What is the minimum and maximum entry age of people under the Optima Plus Plan?

The minimum entry age under this plan is 5 years, while the maximum entry age goes to the age of 65 years. The dependent kids are allowed to be covered from the 91st day, only if either of their parents is covered under this plan.

Who all members from the family are allowed to be covered under this plan?

You and your family members including spouse, dependent kids, dependent parents are eligible to get covered under this plan.

How many members can be covered under the Optima Plus Top-up individual plan?

When it comes to the individual plan of Optima Plus Top-up Policy, a maximum of 4 adults and a maximum of 5 kids can be incorporated in a single policy.

Does Optima Plus Top-up Plan provide any discount to its customers?

Yes, if anyone owns the plan with 2 or more family members, he or she is provided with a family discount of 10%. Also, on choosing this policy for 2 years, 7.5% discount is offered.

What is the policy period for this plan?

The policy can be issued for 1 year or 2 years period after which it needs renewal.

Does this plan own TPA for claim settlement procedure?

No, all claims under the Optima Plus Plan will be processed and settled by in-house claim team only.

Does the plan offer coverage for the emergency ambulance?

Yes, emergency ambulance expenses are provided for up to Rs. 2000 per hospitalisation.

Are daycare treatments covered under the Optima Plus Plan?

Yes, coverage is offered for specified 140 daycare procedures that do not require hospitalisation for 24 hours.

Does this policy offer domiciliary hospitalisation cover for senior citizens?

Yes, the plan gives the coverage for domiciliary hospitalisation to all the insured members including the senior citizens.

Can I earn tax benefit on the purchase of the Optima Plus Plan?

Yes, you can attain tax benefits with this plan as per the section 80D of the IT Act.

HDFC ERGO Optima Plus Health Insurance Wordings

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Highlights

Cashless Approval TAT	Within 37 mins
Claim Settlement Ratio	99.80%
Network Hospitals	13,000+
PED Coverage Starting From	3 year
Special Benefits	2X Cover from Day 1
Starting Premium	Rs. 1090/month

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HDFC ERGO Optima Plus Brochure

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Sep 05, 2019

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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 Optima Plus Health Insurance Plan

What is the minimum and maximum entry age of people under the Optima Plus Plan?
The minimum entry age under this plan is 5 years, while the maximum entry age goes to the age of 65 years. The dependent kids are allowed to be covered from the 91st day, only if either of their parents is covered under this plan.
Who all members from the family are allowed to be covered under this plan?
You and your family members including spouse, dependent kids, dependent parents are eligible to get covered under this plan.
How many members can be covered under the Optima Plus Top-up individual plan?
When it comes to the individual plan of Optima Plus Top-up Policy, a maximum of 4 adults and a maximum of 5 kids can be incorporated in a single policy.
Does Optima Plus Top-up Plan provide any discount to its customers?
Yes, if anyone owns the plan with 2 or more family members, he or she is provided with a family discount of 10%. Also, on choosing this policy for 2 years, 7.5% discount is offered.
What is the policy period for this plan?
The policy can be issued for 1 year or 2 years period after which it needs renewal.
Does this plan own TPA for claim settlement procedure?
No, all claims under the Optima Plus Plan will be processed and settled by in-house claim team only.
Does the plan offer coverage for the emergency ambulance?
Yes, emergency ambulance expenses are provided for up to Rs. 2000 per hospitalisation.
Are daycare treatments covered under the Optima Plus Plan?
Yes, coverage is offered for specified 140 daycare procedures that do not require hospitalisation for 24 hours.
Does this policy offer domiciliary hospitalisation cover for senior citizens?
Yes, the plan gives the coverage for domiciliary hospitalisation to all the insured members including the senior citizens.
Can I earn tax benefit on the purchase of the Optima Plus Plan?
Yes, you can attain tax benefits with this plan as per the section 80D of the IT Act.

View More Questions

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.