HDFC ERGO Health Insurance FAQs

HDFC ERGO Health Insurance

312 reviews Rate This

Highlights

Network Hospitals10,000+
Policies Sold10,63,052
Incurred Claim Ratio63%
Lifelong RenewabilityLifelong
Claim Settlement Ratio84.08%
In-House Claim Settlement100%
COVID-19 CoverYes

Cancer

  • What is waiting period under cancer plan?

    Initial waiting period of 6 months is applicable under cancer plan.

  • What is the renewability criteria of cancer plan?

    The plan allows lifelong renewability.

  • Is there any free-look period under the plan?

    Yes, there is a free-look period of 15 days from the date of purchase of the policy.

  • What is the entry age for cancer plan of HDFC ERGO Health Insurance?

    Individuals aged between 5 years and 65 years can purchase the cancer policy of HDFC ERGO Health Insurance.

Claim Settlement

  • What type of health insurance claim settlement options are available at HDFC ERGO Health Insurance?

    At HDFC ERGO Health Insurance, you can either opt for cashless treatment or reimbursement facility options for claim settlement purpose.

  • What process of health insurance claim intimation do policyholders at HDFC ERGO Health Insurance have to follow?

    To initiate a claim, the policyholders can contact us, at InsuranceDekho at 7551196989. 

  • At what time should I intimate HDFC ERGO Health Insurance about the event of hospitalisation?

    At HDFC ERGO Health Insurance, it is significant for policyholders to initiate contact at least 48 hours prior the event for planned hospitalisation and within 24 hours of the event in case of emergency hospitalisation. 

  • What all documents are required for claim settlement process at HDFC ERGO Health Insurance?

    The list of documents required for claim settlement process at HDFC ERGO Health Insurance includes:

    • Duly filled and signed claim form with policy number.
    • Original discharge summary.
    • Original final bill comprising detailed breakup.
    • Original payment receipt.
    • Original investigation reports.
    • Past treatment documents, if any.
    • Original pharmacy invoices supported by prescriptions, etc.
    • Medico Legal Certificate (MLC) or FIR in case of an accident.

Critical Illness

  • Does HDFC ERGO Health Insurance insurance provide coverage for critical illness?

    Yes, HDFC ERGO Health Insurance insurance offers critical illness cover under its Optima Vital plan. 

  • Does HDFC ERGO Health Insurance insurance provide lifelong renewability under its critical illness plan?

    Yes, HDFC ERGO Health Insurance insurance provides the facility of lifelong renewability under its critical illness plan.

  • Who is eligible to buy HDFC ERGO Health critical illness plan?

    Adults from the age of 18 years to 65 years can apply for a critical illness plan by HDFC ERGO Health Insurance insurance.

  • How many critical illnesses does HDFC ERGO Health Insurance cover under its critical illness plan?

    HDFC ERGO Health Insurance provides coverage for 37 critical illnesses. Cancer, Kidney Failure, Major Burns, Blindness, COMA, Apallic Syndrome, Brain surgery are a few critical illnesses covered by HDFC ERGO Health Insurance.

     

Dengue

  • What is the premium amount to be paid under this plan?

    The premium amount for sum insured of Rs. 50,000 is Rs. 444 and Rs. 1 Lakh is Rs. 578.

  • What is co-payment under the policy?

    There are no sub-limits/co-payment applied under this policy.

  • What are the sum insured options under dengue policy of HDFC ERGO Health Insurance?

    The policy is available for sum insured ranging from Rs. 50,000 and Rs. 1 Lakh.

  • What is the policy term for HDFC ERGO Health Insurance Dengue Care?

    Dengue Care from HDFC ERGO Health Insurance is an annual policy.

Diabetes

  • If I don't have diabetes, should I buy this plan?

    No, you should not buy this plan, as it is a specialized product for those diagnosed with diabetes.

  • What sum insured options available under diabetes plan?

    The sum insured option under this plan is Rs. 2 Lakh, Rs. 3 Lakh, Rs. 5 Lakh, Rs. 10 Lakh, Rs. 15 Lakh, Rs. 20 Lakh, Rs. 25 Lakh & Rs. 50 Lakh on an individual sum insured basis.

