Health Wallet Family Floater- A plan for today and tomorrow
HDFC ERGO Health Wallet insurance plan insures one's health from the soaring medical costs. It provides you with comprehensive protection by paying for inpatient and outpatient expenses and saves you from future financial worries.
Let's explore this plan in detail.
Eligibility
Prosper | Adult | Children |
Minimum Entry Age | 18 years | 91 days |
Maximum Entry Age | 65 years | 25 years |
Sum Insured | Rs. 3 Lakhs to Rs 50 Lakhs |
Policy Tenure | 1/2/3 years |
**Last Updated on 18-12-2020
Coverage of Health Wallet Family Floater
The plan offers complete coverage to you and your family members at the time of medical emergencies. Let's take a look at it:
Parameters | Coverage |
Day Care Treatments | Yes |
Pre Hospitalization Expenses | Covered, up to 60 days |
Post-Hospitalization Expenses | Covered, up to 90 days |
Ambulance Cover | Yes (up to Rs. 2000) |
Domiciliary Treatment Expenses | Yes |
Pre-Medical Health Check-up | Depends on the age and basic sum insured. |
Ayush Treatment Expenses | Available |
World-wide Emergency | 50% of sum insured up Rs.20 lakhs |
Renewability | Lifetime |
Maternity Expenses | No, except ectopic pregnancy |
Organ Donor Expenses | Yes |
**Last Updated on 18-12-2020
What are the benefits of the Health Wallet Family Floater Plan?
The plan delivers a long list of benefits to its customers. Let's take a look at its most significant ones.
- Restore Benefit: It automatically restores the sum insured in case the base sum insured and multiplier benefit (if any) is exhausted during the policy tenure. The restored SI is equal to 100% of the base SI.
- Multiplier Benefit: Under this, the basic sum insured will increase by 50% for a claim-free year (at the time of renewal) and will double for the 2nd claim-free year.
- Preventive Health Checkup: The plan offers preventive health check-ups (at renewal) to keep track of your health insurance. The eligibility for a health check-up is based on the reserve benefit sum insured.
- Reserve Benefit: It helps to cover your present and grows continuously to cover your healthcare costs in old age. Any unused amount is carried forward to the next year and you can earn a 6% bonus on it at renewal.
- Ambulance Cover: Ambulance expenses incurred due to the transportation of the insured to a hospital for emergency treatment are covered (up to Rs. 2000 per hospitalization).
- Inpatient Treatments: If the insured is admitted to the hospital for more than 24 hours for treatment, the policy will pay for its medical expenses. The expenses covered under inpatient treatment are
- Room rent,
- Boarding expenses,
- Nursing,
- Intensive care unit,
- Medical Practitioner(s),
- Anesthesia, blood, oxygen, operation theatre charges, surgical appliances,
- Medicines, drugs, and consumables,
- Diagnostic procedures
- Enhancement of Sum Insured: One can enhance his/her sum insured under the Health Wallet plan. In case of enhancement with one grid up, there is no requirement of medicals. However, for more than one grid up, policyholders may have to undergo medical tests. This enhancement is only possible at the time of renewals.
- Pre & Post Hospitalization Coverage: The plan offers coverage for pre & post hospitalization expenses for consultations, investigations, and medicines incurred up to 60 & 90 days respectively.
- Worldwide Emergency: Expenses incurred against the treatment of illnesses or conditions while traveling abroad are taken care of by the plan (50% of sum insured up Rs.20 lakhs).
- Recovery Benefit: In case your hospital stay stretches beyond 10 continuous days, the plan will offer Rs.10,000 as a lump sum amount.
- Tax Benefit: The premium amount paid under this plan qualifies for a tax benefit under Section 80D of the Income Tax Act, 1961.
- Deductible Option: The plan allows policyholders to avail of deductibles, which permits them to look after their medical expenses up to the pre-decided deductible amount.
- AYUSH Expenses: It looks after the treatment expenses incurred under Ayurveda, Unani, Sidha and Homeopathy in AYUSH Hospital according to the plan's terms and conditions.
- Waiting Period: There is a waiting period of 30 days from the plan's date of purchase. For specific diseases like Hernia, Cataract, Joint replacement, and Hysterectomy, the period stretches to 2 years. Finally, all pre-existing conditions are covered after 3 years.
What's not covered under Health Wallet Family Floater Plan?
Some of the policy exclusions are listed below:
- External congenital diseases.
- Maternity expenses (except ectopic pregnancy).
- Adventure sport injuries.
- Abuse of intoxicant or hallucinogenic substances like drugs and alcohol.
- Hospitalization due to war or an act of war.
- Dental treatment and surgery unless needing hospitalisation.
- Plastic surgery or cosmetic surgery unless necessary as a part of medical treatment.
- Vaccination (except for post-animal bite treatment).
How to buy HDFC ERGO Health Wallet Plan?
Follow the below-listed steps to buy the plan right away.
- Visit the official website of HDFC ERGO and click on 'Health Insurance'.
- Scroll down and find 'Health Wallet Insurance'. Click on 'Buy Now'.
- Enter the requested details and click on 'Calculate Premium'.
- Check and pay the premium online.
- Once the payment is received, the policy document will be mailed to your registered email address.
You can also buy this plan by visiting the nearest branch of the company.
What is the claim process of the HDFC ERGO Health Wallet Plan?
There are two ways to file a claim for the HDFC ERGO Health Wallet plan. Let's discuss both in detail:
Cashless Claim Settlement Process
To avail of a cashless facility, one has to visit the network hospital of HDFC ERGO and follow the steps:
- Reach the insurance desk of the hospital and show your health card and identity proof.
- Download and fill the pre-authorization form from the company's website, and submit it along with other documents.
- The hospital will then share the details with HDFC ERGO.
- The company will verify all the details and documents from their end and convey their decision to you and the hospital.
- On successful verification and acceptance of the claim, you can enjoy a cashless treatment facility. HDFC ERGO will look after the treatment expenses.
Reimbursement Claim Settlement Process
If you can't visit the network hospital, you can apply for a reimbursement claim. Follow the below steps:
- Get your treatment done in any non-network hospital and pay all the bills.
- After your discharge, file a claim for reimbursement.
- Submit all the required documents and bills.
- The company will verify all the information and if approved, will process the claim, and you will receive the amount in your registered bank account.
How To Contact HDFC ERGO?
Contact Address: 1st Floor, HDFC House, Backbay Reclamation, H. T. Parekh Marg,
Churchgate, Mumbai - 400020
Contact Number For Policy Buying: 1800 2666 400
(You can also get in touch with the customer care on Whatsapp: 73045 24888)
