehensive Health Insurance Plan which provides 100% Restoration of Basic Sum Insured instantly after the first claim. Sum Insured Options range from Rs3 lakhs to Rs50 Lakhs.

Key Features of HDFC Ergo Optima Restore Health Insurance Policy

1. This policy offers hospitalization coverage, coverage for Pre- and Post-Hospitalization expenses, Day Care Treatments etc.
2. The Policy provides a Restoration Benefit, where any claim, partial or total, made at any time during the year, gets restored at 100% of the Base Cover automatically, at no additional cost. Additionally, the Policy also has an Unlimited Restore Add-On Cover where the Sum Insured can be restored Unlimited times during a Policy Year.
3. The Policy offers various Sum Insured Options available up to Rs50 Lakhs
4. The Policy has a minimum entry age of 91 days and maximum entry age of 65 years.
5. The Policy provides 50% of the Base Sum Insured as a Multiplier Benefit irrespective of any claims to a maximum of 100%. This means that the Base Sum Insured doubles in 2 years
6. The Policy has No Room Rent Capping Feature which means that all expenses are paid at actuals
7. Pre and Post-Hospitalisation Expenses Coverage for 60 days and 180 Days
8. Policy provides coverage for Domiciliary Hospitalisation and Daycare Procedures
9. Waiting Period of 24 months for Specific Diseases
10. Waiting Period of 36 months for Pre-Existing Diseases
11. Lifelong Renewal

HDFC Ergo Critical Illness Insurance Policy – Platinum Plan

HDFC Ergo Critical Illness Insurance Policy provides a lumpsum benefit on first diagnosis of any of 15 critical illnesses. The Policy has an entry age limit from 5 years to 65 years.

Key Features of HDFC Ergo Critical Illness Insurance Policy – Platinum Plan

1. The Policy offers Sum Insured options from Rs1 Lakh to Rs50 Lakhs
2. Entry Age of 5 Years to 65 years
3. The Policy pays a lumpsum benefit on first diagnosis of any one of the 15 critical illnesses after a 15- or 30-days survival period from the date of the first diagnosis
4. Insured has an option to choose a survival period of 15 days or 30 days
5. The Policy has a Waiting Period of 90 Days
6. The Premiums paid towards HDFC Ergo Critical Illness Plan are eligible for Tax Deductions under Section 80D of Income Tax Act, 1961
7. Lifelong Renewal

HDFC Ergo My:Health Medisure Super Top-Up Health Insurance Plan

HDFC Ergo My:Health Medisure is a Super Top-Up Health Insurance Plan which provides a large Health Insurance Coverage at affordable premiums. The Policy has an entry age of upto 65 years and does not require a medical checkup upto 55 years of age.

Key Features of HDFC Ergo My:Health Medisure Super Top Up Health Insurance Plan

1. Various Sum Insured Options available up to Rs20 Lakhs with a range of Deductible Options ranging from Rs2 lakhs to Rs5 lakhs
2. The Policy offers Floater Option available to cover Spouse and Dependent Children
3. The Policy covers hospitalisation expenses without any sublimits
4. The Policy offers a Critical Illness Add-On cover which pays a lumpsum benefit on the diagnosis of any of the listed 51 major medical illnesses. The Sum Insured options for the Critical Illness Add-on Cover ranges from Rs1 Lakh to Rs50 Lakhs.
5. The Policy also offers a Hospital Cash Benefit Add-On cover which pays a Per Day benefit on medically necessary hospitalisation of an insured person due to illness or injury. The Sum Insured options for the Hospital Cash Benefit Add-on Cover ranges from Rs500 to Rs10,000.
6. The Policy offers Pre and Post-Hospitalisation Expenses Coverage for 30 days and 60 Days
7. Waiting Period of 36 months for Pre-Existing Diseases
8. The Policy offers constant premium after the age of 61 years and above
9. Lifelong Renewal

HDFC Ergo Arogya Sanjeevani Policy

HDFC Ergo Arogya Sanjeevani Policy is a standard Health Insurance policy which provides coverage for Hospitalisation expenses incurred by the Insured. The Policy offers coverage against Hospitalisation expenses, Daycare Procedures, Pre and Post-Hospitalisation Expenses and AYUSH treatment.

