Health Insurance is there to provide financial support by paying for healthcare expenses during any medical emergency. Therefore, it is very important to get health insurance which will provide you complete coverage anytime. HDFC ERGO is one of the best health insurance companies, that pledged to provide 360-degree coverage. The company was founded as a joint venture between HDFC Limited and ERGO International AG, which is a Germany-based company in 2020, and became HDFC ERGO General Insurance. They offer a variety of insurance products like Motor, health, travel, home, personal, marine, and much more.
What does HDFC ERGO Health Insurance do?
In the health insurance vertical, HDFC ERGO General Insurance showcases a wide array of products. These products include customized health insurance policies created for Individuals, Families, Parents, and Senior Citizens. They also have some tailored coverage for critical illness and personal accidents, that you can avail during any emergency.
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HDFC Ergo Health Insurance Plan Detailed Review
Some Interesting Facts About HDFC ERGO Health Insurance Company
HDFC ERGO General Insurance Company Limited was promoted by Erst While Housing Development Finance Corporation Limited.
Earlier, HDFC ERGO Health Insurance was known as Apollo Munich Health Insurance Company.
Having a claim settlement ratio of 98.49% and a solvency ratio of 0% HDFC ERGO General Insurance Company has become the second top company in the health insurance world.
All you need to know about HDFC ERGO Health Insurance? Find complete details in one go!
BFSI Leadership Awards 2022 for Cyber Insurance and Optima Secure Health Insurance.
ETBFSI Excellence Awards 2021 for best COVID strategy implemented- Customer Experience
FICCI Insurance Industry Awards September 2021, for claims and customer service excellence.
A Quick Outlook
Cashless Claim Settlement
2 hours
Minimum Entry Age
91 days
Maximum Entry Age
65 years
Sum Insured
Upto 1 Crore
Network Hospital
12000+
Tax Benefits
Upto 1 Lakh
Solvency Ratio (2021-22)
1.68
Claim Settlement Ratio (2021-22)
98.49%
Ambulance Expenses
Covered
Coverage for Accidents
Yes
HDFC ERGO General Insurance Plans
HDFC ERGO General Insurance offers a range of health insurance plans for their clients. These plans will cater to your different needs and requirements.
HDFC ERGO Health Insurance Individual and Family Floater Plans
Designed especially for people with pre-existing diabetes or hypertension. Get coverage for diabetes and hypertension from Day 1 without any waiting period.
Covers all types of cancer at all stages with lifelong renewability option. If diagnosed with IV stage cancer or relapse, this plan pays 100% of SI as a lump sum.
Unique Features
Coverage for modern treatments
Second opinions available
Coverage for follow-up care
HDFC iCan Cancer (Pros)
Ambulance Cover
Follow up care post treatment
Conventional Treatments
Hormonal Treatment
Stem Cell Transplantation
HDFC iCan Cancer (Cons)
No Non Allopathic treatments
No Prosthetic Devices
No Overseas Treatments
Pre-existing condition for Cancer
HDFC iCan Cancer (Other Benefits)
Sum Insured Enhancement
CritiCare Benefit
Family Care Benefit
Lifetime Renewal
MyCare Benefit
HDFC iCan Cancer (Eligibility Criteria)
Entry Age - 18 Years
Max Entry Age - 65 Years
SI - 5 L to 50 L
Waiting Period - 120 Days
HDFC ERGO Critical Illness, Bonus-oriented health plan, Top-Up, Women-oriented health Plans
An ideal health plan for people with a pre-existing critical illness or a family history of critical illnesses. Get comprehensive coverage for 15 critical illnesses.
A flexible and comprehensive health plan, securing your today & tomorrow. With 'Reserve Benefit' features, this plan grows unused policy amount @6% interest rate.*
Avail of extra cover to meet medical expenses without any limitations by purchasing this deductible-based top-up plan.
Unique Features
Constant premiums post 61 years
No medical checkup up to 55 years
5% discount on 2-year policy term
My:health Medisure Super Top-up (Pros)
In- Patient Hospitalization
High Cover at Low Premium
Post 61 Year No Premium Hike
Day Care Procedure
Pre and Post Hospitalization
My:health Medisure Super Top-up (Cons)
Treatment Of Obesity
Self Inflicted Injury
War Operations Injury
Sexsually Tranmitted Diseases
No Cosmetic Surgery
My:health Medisure Super Top-up (Other Benefits)
Free Look Period
Two Year Policy Period
Guaranteed Renewal for Life
Loading on Renewal
Individual and Floater Options
My:health Medisure Super Top-up (Eligibility Criteria)
Entry Age - 18 years
Max Entry Age - 65 Years
SI - 1 L to 10 L
Waiting Period - 30 Days
Women-oriented health
HDFC ERGO My:health Women Suraksha
Women-oriented health plan providing comprehensive medical insurance with major illnesses cover, and cancer cover all under a single plan but different variants.
