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Health Insurance

A Health Insurance Plan helps you meet your medical expenses by offering financial assistance. It helps you keep your savings intact,which you could use in future to materialise your dreams instead pay for medical bills. It is a financial security and also a tax savings tool as it helps you save tax upto ₹ 75,000 annually.

Health Insurance and Its Role During COVID-19 Outbreak

Health insurance in this situation will be highly beneficial, as it will provide cover against expenses that you may incur in order to get the required treatment. There are numerous hospitalisation expenses involved for getting treatment in case you suffer from Coronavirus. While you focus on quick recovery, we take care of your medical expenses by covering diagnosis, consultation costs at the time of pre hospitalization and post hospitalization as well. We also offer coverage for day care treatments if your treatment gets done in less than 24 Hours. Choose HDFC ERGO, a brand that has brought smiles to 1 crore+ customers.

If you already have a health insurance plan with HDFC ERGO, we will cover hospitalisation expenses due to Coronavirus.

Click here know more about Coronavirus and Healthcare facilities Read More

Note: Every policy offered by HDFC ERGO comes with a waiting period of one month for making a claim against non accidental hospitalization. Please refer to your poliy wordings, brochure for a detailed list of inclusion and exclusion. The above information is for illustrative purpose.

Types of Health Insurance

A health insurance plan can be of several types and you can choose the best plan depending upon your requirements.

  • Indemnity/Base Health Insurance Plan A health insurance plan,which pays for your medical expenses related to hospitalisation on the basis of medical treatment expenses,is called as indemnity plan.This plan is also referred as base plan and is a must have.With HDFC ERGO,my:health Suraksha is the most recommended indemnity base plan.

  • Top–up Health Insurance What if you have multiple health insurance plans like a personal base plan or an employee health insurance plan and wish to just get additional sum insured at a low premium then a super top up plan.Our my:health Medisure Super-Top up is the right top up plan.

  • Lump sum benefit based Health Insurance Plan The medical treatment cost for life threatening diseases is way too much as one life threatening disease is enough to shatter your life long savings.Hence,a benefit based plan pays you for critical illnesses in one go so you don’t have to make claims every time you pay for medical expenses.Get a critical illness cover to protect huge medical expenses

What are the benefits of Health insurance?

  • Cashless Hospitalisation
  • Instant claim settlement
  • No room rent restriction
  • Sum insured rebound
  • Fitness Discount
  • Long Term policy discount
  • Save Tax upto ₹ 75,000
  • Cashless home health care
  • Instant Policy Issuance
  • 24x7 Customer Support

Health Insurance Plans

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Individual Health Insurance

Rising lifestyle diseases may hold you back from achieving life goals. It is wise to buy health insurance by HDFC ERGO, as it promises to cover medical expenses without restrictions.

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Family Health Insurance

Ensure quality health care for your dear ones without disturbing your savings. Our family health insurance plans, ensure all round health protection at an affordable premium.

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Parents Health Insurance

Undoubtedly, health issues are the biggest cause of financial stress in old age. Tackle health distress without any dent on your savings with our Health Insurance Plans for Parents.

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Senior Citizens Health Insurance

We offer health insurance Plans that ensure no entry-age restrictions and lifetime renewability designed specially for benefitting Senior Citizens.

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my:health Women Suraksha

Designed specifically for woman who is looking to secure her future medical expenses with an all-round comprehensive plan. This medical insurance plan aims at covering women-specific surgeries and major illnesses.

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Critical Illness Insurance

Critical Illness treatment may lead to financial crunch. With our critical illness health Insurance get lump-sum benefit on diagnosis, which helps you go a long way in dealing with financial distress.

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my:Health Medisure Super Top up

To ensure you never fall short of health coverage. Choose this health insurance and get a higher coverage of 20 lacs at an affordable premium

What is covered in health insurance policy?

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Sum Insured Rebound

For my:health Suraksha Health Insurance an additional sum insured equivalent to the admissible claim amount upto a maximum of the basic sum insured.