Key Features of HDFC Ergo Arogya Sanjeevani Policy

1. The Policy offers various Sum Insured Options available Rs50,000 to Rs10 Lakhs
2. The Policy has a Room Rent Limit of 2% of Sum Insured subject to a maximum of Rs5000 per day for Normal Rooms and 5% of Sum Insured subject to a maximum of Rs10,000 per day for ICU Rooms
3. The Policy offers Pre and Post-Hospitalisation Expenses Coverage for 30 days and 60 Days
4. Cumulative Bonus of 5% per year for every claim-free year, provided that the Policy is renewed without a break every year, subject to a maximum of 50% of Sum Insured.
5. HDFC Arogya Sanjeevani Policy offers coverage for Modern Treatment Methods such as Balloon Sinuplasty, Deep Brain stimulation, Oral chemotherapy etc. upto a maximum of 50% of Policy Sum Insured.
6. The Policy provides coverage for Cataract Treatment upto 25% of Policy Sum Insured or a maximum of Rs40,000 per eye, whichever is lower, in one Policy Year.
7. Waiting Period of 48 months for Pre-Existing Diseases
8. Waiting Period of 24 months for Specific Diseases
9. Waiting Period of 48 months for joint replacement unless arising from accident age-related osteoarthritis and osteoporosis
10. Co-Payment of 5% on each and every claim
11. Lifelong Renewal

HDFC Ergo Energy Diabetes Health Insurance Policy – Gold Plan

HDFC Ergo Energy Diabetes Health Insurance Plan is a health insurance plan specifically targeting diabetic people. The Policy offers coverage against Hospitalisation expenses, Daycare Procedures, Pre and Post-Hospitalisation Expenses and AYUSH treatment. A unique feature of this Plan is that the Waiting Period for Hypertension and Diabetes is Zero. This means that any hospitalization expenses arising out of Pre-Existing Hypertension and Diabetes is covered from Day 1, that is, without any Waiting Period.

Key Features of HDFC Ergo Energy Diabetes Health Insurance Plan

1. The Policy offers various Sum Insured Options available Rs50,000 to Rs50 Lakhs
2. The Plan has an Entry Age of 18 years to 65 Years
3. The Policy offers Day one coverage for all Hospitalisation Expenses, Pre and Post-Hospitalisation Expenses and Daycare Procedures
4. Pre and Post-Hospitalisation Expenses Coverage for 30 days and 60 Days
5. Waiting Period of 24 months for Pre-Existing Diseases (other than Diabetes and Hypertension). Diabetes and Hypertension are covered from Day 1
6. Waiting Period of 24 months for Specific Diseases like Cataract, Hernia, Joint Replacement Surgeries, Surgery of Hydrocele, etc.
7. Lifelong Renewal

HDFC Ergo iCan Cancer Insurance Plan

HDFC Ergo iCan Cancer Insurance Plan is a specific Health Insurance Plan targeted for cancer patients. The Plan covers medical expenses for hospitalisation (inpatient and daycare) and outpatient treatment taken for cancer.

Key Features of HDFC Ergo iCan Cancer Insurance Plan

1. The Policy offers various Sum Insured Options ranging from Rs5 lakhs to Rs50 Lakhs
2. The Policy covers medical expenses for hospitalisation (inpatient and daycare) and outpatient treatment taken for cancer such as Chemotherapy, Radiotherapy, Organ Transplant etc.
3. Pre and Post-Hospitalisation Expenses Coverage for 30 days and 60 Days
4. The Advanced Plan also covers advanced treatments such as Proton beam therapy, Immunotherapy including immunology agents e.g., Interferon, TNF, etc., Personalised and targeted therapy, Hormonal therapy or endocrine manipulation, Stem cell transplantation etc.
5. The Enhanced Variant of the HDFC Ergo ICan Insurance Plan offers a CritiCare Benefit where the Policy pays 60% of Sum Insured as a lumpsum benefit over and above the base Sum Insured, if the Insured is diagnosed with cancer of specified severity. This CritiCare Benefit is payable only once in a Policy lifetime.
6. The Enhanced Variant of the HDFC Ergo ICan Insurance Plan offers a Family Care Benefit where the Policy pays 100% of Sum Insured as Lumpsum benefit over and above the Base Sum Insured if the insured gets diagnosed with either Advanced metastatic cancer (Stage IV) or Recurrence of Cancer. This Family Care Benefit is payable only once in a Policy lifetime.
7. The Policy has an Initial Waiting Period of 120 Days
8. Any other illnesses apart from cancer are not covered
9. Lifelong Renewal