Unique Features
Maternity complications
SI options from 3L - 1 Cr
Free preventive health checkup
My:health Women Suraksha (Pros)
AYUSH Benefit
Alternative Treatment
Organ Donor Benefit
Domiciliary Hospitalization
Pre and Post Hospitalization
My:health Women Suraksha (Cons)
Adventure Sports Injuries
No Sexsually Transmitted diseases
No Cosmetic Surgery
Alcoholism issues not covered
No Self Inflicted Injuries
My:health Women Suraksha (Other Benefits)
Parent and Child care Cover
Child Care Benefit
Vaccination
Air Ambulance
Health Coach
My:health Women Suraksha (Eligibility Criteria)
Entry Age - 18 years
Max Entry Age - Lifetime Entry
SI - 1 L to 1 Cr
Waiting Period - 30 Days
Why Choose HDFC ERGO General Insurance?
HDFC ERGO General Insurance is a dedicated insurance company that aims to provide a 100% financial safety net. They have significantly designed each of their products with care, that will be suitable for every age group. There are various reasons why you should choose HDFC ERGO General Insurance. Have a look below-
A Trustworthy Brand
At HDFC ERGO, the main motto of the brand is to make insurance easier, more affordable, and more dependable. Their commitment to health insurance and keeping numerous lives secured is very determined.
Cashless Approval for Chronic Diseases
You can get swift approval for cashless treatment for any chronic disease. This way you can kickstart your journey to recovery as soon as possible.
A Wide Range of Health Insurance Plans
HDFC ERGO has a wide range of health insurance plans. You can compare and choose the best among them that will suit your and your family's requirements.
Discounts on mediclaim and diagnostic tests
The discount on mediclaim and diagnostic tests can make your healthcare affordable. You can avail of these discounts at partner e-pharmacies and diagnostic centers.
Tax Saving
You can save tax up to Rs 1 Lakh depending upon the policy to policy.
Know What is Covered- Inclusions
Hospitalization Expenses
Just like other health insurance plans, HDFC ERGO also covers your hospitalization expenses such as room rent, ICU, surgery, doctor fees, and much more during the time of illness or injury.
Mental Healthcare
Mental Healthcare is as important as physical healthcare. Therefore, with HDFC ERGO you will get coverage for hospitalization expenses which are incurred for treating mental illness.
Pre and Post Hospitalization
Your pre-hospitalization and post-hospitalization expenses will be covered. Your pre-hospitalization expenses up to 60 days of admission and post-discharge expenses till 180 days get covered. Expenses like diagnostic costs, physiotherapy, consultation, and much more.
Day Care Treatments
Medical advancements have made the procedures very fast. Many surgeries like cataract takes only 24 hours and HDFC ERGO General Insurance covers them all.
Home Healthcare
If you get approval for home treatment, due to the non-availability of beds much more will be covered in your insurance. This way you can get the right medical treatments in the comfort of your home
Sum Insured Rebound
It is a backup that recharges your exhausted health cover to treat the next hospitalization. With this cover, HDFC ERGO ensures uninterrupted medical coverage in the hard times.
Organ Donor Expenses
To encourage a noble cause, HDFC ERGO covers the medical and surgical expenses of the organ donor while harvesting any major organ from the body of the donor.
Recovery Benefits
If by any chance there is a need to stay in the hospital for more than 10 days at a stretch, then your other expenses will also be covered. In this, HDFC ERGO will pay other financial losses that might have happened during your absence at home. It will help you to take care of all the required expenses during the hospitalization.
AYUSH Benefits
Now, you can get treatment from traditional methods like Ayurveda, Unani, Siddha, and Homeopathy. HDFC ERGO General Insurance covers you with the AYUSH treatment as well.
Free Renewal Health Check-ups
With HDFC ERGO you will get free health check-ups within 60 days of renewal of your policy.
Lifelong Renewability Option
With HDFC ERGO you will get lifelong coverage. Their plans secure you against medical expenses for your entire lifetime on break-free renewals.
Multiplier Benefits
With HDFC ERGO, you will get multiplier benefits. This means, your sum insured will grow by 50% in the next policy year if you don't make any claim in your first year. So, if your sum insured is Rs 5 Lakh in the first year, next year it would be Rs 7.5 Lakh.
