HDFC Ergo Health Insurance: Buy Online, Reviews & Claim Benefits @ Rs 19/Day

HDFC ERGO Health Insurance 

• Network Hospitals: 14,747
• Claim Settlement: 98.50% within 3 months*
• Starting Premium: ₹784/month
• Sum Insured: Up to ₹2 Crore
• Number of Plans: 2
• Pre-Existing Disease Coverage: Available after 3 years

HDFC ERGO Health Insurance offers a wide network of 14,747 hospitals and a high claim settlement rate of 98.50% within three months. With premiums starting at just ₹784 per month, customers can secure a sum insured of up to ₹2 Crore. The insurer provides two plan options, and coverage for pre-existing diseases begins after three years.

Top health insurance plans for HDFC ERGO

1. Individual Plans – Optima Secure and Optima Restore
For those seeking comprehensive health coverage tailored for individuals, HDFC ERGO offers the Optima Secure and Optima Restore plans. These policies are designed to provide extensive protection, ensuring you have access to quality healthcare without worrying about the costs. Whether it’s hospitalization, day-care procedures, or emergency services, these plans have you covered.

2. Senior Citizen Plans – Optima Secure and Optima Restore
HDFC ERGO understands the unique healthcare needs of senior citizens. The Optima Secure and Optima Restore plans for senior citizens offer specialized benefits, including coverage for age-related medical conditions and access to a network of top-notch healthcare providers. These plans are crafted to provide peace of mind and financial security during retirement years.

3. Family Plans – Optima Secure and Optima Restore
For families looking to protect their loved ones under a single policy, HDFC ERGO provides the Optima Secure and Optima Restore family plans. These plans offer a comprehensive solution for the entire family, covering a wide range of medical expenses. From preventive care to emergency treatments, these policies ensure that every family member receives the best care when needed

Overview of HDFC ERGO Health Insurance

HDFC ERGO Health Insurance is provided by HDFC ERGO General Insurance Company Limited, a partnership formed in 2002 between India’s HDFC Ltd. and Germany’s ERGO International AG. This collaboration has resulted in a range of health insurance plans designed to deliver extensive medical coverage for individuals, families, and women, all at competitive rates.

Their offerings include specialized plans that cover critical illnesses, COVID-19, and dengue, ensuring you are protected against a variety of health concerns. Additionally, HDFC ERGO provides an exclusive Value Buy benefit, which allows policyholders to enjoy discounts of up to 50% by choosing a voluntary deductible.

The company is also known for its efficient claims process, with cashless claims typically settled within just 2 hours. Reflecting their commitment to customer satisfaction, HDFC ERGO achieved an impressive incurred claim ratio of 97.47% for the fiscal year 2021-22.

HDFC ERGO Health Insurance Plans

HDFC ERGO General Insurance Company provides a diverse selection of health insurance plans designed for various needs and age groups. Here’s a detailed look at the different plans available:

Let us discuss each insurance plan in detail

HDFC ERGO my

Koti Suraksha Plan

The HDFC ERGO my

Koti Suraksha Plan is a distinctive insurance offering that combines extensive medical coverage with personal accident protection. It features a substantial sum insured ranging from Rs 50 lakh to Rs 1 crore for medical expenses, and from Rs 10,000 to Rs 10 crore for personal accident coverage. This plan provides a cost-effective solution with lower premiums.

Features & Benefits:

• Covers hospitalization, home healthcare, and domiciliary treatments.
• Includes accidental death, permanent disablement, and temporary disablement benefits.
• Offers coverage for alternative treatments, pre and post-hospitalization costs, and ambulance services.
• Provides benefits for broken bones, chauffeur services, and hospital cash for accidents.
• Includes preventive health check-ups, cumulative bonuses, and fitness discounts upon renewal.
• Optional covers include non-medical expenses, emergency worldwide coverage, room rent waivers, and waiting period modifications.
• Additional benefits such as renewal premium advantage, parental care, medical evacuation, and educational support for dependent children.