HDFC Ergo My:Health Women Suraksha

HDFC Ergo My:Health Women Suraksha is a comprehensive Health Insurance Plan designed specifically for Women. The Policy offers multiple Sum Insured options ranging from Rs1 lakh to Rs1 crore. The Policy provides comprehensive coverage for women-specific major illnesses and surgeries

Key Features of HDFC Ergo My:Health Women Suraksha Health Insurance Plan

1. The Policy has an entry age of 18 years to 65 years
2. The Policy offers multiple covers such as Cancer cover, Cardiac Illness Cover, Critical Illness Cover which covers various Critical Illnesses, Cardiac Ailments and Surgical Procedures
3. Policy has coverage for pregnancy complications and newborn baby complications with a Waiting Period of 1 Year
4. The Policy has a Waiting Period of 90 days and 180 days depending on the illness and a Survival Period of 7 days
5. The Policy also provides unique covers like loss of job, reduced premium benefit and Wellness features like fitness discount at renewal, wellness and health coach, etc. for maintenance of good health
6. Policy has a Waiting Period of 36 months for Pre-Existing Diseases and a 1 Year Waiting Period for coverage of pregnancy complications and newborn baby complications.
7. Policy has a feature of Preventive Health Check Up at Renewal
8. Lifelong Renewal

HDFC Ergo My:Health Koti Suraksha Insurance

HDFC Ergo My:Health Koti Suraksha Health Insurance Policy is an affordable Health Insurance Plan which provides coverage of upto Rs1 Crores at reasonable premiums. The Policy has an entry age of 18 years to 65 years and offers coverage for Hospitalisation Expenses, Pre- and Post-Hospitalization expenses, Day Care Treatments, AYUSH Treatments etc.

Key Features of HDFC Ergo My:Health Koti Suraksha Health Insurance Plan

1. HDFC Ergo My:Health Koti Suraksha Health Insurance Plan has a Room Rent restriction of a Single Standard AC Room
2. The Policy has a Co-Payment of 20% for all Pre-existing Diseases and this Co-payment is applicable only during the Waiting Period.
3. The Policy has a Co-Payment of 20% for People who purchase the Policy after the age of 60 years
4. The Policy has a Sublimit of Rs75,000 for various illnesses & procedures like Cataract, Surgeries for Benign Tumours/Cysts/Polyps
5. Pre and Post-Hospitalisation Expenses Coverage for 60 days and 180 Days
6. Policy provides Coverage for Daycare Procedures
7. Cumulative Bonus of 10% per year irrespective of claims under expiring policy, subject to a maximum of 100% of Sum Insured.
8. Policy provides optional covers for Non-Medical Expenses Coverage, Emergency Worldwide Treatment, Overseas Treatment for Specified Illnesses, Waiver of Disease Capping, Room Rent Waiver, Waiver of Co-payment etc.
9. Policy provides add-on covers for Critical Illness and Hospital Cash Benefit
10. Waiting Period of 24 months for Specified Diseases
11. Waiting Period of 36 months for Pre-Existing Diseases
12. Lifetime Renewal

HDFC Ergo Health Wallet Insurance

HDFC Ergo Health Wallet Insurance is a comprehensive Health Insurance Plan with many unique features offering Sum Insured in the range of Rs3 lakhs to Rs50 lakhs.

Key Features of HDFC Ergo Health Wallet Insurance Plan

1. HDFC Ergo Health Wallet Insurance Plan provides coverage for Hospitalisation Expenses, Pre and Post-Hospitalisation Expenses, Daycare Procedures, Organ Donor Expenses etc.
2. The Plan offers a Reserve Benefit where the Sum Insured under the Benefit can be used for OPD Expenses such as Diagnostic Tests, Vaccinations, Consultations etc. The unused portion of the Reserve Benefit carries forward to next year along with a 6% bonus at renewal.
3. The Policy provides 50% of the Base Sum Insured as a Multiplier Benefit in case of a claim-free year subject to a maximum of 100%. This means that the Base Sum Insured doubles in 2 years
4. Restore Benefit under the Policy automatically restores the Policy Sum Insured if the base Sum Insured and Multiplier Benefit is completely exhausted during the policy period. The Restore Benefit is applicable only for Unrelated Illnesses.
5. Worldwide Coverage: The Policy covers Hospitalisation Expenses and Daycare medical expenses incurred for emergency treatments for an illness or injury sustained or contracted outside of India which cannot be postponed until the Insured returns back to India, provided such treatment was medically necessary
6. Pre and Post-Hospitalisation Expenses Coverage for 60 days and 90 Days
7. Waiting Period of 24 months for Specified Diseases
8. Waiting Period of 36 months for Pre-Existing Diseases
9. Lifetime Renewal

What is the Health Insurance Claim Settlement Process with HDFC Ergo General Insurance Company?