What is not Covered?- Exclusion
Adventure Sport Injuries
No doubt adventure gives us an adrenaline rush, but when this adrenaline couples with accidents, it can be life-threatening. A lot of expenses might occur due to these sports injuries, but the health insurance plan will not cover it. Some examples of these activities are, bungee jumping, river rafting, cliff climbing, and much more.
Self-Inflicted Injuries
If you intentionally harm yourself and end up in the medical expenses. Then you have to manage it on your own.
War
War can be unfortunate as well as disastrous. However, the company will not cover the claim that is caused due to war.
Defense Operations
HDFC ERGO does not cover accidental injury happening due to participation in defense operations.
Sexually Transmitted Diseases
Sexually transmitted can be very critical, but HDFC ERGO does not cover these diseases.
Cosmetic Surgery
Treatment of obesity or cosmetic surgery is not included under the health insurance plan.
What is the Waiting Period in HDFC ERGO General Insurance?
The waiting period for HDFC ERGO General Insurance is a certain time period where you need to wait before claiming a health insurance policy. In simple terms, the company incurred some kind of time period, maybe it is 30 days or 1 year, in between you have to pay the premiums but you cannot go for the claim process. However, it depends totally on the policy you choose or any pre-existing disease is there. There are several types of waiting periods, such as:
First 30-day waiting periodThis is the initial waiting period or cooling period that applies to most health insurance.
Pre-existing diseases (PEDs) Waiting PeriodIf you are suffering from any pre-existing diseases, then it becomes necessary to complete a specific waiting period which will be decided at the time of decision-making.
Disease-specific Waiting PeriodSome of the diseases like Cataract, ENT, Hernia, and much more have a specific waiting period to offer.
Waiting Period for Maternity ExpensesMany insurance policies put a waiting period before you can claim for maternity expenses under the Health Insurance Plans.
Factors to Consider While Buying a Health Insurance Plan
Have you ever wondered which is the best health insurance plan for you when you check out those health insurance plans? Let us read below to know the answer.
Understand your Healthcare Needs-You must evaluate your healthcare requirements like age, existing medical conditions, frequency of doctor's visits, and what medical treatments you need.
Understand Coverage Options-Ask questions to familiarize yourself with the different plans like family plans, employer-sponsored plans, critical illness plans, senior citizens plans, and much more. Every plan offers different coverage limits and benefits.
Review Cost and Affordability-You must evaluate the premiums, deductibles, and co-payments. Compare the cost of different plans, and choose the best for you.
Examine the Benefits and Services- Check out the benefits and services offered by every plan before choosing for yourself. Access the coverage for hospitalization like whether it covers enough services for your needs in the future. Look for the additional benefits of modern and alternative treatments.
Read the documents-Go through the documents before purchasing the one for you. Pay keen attention to every small detail on inclusions and exclusions and other things. Understand the process of claim settlement and the process of filing complaints.
Adequate Sum Insured-You need to get yourself an adequate sum insured. For example, the sum insured by a person living in a metro city is higher than the one who is living in a tier 2 city. Similarly, the sum insured for the family floater plan will be higher, so it is necessary for you to select the adequate sum insured.
No Sub-Limits Help-Usually, your medical expenses depend on the type of hospital room you choose. Therefore, it is recommended to go for a health insurance plan that does not have any sub-limits on the room rent. Most of the policies by HDFC ERGO do not only diseases.
Why Choose Online Procedure to Buy Mediclaim Policy?
Getting a medical insurance policy online from Policyx or directly from the company is full of benefits. Read below to know more.
Easy to Compare-Online platforms give access to compare different Star Health plans at the same place. You can pick the right one for you while comparing the premiums.
Buying Insurance within 5 minutes-At an online platform you can choose and buy your policy within 5 minutes, without any hustle and bustle.
24*7 Customer Service-The experts are always at your service. No matter what the time is, you can contact them any time to clear your doubts.
Instant Quote-With online accessibility, you can get quotations with one click. You can collect several quotes and choose the right one for you.
Benefits of Purchasing at an Early Age
Although, there are no specific age criteria for buying health insurance plans. But buying insurance at an early age is highly beneficial. Read below to get to know why buying health insurance at an early age is beneficial.
Your premiums will be less at an early age.
At an early age, a continuous cover with renewals will help you to go out with the waiting period.
No medical test is required if you purchase health insurance at an early age.