HDFC ERGO Optima Secure

The HDFC ERGO Optima Secure plan enhances medical coverage significantly, offering up to four times the coverage at no extra cost. Policyholders can also enjoy up to 50% reduction in premiums by selecting a deductible under the Value Buy benefit. The sum insured ranges from Rs 5 lakh to Rs 2 crore.

Features & Benefits:

• Covers hospitalization expenses, AYUSH treatments, and home healthcare.
• Includes e-opinion for critical illnesses and daily cash benefits for choosing shared accommodations.
• Covers pre and post-hospitalization expenses, ambulance charges, and organ donor costs.
• Secure benefit starts with 2x coverage from day one, with Plus benefit increasing coverage by 100% after two years.
• Optional covers include critical illness cover, hospital cash benefit, and unlimited restore benefits.

HDFC ERGO Critical Illness Insurance

The HDFC ERGO Critical Illness Insurance plan provides a lump sum benefit upon the diagnosis of up to 15 critical illnesses, with sums insured ranging from Rs 1 lakh to Rs 50 lakh. Available in Silver, Gold, and Platinum variants, each tier offers different levels of coverage.

Features & Benefits:

• Silver plan covers 8 illnesses, Gold plan covers 11, and Platinum covers 15 critical illnesses.
• Options for survival periods of 15 or 30 days.

HDFC ERGO Day2day Care

The HDFC ERGO Day2day Care plan offers immediate outpatient coverage from day one, available in Silver and Gold variants.

Features & Benefits:

• Unlimited outpatient consultations with network providers.
• Covers pharmacy costs, diagnostic tests, and provides annual health check-ups.

HDFC ERGO Dengue Care

The HDFC ERGO Dengue Care plan covers both inpatient and outpatient expenses related to dengue treatment, with sums insured between Rs 50,000 and Rs 1 lakh.

Features & Benefits:

• Coverage for inpatient hospitalization, pre and post-hospitalization expenses.
• Includes OPD consultations, pharmacy costs, diagnostic tests, and home nursing services.
• Shared accommodation benefit, non-medical expenses cover, and wellness offers.
• No medical check-up required, with a single premium applicable irrespective of age.

HDFC ERGO Energy Health Insurance

The HDFC ERGO Energy Health Insurance plan covers hospitalization costs for diabetes, hypertension, and related conditions from day one, with sum insured amounts ranging from Rs 2 lakh to Rs 50 lakh in Silver and Gold variants.

Features & Benefits:

• Covers inpatient hospitalization, day care procedures, and associated expenses.
• Includes HbA1C check-up benefits, restore benefits, and cumulative bonuses.
• Offers wellness programs and benefits.

HDFC ERGO Easy Health Insurance

The HDFC ERGO Easy Health Insurance plan caters to families and individuals, offering extensive benefits to those who maintain an active lifestyle. Coverage ranges from Rs 1 lakh to Rs 50 lakh and is available in Standard, Exclusive, and Premium variants.

Features & Benefits:

• Covers inpatient treatment, pre and post-hospitalization costs.
• Includes AYUSH benefits, daily cash for shared accommodation, and maternity expenses.
• Covers newborn baby expenses, road ambulance charges, and more.
• Offers critical illness cover as an optional add-on.

HDFC ERGO Health Wallet Insurance

The HDFC ERGO Health Wallet plan is a unique policy that allows unused sums insured from previous years to be carried over to the next year. It offers coverage ranging from Rs 3 lakh to Rs 50 lakh.

Features & Benefits:

• Covers inpatient, AYUSH, and domiciliary treatments.
• Includes day care procedures, ambulance charges, and pre-post hospitalization expenses.
• Provides reserve, recovery, restore, and multiplier benefits.
• Covers worldwide emergency care and preventive health check-ups.

HDFC ERGO Health Suraksha Top-up Pro Plan

The HDFC ERGO Health Suraksha Top-up Pro Plan offers additional coverage when the base policy sum insured is exhausted, with deductible amounts ranging from Rs 1 lakh to Rs 5 lakh and sum insured from Rs 2 lakh to Rs 10 lakh.