HDFC ERGO Health Insurance Claim Settlement Process – Cashless Claim Settlement

The Policyholder must follow the steps listed below to avail Cashless Claim Settlement under the HDFC Ergo Health Insurance Policy:

1. Locate the nearest network hospital covered by the HDFC Ergo Health Insurance Policy to avail treatment
2. Inform HDFC Ergo about the hospitalization 3-4 days before in case of a planned hospitalization and within 4-5 hours in case of an emergency
3. Show the Health Card issued by the Insurance Company to the Insurance desk at the hospital
4. Fill the Pre-Authorization Claim Form provided by the hospital
5. The Hospital sends the Pre-Authorization Claim Form to HDFC Ergo for Claim Settlement
6. The Insurance Company will inspect the details and inform the Insured about the approval or rejection of the Claim
7. Once the Claim gets approved, the hospital sends the expenses and receipts to the Insurer and the hospital gets reimbursed for the treatment expenses directly by HDFC Ergo General Insurance Company. Ineligible expenses, copayments, and deductions must be paid by the Insured. The advantage of cashless claim settlement is that the Policyholder does not need pay any amount from his own pocket.

HDFC ERGO Health Insurance Claim Settlement Process – Reimbursement Claim Settlement

If the Policyholder chooses a non-network hospital, he will have to opt for Reimbursement Claim Settlement. The Reimbursement Claim Settlement is listed below:

1. Inform HDFC Ergo within 24 hours of admission to the hospital. The Company will provide the Policyholder with a Claim Intimation Number after the claim is raised so that the Claim Status can be tracked.
2. Make the payment to the hospital for the medical expenses incurred and keep original copies of all the Invoices.
3. Submit the required documents to HDFC Ergo General Insurance Company
4. The Insurance Company will verify the Claim Details, ask for additional documents if required and will approve or reject the Claim.
5. The approved Claim Amount gets credited directly to the Bank Account of the Insured

What are the documents Required for a Reimbursement Claim under a Group Health Insurance Policy?

1. The Insured needs to submit the following documents to HDFC Ergo to avail Reimbursement Claim Settlement under the Policy:
2. ID Proof, Policy Health Card and Address Proof
3. Duly Filled and Signed Claim Form
4. Pathology Reports
5. Medicine Prescriptions and Pharmacy Bills
6. Pre and Post-Hospitalisation Bills
7. Hospital Bills
8. Discharge Summary

How to Buy a HDFC Ergo Health Insurance Policy?

The steps to buy a HDFC Ergo Health Insurance Policy with Qian are as follows:

1. Go to Qian Insurance Broking website <www.qian.co.in> and click on the Health Insurance icon
2. Fill the ‘Get a Free Quote Form’ by submitting your Name, Email ID and Mobile Number
3. An Expert Health Insurance Executive would reach out to you within 15 mins and take the relevant details like the People to be Insured and their Date of Births, Details of Pre-Existing Diseases, Sum Insured and Policy Features required and Premium Budget.
4. The executive will suggest multiple plans from HDFC Ergo based on your requirements and budget.
5. Finalise the Plan and submit necessary documents such as ID proof, Address Proof etc.
6. Pay the premium using net banking, UPI, credit/debit card or wallet.
7. The policy will be emailed to your registered email ID.

How to Renew HDFC Ergo Health Insurance Policy?

The Process to renew HDFC Ergo Health Insurance Policy with Qian is as follows:

1. Contact Qian Insurance Broking or visit the nearest branch office of the Company.
2. Provide relevant details along with the details of EPolicy
3. The Qian Insurance Team will assist you with renewal quotes and to submit relevant documents.
4. Pay the premium via cash, cheque or demand draft.
5. The Policy will be mailed to your address within 2 days

Get Best Quotes for HDFC Ergo Health Insurance Policies with Qian!

HDFC ERGO has a reputation for fast claim settlement, a large hospital network, and customizable benefits make their Health Insurance Plans a wise choice. Qian is a licensed Insurance Broker with HDFC Ergo General Insurance Company. We can assist you with all Health Insurance Policies as well as Claim Settlement with HDFC Ergo. Get a Quote for HDFC Ergo’s Health Insurance Policy from Qian. You can reach out to us via email at insurance@qian.co.in or call us on 022-35134695. We would be glad to assist you