  • Who can buy HDFC ERGO Health Insurance diabetes Plan?

    Anyone diagnosed with Diabetes Type 1, Diabetes mellitus Type 2 and pre-diabetes (IFG, IGT) and/or hypertension can buy this plan.

  • Is the portability option available under the diabetes policy?

    Yes, this plan is easily portable into other plans. For more details, call insurancedekho at 7551196989.

Family Floater

  • What are the family health insurance plans offered by HDFC ERGO Health Insurance?

    HDFC ERGO Health Insurance family health insurance plans include Optima Restore, Easy Health and Health Wallet.

  • What are the benefits of HDFC ERGO Health Insurance Optima Restore policy?

    Benefits of Optima Restore are manifold. The key benefits are 60 & 180 days pre & post-hospitalisation cover, stay active benefit, restore benefit, multiplier benefit, no sub limits, no co-payment, critical advantage rider, discounts at renewal with the “stay active” benefit and much more. 

  • Who can be covered by the HDFC ERGO Health Insurance family health insurance policies?

    Self, spouse, son, daughter, father, mother, mother-in-law, father-in-law is covered by HDFC ERGO Health Insurance family health insurance policies.

  • What are the key benefits of HDFC ERGO Health Insurance family health insurance policies?

    There are many benefits. Key benefits include pre & post hospitalization coverage for 60 days & 180 days, all day-care procedures, domiciliary treatment, expenses for organ donor, daily cash for choosing shared accommodation, emergency ambulance, health checkup and so on. 

  • Does HDFC ERGO Health Insurance offer any individual health insurance policy?

    Yes, HDFC ERGO Health Insurance offers individual health hindrance policy. The plans are Energy Insurance. This plan is especially suitable for a diabetic patient. Other policies that are available on an individual basis are Health Wallet, Optima Restore, Easy HealthHealth Wallet. 

Feature

  • What are the policy terms available under this health insurance policy?

    The HDFC ERGO Corona Kavach Health Insurance Plan is available with different policy terms such as 3.5 months, i.e., 105 days, 6.5 months , i.e., 195 days and 9.5 months, i.e., 285 days.

  • What is the waiting period under this health insurance plan?

    HDFC ERGO Corona Kavach Plan is available with a waiting period of 15 days from the date of policy commencement. You can avail this policy only after the completion of this waiting period.

  • Is this HDFC ERGO Corona Kavach Health Insurance Policy renewable?

    No, this HDFC ERGO Corona Kavach Plan can not be renewed. You can buy a fresh plan after its policy term expires. 

General Information

  • What is Pre-Authorization?

    A pre-authorization is a process in which the insured or the service provider gets the approval of the payment from the insurer or its TPA before the hospitalisation.

  • How long are the policies of HDFC ERGO Health Insurance valid for?

    The policies of HDFC ERGO Health Insurance are valid for one to two years depending on the policy you have purchased.

  • Is pre-policy medical check-up mandatory?

    No, the pre-policy medical checkup is not mandatory in all cases. It is subject to your age. For example, if you’re 60 or above, you may go for a pre-medical checkup at designated clinics of HDFC ERGO Health Insurance.

  • Who is a third-party administrator (TPA) of HDFC ERGO Health Insurance?

    HDFC ERGO Health Insurance has no TPA. It has its own in-house claim settlement team to handle retail policies. However, the claims of group plans are handled by Family Health Plan Limited (FHPL).

  • Does HDFC ERGO Health Insurance pay all medical expenses or only a share of the bill?

    HDFC ERGO Health Insurance (formerly known as Apollo Munich Health Insurance) pays only the medical bill expenses, subject to the terms of the policy. It doesn’t bear the expenses more than the sum assured by the policy. So, if the amount exceeds the sum insured, it is borne by the insured.

  • Through which mode does HDFC ERGO Health Insurance release the payment of a claim?

    All claim amount is made to the policyholder through bank transfer, cheque or DD.

  • Is Health check-up covered by policies?

    Yes. Health check-up is covered by policies at the end of a block of every continuous 2/3/4 years (as per variant opted). The maximum liability of HDFC ERGO Health Insurance is subject to 1% of the sum insured for the policy year.

  • Do all the leading hospitals come in the HDFC ERGO Health Insurance network?