Features & Benefits:

• Covers inpatient treatment, emergency ambulance, and day care procedures.
• Includes domiciliary treatment, organ donor cover, and cumulative bonuses.

HDFC ERGO Health Suraksha Top-up Plus Plan

The HDFC ERGO Health Suraksha Top-up Plus Plan provides extra medical coverage when multiple claims exceed the deductible amount. The deductible ranges from Rs 1 lakh to Rs 5 lakh, with sum insured amounts from Rs 2 lakh to Rs 10 lakh.

Features & Benefits:

• Covers inpatient and domiciliary treatments, organ donor expenses, and emergency ambulance services.
• Provides day care procedures, pre and post-hospitalization expenses.
• Includes a 5% cumulative bonus for every claim-free year.

HDFC ERGO iCan Insurance Plan

The HDFC ERGO iCan Insurance Plan offers coverage for cancer treatment with sums insured ranging from Rs 5 lakh to Rs 50 lakh, available in Standard and Advanced variants.

Features & Benefits:

• Covers inpatient and outpatient treatments, follow-up care, and second opinions.
• Includes day care procedures, emergency ambulance cover, and both pre and post-hospitalization expenses.
• Advanced plan offers CritiCare and family care benefits.

HDFC ERGO Maxima Insurance

The HDFC ERGO Maxima Insurance plan covers daily health needs, including both inpatient and outpatient expenses, with a sum insured of Rs 3 lakh.

Features & Benefits:

• Covers OPD consultations, diagnostic tests, and dental treatments.
• Includes maternity benefits, newborn cover, and daily cash for accompanying children.
• Provides day care procedures, organ donor expenses, and domiciliary treatment.

HDFC ERGO my

Suraksha Plan

The HDFC ERGO my

Suraksha Plan offers comprehensive medical coverage for all ages, with sum insured options ranging from Rs 1 lakh to Rs 5 crore in Silver Smart, Gold Smart, and Platinum Smart variants.

Features & Benefits:

• No pre-policy health check-up required up to age 45.
• Covers hospitalization, alternative treatments, and domiciliary care.
• Includes mental healthcare, home healthcare, and organ donor cover.
• Provides day care procedures, road ambulance services, and preventive health check-ups.
• Optional covers include non-medical expenses, major illness benefits, and global health cover.

HDFC ERGO my

Women Suraksha

The HDFC ERGO my

Women Suraksha Plan is tailored for women’s health needs, with sum insured amounts from Rs 1 lakh to Rs 1 crore. It includes six variants addressing different health concerns.

Features & Benefits:

• Covers cancers, cardiac ailments, and other major illnesses.
• Includes preventive health check-ups and active benefits.
• Offers reduced premium benefits and optional covers for pregnancy complications and job loss.

HDFC ERGO my

MediSure Super Top Up

The HDFC ERGO my

MediSure Super Top Up Plan provides additional coverage at lower premiums. It can be used as a backup if the base policy sum insured is depleted, with coverage amounts from Rs 3 lakh to Rs 20 lakh and deductibles from Rs 2 lakh to Rs 5 lakh.

Features & Benefits:

• No pre-policy medical tests required up to age 55.
• Covers inpatient hospitalization, day care procedures, and related expenses.
• Includes critical illness cover and hospital cash benefits.

HDFC ERGO Optima Restore

The HDFC ERGO Optima Restore Plan enhances medical coverage with a restore benefit, offering sum insured amounts from Rs 3 lakh to Rs 1 crore.

Features & Benefits:

• Covers hospitalization, organ donor expenses, and domiciliary treatments.
• Provides daily cash benefits for shared accommodation and e-opinion for critical illnesses.
• Includes day care procedures, road ambulance, and air ambulance expenses.

