Health insurance is the core of any financial plan. Talking about health insurance, HDFC Ergo Health Insurance has emerged as one of the most dependable choices available in India. It provides multiple plans for any need thus offering complete coverage with effortless claims settlements. HDFC Ergo focuses on the customer benefit thus providing health options worthy to invest in. This overview will prove helpful to guide you through understanding their health insurance offerings and assist you in making well-informed decisions with regard to your healthcare needs.
Introduction to HDFC Ergo Health Insurance
HDFC Ergo Health Insurance is a range of health insurance policies offered by the company HDFC Ergo General Insurance Company. Different plans that are designed to provide hospital or medical emergency coverage with a personal touch to individuals, their families, and senior citizens will be covered.
Types of HDFC Ergo Health Insurance Plans
HDFC Ergo has several plans to cater to the needs of different people and families:
- Individual Health Insurance: This plan covers medical expenses for one person. It includes costs for hospitalization, as well as pre- and post-hospitalization care and daycare treatments.
- Family Floater Health Insurance: You can cover the whole family with one premium. It is a good plan for families who have children and aged members.
- Critical Illness Insurance: The benefit you will qualify for in case you have a critical illness, for instance, cancer, heart attack, or stroke is a lump sum payment. You are thus financially stable to go through treatment.
- Senior Citizen Health Insurance: This is a plan for people above 60 years. It has conditions for pre-existing diseases after some waiting period.
- Top-Up Health Insurance: This plan improves your health insurance as it gives you extra financial support.
Benefits of HDFC Ergo Health Insurance
- Financial Protection: Covers high medical bills, easing financial stress during emergencies.
- Tax Savings: You can claim deductions for premiums under Section 80D of the Income Tax Act.
- Flexibility in Plans: HDFC offers different policies to meet various needs. You can choose options like critical illness coverage or family floaters.
- Enhanced Claim Settlement Ratio:HDFC has a high claim settlement ratio and ensures that the claim process is smooth.
HDFC ERGO Health Insurance Plans for Family
Here’s a list of HDFC ERGO health insurance plans for families that you can find in the market.
Plans | Sum Insured (Rs) | Pre-existing Diseases Waiting Period |
HDFC ERGO Optima Secure Plan | 5 lakh to 2 crore | 3 years |
HDFC ERGO my:health Suraksha Plan | 1 lakh to 5 crore | 4 years |
HDFC ERGO Optima Restore Plan | 3 lakh to 1 crore | 3 years |
HDFC ERGO Easy Health Insurance Plan | 1 lakh to 50 lakh | 3 years |
HDFC ERGO Health Wallet Plan | 3 lakh to 50 lakh | 3 years |
Eligibility Criteria for HDFC ERGO Health Insurance for Family
Here are the eligibility criteria to buy HDFC ERGO health insurance for a family:
Categories | Eligibility Criteria | |
Adult | Child | |
Minimum Entry Age | 18 years | 91 days |
Maximum Entry Age | 65 years
No age limit (For my:health Suraksha plan) |
25 years |
Family Members Covered | Self, spouse, dependent children, father, mother, father-in-law, and mother-in-law | |
Renewability | Lifetime |
HDFC ERGO Health Insurance Plans
1) HDFC ERGO my:health Koti Suraksha
For individuals
Min. Age | Max. Age | Min. Coverage | Max. Coverage |
91 days | 65 Years | ₹ 50 Lakh | ₹ 1 crore |
2) HDFC ERGO Optima Secure
For individuals
Min. Age | Max. Age | Min. Coverage | Max. Coverage |
91 days | 65 Years | ₹ 5 Lakh | ₹ 2 crore |
3) HDFC ERGO Critical Illness Insurance Plan