    Most of the leading hospitals are covered under HDFC ERGO Health Insurance network. To know the name of the hospitals, give a call to our experts.

  • Is this HDFC ERGO Corona Kavach Health Insurance Policy renewable?

    No, this HDFC ERGO Corona Kavach Plan can not be renewed. You can buy a fresh plan after its policy term expires. 

Help to Buy

  • How to buy and apply for HDFC ERGO Health Insurance Policy?

    You can buy or apply for HDFC ERGO Health Insurance policy directly at its official website or through the online broker website like www.insurancedekho.com.

Individual

  • What are the benefits of Optima Restore Individual plan?

    Key benefits of the plan include In-Patient Hospitalisation, Pre and post-Hospitalisation, Day-Care treatment, Domiciliary Treatment, Organ Donor expenses, Emergency Ambulance, daily cash, e-opinion, restore benefits and much more. 

  • What are sum insured options for buying an individual health insurance policy of HDFC ERGO Health Insurance?

    You can choose a wide range of sum insured options, depending on the plan you want to purchase. The sum insured options are Rs. 3 Lakh, Rs. 5 Lakh, Rs. 10 Lakh, Rs. 15 Lakh, Rs. 20 Lakh, Rs. 25 Lakh, and Rs. 50 Lakh. The sum insured options may differ depending on the policy you want to buy. 

  • Who can buy individual health insurance at HDFC ERGO Health Insurance?

    HDFC ERGO Health Insurance covers an individual from the age of 5 years with a maximum entry age of 65 years. The individual health policies also cover a dependent child from 91-day. 

Kids

  • Does HDFC ERGO Health Insurance cover children in its health insurance plans?

    Yes, at HDFC ERGO Health Insurance, you can get your kids covered for health insurance.

  • Under which plans does HDFC ERGO Health Insurance offer health insurance for children?

    Easy Health individual and Optima Cash plan are the key plans under which one can get their kids covered. Under Easy Health family plan, a policyholder can get themselves and their family including dependent children covered for health insurance.

  • Does HDFC ERGO Health Insurance offer coverage for new born baby under its health insurance plans?

    Yes! A policyholder can opt for newborn baby cover with the waiting period of 4 years under the Exclusive and Premium variants of the Easy health plan of HDFC ERGO Health Insurance.

  • What benefits does HDFC ERGO Health Insurance offer under its health insurance policy for children?

    Hospitalisation Cover, Critical Illness Rider, Cumulative Bonus, Stay Active Benefit, AYUSH Benefit are a few benefits that HDFC ERGO Health Insurance offers for kids under its health insurance plans. 

Maternity

  • Is the ‘Stay Active Benefit’ available in the maternity insurance plan?

    Yes, the Stay Active Benefit is available wherein you can earn 8% discounts on your renewal premium. 

  • Which health policy of HDFC ERGO Health Insurance insurance covers maternity coverage?

    Easy Health - family, a plan by  HDFC ERGO Health Insurance insurance covers maternity expenses. The expenses incurred during pregnancy are covered in the Easy Health Premium Plan and Easy Health Exclusive Plan.

  • Does the maternity plan of HDFC ERGO Health Insurance insurance come with a 'New Born Cover' feature?

    Yes, on the payment of additional premium, you can enjoy the benefit of 'New Born Cover' feature under the maternity health insurance product of HDFC ERGO Health Insurance insurance. 

  • Can I buy maternity health insurance online?

    Yes, you’re able to buy the policy online. HDFC ERGO Health Insurance insurance strives for providing all possible help to policyholders online.  

Parents

  • Which is the perfect health insurance plan for parents at HDFC ERGO Health Insurance?

    HDFC ERGO Health Insurance offers Optima Senior plan for parents health insurance. 

  • What is the maximum entry age for parents health insurance at HDFC ERGO Health Insurance?

    HDFC ERGO Health Insurance, under its parents health insurance, provides coverage for individuals from the age of 61 years and above.

     

  • Does HDFC ERGO Health Insurance provide e-opinion in case of critical illness under its parents health insurance?

    Yes, HDFC ERGO Health Insurance offers the optional benefit of e-opinion in case of critical illness under its parents health insurance.