HDFC ERGO Optima Senior

The HDFC ERGO Optima Senior Plan is designed for senior citizens over 60, with sum insured options of Rs 2 lakh, Rs 3 lakh, and Rs 5 lakh.

Features & Benefits:

• Covers inpatient treatment, emergency ambulance, and day care procedures.
• Includes organ donor expenses, domiciliary treatment, and pre-post hospitalization costs.
• Provides e-opinion for critical illnesses and a 5% no-claim bonus for every claim-free year.

HDFC ERGO Optima Super

The HDFC ERGO Optima Super Plan is a top-up insurance that can be converted into a regular health policy after five consecutive renewals or between ages 55 and 60. It offers sums

Why Should You Buy HDFC ERGO Health Insurance Plans?

When choosing a health insurance provider, HDFC ERGO stands out for several compelling reasons:

1. Exceptional Benefits: HDFC ERGO offers a variety of specialized benefits in their health insurance plans. These include:

• Value Buy: Get access to essential health coverage at competitive rates.
• Secure Benefit: Added protection against unforeseen medical expenses.
• Reduced Premium Benefit: Opportunities to lower your premiums while maintaining coverage.
• Protect Benefit: Enhanced safety nets for serious health issues.
• Multiplier Benefit: Benefits that grow over time, offering increased coverage and value as your policy matures.

These unique features ensure that you receive comprehensive and customized coverage tailored to your needs.

2. Rapid Claims Processing: One of the standout features of HDFC ERGO is their efficient claims processing. Their in-house claims team is dedicated to managing cashless claims with remarkable speed, typically settling them within 2 hours. This rapid turnaround means you can focus on recovery without worrying about delays or paperwork.

3. 24/7 Customer Support: HDFC ERGO places a strong emphasis on customer service. Their support team is available 24/7, ensuring that help is always at hand, no matter the time of day. Whether you have questions, need assistance, or face any issues, their customer support is just a call away, providing timely and effective solutions.

4. Tax Savings: Investing in HDFC ERGO health insurance also offers financial benefits beyond just health coverage. Premiums paid for these policies are eligible for tax deductions under Section 80D of the Income Tax Act. This means you can save on your tax bill while securing valuable health coverage.

HDFC ERGO health insurance premium chart

HDFC ERGO Health Insurance offers various plans with different premiums based on factors such as age, coverage, sum insured, and policy term. Here’s a general outline of the premium chart for some popular HDFC ERGO Health Insurance plans. The premiums are approximate and can vary based on specific circumstances.

1. HDFC ERGO Health Suraksha

• Sum Insured: ₹3 lakh to ₹75 lakh
• Coverage: Individual, Family Floater
• Premium Range: Starting from approximately ₹3,000 to ₹40,000+ annually
• Age: 18 to 65 years (renewable lifelong)

2. HDFC ERGO Optima Restore

• Sum Insured: ₹3 lakh to ₹50 lakh
• Coverage: Individual, Family Floater
• Premium Range: Starting from approximately ₹4,000 to ₹50,000+ annually
• Age: 18 to 65 years (renewable lifelong)

3. HDFC ERGO my

Suraksha

• Sum Insured: ₹3 lakh to ₹1 crore
• Coverage: Individual, Family Floater
• Premium Range: Starting from approximately ₹4,000 to ₹60,000+ annually
• Age: 18 to 65 years (renewable lifelong)

4. HDFC ERGO Critical Illness Insurance

• Sum Insured: ₹1 lakh to ₹1 crore
• Coverage: Individual
• Premium Range: Starting from approximately ₹500 to ₹40,000+ annually
• Age: 18 to 65 years

5. HDFC ERGO Health Medisure Super Top-up

• Sum Insured: ₹3 lakh to ₹10 lakh
• Coverage: Individual, Family Floater
• Premium Range: Starting from approximately ₹1,500 to ₹15,000+ annually
• Age: 18 to 65 years

Key Factors Affecting Premiums:

1. Age of Insured: Higher age groups generally have higher premiums.
2. Sum Insured: Higher sum insured leads to higher premiums.
3. Policy Type: Individual vs. family floater.
4. Add-ons/Riders: Additional coverages like maternity benefits, critical illness, etc.
5. Medical History: Pre-existing conditions may increase premiums.
6. Location: Premiums can vary by city or region.

