Health care is always accessible at the time of need
Stay worry-free from unforeseen
hospitalisation expenses
with Optima Secure’s 4X
Health Coverage°°
Quick Quote for Health Insurance.
Why Choose HDFC ERGO Health Insurance
13,000+ Cashless
Hospitals Networkˇ
₹12000+ Crores
Claims Settled ̑
1 Claim Settled
Per Minute^^
Covers Coronavirus
Hospitalization
No Health Check-up
up to age of 45 years~^
1.6 Crore+
Happy Customers@
Compare our Best Health Insurance Plans
- Just launched
Optima Secure
Optima Restore
Optima Secure Global
my:health Medisure Super Top-up
Optima Secure
4X Coverage°°
Wider Pre & Post Hospitalisation"
Free preventive health-check ups
Key Features
- Secure Benefit: Get 2X coverage from Day 1<
- Plus Benefit: 100% increase in coverage after 2 years
- Restore Benefit: 100% restores your base coverage
- Protect Benefit: Zero deductions on listed non-medical expenses'*
Optima Restore
Nearly 13,000+ Cashless Hospitals Networkˇ
1 claim processed every minute^^
Free preventive health-check ups
Key Features
- 100% Restored Benefit: Get 100% of your cover restored instantly after your first claim
- 2X Multiplier Benefit: Get up to 100% additional policy cover as no claim bonus
- Complete coverage 60 days prior & 180 days post your hospitalization. This ensures better planning of your hospitalization needs
So Much Trust
Expanded Coverage
Policy Options
Tenure
Key Features
- Coverage: Choose between wide range of base cover from ₹5 lacs to 2 crores
- Policy Options: You can buy individual and family floater options
- Tenure: Select policy tenure between 1, 2 and 3 years
my:health Medisure Super Top-up
Higher cover at low premium
Compliments existing health insurance
No premium hike post 61 years
Key Features
- Works on Aggregate Deductible: This health plan comes into action once your all-round total claim amount reaches the aggregate deductible in a year, it’s not necessary for a single claim to meet the deductible unlike other top-up plans.
- No health checkups up to Age 55 years: It’s better to be safe than sorry! Secure your health when you are young to avoid medical tests.
- Payless, Get more: Opt for a long-term policy of 2 years and get a 5% discount.
3 Types of Health Insurance Plans you should know about
1
Indemnity Health Insurance Plan
This type of health insurance plan pays for your actual medical expenses on both cashless as well as reimbursement basis upto the sum insured. This is the most basic health insurance plan that everyone must-have. Optima Restore is one of the most recommended Indemnity health insurance plans offered by HDFC ERGO.
Just launched
Optima Secure
4X Health Cover at No Additional Cost- Sum Insured from 5 lacs -2 Cr lakhs
- Multiple Discount Options Save up to 50% on premium with our various discount options.
- Protect Benefit Zero deductions on listed non-medical expenses'*
Optima Secure Global
Global Health Cover- Expanded Coverage: Choose between wide range of base cover from ₹5 lacs to ₹2 Crores
- Policy Options: You can buy individual and family floater options
- Policy Tenure: Select policy tenure between 1, 2 and 3 years.
Optima Restore
Recommended for small families- Sum Insured from 5-50 lakhs
- Restore Benefit Get instant addition of 100% basic sum insured to your cover on your very first claim.
- Multiplier Benefit Doubles your sum insured in two consecutive claim-free years.
my:health Koti Suraksha
Big Coverage @ Small Prices- 50 lacs & 1 crore sum insured available
- No room rent capping up to private AC room
- Unlimited day-care procedures
2
Top-up Health Insurance Plan
As the name goes, a top-up health insurance plan acts as an enhancement to your existing health insurance. If you already have health insurance or a corporate health cover and wish to get a wider cover at a low premium then a top-up plan works best. At HDFC ERGO, we have gone a step ahead to offer you a Super-top up plan that strengthens your existing health cover. It offers extremely high coverage at low premiums.
my:health Medisure Super Top-higher
health cover at pocket-friendly premiums- No health checkups up to Age 55
- Constant premiums from Age 61
- Payless, Get more
- Offers pre-post hospitalisation expenses
- Works on aggregate deductible
- Covers day care procedures
3
Fixed benefit Health Insurance Plan
While indemnity based health insurance and top up plans pay for medical bills on an actual basis, a lump sum benefit based health insurance plan pays you in one go or lump sum. It's beneficial for meeting endless medical expenses arising out of critical ailments such as Stroke, Cancer, Paralysis, Multiple Sclerosis, etc.