  • What are the other benefits associated with parents health insurance at HDFC ERGO Health Insurance?

    Cashless service, 5% cumulative bonus, sum insured enhancement, portability, and tax benefits under Section 80D of Income Tax Act are a few other benefits that come with parents health insurance at HDFC ERGO Health Insurance.

     

Plan Coverage

  • What are ‘Restore Benefits’ provided by insurance companies?

    Restore Benefits are a type of benefit, which is designed to reinstate your sum insured when it gets exhausted within a policy period. T&C apply.

  • What types of medical expenses are covered by HDFC ERGO Health Insurance?

    All reasonable expenses related to inpatient hospitalisation, pre and post hospitalisation, ambulance costs, room rent, etc. are covered to the maximum cap of the sum assured.

  • Who can get covered under this HDFC ERGO Corona Kavach Health Insurance Policy?

    This policy can be purchased by anyone between the age of 18 years and 65 years, but it gives coverage from 1-day old baby to 65-year-old person. It gives coverage to different family members including legally wedded spouse, dependent children (biological or legally adopted) from 1 day to 25 years, parents and parents-in-law. However, financially independent children of above 18 years can not be covered.

Portability

  • Can I apply for health insurance portability at HDFC ERGO Health Insurance insurance?

    Yes, you can apply for heath insurance portability at HDFC ERGO Health Insurance insurance. 

  • When is the right time to apply for health insurance portability at HDFC ERGO Health Insurance?

    Application for health insurance portability at HDFC ERGO Health Insurance should be provided 30 days before the renewal date of the previous policy. 

  • What are the documents required at the time of health insurance portability at HDFC ERGO Health Insurance?

    The documents to be submitted for health insurance at HDFC ERGO Health Insurance include an application form, portability form, and details of the previous policy. Also required are customer’s self-declaration regarding no claims made. In case of a claim in the existing policy, the documents required include discharge summary, investigation, and follow up report copies. In case of a past medical history, prescription, consultation papers, investigation, treatment, and report copies are required.

     

  • What is the process of health insurance portability at HDFC ERGO Health Insurance?

    The process of health insurance portability at HDFC ERGO Health Insurance involves the following steps:

    • Compare, evaluate, and choose your health insurance plan.
    • Apply for portability at HDFC ERGO Health Insurance.
    • HDFC ERGO Health Insurance processes the policy.
    • HDFC ERGO Health Insurance provides a decision within 15 days of receiving information from the previous insurer.

Premium

  • How can I calculate HDFC ERGO Health Insurance insurance premium?

    Calculating health insurance premium at HDFC ERGO Health Insurance insurance is easy. All you need to do fill the form available on the home page of this website. Enter your requirements, your age and InsuranceDekho will calculate the premiums based on the requirement you have inerted. You can also call our experts at to get your premium calculation related queries answered.

     

  • What are the factors that play a deciding role in calculating the premium in HDFC ERGO Health Insurance?

    Plan opted, coverage limit, age, number of people, pre-existing diseases, and family history are the major aspects that affect premium. Note that the premium increases with age. Also, that premium for family floater coverage is greater in comparison to the one in individual coverage. 

  • What are the modes of premium payment in HDFC ERGO Health Insurance?

    To pay your health insurance premium you can make use of either credit/debit card, cheque, net banking, UPI, or cash. To gather detailed information about premium payment, you can talk to experts at InsuranceDekho at 7551196989.

  • Does HDFC ERGO Health Insurance offer discount on renewal premium?

    By walking and staying healthy, you can earn up to 8% discount on your renewal premium. To uncover more, visit the website of HDFC ERGO Health Insurance. If interested, you can also call us at 7551196989. 

Senior Citizen

  • Is there any HDFC ERGO Health Insurance plan specially designed for Senior Citizens?

    Yes, HDFC ERGO Health Insurance Optima Senior is the plan, exclusively designed for Senior Citizens. This comes with comprehensive cover. 

  • Who is covered under the senior citizen plan of HDFC ERGO Health Insurance?

    The Senior Citizen plan of HDFC ERGO Health Insurance offers coverage for self and spouse on individual sum insured basis. 

  • Does HDFC ERGO Health Insurance offer any discounts to Senior Citizens?