How to File a Claim with an HDFC ERGO Health Insurance Plan?

• Seek Hospitalization Begin by getting admitted to a hospital that is part of the HDFC ERGO network to access cashless treatment.
• Present Your Documents At the hospital, provide your HDFC ERGO health insurance card along with a valid photo ID.
• Request Cashless Pre-Authorization The hospital will submit a pre-authorization request form to HDFC ERGO to initiate the cashless treatment process.
• Receive Cashless Treatment Approval HDFC ERGO will review the request and, if approved, will notify the hospital to proceed with the cashless treatment.
• Submit Final Documents Once you are discharged, the hospital will send the final bill and all necessary documents to HDFC ERGO for processing.
• Obtain Final Authorization HDFC ERGO will review the documents submitted by the hospital and issue the final authorization to cover the treatment costs.

Documents Required for HDFC ERGO Health Insurance Claim

To ensure a seamless reimbursement process for your HDFC ERGO health insurance claim, please prepare and submit the following documents:

1. Completed Claim Form: Fill out the HDFC ERGO health insurance claim form completely and include your policy number.
2. Hospital Discharge Summary: Submit the original discharge summary from the hospital.
3. Final Hospital Bill: Provide the original final bill from the hospital, including a detailed breakdown of all charges.
4. Pharmacy Invoices: Include original invoices from the pharmacy, accompanied by the doctor’s prescriptions.
5. Payment Receipts: Provide original receipts for all payments made.
6. Investigation Reports: Submit the original reports from any investigations conducted.
7. Implant Documentation: If applicable, include the implant sticker or invoice.
8. Accident Documentation: For claims related to accidents, provide either an FIR (First Information Report) or a Medico Legal Certificate (MLC).
9. Past Treatment Records: Include documents related to any previous treatments.
10. Legal Heir Certificate: If the nominee is a minor, submit a legal heir certificate.
11. Bank Verification: Provide a cancelled cheque or a copy of the passbook, duly attested by the bank.
12. KYC Documentation: For claims amounting to Rs 1 lakh or more, submit a completed KYC form along with a copy of one KYC document.

HDFC ERGO Health Insurance Network Hospitals

HDFC ERGO offers an extensive network of over 11,400 hospitals across India, enabling customers to benefit from cashless hospitalization services. This means that policyholders can receive medical treatment at any of the HDFC ERGO network hospitals without the need to pay upfront. The insurance company directly settles the hospital bills, making the process hassle-free for the insured.

Prominent Cities with HDFC ERGO Network Hospitals

• Delhi
• Bengaluru
• Hyderabad
• Pune
• Mumbai
• Thane
• Gurgaon
• Ghaziabad
• Lucknow
• Ahmedabad

Top Cities Featuring HDFC ERGO Network Hospitals

• Delhi
• Gurgaon
• Mumbai
• Bengaluru
• Chennai
• Hyderabad
• Pune
• Kolkata
• Ahmedabad
• Chandigarh

Network Hospital Affiliates

HDFC ERGO partners with a wide range of hospitals, including those affiliated with various insurance providers:

• Aditya Birla Network Hospitals
• Bajaj Allianz Network Hospitals
• Bharti AXA Network Hospitals
• Care Health Network Hospitals
• Cholamandalam MS Network Hospitals
• Future Generali Network Hospitals
• Go Digit Network Hospitals
• Iffco Tokio Network Hospitals
• Kotak Mahindra Network Hospitals
• Liberty General Network Hospitals
• ManipalCigna Network Hospitals
• Niva Bupa Network Hospitals
• Reliance Network Hospitals
• SBI General Network Hospitals
• Star Health Network Hospitals
• TATA AIG Network Hospitals
• Universal Sompo Network Hospitals
• ZUNO General Insurance (formerly Edelweiss General Insurance) Network Hospitals

With such a broad network, HDFC ERGO ensures that customers across India have access to high-quality medical care without the financial stress of immediate payments.

