HDFC Ergo My: Health Suraksha Smart Plan

My: Health Suraksha Smart Plan, a comprehensive plan has been recently launched by the HDFC Ergo Health Insurance company, that aims at providing 360-degree protection against the rising medical expenses. This plan offers you the best returns to serve your needs. This plan is specifically designed for individuals, families, and senior citizens. With this plan, you can protect your family against any unforeseen illnesses and accidental injuries.

The cashless hospitalization in network hospitals and the facility of reimbursement of medical bills or expenses incurred on treatments done in non-network hospitals is the amazing benefit offered by this plan . It also covers the in-patient treatment cost, pre and post medical expenses on hospitalization along with no sub-limits on illness, hospital room rents, a fee of the doctor, and charges of the hospital.

Key Features of My: Health Suraksha Smart Insurance Plan

There are several health insurance plans available in the market but which one to choose? We at PolicyX.com will help and guide you properly regarding this. So let’s explore the key features of this plan that will help you to lead a financially healthy and secure life.

• The Plan offers you multiple sum insured options which range between Rs. 3 lakhs and Rs. 75 lakhs.
• Any entry age with a lifetime renewal offer is available.
• Exclusive covers like an air ambulance, recovery benefit, and infertility benefits are provided under the plan.
• Wellness features like fitness discounts at renewal, health incentives for the maintenance of health.
• A long-term policy tenure of 3 years at a reasonable premium amount.
• Option to pay the yearly premium in 3, 6, and 12 equal installments.
• Flexible discounts like choosing room rent capping and co-pay to avail discounts on premium. It also offers a family discount of 10%, if you want to cover 2 or more family members under the plan on an individual sum insured basis.
• Various discount options are available like a family discount, long-term family discount and loyalty discount.
• This plan also offers wellness features such as health incentives for maintaining health and fitness discounts at renewal.

Benefits of My: Health Suraksha Smart Insurance Plan

Remember that the utility of medical coverage of health insurance plans not only depends on the key features but also on how well aware you are about its usage. Let's understand the benefits of My: Health Suraksha in detail:

1. Day Care Treatments

   This plan offers daycare treatments as some surgeries or medical treatments do not require you to be hospitalized for a minimum of 24 hours to raise a claim. Insured gets coverage for all the daycare procedure expenses within the policy tenure.

2. Pre and Post Hospitalization Cover

   All the medical expenses incurred in the treatment of the insured 60 days before the hospitalization get coverage under the HDFC my: health Suraksha Plan. And the Post-Hospitalization Covers, all the treatment expenses incurred in 180 days after the insured is discharged from the hospital are covered under this plan.

3. Restore benefits

   This benefit offers you to restore your base sum insured automatically if you exhaust the amount during the policy term.

4. Recovery Benefit-

   A specific amount is paid in case of medically necessary hospitalization of the insured exceeding 10 continuous days of illness. This benefit is not provided in case the medical treatment is taken under home healthcare and domiciliary hospitalization.

5. Medical Checkup

   If you want to have a health check-up for consecutively 4 claim-free years, then you can get up to 1% of the sum insured i.e. up to Rs. 5000.

6. Medical Expenses

   The plan covers the following medical expenses,

   • Room rent cover, boarding, and nursing charges
   • Doctor's consultation fee
   • Diagnostic procedures
   • Intensive care unit charges
   • Anesthesia, blood, oxygen, operation theatre charges, surgical appliances
   • Medicines, drugs, and consumables
   • The cost of prosthetics and other devices or equipment if implanted internally during a surgical procedure.

   In case the insured has opted for copayment at the time of buying the policy, then he/she is subject to certain payments at the time of taking a medical facility for each cover mentioned above

7. Cover for Organ Donor

   It covers medical expenses incurred during organ transplantation.

8. Road Ambulance Cover

   The ambulance cover includes three incidents like transfer of the insured from home to the nearest hospital in the case of emergency, transfer of insured from one hospital to another hospital, and final transfer of the insured from the hospital to respective home. All the expenses incurred in these transfers are covered under my: health Suraksha insurance policy.

9. Air Ambulance

   In case of emergency or accident, the insured is provided with an air ambulance either in the form of an airplane or helicopter, subjected to the condition suggested by the medical practitioner about the urgent treatment of the patient.

   Note: Return transportation cost is not covered by the insurance company.

10. Mental Health Care

    The insured is paid for medical expenses for any sort of mental disease contracted during the policy period under the mental healthcare act 2017. The regular amendments and other applicable rules and laws mention that: 'The hospitalization is advised by a medical practitioner for mental illness.The hospitalization process is done in the mental health establishment'

11. Home Health Care

    Under this coverage, the insured is provided with a hospitalization facility at home in case s/he is not in a condition to travel to the network hospital. My: health Suraksha Plans provides this facility to its insured only in case of the following illnesses:

    • Gastroenteritis
    • Bronchopneumonia
    • Respiratory tract infection
    • Chemotherapy
    • Pancreatitis
    • Dengue
    • COPD management
    • Hepatitis
    • Fever management

    Cashless facilities are available for these treatments at the network hospitals.