You can avail a no-claim bonus for every claim-free year.
You do not need to share your medical bills as the co-payment is not applicable in this case.
How to Renew Health Insurance Policy?
To avail of the continuity of the benefits, you need to renew your health insurance policy on time. In the below content, you will get some simple steps on how to renew your health insurance policy.
Step 1
Visit the official website of HDFC ERGO General Insurance.
HDFC ERGO offers a smooth and quick buying process for every type of HDFC ERGO Health Insurance policy. You can buy the HDFC health insurance plans from the company's official website as well as through PolicyX.com.
Buy from the Company
Visit the company's official website.
Choose the desired health plan and click on the 'Buy' button.
Fill in all the necessary details.
Calculate the premium and make the payment.
The insurer will send the policy documents to your registered email address.
Pay the premium and your HDFC ERGO policy document will be shared on your registered email.
How to Claim?
HDFC ERGO Health insurance offers two simple claim process to file claims i.e. Cashless Claim Process and Reimbursement Claim Process. Take a look at both claim settlement processes of HDFC medical insurance in the section below:
The company claims to approve cashless claims within 20 mins and the process is defined below:
Intimate the company by filling the pre-auth form
The company will update you on the status of the form
Hospitalization will be done on the basis of claim form approval
At the time of discharge of the patient, the company will settle the claim directly with the hospital.
The company claim that it settles the reimbursement claim within 6 working hours and the process is mentioned below:
Intimate the company within 48 hours of hospitalization (24 hours in case of emergency)
Submit the claim form along with ID proofs, KYC documents, and a canceled cheque
Claim team will verify the form and the documents
The company will send the approval letter
Insurance company will reimburse the claim amount within 6 working days
Documents Required
While filing the claim you need to keep these documents handy. Read below to know more-
The claim form with your signature and valid identity proof.
Prescription of the doctor stating hospitalization, diagnostic tests, and medicines.
Original Hospital, diagnostic, doctors, and medicine bills along with receipts.
Discharge summary, case papers, and investigation reports.
Police FIR/medico-legal case report (MLC) or post-mortem report if applicable.
Proof of named Bank Account like Cheque copy/Passbook/Bank statement.
How to Calculate the Premiums?
You can calculate your health insurance premiums online at Policyx. This HDFC ERGO General Insurance premium calculator is a tool that is designed to enable some potential buyers to estimate the premiums that they need to pay.
HDFC ERGO Health Insurance Optima Restore
Age: 30 years
1 Adult
2 Adult
2 Adult+1 Child
Average Premium (INR)
5L
8852
15935
22603
15796
15L
13873
24971
34017
24287
HDFC ERGO Health Insurance Optima Secure for Senior Citizens
Age: 65 years
1 Adult
2 Adult
Average Premium (INR)
5L
49045
71114
60079
15L
135205
109556
122380
HDFC ERGO Health Insurance Critical Illness Silver
Age: 30 years
1 Adult
Average Premium (INR)
5L
1475
15796
10L
2950
24287
HDFC ERGO Top-Up Plans
One of the very specific features of HDFC ERGO Insurance company is known as Top-up plans. Currently, the company is offering two variants with two plan options for each:
My health-medisure Super top-up plan
Health Suraksha Top-Up Health Insurance
These plans have their own benefits and features, which you can avail of by paying regular premiums. You can calculate your premiums at the premium Calculator or you can contact Policyx experts to know more.
HDFC Ergo entails a wide network of cashless Hospitals that impact millions of lives PAN India. A well connected network of over 13,000+ cashless hospitals, HDFC Ergo ensures that you are medically secured, irrespective of the city you reside in.
Choose Policyx for all your HDFC ERGO Health Insurance-related queries.
PolicyX is a reliable source to buy health insurance policies. Well, we are here to answer. about why PolicyX.com is the best option to buy the HDFC ERGO health insurance policy.
IRDAI ApprovedPolicyX.com is an IRDAI approved web aggregator that helps consumers in comparing, choosing, and buying policies online.
Free Comparison ServicePolicyX.com provides a single platform where you can compare different insurance companies, insurance plans, and their premiums.
Compare 15 companies in 30 secConsumers can compare up to 15 companies in just 30 sec on PolicyX.com.
Buy Insurance within 5minsPolicyX offers a simple and quick buying process where consumers can buy insurance in less than 5mins.
24x7 Customer ServicePolicyX is always with their customers as we offer 24x7 customer care service.
Free Future Claim AssistancePolicyX is always there to help and assist your claim under any term insurance company.