    Yes, there is a discount of 5% if both you and your spouse are covered by the Senior Citizen policy. 

  • What are the key features of HDFC ERGO Health Senior Citizen health insurance policy?

    Key features of Senior Citizen health insurance policy for senior citizens are a Cumulative Bonus (CB) of 5% for every claim-free policy year, Cashless treatment Service, Sum Insured Enhancement at the time of renewal. 

Tax Benefit

  • Can I avail tax benefits with this HDFC ERGO Corona Kavach health insurance plan?

    Yes, you can earn the tax benefits on the premium amount of this HDFC ERGO Corona Kavach Plan. The tax deductions are available under the section 80D of the Income Tax Act, 1961.

     

Top-up

  • Are there any top-up plans offered by HDFC ERGO Health Insurance insurance?

    Yes! HDFC ERGO Health Insurance insurance provides Optima Super as its top-up plan.

  • What benefits does HDFC ERGO Health Insurance provide under its top-up plan?

    The benefits one can avail under HDFC ERGO Health Insurance top-up plan include Inpatient Treatment, Pre & Post-hospitalisation, Domiciliary Treatment, Expenses for Organ Donor, Day-care Procedures, Emergency Ambulance, and others. Furthermore, the affordable plan comes with 100% lifelong renewal, tax deduction under Section 80D, and various other benefits.

  • What is the eligibility criteria to buy a top-up plan by HDFC ERGO Health Insurance?

    Any individual in the age group ranging from 91 days to 65 years can purchase HDFC ERGO Health Insurance top-up plan.

  • Who should buy top-up plan by HDFC ERGO Health Insurance?

    HDFC ERGO Health Insurance top-up plan is an excellent choice for those who have group cover and low sum insured policies.

     

Woman

  • Does HDFC ERGO Health Insurance have a separate plan for women?

    To cater to women and their specific medical requirements, HDFC ERGO Health Insurance offers Easy Health plan. If interested, you can choose Exclusive or Premium variant of Easy Health plan.

     

  • What are the benefits offered by HDFC ERGO Health Insurance under its specific plans for women?

    HDFC ERGO Health Insurance, under its health insurance for women, provides multiple benefits including maternity benefit, new born baby cover (additional benefit on payment of the additional premium), in-patient treatment, pre & post hospitalisation, day care procedures, domiciliary treatment, lifelong renewability, tax benefits under Section 80D of the Income Tax Act, etc.

  • Does HDFC ERGO Health Insurance provide hospitalisation coverage delivering a baby via normal and cesarean?

    Yes, HDFC ERGO Health Insurance offers in-patient hospitalisation benefit for both normal and cesarean delivery.

  • Does HDFC ERGO Health Insurance offer AYUSH treatment under its health insurance plan covering maternity expenses?

    Yes, HDFC ERGO Health Insurance covers medical expenses for in-patient treatment taken under Ayurveda, Unani, Sidha, and Homeopathy, under its Exclusive or Premium variant of Easy Health plan covering maternity expenses.

HDFC ERGO Health Insurance Plan List

Name of PlanSum Insured
Optima RestoreMin: 91 Days, Max: 65 Years3 Lakh Get Quotes Now
Easy Health ExclusiveMin: 91 Days; Max: 65 Years3 Lakh Get Quotes Now
Easy Health PremiumMin: 91 Days; Max: 65 Years4 Lakh Get Quotes Now
Health WalletMin: 91 Days; Max: 65 Years3 Lakh Get Quotes Now
EnergyMin: 18 Years, Max: 65 Years2 Lakh Get Quotes Now
Dengue CareMin: 91 Days; Max: 65 Years50 Thousand Get Quotes Now
Easy Health Standard Min: 91 Days; Max: 65 Years1 Lakh Get Quotes Now
iCan CancerMin: 5 Years; Max: 65 Years5 Lakh Get Quotes Now
Optima VitalMin: 18 Years; Max: 65 Years1 Lakh Get Quotes Now
Optima SeniorMin: 61 Years; Max: No Limit 2 Lakh Get Quotes Now
Optima CashMin: 91 Days; Max: 65 Years1000/day Get Quotes Now
Maxima HealthMin: 91 Days; Max: 65 Years3 Lakh Get Quotes Now
Arogya Sanjeevani PolicyMin: 3 Months; Max: 65 Years 1 Lakh - 5 Lakh Get Quotes Now
Corona Kavach PolicyMin: 1 day; Max: 65 years50,000 - 5 lakh Get Quotes Now