12. Domiciliary Hospitalization

    Under this My: health Suraksha Plans pays for domiciliary hospitalization of the insured person subjected to the following facts:

    • A recognized medical practitioner has suggested the treatment.
    • The insured is not in a condition to be moved or traveled to any of the nearest hospitals.
    • The treatment at home is done under the condition that there is no availability of room in the hospitals.

13. Organ Donor Expenses

    In the case of organ donation, the treatment expense incurred is covered under My: health Suraksha Plans. All the procedures relating to the treatment of the insured are paid off to the policyholder under this plan.

14. Alternative Treatment

    HDFC My: health Suraksha Policy has a special coverage for the insured i.e. AYUSH/Non-Allopathic Treatment Cover. This plan offers for the non-allopathic expense incurred for in-patient treatment. This includes ayurvedic, Unani, Siddha, and homeopathy treatment. There are a few conditions applied to this coverage:

    • The treatment performed should only be on an inpatient basis.
    • The treatment should be taken from any of the government hospitals, or a recognized medical institution, failing which the insured is not eligible for the coverage.
    • There can be no claim for the same illness under allopathic treatment. If the insured has already claimed for the particular illness then it is subjected to rejection.

Eligibility and other Age Restrictions

Proposer	Adult Dependant	Child/ Children
Minimum Entry Age: 18 Years	Minimum Entry Age: 18 Years	Minimum Entry Age: 91 Days
Maximum Entry Age: Lifetime Entry	Maximum Entry Age: Lifetime Entry	Maximum Entry Age: 25 Years
Maximum Age Entry For Add on Covers	Maximum Entry Age: 65 Years	Maximum Entry Age: 65 Years
Parents & Child Care Cover - Basic & Booster - Entry Age up to 45 Years	Parents & Child Care Cover - Basic & Booster - Entry Age up to 45 Years	N/A

Why Should I Choose My: health Suraksha Smart Plan?

There are several facilities provided under my: health smart plans that will give you the reasons to buy the policy. A few of them have been mentioned below:

• No Room Rent Capping - This plan helps you to afford a room of your comfort.
• Insured Rebound - Get the benefit of the sum insured rebound, get the additional sum insured up to the base sum insured even in case your existing sum insured exhausts. 
• Free health check-up every year- This plan provides coverage against free health check-up.
• Cashless home healthcare - Some illnesses require home healthcare. And the plus point with this plan is that it provides you a cashless care facility for treatments at home without paying. 

Types of my: Health Suraksha Smart Plans

HDFC Ergo has three variants under my: Health Suraksha Smart Policy,

• Silver Smart Plan
• Gold Smart Plan
• Platinum Smart Plan

Individuals who fulfill the eligibility criteria mentioned in the table can buy a plan of their choice.

Comparison Between HDFC Ergo My :Health Suraksha : Silver, Gold and Platinum Smart Health Plans 

All three variants of my: health suraksha smart plan can easily meet your requirements but it becomes equally important to know which one suits your requirement the most out of three. We have prepared a table of comparison for your reference given below. Check out this table carefully and choose your plan wisely.

Covers	Silver Smart Plan	Gold Smart Plan	Platinum Smart Plan
Sum Insured	5 lakhs	7.5 lakhs 10 lakhs 15 lakhs	Rs. 20 Lakhs Rs. 25 Lakhs Rs. 50 Lakhs Rs. 75 Lakhs
Pre hospitalization	60 days	60 days	60 days
Post hospitalization	180 days	180 days	180 days
Road Ambulance	Rs. 2000 For Sum Insured 3 Lacs - 5 lacs	Rs. 3,500 for sum insured 7.5 lakhs - 15 lakhs	Rs. 3,500 for sum insured 20 lakhs - 50 lakhs Rs. 15,000 for sum insured above 50 lakhs
Air Ambulance Cover	Not covered	Max. up to 2 Lacs	Max. up to 5 Lacs
Recovery Benefit	Rs. 5,000	Rs. 15,000	Rs. 25,000
Cumulative Bonus	For every claim-free year - 10% and a maximum up to 100%	For every claim-free year - 10% and a maximum up to 100%	For Every claim-free year - 25% and maximum up to 200%
Parent and Child Care Cover Booster	Cover 1: Normal Delivery - Rs. 15,000, C-Section Delivery - Rs. 25,000 Cover 2: Normal Delivery - Rs. 25,000, C-Section Delivery - Rs. 40,000	Cover 1:Normal Delivery - Rs. 15,000, C-Section Delivery - Rs. 25,000 Cover 2: Normal Delivery - Rs. 25,000, C-Section Delivery - Rs. 40,000	Cover 1: Normal Delivery - Rs. 25,000, C-Section Delivery - Rs. 40,000, Termination of Delivery - 25,000 Cover 2: Normal Delivery - Rs. 50,000, C-Section Delivery - Rs. 75,000, Termination of Delivery - 50,000
Pre and Post Natal Expense	Max limit - Parent care sum insured	Max limit - Parent care sum insured	Max limit - Parent care sum insured
Infertility Treatment	Max limit - 50% of the normal delivery sum insured	Max limit - 50% of the normal delivery sum insured	Max limit - 50% of the normal delivery sum insured
New Born baby care	Max limit - Parent care sum insured	Max limit - Parent care sum insured	Max limit - Parent care sum insured
Vaccination Charges	Rs. 5,000	Rs. 5,000	Rs. 5,000 Rs. 15,000
Waiting Period Modification Option	Optional 3 Year	Optional 3 Year	Optional 3 Year
Non-Medical Expenses Cover	Optional	Optional	Optional
Extended Cumulative Bonus	Optional:25% and max 200%, 50% and max 200%	Optional: 25% and max 200%, 50% and max 200%	Optional: 50% and max 200%
Room Rent Modification Option	OptionalN/A	N/A	N/A
My: health Hospital Cash add on	Rs.1,000, 2,000 on daily basis	Rs.3,000, 5,000 on daily basis	Rs.3,000, 5,000, 7,500 on daily basis
My: health Critical Illness add on	Optional	Optional	Optional
Co-payments	10% or 20%	15% or 25%	15% or 25%