For critical illness
Min. Age | Max. Age | Min. Coverage | Max. Coverage |
5 Years | 65 Years | ₹ 1 Lakh | ₹ 50 Lakh |
4) HDFC ERGO Day2Day Care Plan
For OPD
Min. Age | Max. Age | Min. Coverage | Max. Coverage |
91 Days | 65 Years | ₹ 5000 | ₹ 8000 |
5) HDFC ERGO Dengue Care Health Insurance
For Dengue
Min. Age | Max. Age | Min. Coverage | Max. Coverage |
91 Days | 65 Years | ₹ 50000 | ₹ 1 lakh |
6) HDFC ERGO Energy Health Insurance Plan
For diabetes & hypertension
Min. Age | Max. Age | Min. Coverage | Max. Coverage |
18 Years | 65 Years | ₹ 2 lakh | ₹ 50 lakh |
7) HDFC ERGO Easy Health Insurance Plan
For family
Min. Age | Max. Age | Min. Coverage | Max. Coverage |
91 Days | 65 Years | ₹ 1 lakh | ₹ 50 lakh |
8) HDFC ERGO Health Wallet Insurance Plan
For individuals
Min. Age | Max. Age | Min. Coverage | Max. Coverage |
91 Days | 65 Years | ₹ 3 Lakh | ₹ 50 Lakh |
9) HDFC ERGO Health Suraksha Top Up Pro
For top-up
Min. Age | Max. Age | Min. Coverage | Max. Coverage |
5 Years | 65 Years | ₹ 2 Lakh | ₹ 10 lakh |
10) HDFC ERGO Health Suraksha Top Up Plus
For super top-up
Min. Age | Max. Age | Min. Coverage | Max. Coverage |
5 Years | 65 Years | ₹ 2 Lakh | ₹ 10 lakh |
11) HDFC ERGO iCan Insurance Plan
For Cancer
Min. Age | Max. Age | Min. Coverage | Max. Coverage |
5 Years | 65 Years | ₹ 5 Lakh | ₹50 lakh |
12) HDFC ERGO Maxima Health Insurance Plan
For family
Min. Age | Max. Age | Min. Coverage | Max. Coverage |
91 Days | 40 years | ₹ 3 Lakh | ₹ 3 Lakh |
13) HDFC ERGO my:Health Women Suraksha
For Women
Min. Age | Max. Age | Min. Coverage | Max. Coverage |
18 years | 65 Years | ₹ 1 Lakh | ₹ 1 crore |
14) HDFC ERGO my:Health Medisure Super Top Up
For super top-up
Min. Age | Max. Age | Min. Coverage | Max. Coverage |
91 Days | 65 years | ₹ 3 Lakh | ₹20 lakh |
15) HDFC ERGO Optima Restore Plan
For hospital cash
Min. Age | Max. Age | Min. Coverage | Max. Coverage |
91 Days | 65 years | ₹ 3 Lakh | ₹20 lakh |
16) HDFC ERGO Optima Senior Plan
For senior citizens
Min. Age | Max. Age | Min. Coverage | Max. Coverage |
61 years | No age limit | ₹2 lakh | ₹5 lakh |
17) HDFC ERGO Optima Super Plan
For Top up
Min. Age | Max. Age | Min. Coverage | Max. Coverage |
91 Days | 65 years | ₹ 5 Lakh | ₹ 10 Lakh |
18) HDFC ERGO EquiCover Health
For persons with disability
Min. Age | Max. Age | Min. Coverage | Max. Coverage |
1 Day | 75 years | ₹ 4 Lakh | ₹ 5 Lakh |
19) HDFC ERGO Hospital Cash Insurance Plan
For hospital cash
Min. Age | Max. Age | Min. Coverage | Max. Coverage |
91 Days | 65 years | ₹ 500 per day | ₹ 2500 per day |
20) HDFC ERGO my:Credit Comprehensive Suraksha Insurance
For persons with disability
Min. Age | Max. Age | Min. Coverage | Max. Coverage |
16 years | 65 years | ₹ 1 lakh | ₹ 5 crore |
21) HDFC ERGO Optima Cash Insurance Plan
For hospital cash
Min. Age | Max. Age | Min. Coverage | Max. Coverage |
91 Days | 65 years | ₹ 500 per day | ₹ 5000 per day |
22) HDFC ERGO my: Health Critical Suraksha Plus
For critical illness
Min. Age | Max. Age | Min. Coverage | Max. Coverage |
18 years | 65 years | ₹ 1 lakh | ₹ 5 Crore |
How to Buy HDFC Ergo Health Insurance?
To buy a policy, follow these steps:
- Go to the HDFC Ergo website or mobile app.
- Choose a plan that fits your needs.
- Enter your personal and medical information.
- Pick the amount of coverage you want.
- Pay the premium online to activate your policy.
How to Renew HDFC ERGO Health Insurance
You have to renew your policy to continue availing of the HDFC ERGO Health Suraksha benefits, including the cumulative bonus and any cover of pre-existing illnesses from your previous policy.
Step 1: Visit the official website of Policy Bazaar Insurance Brokers Private Limited.