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Day Care Procedures

Your hospitalization lasted for just a day that doesn’t mean it remains excluded. We cover 586 day care procedures in this health insurance plan.

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Pre-hospitalisation Cover

Before hospitalisation, there are expenses towards doctor consultations, check-ups and prescriptions. We provide full coverage of such expenses 60 days prior to hospitalisation with HDFC ERGO Health Insurance.

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Post-hospitalisation Cover

This health insurance plan offers full coverage of expenses incurred on doctor consultations, rehabilitation charges etc. till 180 days after discharge from hospital.

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Mental Healthcare

If any of the insured member suffers from mental illness, the expenses for hospitalization gets covered in this health insurance plan.

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Home Healthcare

If your doctor recommends treatment at home, you can avail the services right at your home that too with ^^^cashless facility. Get this health insurance now.

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Hospitalisation Expenses

Everything from bed-charges, nursing charges, blood tests, ICU and consultation fees gets covered effortlessly with this health insurance.

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Road Ambulance Cover

This health insurance plan covers expenses for transfer from hospital to home in an ambulance (within the same city) is also covered if the insured encounters life-threatening medical emergency.

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Organ Donor Expenses

For a noble deed as organ donation, HDFC ERGO Health Insurance cover the organ harvesting expenses incurred to the donor in case the insured has to undergo organ transplant.

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Alternative Treatments (Non-Allopathic)

We support the healing powers of Ayurveda, Unnani, Sidha and Homeopathy treatment. No matter what type of treatment you prefer, we are always there for you in the time of need. Get this health insurance now.

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Recovery Benefit

This health insurance plan offers a lump sum amount of Rs.5000 as recovery benefit if hospitalization exceeds 10 continuous days so that taking care of household expenses doesn’t stress you out.

What is not included in Health Insurance Policy?

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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.

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Self-inflicted injuries

You might think of causing injury to your precious self, but we don’t want you to hurt yourself. Our health insurance plan does not cover self-imposed injuries.

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War

War can be disastrous and unfortunate. However, our health insurance plan does not cover any claim that are caused due to wars.

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Participation in defense operations

Our health insurance plan does not cover accidents while you are participating in defense (Army/Navy/Air Force) operations.

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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.

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Treatment of Obesity or Cosmetic Surgery

Treatment of obesity or cosmetic surgery is not eligible for coverage under your health insurance plan .

For detailed inclusion and exclusion of health insurance plan please refer the sales brochure/policy wordings

Save Tax with Health Insurance

Tax deduction based on medical insurance premium paid

Under Section 80D, you can get a deduction of up to Rs. 25,000 per budgetary year for medical insurance premium. The premium paid for a health insurance plan can be for you, your spouse, and dependent children. If you or your spouse is a senior citizen, then this limit can go up to Rs. 50,000.


Deduction on preventive health check-ups

You can also claim tax benefits on preventive health check-ups annually under the Section 80D of Income Tax Act. You can claim up to INR 5,000 every budgetary year as expenses incurred for preventive health check-ups.


Deduction on medical insurance premium payment for parents

If you are paying medical insurance premium for guardians then you can also claim an additional deduction of up to INR 25,000 every budgetary year. If your parents or either of them is a senior citizen, then this limit can go up to INR 30,000.


6 Reasons to buy Health Insurance

  • 1. Lifestyle Diseases: Stress, pollution, unhealthy eating habits, gadget addiction and undisciplined lives have made lifestyle diseases widespread. It’s important to buy a health insurance plan to tackle medical expenses rising due to lifestyle issues.

  • 2. Inadequate insurance: Do you think you are securely covered under one insurance policy against all threats? Be informed that your employee health cover may prove insufficient. These days medical science has advanced hence it’s important to get higher sum insured health plans.

  • 3. Beat medical inflation: The cost of medical treatment in India is always on the rise. Funding medical expenses on your own will lead to financial loss hence it’s important to buy a health insurance plan to beat the medical inflation.

  • 4. Big Savings: Avail discounts on paying for 2/3 years policy tenure, also buying insurance policy for more than 2 family members on individual sum insured basis can fetch you more discounts. Be a smart insured and keep looking for long term discounts and save your premiums.

