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HDFC ERGO Maxima Health Insurance Wordings

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Highlights
Cashless Approval TAT45 mins Cashless Claim Processing
Claim Settlement Ratio100%
Network Hospitals12,000+
PED Coverage Starting From3 year
Special Benefits2X Cover from Day 1
Starting Premium Rs. 1090/month

Health Insurance Calculator

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Disclaimer : Actual Premium might vary basis your location, age and number of members

HDFC ERGO Health Insurance Plan List

  • Family (3)
  • Individual (4)
  • Cancer (1)
  • Critical Illness (2)
  • Diabetes (1)
  • Parents (1)
  • Senior Citizen (1)
Name of PlanSum Insured
Optima SecureMin: 91 Days, Max: 65 Years Check Premium
Optima RestoreMin: 91 Days, Max: 65 Years3 Lakh Check Premium
my: health SurakshaMin: 91 Days; Max: No Limit3 Lakh Check Premium
Health Suraksha Top-Up Plus PolicyMin: 91 days; Max: 65 years3 Lakh - 10 Lakh Check Premium
my:Health Women Suraksha PolicyMin: 18 years; Max: 45 years1 Lakh - 1 Crore Check Premium
Dengue Care Policy Min: 91 Days; Max: 65 years50 Thousand - 1 Lakh Check Premium
Easy Health PolicyMin: 91 days; Max: 65 years1 Lakh - 50 Lakh Check Premium
my:Health Koti SurakshaMin: 18 years; Max: 65 years Check Premium
Maxima PolicyMin: 91 Days; Max: 65 years Check Premium
Day2Day Care PolicyMin: 91 Days; Max: 65 years Check Premium
iCan CancerMin: 5 Years; Max: 65 Years5 Lakh Check Premium
Health WalletMin: 91 Days; Max: 65 Years3 Lakh Check Premium
EnergyMin: 18 Years, Max: 65 Years2 Lakh Check Premium
Optima SeniorMin: 61 Years; Max: No Limit 2 Lakh Check Premium
Corona Kavach PolicyMin: 1 day ; Max: 65 years50,000 - 5 lakh Check Premium
Arogya Sanjeevani PolicyMin: 3 months; Max: 65 years1 Lakh - 5 Lakh Check Premium
Critical Illness PlanMin: 5 Years; Max: 65 Years 5 Lakh Check Premium

HDFC ERGO Health Insurance Top Up List

  • Top-up (4)
  • Family (1)
  • Individual (1)
Name of PlanSum Insured
Optima PlusMin: 91 Days; Max: 65 Years5 Lakh Check Premium
my: Health Medisure Super Top-upMin: 3 Months; Max: 65 Years3 Lakh Check Premium
Optima SuperMin: 91 Days; Max: 65 Years5 Lakh Check Premium

9552 HDFC ERGO Cashless Network Hospitals in India

Choose HDFC ERGO Critical Illness Plan

FAQs on Maxima Policy Health Insurance Plan

  • Am I covered for outpatient expenses under Maxima Policy?

    Yes. Maxima Policy covers you for the following outpatient expenses:

    • Doctor consultations
    • Pharmacy expenses
    • Diagnostics
    • Specialist services
    • Health check-ups
    • Pre-existing illnesses under OPD benefits
  • Am I covered for dental treatment under Maxima Policy?

    Yes. Maxima Policy covers you for dental treatment, contact lenses, and spectacles, up to a certain limit, as a part of specialist services. 

  • Which in-patient hospitalisation expenses am I covered for under Maxima Policy?

    Maxima Policy covers you for a sum insured of Rs. 3 Lakh that includes in-patient treatment, pre-hospitalisation and post-hospitalisation expenses, daycare procedures, domiciliary treatment, daily cash in case of shared accommodation, etc. The policy also covers you for emergency ambulance expenses, organ donor expenses, daily cash for accompanying the insured child, care for a newborn, and maternity expenses.

  • Can I avail tax benefits on the premium paid for Maxima Policy?

    Yes. You can avail tax benefits on the premium paid for Maxima Policy, under Section 80D of the Income Tax Act, 1961. 

  • Is there any limit on cover for doctor’s consultations under Maxima Policy?

    Yes. If one member is covered under the Maxima Policy, then he/she can avail up to 4 consultations per policy year; if two members are covered under the Maxima Policy, then he/she can avail up to 6 consultations per policy year; whereas if 2 adults+up to 2 children are covered under the policy, then up to 8 consultations can be availed. 

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 Contact Details

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