Online Purchase

1. Visit the HDFC ERGO Website:

1. • Go to the official HDFC ERGO website (www.hdfcergo.com).

2. Navigate to Health Insurance:

1. • Click on the “Health” section from the menu or homepage to view the available health insurance plans.

3. Choose a Plan:

1. • Browse through the various health insurance plans and select the one that suits your needs.

4. Get a Quote:

1. • Use the online quote tool to enter details like age, sum insured, and other relevant information to get a quote.

5. Fill Out the Application Form:

1. • Complete the application form with your personal and medical details. Make sure all information is accurate.

6. Upload Documents:

1. • Upload the necessary documents as required for the policy, such as identity proof, address proof, and medical reports.

7. Make Payment:

1. • Choose your preferred payment method (credit/debit card, net banking) and complete the payment for the policy.

8. Receive Policy Document:

• • After successful payment, you will receive the policy document via email or through the customer portal.

Offline Purchase

1. Visit an HDFC ERGO Branch:

1. • Locate the nearest HDFC ERGO branch or office. You can find the addresses on their website or contact their customer service for assistance.

2. Consult an Insurance Advisor:

1. • Meet with an insurance advisor or representative at the branch. Discuss your health insurance needs and the available plans.

3. Select a Plan:

1. • Choose a health insurance plan based on the advice and information provided by the advisor.

4. Fill Out the Application Form:

1. • Complete the application form with your personal and medical details. Ensure that all information is correct.

5. Submit Documents:

1. • Provide the necessary documents, such as identity proof, address proof, and medical reports, to the branch.

6. Make Payment:

1. • Pay the premium amount through accepted payment methods (cash, cheque, or card) at the branch.

7. Receive Policy Document:

• • After completing the payment, you will receive the policy document either immediately or via mail.

How to Renew HDFC ERGO Health Insurance Plans?

Online Renewal

1. Visit HDFC ERGO website (www.hdfcergo.com).
2. Log In to your account with policy number and password.
3. Go to the “Policy Renewal” section.
4. Select your policy to renew.
5. Review and update renewal details.
6. Pay the renewal premium.
7. Receive confirmation and updated policy via email.

Offline Renewal

1. Visit the nearest HDFC ERGO branch.
2. Provide policy number for renewal.
3. Discuss renewal options and changes.
4. Fill out the renewal form.
5. Pay the renewal premium.
6. Receive updated policy document immediately or by mail.

HDFC ERGO Health Insurance Premium Calculator

calculate the HDFC ERGO Health Insurance premium, you can use the following formula:

Premium = Base Premium + (Sum Insured × Rate of Premium) – Discounts + Add-on Costs

Here’s a small paragraph explaining the calculation:

To calculate your HDFC ERGO health insurance premium, start with the base premium amount. Then, add costs based on the sum insured and the rate of premium, which varies depending on factors like age and coverage. Subtract any available discounts and add the cost of any add-ons. For a precise calculation, it’s best to use the online premium calculator provided by HDFC ERGO or consult their customer service.

HDFC ERGO Health Insurance Customer Care

Take a look at the contact details of HDFC ERFO General Insurance Company below:

FAQs..

Conclusion

HDFC ERGO Health Insurance offers comprehensive coverage with a vast network of 14,747 hospitals and a high claim settlement rate of 98.50% within three months. With affordable premiums starting at ₹784 per month and a range of plans like Optima Secure and Optima Restore, individuals and families can find tailored solutions to meet their healthcare needs. The plans provide extensive coverage, including pre-existing disease coverage after three years and a sum insured of up to ₹2 Crore. Whether you’re seeking individual, senior citizen, or family plans, HDFC ERGO ensures quality healthcare and financial protection.