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HDFC ERGO Optima Plus 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 Optima Plus Brochure

  • 571.32 KB
  • PDF Document
  • Sep 05, 2019

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 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.

     

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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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