  • 5. Early Decision: Getting insurance early has innumerable benefits right from lower premiums to wider coverage options. With less probability of having existing health conditions, you get the benefit of lower premium while buying a policy.

  • 6. Tax Savings: Insurance is a tax saving instrument. Enjoy upto ^^Rs.75, 000 Tax savings annually under section 80D with health insurance plans. Isn’t it amazing? You can save tax and secure your health too.

Know what the Expert Speaks about our Health Insurance Plans

Diwaker Asthana| Health Insurance Expert
Diwaker Asthana, Head of Underwriting & Claims for Health & Accident Insurance
"Recommends buying my:health Suraksha Insurance to get the benefit of a wide range of coverage that the plan offers. For some unique benefits like cashless home health care and in-patient treatment for mental illness, he believes this plan will benefit customers in the long run".

Are you covered enough?

Scenario 1: My employer is taking care of my health insurance I don’t need one

Most of us consider employee health insurance as a secured cover for taking care of medical expenses. But, let us tell you that employer health insurance isn’t the right solution. Once you leave the company or switch jobs you lose your health insurance benefits. Also, you don’t have the flexibility to change covers and increase or decrease sum insured. Relying on employee health insurance for a long time may lead to washing off waiting periods.

Scenario 2: Staying unaware

Most of us don’t realize the importance of health insurance until something fatal hits us or people around us. Lack of awareness may hamper your savings, if an unexpected medical expense comes up.

Scenario 3: Low Sum Insured

It’s important to understand that you need a higher sum insured if you reside in a metro city where medical treatment expenses are high. If a single hospitalization in a year is enough to exhaust your sum insured then you should consider a higher sum insured. Just buy a health insurance won’t help in the longer run getting a sum insured that’s enough to cover your medical expenses is equally important. Also, if you are covering more family members then consider taking a health insurance policy with sum insured above 10 lacs.

Scenario 4: Looking at premium budget over the coverage

Don’t just look at the premium and go back thinking if you should buy this health insurance plan. Looking at the list of coverage and benefits of buying a health insurance plan is important and should not be overlooked. If you think of buying a health insurance plan with low premium then there are high chances that you may lose out on coverage. In future, you may feel that certain coverage is important but your policy doesn’t cover it. For example: HDFC ERGO Health Insurance offers cashless in-home health care, no room rent restrictions on hospitalization and approves cashless claims within 20 minutes seamlessly.

Scenario 5: It’s not just a Tax saving tool

Many of us buy health insurance just to save tax under section 80 D. A health insurance plan helps you save tax upto Rupees 65,000. However, there’s lot more to beyond saving taxes. Get yourself a health insurance plan that helps you during critical times and helps in saving finances in the long run. You must also get a health insurance plan for your parents, spouse and kids to ensure complete financial security.

How to choose a right health insurance plan?

Every time you look for a health insurance plan the thought that hits your mind is what is an ideal health insurance plan like? What all coverage should it have? Let’s decode the hacks to get the right health insurance plan.

1. Get yourself adequate sum insured: If you are residing in the metro cities then cost of treatment is high hence for an individual your sum insured should ideally range between 7 lacs to 10 lacs. If you are looking for a family cover to insure your spouse and kids a sum insured that ranges between 8 lacs to 15 lacs suits best on floater basis. It should be adequate enough to cover more than one hospitalisation that may happen in a year.

2. Look for co-payment to reduce premium: If you wish to reduce your premium and you are fine with making partial payments for your medical expenses then look for a health insurance plan with co payment facility. You share the medical expenses with your health insurer hence you don’t have to pay a heavy premium.

3. Look for in-home health care: What if you are unable to get a bed at the hospital or your parents aren’t comfortable seeking medical attention at the hospital? Under such circumstances you can easily get treatment done at home without much hassles. HDFC ERGO offers cashless health insurance for in-home health care.

4. No sub-limits help: Usually your medical expenses depend upon your room type. It’s recommended to buy a health insurance plan that does not have sub limits. Just like my:health Suraksha Insurance it does not imply any room rent restrictions or sub limits.

