Health Insurance: my:health Medisure Super Top Up Insurance Policy
HEALTH SURAKSHA TOP UP PLUS Ensuring happiness for your family
  • - Additional Coverage to health policy
  • - Lifetime Renewability
  • - Tax Benefits U/s 80D*
  • - No Sublimit

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my:health Medisure Super Top Up Insurance

Presenting my:health Medisure Super Top Up Insurance a policy that works alongside your current health insurance policy and enhances it to provide you a larger coverage at a much lower premium. The premium amount for a Rs 20 lakhs health insurance cover with a Rs 5 Lakhs deductible for an individual who is less than 35 years of age is only Rs Rs.2530/ ( Rs 2200 + Rs.330 S tax- 15%)!!

What’s more, you can opt for this policy even if you don’t have an existing health insurance policy. The initial expenses (called deductible) can either be covered by your current policy or can be paid by you. Once this deductible amount is crossed, my:health Medisure Super Top Up Insurance becomes active and pays the excess amount. This policy is not only extremely affordable but also simple to purchase as it doesn’t require you to undergo medical tests upto the 55 years of age, if you have no existing illness. The premium gets fixed at 61 years and remains the same and can be renewed lifelong, subject to change in base premium rates and service tax.

  • Get coverage ranging from Rs. 3 lakhs to Rs. 20 lakhs at a nominal cost with medical expenses over and above Rs. 2 lakhs to Rs. 5 lakhs
  • In-patient hospitalization expenses without sub-limits
  • No medical tests upto the age of 55 years if you have no pre-existing illness
  • Constant premium at the age of 61 years & above
  • Age limit till 65 yrs, however you have to undergo medical tests if your age is >55 yrs or if you have declared any pre-existing diseases
  • Avail a family discount of 10% for three or more members covered in same policy under individual sum insured basis
  • 6 Hours response guarantee on every cashless claim or we pay the penalty
  • Lifelong renewability
  • Tax Benefit under section 80D
For details, please refer to policy terms and conditions
  • In-patient Treatment - Medical expenses for room rent, boarding expenses, nursing, ICU, anesthesia, blood, oxygen, medicines, drugs and consumables, diagnostic procedures etc
  • Pre-Hospitalization -Medical expenses 30 days immediately before hospitalization
  • Post-Hospitalization - Medical expenses 60 days immediately after hospitalization
  • Day care procedures - Medical expenses for existing and upcoming day care procedures which do not require 24 hours hospitalization due to technological advancement in medical science.
  • Expenses for Pre-existing diseases -You can rest assured that expenses incurred towards the treatment of pre-existing diseases that you might have contracted before the inception of the policy will be covered by us. Please note that such expenses will be covered only after 3 continuous renewals with us.
  • Co-payment - All person(s) named in the schedule to this policy above the age of 80 years (age as of last birthday) shall bear a co-pay of 10% for each and every claim
  • Sum Insured (Rs.) - 3, 5, 6, 7, 8, 10, 11, 12, 15, 16 and 20 lacs
  • Deductible (Rs) ^ - 2, 3, 4 and 5 Lacs
  • Family Discount - The family includes self, spouse, dependent children (up to the age of 23 years) and dependent parents. Dependent parents have to be covered under separate family floater policy
  • Free-Look Period -It is possible that you might decide to opt out of the policy after buying it. We give you the option of cancelling the policy within 15 days from the date of receipt of policy documents, if you are not satisfied with the coverage and terms of the policy. We will refund the premium paid after adjusting the amounts spent on stamp duty charges, Medical examination (wherever applicable) and proportionate premium (if policy has already commenced). Refund will not be applicable if you have made a claim against the policy during that period.
  • Entry Age -From 18 years to 65 years. Cover children aged 91 days till 23 Years, subject to both parents being covered under same policy
  • Policy Period - policy will be issued for 1 year /2 years period
  • Pre-Policy Check up - Required > 55 Yrs (Except if PED declared)
  • ^ Deductible is the limit selected by you while taking my:health medisure Super-Top-Up policy with HDFC ERGO. Coverage of Super Top Up policy triggers as soon as expenses born by you against one or more medical exigencies exhausts the Deductible limit during one policy year