Critical Illness Insurance
- Up to 15 Critical Illnesses covered
- Lump-Sum payment in a single transaction
- 2 Plans available
- Option to buy for 1 & 2 Years
iCan Cancer Insurance
- All types of Cancers Covered
- Cashless Cancer Treatment
- 60% Sum insured is available for lump sum payout
- Avail 100% of SI for cancer treatment
Understand Coverage Offered by Our Health Insurance Policies
Hospitalization Expenses
Just like every other health insurance plan, we also cover your hospitalization expenses such as room rent, ICU, investigations, surgery, doctor consultations etc due to illnesses and injuries seamlessly.
Mental Healthcare
We believe mental healthcare is just as important as hospitalization due to physical illness or injury; hence, we cover hospitalization expenses incurred for treating mental illnesses.
Pre & Post Hospitalisation"
It means all your pre hospitalization expenses up to 60 days before the date of admission and post-hospitalization expenses up to 180 days after discharge from the hospital are covered.
Day Care Treatments
Medical advancements help in wrapping up important surgeries and treatments in less than 24 hours, and guess what? We cover you for that as well.
Home Healthcare#
Cashless Home Healthcare for medically necessary treatment of Illnesses, if prescribed by treating medical practitioner.
Sum Insured Rebound
This benefit adds to the Sum Insured, an amount equivalent to the claim amount, up to basic sum Insured, on subsequent Hospitalization.
Organ Donor Expenses
Organ donation is a noble cause and we cover the medical and surgical expenses of the organ donor while harvesting a major organ from the donor’s body.
Recovery Benefit
If you stay in a hospital for more than 10 days at a stretch, then we pay for other financial losses. It helps to take care of other expenses during your hospitalization.
AYUSH Benefits
Let your belief in alternate therapies like Ayurveda, Unani, Siddha, and Homeopathy stay intact as we cover hospitalization expenses for AYUSH treatment as well.
Preventive Health Check-up
We care for your well-being and hence we offer preventive health check-up at renewal.
Lifelong Renewability
Once you get yourself secured with, our health insurance plan there is no looking back. Our health plan continues to secure your medical expenses for your entire lifetime on break free renewals.
Multiplier Benefit
If there is no claim in the first year, in the next policy year, the sum insured will grow by 50%. It means, instead of ₹ 5 Lakh, your sum insured would now stand at ₹ 7.5 Lakh for the second year.
The above mentioned coverage may not be available in some of our Health plans. Please read the policy wordings, brochure and prospectus to know more about our health insurance plans.
Adventure Sport Injuries
Adventures can give you an adrenaline rush, but when coupled with accidents, it can be hazardous. Our health insurance plan does not cover accidents encountered while participating in adventure sports.
Self-inflicted Injuries
If you ever end up causing injury to your precious self, then unfortunately our health insurance plan will not cover for self imposed injuries.
War
War can be disastrous and unfortunate. However, our health insurance plan does not cover any claim that is caused due to wars.
Participation in Defence Operations
Our health insurance plan does not cover accidental injury while you are participating in defence (Army/Navy/Air Force) operations.
Venereal or Sexually Transmitted Diseases
We do understand the criticality of your disease. However, our health insurance plan does not cover venereal or sexually transmitted diseases.
Treatment of Obesity or Cosmetic Surgery
Treatment of obesity or cosmetic surgery is not eligible for coverage under your health insurance plan.
How to Make a Claim for your HDFC ERGO Health Insurance
The sole purpose of buying a health insurance plan is to get financial support at the time of medical emergency. Hence, it is important to read the below steps to know how Health Insurance claims process works differently for cashless claimsand reimbursement claim requests.