5. Check waiting periods: Your health insurance plan doesn’t come into action while your waiting period is not completed. Always check health insurance policies with lower waiting periods for pre existing ailments and maternity benefit.These are the most important covers to look for before buying a health insurance plan. Other than most important coverage there are a few more benefits that need to be looked upon before choosing a health insurance for yourself, your family and parents.

Know the Top 7 Factors that decide your premium

1. Age: Undeniably, age is the most prominent factor that fixes up your premium. It’s highly recommended to buy a health insurance policy while you are young, because premium rises with age. At a younger age you are less likely to have pre existing diseases due to which your premium is low as compared to higher age groups. It’s highly recommended to buy health insurance at an early age.

2. Pre existing illnesses: Any health condition or ailment that you are already suffering before getting a health insurance policy is termed as pre existing illness. If you are a diabetic or suffering from hypertension there is a chance that your premium will raise. Buying health insurance plan early when you are hale and hearty will help you skip high premiums due to pre existing ailments.

3. Family History: This could be a factor that affects your premium calculation, if your family has a diabetes history there are higher chances you too may acquire it at some point of time in life. Due to which insurance premium may be charges high to such individuals.

4. Location of stay: If you reside in a metro city then there are chances that your premium may go on a higher side as the cost of treatment is high in developed cities as compared to tier 2 or 3 cities. Hence premium for someone who stays in Delhi will be high as compared to someone who stays in Nagpur.

5. Members covered: Your health insurance premium will be low if you choose to cover yourself as compared to a family floater policy wherein you cover your spouse and kids. Even under family health insurance you can choose to have individual sum insured for every family member or get them all over one sum insured in a floater plan. Sharing the sum insured under one floater plan will incur low premium than getting individual sum insured for all.

6. BMI or Body Mass Index: If your weight isn’t proportionately balanced with your height leading to obesity then there are chances that you may have to pay higher health insurance premiums. People with higher BMI are prone to joint paints, hypertension, high blood pressure and various other ailments due to which they fall under high risk category. Insurance premium is generally high for high health risk individuals.

7. Smoking Habits: If you are a chain smoker then there are chances that your insurance premium may burn your pocket as insurance company may consider you as a high risk individual. Your smoking habit may affect your lungs in the long run leading to respiratory ailments. Other habits like chewing tobacco or high consumption of liquor may also affect your body and may also cause cancer; hence your premium may shoot up.

How to Make a Claim for your Health Insurance Plan?

To register a claim for your health insurance plan there are several steps to be followed. Health Insurance claim process works differently for reimbursement claim requests and cashless claims. Read the below process to understand how HDFC ERGO settles health insurance plan claims.

Health Insurance Cashless Claims get approved within 20** minutes
Hospitalization

Policy Holder Needs to find the nearest cashless hospital

Locate your nearest cashless hospital

Collect form from Hospital, Fill and Submit at the Hospital

Collect the cashless form from hospital and fill it duly

Submit it with necessary documents along with your Photo ID and health insurance card

Pre-authorization

On receiving the documents our internal claims team approves/rejects the claim depending upon the documents, course of treatment and coverage.

Claim Settlement

On approval you can undergo medical treatment without paying anything to the hospital.

On discharge HDFC ERGO will check the documents and discharge summary and settle the claim with the hospital directly.

Status Update

At each and every stage you can track your claim status and we shall keep informing you about your claim request


Health Insurance Reimbursement Claims get reimbursed within 3** days

Hospitalization

Once you are hospitalised at a non-network hospital intimate HDFC ERGO about your hospitalisation

Post Discharge

Collect all documents from the hospital and send it to HDFC ERGO General Insurance Company Ltd 5th Floor, Tower 1, Stellar IT Park, C-25,
Sector-62,Noida 201301 State : Uttar Pradesh , City : Noida Pin Code : 201301.

Document Scrutiny and approval

We will check the documents and approve/reject the claim

Settlement

If your claim is approved your claim amount shall be reimbursed via NEFT.

