HDFC ERGO Energy Health Insurance Plan helps to reduce the burden of medical expenses raised due to diabetes, the most common and deadly diseases of all. It is specially designed for people with diabetes and hypertension and offers you to live with these two successfully and peacefully.
Let us now explain this plan in detail for a better understanding.
Eligibility:
Type Of Disease | Type 1 and 2 Diabetes or Pre-Diabetes (Impaired Fasting Glucose/ Impaired Glucose Tolerance) or Hypertension. |
Entry Age | 18-65 years |
Minimum Sum Insured | Rs.2 lakhs |
Maximum Sum Insured | Rs.50 lakhs |
Who Can Apply | Only one individual with any of the aforesaid diseases. |
**Last Updated on 18-12-2020
Variants | Details |
Silver Plan | The cost of wellness tests is excluded- a. Without Co-pay b. With 20% Co-pay |
Gold Plan | The cost of wellness tests is included- a. Without Co-pay b. With 20% Co-pay |
**Last Updated on 18-12-2020
This dedicated plan covers most of the expenses that may arise due to diabetes and hypertension. Have a look at the below table for the details.
Parameters | Coverage |
Day Care Treatment | Yes, up to 182 Days |
Waiting Period | No (for diabetes and hypertension) |
In-Patient Hospitalization | Yes |
Pre-Hospitalization Coverage | 30 days |
Post-Hospitalization Coverage | 60 days |
Emergency Ambulance Coverage | Yes |
Organ donor expenses | Yes |
Wellness Program |
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Reward Points |
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**Last Updated on 18-12-2020
The plan offers several benefits that are listed below-
Comprehensive Coverage - This plan offers day one coverage for all hospitalization arising out of diabetes and hypertension with no waiting period.
Pre and Post-Hospitalization - Your costs for diagnosis, investigation, and even post-hospitalization expenses are covered. All your pre-hospitalization expenses up to 30 days (before admission) and post-discharge expenses (till 60 days) are included.
Emergency Road Ambulance - If an emergency arises and you need to hurry to the hospital, your ambulance costs are compensated up to Rs.2000 per hospitalization.
Lifelong Renewability - Once you get connected with HDFC ERGO Energy Health Insurance Plan, there is no looking back. It can continue lifetime on break free renewals.
Organ Donor Expenses - The plan covers the medical and surgical expenses of the organ donor while having a major organ transplant.
Tax Saving - It offers tax benefits up to Rs.75,000 for the premiums paid under Section 80D of the Income Tax Act, 1961.
Personalized Health Guide - Under this plan, you can also get your personalized, highly trained health coach to guide, instruct, remind, and create your nutrition and fitness plan.
Wellness Portal - With this plan, you can avail of a personalized wellness web portal that tracks and stores all your medical records. It helps you to monitor your health condition along with the facility to purchase health products at special offers.
Easy Access to Valuable Information - After purchasing this plan, you can get easy access to the helpline number to answer all the queries, along with the monthly newsletters to provide you important information regarding healthcare and management.
HbA1C Benefit - Your costs of HbA1C tests are covered up to Rs.750 per policy year. Two complete medical check-ups (known as wellness tests) are also compensated up to Rs.2000 for Gold Plan on a cashless claim.
The major exclusions are as follows-
Follow the below-mentioned steps to buy this plan easily and smoothly.
If you aren't a fan of online buying, you can buy this plan from the nearest branch of HDFC ERGO.
In case you don't get a suitable response from HDFC, you can also buy this plan from PolicyX.com. Here is the process for the same.
The claim process can be of two types - 1. Cashless claim and 2. Reimbursement claim. Both the claim processes are discussed here with proper steps. Have a look.
Cashless Claim:
Hospitalisation - You have to get admitted to one of the authorized network hospitals of HDFC ERGO.
Provide proper documents to the hospital - Show your health card, valid photo ID, and other documents (if required) to the hospital.
Preauthorization - The hospital will send the cashless request to HDFC ERGO and coordinate with the company for the pre-authorization form.
Scrutiny - HDFC ERGO will do its investigation on the received documents and reflect on the claim stating its final stand.
Status update - You will be kept notified through SMS or mail on your registered mobile number or email-ID about each stage of the claim.
Authorization and approval - On approval, you can take the treatment, and the bills will be settled by HDFC ERGO. Any inadmissible expenses, copayments, and deductions will have to be paid by you.
Reimbursement Claim:
Hospitalisation- You can get admitted to any hospital according to your convenience. The amount will be settled directly by you, not the hospital.
Claim Registration - After discharge, download the claim form from HDFC's official website. To make your claim procedure quicker, it would be advisable to submit the soft copies of your bills and documents on the claim registration module. Once you have shared the documents, the team will initiate the processing of your claim.
Else, you may send soft copies of your claim documents along with the claim form to healthclaims[at]hdfcergo[dot]com.
Approval of Claim - HDFC ERGO will review and scrutinize all the documents. If additional documents are required, you will be informed by the insurer. After you meet their satisfaction level, the claim will be settled by the company.
Status Update - You will be kept notified through SMS or mail on your registered mobile number or email-ID about each stage of the claim.
Claim Settlement - After the completion of the procedure, the amount of the claim will be transferred through NEFT.
Note: On receipt of complete documents, the claim would be processed within 7 days from the time the last document is received.
For filing your claim and getting it approved, you need the following documents.
Note: For safety, it would be advisable to keep the documents both in original form and photocopied form.
1. Will I get life-long renewability with HDFC ERGO Energy Health Insurance Plan?
Yes, they provide life-long renewability unless the policyholder behaves improperly.
2. What is the Grace Period of this plan?
The insured will get a 30 days grace period to renew his / her policy.
3. Can I cancel my policy at any time?
The company offers 15 days from the date of receipt of the policy document to review the terms and conditions of this policy. In case of any objections, you have the option of cancelling the policy and you shall be refunded the premium paid by you after adjusting the amount spent on any stamp duty charges, medical check-up, and proportionate risk premium.
4. Can I enhance the amount of sum insured?
Yes, you can enhance the sum insured at the time of renewal. Just make sure that no claim has been made under the policy.
5. Can I port my policy?
Yes, any insured person has the option to choose another indemnity health insurance policy available with HDFC ERGO at the time of renewal and all the benefits of the previous policy will be carried forward if you have paid the premium without any break.
Last updated on 18-12-2020