1 claim processed every minute^^
Intimation
Fill up the pre-auth form at the network hospital for cashless approval
Approval/Rejection
Once hospital intimates us, we send you the status update
Hospitalisation
Hospitalisation can be done on the basis of pre-auth approval
Claim settlement
At the time of discharge, we settle the claim directly with hospital
1 claim processed every minute^^
Hospitalisation
You need to pay the bills initially and preserve the original invoices
Register a claim
Post hospital discharge send us all your invoices and treatment documents
Verification
We verify your claim related invoices and treatment documents
"Claim Settlement
We send the approved claim amount to your bank account.
Frequently Asked Questions on Health Insurance
1. I’m covered under my employer's group policy, do I need a seperate health insurance policy?
Yes. You do need a personal health insurance plan as your employee health insurance covers medical expenses only till the time your employment in valid in the organization the moment you leave the job your policy term ends. Looking at the medical inflation it is important to have a personal health insurance plan, which you choose as per your medical needs unlike a corporate health plan which is commonly designed for all employees.
2. What are the benefits of the health insurance portability for the policy holders?
Portability helps you change your health insurance plan so that you don't have to again go through a fresh waiting period term instead smoothly move from one insurer to another if your current plan is not helping you cover rising medical costs.
3. What do you mean by pre-existing disease?
A pre-existing disease is a condition, ailment or injury that already exists at the time you buy a health insurance policy and these PEDs are generally excluded from the policy coverage for an initial waiting period. It could be diabetes, hypertension, thyroid, asthma etc
4. In a health insurance policy, what does cashless hospitalisation means?
Cashless hospitalization is a process wherein the insured person doesn't have to pay a medical expenses out of his pocket in case of a hospitalization or surgery and the entire . However, you may have to pay certain deductibles or non medical expenses at the time of discharge.
5. What are pre-and post-hospitalisation expenses?
Whenever you plan have a surgery there are certain pre hospitalization expenses such as diagnosis cost, consultations etc similarly post discharge there could be similar expenses to monitor the health of the insured patient, such expenses are termed as pre and post hospitalization expenses.
6. Do I have to undergo any medical examination before buying a health insurance ?
Yes, you may have to undergo medical tests before buying a health insurance. Also, some health insurance policies ask for it only if you have a pre existing illness or you are above 40 years old.
7. How can I add my family members to my existing policy?
You can add your family members at the time of buying the policy or at the time of renewal.
8. At what age can I include my children in the plan?
You can include your child post 90 days of birth up to 21 years.
9. What is the benefit of buying health insurance at a young age?
You get to pay a lower premium and higher benefits. Probability of having a pre-existing illness is low hence waiting periods may also not impact you. Also, common illnesses such as flu and accidental injury can happen at any age so staying covered even when you are young is important.
10. Can a person have more than one health insurance policy?
Yes. You can always have more than one health insurance plan based on necessity and coverage requirements as every plan works differently and offer varied benefits.
11. What do you mean by waiting period in health insurance plans?
Waiting period is the time span during which you cannot register a claim to avail some or all benefits of the health insurance from your insurance provider for a specified illness. This means you must wait for a specified amount of time before you make a claim.
12. What is a ‘free look period’?
During this free look period, you have the option of canceling your policy without penalty if you feel your policy is not beneficial. Depending on the insurance company and the plan offered, the free look period can be 10-15 days or even longer.
13. What do you mean by network/non-network hospitalization?
Network hospitals often referred as cashless hospitals are tied up with your insurance company due to which you can avail cashless hospitalization benefit, however whenever you get admitted at a non-network hospital you have to pay the bills first and later claim for reimbursement. Always choose a health insurance company which has a large network hospital tie-up like HDFC ERGO has nearly 10,000 cashless hospital network.
14. What is "domiciliary hospitalization"?
When the Insured Person is in such a state that he/she cannot be moved to a hospital or the treatment is taken at home due to non-availability of room in the hospital is termed as Domiciliary Hospitalization.
15. What are the benefits under basic hospitalisation?
In case of a hospitalization cover we cover expenses like pre and post hospitalization expenses for your diagnostic tests, consultations and medicine costs. We also cover ICU, Bed charges, medicine cost, nursing charges and Operation theatre expenses widely.