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Frequently Asked Questions on Health Insurance

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
Having a health insurance policy covers expenses incurred due to hospitalization. This includes in-patient treatments, pre and post hospitalization charges, day care procedures, domiciliary treatments, etc.
All HDFC ERGO Health Insurance Plans are available online for purchase via various online payment options. Simply take our online journey for the product that suits you best & apply with just a few clicks.
You need to fill a health declaration and an endorsement form and the new member will be added to your existing family floater health insurance at an additional amount.
Yes, if needed you can change the hospital during the treatment. However, you might need to provide necessary information for a smooth claim process of your health insurance plan.
You cannot take an independent health insurance policy for a 3 year old. Children below 5 years are covered only when both the parents are covered under the health insurance policy
In certain conditions you might be eligible for reimbursement of overseas treatment, such as pre-diagnosed planned hospitalization, outpatient treatment, and second opinion in case of sudden illness while travelling under your health insurance plan.
Most pre hospitalization and post hospitalization expenses (up to 60 days) are  covered under the health insurance policy, such as X - rays, CT scan, MRI, ultrasound nursing, physicians, medicines , other diagnostic needs. After successful completion of 4 claim-free year, you are eligible for free health check-up as well. This is subject to no medical adversities.
Most insurance health insurance plans have a 15 day cooling off period called as free-look period during which you can cancel your policy. However, in case you wish to cancel the health insurance policy mid-term then you need to provide a suitable reason for cancellation. Premium refund is subject to nil claims & as per the refund chart mentioned in the health insurance policy wordings.
In case of the death of primary insurer in a health insurance policy, the other adult person may continue with the policy and the sum insured will remain the same.
You can change your health insurance policy details online through our website hdfcergo.com. Visit the 'HELP' section on the website and place a request. To place request or explore services, click here

Common Insurance Terminologies used in Health Insurance Plan

We often come across terminologies while reading features & benefits offered by health insurance companies. Below are the 10 most commonly used jargons while explaning the coverage & exclusion of a health insurance plan. Let's demystify them to understand better.

Cumulative Bonus

Your health insurance company rewards you for staying hale and hearty! Every year you get cumulative bonus in the form of increased sum insured for not making any claims. We at HDFC ERGO offer cumulative bonus of upto 200%.

AYUSH Benefit

This terminology is an acronym for Ayurveda, Unani, Siddha and Homeopathy; It refers to treatments or therapies that you can take other than the usual allopathic course of treatment. If you believe in the healing powers of non allopathic treatment, we cover your hospitalization expenses seamlessly under our health insurance plan.

Co-payment

The fixed amount or % paid by the insured ( the one who is covered) for the medical treatment. If your co-payment percentage is 20% then in case of hospitalization you are suppose to bear 20% of the expense and remaining shall be paid by your insurer.

Endorsement

The process of making changes in your policy document such as change in name, adding or removing members and increasing sum insured etc is a part of endorsement.

Pre-existing disease

If you are suffering from any ailment at the time of buying a policy is termed as pre existing illness or disease. It’s important to declare pre existing disease at the time of policy issuance or else at the time of claim; if the insurer knows about your existing illness your claim may get denied.

Free Look Period

Health Insurance Company gives you a chance to cancel your policy post payment if you have found a better plan and wish to take a different plan. This period is called free-look period.

Waiting Period

In simpler terms, waiting period is the duration when an insured must wait to get coverage for some disease or treatments. The insured may not receive benefits for claims filed during the waiting period. For example, there are waiting periods for pre existing disease and maternity treatment in a health insurance plan.

Sum Insured Rebound

Get additional sum insured equal to your actual sum insured in case your sum insured gets exhausted.

No Sub-limits

Health insurance companies add sub limits on diseases, hospital room rent and coverage, which means after a certain limit you do not get the benefits. However, with HDFC ERGO my:health Suraksha there is no sub limit on room rents or diseases.

ADD on covers or Riders

To enhance your health insurance policy you can choose to get additional covers or riders to stay extra safe. There are several add ons like critical illness cover or hospital daily cash etc.

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