HDFC ERGO Health Optima Senior Plan (formerly known as Apollo Munich Health Insurance)
Optima Senior plan is served by HDFC ERGO Health Insurance (formerly known as Apollo Munich Health Insurance). It is a health plan for senior citizens. Optima Senior Plan can be bought to make the old age comfortable and stress-free. The human body falls weak with the growing age so plans like Optima Senior can be taken as a support to the old age. To buy Optima Senior Plan, you need several pieces of information regarding the same. So, here is the relevant information for your help.
The eligibility criteria have been mentioned below:
|Minimum Entry Age||61 Years|
|Maximum Entry Age||No Limit|
|Policy Tenure||1 or 2 Years|
|Coverage Amount||Rs.2 Lacs, Rs.3 Lacs or Rs. 5 Lacs|
Features Of HDFC Ergo Health Optima Senior?
The features are as follows:
- Lifelong Renewability
After you have bought the Optima Senior Plan, you are covered and the policy can be renewed forever.
- Second E-Opinion
In case you are suffering from critical illness then the HDFC Ergo Health Optima Senior Plan has a provision under which you can take a second opinion from a team of medical experts relating your treatment.
The services provided by HDFC ERGO Health Insurance (formerly known as Apollo Munich Health Insurance) is to its best and adorable. But still, HDFC ERGO Health Insurance company (formerly known as Apollo Munich Health Insurance) provides you with the liberty to choose an insurance company of your choice in case you are not satisfied with the services provided by the company or the terms and conditions of the company.
- No Claim Discount
HDFC ERGO Health Insurance (formerly known as Apollo Munich Health Insurance) Health Insurance company provides no claim discount under the Optima Senior Policy. The insured gets a 5% discount on the renewal premiums payable for the claim-free years. It is subjected to a condition that the policy renewal should be done frequently without any pause or break.
- Cashless Transactions
The 4000+ huge spread network hospital of HDFC ERGO Health Insurance (formerly known as Apollo Munich Health Insurance) Optima Senior Policy across 800 cities gives the policyholder the golden opportunity to take the service of the HDFC ERGO Health Insurance (formerly known as Apollo Munich Health Insurance) Health Insurance company.
- Waiting Period
There is a waiting period of 3 years under the plan for certain illnesses.
- Medical Check-up
Under the HDFC ERGO Health Insurance (formerly known as Apollo Munich Health Insurance) Optima Senior Policy the policy buyer is cross-examined before getting the custody of the policy. The medical examination is subjected to the age of the policy buyer and the medical test includes tests like a blood test, cardiac status, cholesterol levels, blood sugar, urine analysis, and cardiac test to check the condition of the heart and kidney.
After the medical test is finished and you pass the medical examination then you are eligible to buy the HDFC ERGO Health Insurance (formerly known as Apollo Munich Health Insurance) Optima Senior Plan and 50% of the medical examination expenses incurred are paid by the insurance company under the terms and conditions.
- Tax Benefit
The premiums paid under HDFC Ergo Health Optima Senior are tax exempted under section 80D of the income tax act, 1961
Coverage Under HDFC Ergo Health Optima Senior Policy
Other than the insured sum coverage there are many other coverages provided under this policy. The same has been presented in tabular form for your convenience:
|In-patient Treatment||Coverage Available|
|Pre-Hospitalization||Coverage Available up to 30 days before hospitalization|
|Post Hospitalization||Coverage Available till 60 days after discharge from the hospital|
|Day Care Procedures||Coverage Available for 140 Day Care Procedures|
|Domiciliary treatment||Coverage Available|
|Organ Donor||Coverage Available|
|Emergency Ambulance||Coverage up to Rs. 2000 per hospitalization|
|E-Option||Once a policy year|
Optima Senior Policy Premium Calculation
Here is a table to give you a rough idea about the premiums that have to be paid for a particular sum insured (SI).
|Age Of Insured||If SI Rs. 2 Lacs||If SI Rs. 3 Lacs||If SI Rs. 5 Lacs|
|61 Years - 65 Years||Rs. 11,932||Rs. 14,615||Rs .22,553|
|66 Years - 70 Years||Rs. 15,137||Rs. 19,201||Rs. 30,719|
|71 Years - 75 Years||Rs. 18,367||Rs. 23,986||Rs. 39,428|
|76 Years - 80 Years||Rs. 24,219||Rs. 31,629||Rs. 52,125|
|81 Years - 85 Years||Rs. 32,051||Rs. 42,433||Rs. 70,849|
|> 85 Years||Rs. 42,497||Rs. 57,032||Rs. 96,402|
CoPayments In HDFC Ergo Health Optima Senior Plan
In HDFC Ergo Health Optima Senior Policy, co-payments are applicable. The insured needs to bear a percentage of medical expenses in collaboration with the HDFC ERGO Health Insurance (formerly known as Apollo Munich Health Insurance) Health Insurance company. Details are mentioned below:
- A co-payment of 15% is applied for twin sharing and 30% is for a single private room.
- Copayment for 30% applies to certain illnesses surgery. The list contains cataract, hysterectomy, arthroscopy, etc. other than this, there are no additional co-payments applicable under this case.
- All daycare falls under co-payment applicability of 15%.
Exclusions Of The Policy
- In the initial 30 days of cover, no treatment relating to any illness is entertained, except accidental injury.
- Pre-existing conditions are only considered after the completion of the waiting period of three years.
- Costs arising from HIV or AIDS treatment.
- Psychiatric treatment expenses, mental disorder, congenital disease, non-allopathic treatment, cosmetic surgery, hair-fall treatment, etc are not covered.
- Medical treatment for alcoholism and drug addiction is also not covered.
- Any injury in war or due to nuclear, chemical or biological weapons does not get a cover.
- Items bought for personal comfort and luxury are not entertained.
- 2 years of the waiting period for treatment like hernia, hysterectomy, joint replacement, hydrocele, cataracts do not get coverage.
HDFC Ergo Health Optima Senior Policy Renewal
Here are few facts relating the terms for renewal of the policy:
- A grace period of 30 days is provided to the insured for the renewal of the policy. The insured can pay the renewal premium within the grace period to get the policy renewed.
- There is nothing like maximum cover ceasing age under the policy. This means the policy has lifelong renewability.
- For every continuous renewal, the waiting period mentioned in the policy decreases by 1 year.
- The insured sum can be incremented at the time of renewal of the policy.
- An insured can take the benefit of the port facility to change to another insurance entity only at the time of renewal of the policy. All the accumulated bonuses, waivers of the waiting period are restored when the insured ports the insurance company.
Discounts Under HDFC ERGO Health Optima Senior Plan (formerly known as Apollo Munich Health Insurance)
Below mentioned are the discounts that a buyer should be aware of:
- In case the policy is renewed without a break then for every claim-free policy year the insured get a 5% discount on the renewal premiums.
- A 5% discount is applicable in case both the husband and wife choose to buy the plan.
- In case you opt for a two-year policy then you get an additional discount of 7.5% on the total premium.
Optima Senior Plan Review
HDFC Ergo Health optima senior plan is one of the best health plans for senior citizens to invest in. Human beings get more prone to illness as they grow in age. So, it is essential to have a health plan that provides you with several facilities relating to claim and renewal. Moreover, it provides a discount under certain cases. So, buy a policy today.