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.

HDFC ERGO Maxima Health Insurance Wordings

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Highlights

Cashless Approval TAT	45 mins Cashless Claim Processing
Claim Settlement Ratio	100%
Network Hospitals	12,000+
PED Coverage Starting From	3 year
Special Benefits	2X 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 Plan	Sum Insured
Optima SecureMin: 91 Days, Max: 65 YearsPopular		Check Premium
Optima RestoreMin: 91 Days, Max: 65 YearsPopular	3 Lakh	Check Premium
my: health SurakshaMin: 91 Days; Max: No LimitPopular	3 Lakh	Check Premium
Health Suraksha Top-Up Plus PolicyMin: 91 days; Max: 65 years	3 Lakh - 10 Lakh	Check Premium
my:Health Women Suraksha PolicyMin: 18 years; Max: 45 years	1 Lakh - 1 Crore	Check Premium
Dengue Care Policy Min: 91 Days; Max: 65 years	50 Thousand - 1 Lakh	Check Premium
Easy Health PolicyMin: 91 days; Max: 65 years	1 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 Years	5 Lakh	Check Premium
Health WalletMin: 91 Days; Max: 65 Years	3 Lakh	Check Premium
EnergyMin: 18 Years, Max: 65 Years	2 Lakh	Check Premium
Optima SeniorMin: 61 Years; Max: No Limit	2 Lakh	Check Premium
Corona Kavach PolicyMin: 1 day ; Max: 65 years	50,000 - 5 lakh	Check Premium
Arogya Sanjeevani PolicyMin: 3 months; Max: 65 years	1 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 Plan	Sum Insured
Optima PlusMin: 91 Days; Max: 65 YearsPopular	5 Lakh	Check Premium
my: Health Medisure Super Top-upMin: 3 Months; Max: 65 YearsPopular	3 Lakh	Check Premium
Optima SuperMin: 91 Days; Max: 65 Years	5 Lakh	Check Premium

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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.