16. What is the right age to buy health insurance policy?
You can buy a health insurance plan for yourself once you are 18 years old before that you can get yourself covered under family health insurance plan.
17. Can a minor buy health insurance?
No. Health insurance cannot be bought individually by a minor, however the parents can cover the child under their family floater health insurance.
18. What to do if I am admitted in a non-network hospital?
Whenever you get admitted at a non-network hospital you have to pay the bills first and later claim for reimbursement. Always choose a health insurance company which has a large network hospital tie-up like HDFC ERGO has 10,000+ cashless hospital network.
1. Do health insurance plans cover diagnostic charges like X-ray, MRI or ultrasound?
Yes. Health insurance plans are designed keeping in mind the modern medical requirements. Hence, we cover diagnostic expenses incurred on X-ray, MRI, ultrasound, blood investigations etc.
2. Does my policy covers diagnostic charges?
All HDFC ERGO health insurance plans cover diagnostic charges during hospitalization, pre-hospitalization and post discharge as well.
3. Will I get covered for my pre-existing illnesses?
Yes. Once your specified waiting period is over you will get coverage for your pre-existing illnesses.
4. How can I know if my family is coverd in my helath insurance policy?
You need to check your policy document and enroll your family members by mentioning their name and age to get them covered.
5. When we buy a health insurance policy from your website, will we get a cashless card?
Buying a health insurance plan online is no different than receiving a policy copy physically, in fact buying online is quick and hassle-free. You do get your cashless card via courier/postal services. To know about cashless hospitals you can visit our website or call us. We have a huge network of nearly 10,000 cashless network hospitals.
6. What are the expenses covered under hospitalisation expenses?
We cover medically necessary expenses such as blood investigations, diagnostic charges such as CT scan, MRI, sonography etc. You also get covered for hospital room rent, bed charges, nursing charges, medicines and doctor visits.
7. Do health insurance covers robotic surgery & modern treatments?
Yes, Most of the health insurance policies offered by HDFC ERGO do cover modern treatments and robotic surgeries.
1. Can the nominee be changed in the mid-term of the policy?
Yes. You can raise an endorsement request and ask for change in nominee.
2. What happens when policy lapses during hospitalization?
You do not have to worry if your policy has got lapsed during hospitalization as you get a grace period of 30 days post expiry, however if you do not renew your policy within the grace period and hospitalization happens post grace period then you policy lapses and you will have to pay for the medical expenses.
3. If I increase my sum insured at the time of renewal, does a waiting period apply?
Waiting periods are applied right at the inception of the policy it doesn't really change with renewal. However, with every renewal you tend to waive off waiting period until you reach a time when you have no waiting period and your policy covers you for most of the treatments.
4. I am a foreign citizen?Can I take a health policy for my child who is continuing further studies in India?
Yes. You can only if your child is an Indian citizen. Or else you may have to get a travel insurance for students.
5. How does smoking affect health insurance premiums?
Smokers are exposed to higher risks! If you smoke there are chances that you may develop some or the other ailment at later life stage due to which you may claim. Hence, insurance companies looks at such insured as high risk and the premium is a bit high for such individuals.
6. What is cumulative bonus in a health insurance policy?
Cumulative Bonus as the name goes is the bonus/ reward that one gets for remaining fit and not filing a claim. The benefit of cumulative bonus is granted in the year of renewal by making an increase in the sum insured amount, only up to a certain year for every claim-free year. This helps you avail higher sum insured without paying extra.
7. What are the discounts available in HDFC ERGO health policy?
With HDFC ERGO, you get family discount if you cover 2 or more family members under a single health plan on individual sum insured basis. You can also avail long term policy discount on buying a health insurance for more than 2-3 years. We also offer fitness discount on renewals.
8. Can my friend buy a health insurance policy if he/she is not an indian National but living in India?
Ideally No. Health insurance plans in India is offered to Indian citizens only.
9. Can I cancel my health insurance?If yes will I get my premium back?
If you cancel your health insurance plan within the free look period you will get your premium back post that you wont.
