With the HDFC ERGO Health Suraksha health insurance plan, you get access to a network of more than 5000+ hospitals in the country for availing cashless hospitalization and health care facilities. Health Suraksha offers a policy period of 1 year and 2 years with basic sum insured per year ranging from Rs 3 to 10 lacs. It covers in-patient treatments, pre-hospitalization expenses, 144 day-care procedures, domiciliary treatments and many such expenses incurred during treatment. Also, a pre-policy check is required only if the individual is above 45 years in age.
In addition to these, HDFC ERGO Health insurance offers the benefit of Cumulative Bonus on completion of every claim-free year and reimbursement on health check-ups after completing 4 years of cash-less service. And along with that, you can avail benefits on Income Tax. Plus, enjoy a hassle free claim procedure post hospitalization. With Health Suraksha, be rest assured of no sub-limits on the hospital room rents, hospital charges, specific diseases and even doctor fees.
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(* Subject to the change in Tax Laws)
Key Highlights of HDFC ERGO’s Health Suraksha Plan
- Health insurance plans available at affordable rates
- Choose either an Individual Health Insurance or a Family Floater Health Insurance
- Option to choose either an annual policy or a two year policy
- Avail Cumulative Bonus at the end of each claim-free year
- Health check-up expenses are covered in the plan on completion of 4 claim-free years.
- Avail cashless services from our vast network of more than 5000+ hospitals
- Avail Income Tax exemption under Section 80D of the Income Tax Act
- Take advantage of the least documentation and settlement time as well as a hassle free claim procedure
- Health check-up not mandatory for individuals below 45 years of age
- No Sub-limits on hospital room rents, hospital expenses, specific diseases and doctor fees.
HDFC ERGO Health Insurance Plan
| Schedule of Benefits - Individual & Family Floater |
| Basic Sum Insured per Policy Year || Rs 300000, Rs 400000, Rs 500000, Rs 750000 and Rs 100000 |
| In-patient Treatment || Hospitalization expenses due to an illness or accident are covered in the policy up to the Policy Sum Insured amount. This includes room rent, boarding expenses, nursing, intensive care unit, medical practitioner, anesthesia, operation theatre charges, blood, oxygen, surgical appliances, medicines, drugs and consumables, Diagnostic procedures, Cost of prosthetic & other devices or equipment if used internally during a surgical procedure |
| Pre-hospitalization || Medical costs that are incurred 60 days prior to the hospitalization of patient are subject to reimbursement |
| Post-hospitalization || Medical costs that are incurred during the 90 day period following patient's discharge, post hospitalization is subject to reimbursement |
| Day Care Procedures || Medical expenses for 144 day-care procedures which do not require a 24 hours hospitalization of the patient due to technological advancements are subject to reimbursement |
| Domiciliary Treatment || Medical expenses that are incurred by an Insured Person for availing medical treatments at his/her home at the advice of the attending Medical Practitioner, in case he/she cannot be transferred to the hospital or because of non-availability of hospital bed, are subject to reimbursement. |
| Organ Donor || Medical cost that is incurred for harvesting an organ donated is subject to reimbursement. |
| Emergency Ambulance || Expenses incurred for availing ambulance service in case of emergency depending on the policy opted |
| AYUSH Benefit || Medical expenses that are incurred for in-patient treatment under Homeopathy, Ayurveda, Siddha or Unani, are subject to reimbursement. |
| Cumulative Bonus || Every claim-free year is subject to an increase in the Sum Insured amount by 5% (of the basic sum insured); up to a maximum of 50% increase of the sum insured. |
| Medical checkups || Reimbursement of 1% of Sum Insured amount or Rs. 5000, whichever is less, after 4 continuous claim free years. |
Exclusion Policy – HDFC ERGO Health Suraksha Plan
Note: The content is descriptive only. For actual coverage, kindly refer the policy document.
- A 30 day waiting period for claims
- 2 years waiting period for Particular Diseases and Treatment such as surgery on tonsils and sinuses, cysts, internal tumor etc.
- Preexisting conditions are not covered unless the insured is covered for 48 months
- In case of war or any sort of armed conflicts
- Violation of any law with an intent of crime
- injuries caused due to an act of self-destruction, suicide or suicide attempts
- radioactivity or war, terrorist activities
- Claims for illness that may arise due to intoxication of alcohol and drugs
- Plastic or cosmetic surgery unless performed as an internal part of the treatment
- Vaccinations including inoculation and immunizations taken for preventive measures
- Refer to the Policy Wording document for a complete list of exclusions
FAQs Read more ...
- Why do I need a health insurance plan?
With the advancement in treatments and health care costs, the purpose of health insurance is to help you pay for health care. It protects you and your family financially in the event of unexpected illness or injury that could be very expensive.
- What are the benefits offered by Health Suraksha?
With Health Suraksha plan you can enjoy maximum health benefits at the most affordable prices. The policy offers cashless hospitalization, reimbursement of expenses that may occur due to any illness or accidents and further extends to cover day care procedures, organ donor expenses, emergency ambulance, domiciliary treatments and AYUSH benefits.
- What are the various plans available under this policy?
There are four kinds of plans available under this policy with Sum Insured ranging from Rs. 3 lacs to Rs. 10 lacs.
- 1 Adult
- 2 Adults
- 2 Adults 1 Child
- 2 Adults 2 Children
- 1 Adult and 1 Children
- 1 Adult and 2 Children
- With this policy, you can avail the option of covering on the basis of individual sum insured and on family floater basis.
- What are the eligibility criteria for purchasing the policy?
HDFC ERGO's Health Suraksha plan is open for children from the age of 91 days onwards. Also, there is no maximum age limit at entry.
- Do these policies offer any tax exemptions?
Yes, you can avail tax exemptions up to a sum of Rs. 15,000 as tax benefit under 'Section 80D'. In case of senior citizens, you are allowed to avail tax exemption up to a sum of Rs. 20,000 under Section '80D'.
- What is the procedure for reimbursement of medical expenses?
For reimbursement of medical expenses -
- Register your claim with us within 7 days of patient's discharge
- Send the duly signed claim form and all the documents mentioned therein to us within 15 days of the occurrence of the incident
- After receiving the complete set of claim documents, we will send the payment for admissible amount along with claim settlement statement within 30 days in the name of the proposer.
- How can I port my existing health insurance with HDFC ERGO's Health Suraksha?
If you own a health insurance plan issued by an Indian general insurer and you want to shift to HDFC ERGO on renewal, Health Suraksha policy offers portability of accrued benefits and make due allowances for waiting period etc. as per the regulation and guidelines on portability issued by IRDA.
If the person insured transfers from any other insurer and enhances coverage, then the portability benefits will be offered on the previous sum insured.