HDFC ERGO Health Insurance Top Up List

Name of PlanSum Insured
Optima SuperMin: 91 Days; Max: 65 Years5 Lakh Get Quotes Now
Optima PlusMin: 91 Days; Max: 65 Years5 Lakh Get Quotes Now

Claim Process at HDFC ERGO Health Insurance

  • Network Hospital
  • Non-Network Hospital
  • 1

    Claim Assistance

    For any assistance or query, call InsuranceDekho at the toll-free number 755 1196 989.
  • 2

    Claim Intimation

    Emergency hospitalisation needs intimation within 24 hours and for planned hospitalisation intimate within 48 hours prior to admission.
  • 3

    Claim Processing

    Fill in the pre-authorisation form and hand it over to hospital's insurance/TPA desk to initiate claim request.
  • 4

    Claim Settlement

    Once your request is approved, claim is settled. If not approved, claim for reimbursement after discharge.
  • 1

    Claim Assistance

    For any assistance or query, call InsuranceDekho at the toll-free number 755 1196 989.
  • 2

    Claim Intimation

    Emergency hospitalisation needs intimation within 24 hours and for planned hospitalisation intimate within 48 hours prior to admission.
  • 3

    Claim Processing

    Submit claim form with original documents such as doctor’s reports, hospital bills, diagnostic tests, etc.
  • 4

    Claim Settlement

    Once your request for reimbursement of expenses is approved, the claim will be settled.

HDFC ERGO Health Insurance User Reviews

What users are saying
  • Prasad

    Excellent policy.

    Read More
    K
    Corona Kavach Policy
    By Konalaprasad
    On: Aug 02, 2020
  • A reliable choice

    The InsuranceDekho platform is quite a reliable choice for all the customers seeking insurance plans. It helpe...

    Read More
    A
    Arogya Sanjeevani Policy
    By Aniket Verma
    On: Jun 18, 2020
  • Value for money product

    This Arogya Sanjeevani Plan is an amazing health insurance coverage offered by United India Insurance Company....

    Read More
    U
    Arogya Sanjeevani Policy
    By Umesh Rawat
    On: Jun 16, 2020
  • The best a family can get

    The Arogya Sanjeevani policy by HDFC ERGO Health is a plan that every family deserves. It has provided me and ...

    Read More
    R
    Arogya Sanjeevani Policy
    By Rahul Lamba
    On: Jun 13, 2020
  • User-friendly platform

    InsuranceDekho is a user-friendly insurance platform that helped me find this Arogya Sanjeevani Policy. The in...

    Read More
    S
    Arogya Sanjeevani Policy
    By Sumit Kumar
    On: Jun 12, 2020
  • Extensive coverage available

    The InsuranceDekho team offered me this plan for my family as it has got high coverage options that include en...

    Read More
    J
    Arogya Sanjeevani Policy
    By Jatin Saxena
    On: Jun 02, 2020
  • Highly Satisfied

    Care Freedom health insurance plan has designed this plan in accordance to the requirements of senior citizens...

    Read More
    B
    Care Freedom
    By Bijendra Singh Rawat
    On: Feb 28, 2020
  • Committed and Prompt!!

    This is one of the greatest plan available in the market for senior people. I am happy to witness the commitme...

    Read More
    N
    Care Freedom
    By Naresh Verma
    On: Feb 28, 2020
  • Decent and affordable scheme.

    I found this scheme very easy to use and affordable to bear. I am using this plan for more than 2 years and mu...

    Read More
    V
    Optima Senior
    By Vishank Agnihotri
    On: Feb 20, 2020
  • Great top-up plan!

    This top up plan has been a perfect solution to all my problems. There are many benefits under this plan that ...

    Read More
    J
    Optima Super
    By Jaikishan Singh
    On: Feb 17, 2020

HDFC ERGO Health Insurance Contact Details

Reach us for help anytime

Latest HDFC ERGO Health Insurance News