Step 2: Click on ‘Renew Your Policy’ at the top of the page.
Step 3: From the dropdown menu, select ‘Health Renewal.’
Step 4: Enter your mobile number and the OTP to log in.
Step 5: If you are a first-time user, click on the ‘Health Insurance’ icon on the homepage and provide the requested details.
Step 6: Choose your HDFC ERGO health insurance renewal plan and pay the renewal premium online.
Step 7: The insurance company will renew your HDFC ERGO health insurance policy.
Also Read: Health Insurance Plans For Family | Health Insurance Plan for Single Female
HDFC ERGO Health Insurance Exclusion
Here are the important exclusions in the policy that you should know about.
- There is a 30-day waiting period before coverage starts.
- There is a 2-year waiting period for specific illnesses and treatments, such as internal tumours, cysts, or surgery on tonsils and sinuses.
- Pre-existing conditions are not covered until you have 48 months of continuous coverage.
- Claims related to war or acts of war are not covered.
- Any claims due to breaking the law with criminal intent are excluded.
- Claims for self-harm, attempted suicide, or suicide are not covered.
- Coverage does not include claims related to drug or alcohol use.
- Plastic or cosmetic surgery is not covered unless it is necessary for medical treatment.
- Preventive care, vaccinations, inoculations, and immunizations are not covered.
HDFC ERGO Health Insurance Claim Procedure
HDFC ERGO Health Insurance can be accessed at the official website, which provides details on the process of starting and tracking the claim process. You may file your claim or find out the procedure of filing it.
OR
HDFC ERGO can be contacted via WhatsApp at 8169500500.
OR
Contact HDFC ERGO’s toll-free helpline on 022 6234 6234 or 0120 6234 6234 for the registration of claims.
HDFC ERGO Health Insurance Claim Procedure Online
Step 1: Contact the claims support team about your hospitalization. Call 1800-258-5881 or
Step 2: Log in to your account and select ‘File a New Claim’ under the ‘Claims’ tab.
Step 3: Choose ‘Health Insurance’ and log in using your mobile number and OTP/password.
Step 4: Follow the instructions on the screen and click on ‘File a new claim.’
Document Required
To claim your HDFC ERGO health insurance, please submit the following documents:
-
- A completed claim form with your policy number.
- The original hospital discharge summary.
- The original final hospital bill, including a detailed breakdown of charges.
- Original pharmacy invoices backed by doctor’s prescriptions.
- Original payment receipts.
- Original investigation reports.
- The implant sticker or invoice.
- An FIR or Medico Legal Certificate (MLC) if it is an accident case.
- Documents for any past treatments.
- A legal heir certificate if the nominee is a minor.
- A cancelled cheque or an attested copy of your passbook.
- A KYC form and a copy of anyone KYC document for claims of ₹1 lakh or more.
HDFC Ergo Digital Initiatives
It avails easy electronic platforms where one manages the health cover. Among other relevant features :
- It can easily be bought or renewed anywhere around the globe.
- Manage your claims, download policy documents, and seek health assistance through our mobile app.
- Track your claim status with the latest updates.
Tax Benefits of HDFC Ergo Health Insurance
Health insurance premiums are eligible for tax deductions under Section 80D:
Category | Deduction Limit |
Self and family (below 60 years) | Up to ₹25,000 |
Senior citizens | Up to ₹50,000 |
Parents (above 60 years) | Additional ₹50,000 |
Final Word
HDFC Ergo health insurance offers diverse and customized health plans catering to various needs. It has a wide network and a strong digital support base, thus being a reliable partner in safeguarding health through consumer-focused policies.
FAQ’s For HDFC Ergo Health Insurance
Q: What is home healthcare cover?
Ans: Home healthcare care is one single cashless cover wherein the insurer is covered under home treatments. This may be treated when the treatment medical practitioner recommends them to be treated for numerous maladies, including chemotherapy and gastroenteritis, and even medication for hepatitis and fever right up to dengue and such other conditions.
Q: How can I claim benefits for Home Healthcare?
Ans: Once the diagnosis is made, give them the policy details, treatment plans, and the date for the first assessment. Call the Home Healthcare service provider and the treating physician whether the equipment is required and prepare a care plan along with the approximate cost incurred. Once the documentation is done, the insurance agency issues a letter of authorization for the amount approved or rejects the cashless request like in other cases of standard cashless hospitalizations.
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