How To Contact HDFC ERGO Health Insurance?
For HDFC ERGO mediclaim policy related queries, you can contact the company in the following ways:
Registered & Corporate Office
1st Floor, HDFC House, Backbay Reclamation, H. T. Parekh Marg, Churchgate, Mumbai - 400020
Health Insurance Claim office (HCS - Noida)
5th floor, Tower 1, Stellar IT Park, C-25, Sector-62, Noida, UP, India - 201301
Contact through Whatsapp App:
73045 24888, 8169500500
For buying a new policy: 022 6242 6242
HDFC ERGO Health Insurance: Frequently Asked Questions
1. When can I include my kids in HDFC health insurance policies?
You can include your kids post 90 days of birth up to 21 years of age in HDFC health insurance policies.
2. Is it necessary for me to undergo medical tests before buying health insurance?
Yes, to buy HDFC health insurance policy, you may be required to undergo a medical examination. Some health insurance policies only require it if you have a pre-existing condition or you are above 40yrs of age.
3. Will a health plan offered by HDFC ERGO cover pre-existing illness?
Your respective insurance company will not cover pre existing illnesses for a certain time period at the starting of your policy term. This is called the waiting period. Different pre-existing diseases have different waiting periods, so you can get in touch with your insurance company or go through your policy documents once and find out about the waiting period for your disease. Some of the conditions which are pre-existed are completely excluded from the health plans.
4. What is the waiting period for pre-existed illness in HDFC ERGO Health Insurance?
If you are suffering from health-related problems at the time of buying a health insurance plan or you have had any medical history such as hypertension, high blood pressure, diabetes, etc then this should be informed to your respective health insurance company. HDFC ERGO covers pre-existing diseases after a 4 years waiting period. So once your waiting period is covered for the informed diseases, you can claim under it.
5. Can I add a family member to my existing family health plan?
Yes, You can add a family member to your existing plan. But for this you need to fill the required forms, such as the health declaration form and endorsement form and pay an extra premium amount.
6. In HDFC ERGO, how many claims are permissible in a year?
You can file any number of claims over a year. However, this should be kept in mind that the claim amount should not exceed the sum assured of your plan. For example, if you have a health insurance of INR 2 lakh, then you can claim up to INR 2 lakh only from your insurance company.
7. What is the integrated Wellness App of HDFC ERGO General Insurance?
HDFC ERGO goes beyond health insurance; it cares not only for the physique but for the mind of the policyholder as well. Integrated Wellness application will help you to embrace a healthy lifestyle, track your calorie intake, monitor your physical activity, maintain proper health care, and enjoy well-being at its best.
8. Is it possible to change my hospital during the course of treatment?
Yes, it is possible, if required. You can change the hospital at the time of your treatment. However, you are required to provide the necessary details for a quick and smooth process.
9. What if I want to cancel my policy in mid- duration?
Most of the health insurance plans available in the market usually have a cooling period of 15 days i.e., called free look up period. During which you can cancel your policy with full premium refund. However, in that case if you want to cancel your policy in mid then you are required to provide a suitable reason.
10. Is it possible to port my existing health policy to HDFC ERGO?
Yes, it is possible to port your existing health policy to HDFC ERGO health insurance, provided you have renewed your previous policy without any break.
11. Can I pay the premiums of HDFC ERGO Health Insurance plans in EMI?
Yes, HDFC ERGO has recently launched the facility to pay the health insurance premium in installments.
12. How can you get the reimbursement for pre and post hospitalization expenses under this policy?
You are required to show the bills and duly filed a claim application to the insurer. After the inspection, the bills are reimbursed by the insurance provided to the policyholder.
13. Will my pre-existing illness be covered in Super Top up Policy?
Pre existing illnesses will be covered in Super Top Up Policy only after 3 years of continuous coverage.
14. Is buying HDFC Ergo Health plan a good choice?
As per the IRDAI Annual report of 2021-22, the company comes with a good CSR, fulfils the solvency ratio criteria, and has a wide network of empanelled hospitals. All these features make HDFC Ergo a good choice.
15. Is HDFC the no.1 health insurance company in India?
Every individual has a different set of healthcare needs which may vary from individual to individual. Therefore, there are no specific criteria to select the number one health insurance. If all your healthcare needs are met by any HDFC Health plan then you should go for it.
An explorer and a curious person, Simran has worked in the field of insurance for more than 3 years. Traveling and writing is her only passion and hobby. Her main agenda is to transform insurance information into a piece that is easy to understand and solves the reader’s query seamlessly.