1. Does every network hospital provide a cashless facility?
Yes. Network hospitals have a pre-agreed tie-up with your insurance company hence every network hospital offer cashless facility.
2. What is the maximum number of claims allowed over a year?
There's no limit on number of claims. If your sum insured gets exhausted then you may not be able to raise claims. We recommend buying our Optima restore health insurance plan or my:health suraksha as both of these plan help you by offering coverage post sum insured gets exhausted by restoring the lost sum insured. This helps you register more claims.
3. Can a request for authorization for cashless claim be rejected/ repudiated?
Yes. There is a possibility that your pre-authorization request for cashless claim may get rejected if you have filed a claim for an ailment/disease which is either permanently excludes, falls in waiting period or if your sum insured has exhausted.
4. Does a claim have to be lodged or made in a specific time frame from the time of the accident?
For reimbursement claims you need to intimate the insurance company within a period of 30 days post discharge.
5. What is a claim settlement ratio?
The claim settlement ratio (CSR) reveals the percentage of claims the insurer has paid out during a financial year. In simple words, it helps you know if your insurer has a strong financial capability to pay for claims.
6. What happens to the policy after the claim is filed?
Your policy continues as is only the amount you claimed for gets deducted from your sum insured. However, post renewal your sum insured again gets back to what you had opted for at the time of renewal.
7. Does a higher cover provide privileged treatment in case of hospitalisation and claim?
Not really, however having a high cover health insurance like Koti Suraksha by HDFC ERGO ( 1 crore health plan) helps you tackle all the possible medical expenses. You don't have to worry about rising medical expenses.
8. How do I claim health insurance?
You can raise either a cashless claim request by contacting the insurance department at the network hospital or inform your insurer post discharge about the hospitalization and send invoices to avail reimbursement benefits.
9. How long do you have to file medical insurance claims?
You need to intimate your insurer/raise a claim request as soon as possible maximum time is 30 days post discharge.
10. What is medical claim process?
Mediclaim process is the modern day reimbursement process, wherein you raise a claim post discharge by submitting original invoices and treatment documents.
11. Is there any waiting period for claims under a policy?
Yes. There are waiting periods depending upon the policy. Usually there is a waiting period for specific ailment/diseases which could be for 2-4 years.
1. How do I renew my mediclaim policy?
With the development in technology, treatments and the availability of more effective medicines the cost of healthcare has steeply increased. All this increase ends up being a burden for the consumers, making healthcare unaffordable for many. This is where HDFC ERGO’s health insurance policies come into play, as they take care of the hospitalization and treatment charges, leaving the consumer free of financial woes. Get yourself a health insurance plan now.
2. Is my health insurance policy transferable without losing renewal benefits?
You can renew health insurance policies within a few minute. Click here to renew instantly.
3. If I increase my sum insured at the time of renewal, does a waiting period apply?
Yes. You can port your health insurance policy with any other insurer without impacting your waiting periods.
4. Do I get a discount on the renewal of the policy with the same health insurance policy?
Waiting period is fixed at the inception of the policy it is not dependant on the sum insured. Hence, even if you increase your sum insured your waiting period continues until you keep renewing to get away with the waiting period term.
5. If my policy is not renewed in time before expiry date, will it be denied for renewal?
Yes. If you have not made claims then you get a cumulative bonus, which is increase in sum insured without paying for the same. You can also get fitness discount if your health parameters such as BMI, diabetes, Blood pressure is improved.
6. Is it possible to modify my add-on cover while renewing health insurance policy?
Possibly yes. If you have not renewed your policy within the grace period then there are high chances that your policy may lapse.
7. Is there a grace period for renewal?
Yes. You can add or remove optional/add on cover at the time of renewal. This is not permitted during the policy tenure.
8. How long does online renewal of a health insurance policy take?
It takes less than 5 minutes to renew HDFC ERGO health insurance policy online.
9. What to do if health insurance policy renewal date is Missed?
You usually get a grace period of 30 days to renew so you can renew within the grace period, however if your grace period is also over then your policy lapses and you need to contact your insurer for renewing expired health insurance plan.