    For details, please refer to policy terms and conditions

    * 50% of the standard medical tests charges would be reimbursed, subject to acceptance of proposal and policy issuance.
  • The company will not be liable for any payment unless the medical expenses exceed the deductible
  • All pre-existing diseases / illness / injury / conditions as defined in the policy, until 36 months of continuous covers have elapsed since inception of the first policy with us
  • Waiting Periods
    • 30 days waiting period will apply to all claims, except if any insured person suffers an accident
    • 2 years exclusions for specific diseases
    • 3 years exclusion for pre-existing conditions
  • Permanent exclusions in the policy:
    • Non-allopathic treatment
    • Expenses arising from HIV or AIDS and related diseases are permanently excluded
    • Mental disorder or insanity, cosmetic surgery, weight control treatment
    • Abuse of intoxicant or hallucinogenic substance like drugs and alcohol
    • Hospitalization due to war / acts of war, nuclear, chemical / biological weapon & radiation of any kind
    • Pregnancy, dental and external aids and appliances unless covered under specific plans
    • Experimental, investigational or unproven treatment, devices and pharmacological regimens
For a complete list, kindly refer the Policy Wordings

For details, please refer to policy terms and conditions

My Health Medisure Super Top Up is a filed and approved product of HDFC General (formerly known as L&T Insurance), a wholly owned subsidiary of the Company and hence the Company is also offering the said product

FAQs

  • Do Threshold/deductable limit consist of single claim or multiple claims?

    Threshold/ deductable limit is an aggregate deductable which the customer has to pay either from his pocket or through other Mediclaim, beyond aggregate deductable (crossed in single claim or in multiple claims in a policy year) full claim amount will be paid by HDFC Ergo General Insurance.

    Example-1: Single Claim in a policy year

    Dedcutible Sum Insured in HDFC Ergo General Insurance Insured Super Top up Policy Claim amt assessed Dedcutible Exhaustion balance Dedcutible Claim amt payable by other policy / saving Claim amt payable by HDFC Ergo General Insurance Insured Super Top up Policy
    At inception 200,000 800,000 0 0 200,000 0 0
    Claim 1 200,000 800,000 10,000,00 2,00,000 0 2,00,000 8,00,000

    Example-2: Multiple Claims in a policy year

    Dedcutible Sum Insured in HDFC Ergo General Insurance Insured Super Top up Policy Claim amt assessed Dedcutible Exhaustion balance Dedcutible Claim amt payable by other policy / saving Claim amt payable by HDFC Ergo General Insurance Insured Super Top up Policy
    At inception 200,000 800,000 0 0 200,000 0 0
    Claim 1 200,000 800,000 150,000 150,000 50,000 150,000 0
    Claim 2 200,000 800,000 300,000 50,000 0 50,000 250,000
    Claim 3 200,000 800,000 550,000 0 0 0 550,000
  • I have completed 4 years in ‘xyz’ company Mediclaim and my diabetes/BP is now covered, will Super Top Up cover my PED?

    In Super Top Up policy waiting periods will start afresh.
  • Will the continuity benefit (2years) be given on Super Top Up plan as well?

    Continuity benefit will not be available in Super Top Up plan as portability benefits are not available in this product.
  • Does pre-existing cover starts after 4 years?


    The Policy covers expenses incurred for the treatment of diseases that you have before taking the Policy. Such will be covered only after 36 months of continuous coverage.
  • The Policy covers expenses incurred for the treatment of diseases that you have before taking the Policy. Such will be covered only after 36 months of continuous coverage.

    Yes, since chemo & dialysis are recurring procedures and does not require local or general anesthesia, in this context all such procedures will be covered & paid under day care procedures.
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