We suggest you go through this table for comparison and be aware of your plan. Now let's discuss sample rates of premium of these variants that will provide you a good idea about the selection of your plan on the basis of premiums.

Sample rates of premium

1. My: Health Suraksha Silver Plan

   This table illustrates the premium payable by individuals under HDFC Ergo My: Health Suraksha at different ages. 

   	Policy Premium (without taxes)
   Age	1 year	2 year	3 year
   30	9138	16906	23988
   35	9138	18453	26917
   40	10812	20002	28380

   **Last Updated on February, 2022

   Let's have a quick and smooth understanding about the Silven plan  with the help of the graph,

   1 year Premium payable at different ages

   

   At the age of 30 years, you are required to pay Rs. 9138 under the My: Health Suraksha Silver plan for 1 year Policy Premium, then at the age of 35 years, it is constant but at 40 years of age, the premium increases to Rs. 10812 annually. The premium increases along with age as it is believed that with an increase in age, the chances of problems associated with health also escalates and accordingly the premium amount increases.

2. My: Health Suraksha Gold Plan

   This table illustrates the premium payable by individuals under HDFC Ergo My: Health Suraksha Gold Plan at different ages and sum insured.

   	Sum Insured options
   Age	7.5 lakh	10 lakh	15 lakh
   30	10752	11768	14167
   40	12761	13969	16819
   50	16636	18213	21937

   **Last Updated on February, 2022

3. My: Health Suraksha Platinum Plan

   This table illustrates the premium payable by individuals under HDFC Ergo My: Health Suraksha Platinum Plan at different ages and sum insured. 

   	Sum Insured options
   Age	20 lakh	25 lakh	50 lakh	75 lakh
   30	17112	19544	31123	37975
   35	20345	23235	36995	45137
   40	34410	39304	62605	76392

   **Last Updated on February, 2022

My:Health Suraksha Gold Vs Silver Smart Plan

After seeing these tables of premium payable at different ages and sum insured, What do you think? Which is the best option for you and your family. Let's compare My: Health Suraksha Silver and Gold  Insurance Plan.

My: Health Suraksha Silver Plan - Premium Payable in 1, 2 and 3 years at different ages.



My: Health Suraksha Gold Plan - Premium payable at different ages and at different sum insured.



Though, both plans are considered to be ideal plans for an individual, families, and senior citizens. The sum insured in the case of the Silver plan is Rs. 5 lakh whereas in the case of Gold, there are different options for sum insured are available, such as Rs. 7.5 lakhs, Rs. 10 lakhs, and Rs. 15 lakhs. Accordingly, the premium for 1 year, 2 years, and 3 years varies based on different factors such as age, location, illness, etc. At the age of 40, the premium amount for silver plan in 1 year is Rs 10812 annually increases to Rs. 10752 annually in the case of the Gold plan. Therefore, you can choose your preferred variant as per your needs and requirments.

HDFC Ergo Health Suraksha Individual Vs. Optima Restore

A comparison table of My: Health Suraksha Vs. Optima Restore is prepared. We suggest you go through this table once for a better selection.

Factors	My: Health Suraksha	Optima Restore
Policy Term	1,2,3	1,2
Minimum Entry Age	Adults - 18 years  Child - 91 days	Adults - 18 years  Child - 91 days
Maximum Entry Age	Adults - Lifetime Child - 21 years	Adults - 65 years  Child - 25 years
Sum Insured	5 lakh - 75 lakh	Rs. 5 lakhs - 50 lakhs
Renewability	Lifelong	Lifelong
No. of daycare treatments covered	144	All
Hospital Cash Benefit	Optional	Yes
Ayurvedic treatments	Covered	Covered
Co-payments	No	No
Tax Benefits	Yes, U/S 80(D)	Yes, U/S 80(D)

Comparison of Sample Rates of Premium 

This table illustrates the premium payable by individuals under HDFC Ergo My: Health Suraksha and Optima Plan at different ages and 10 lakh sum insured.

Age	My: Health Suraksha	Optima Restore
30	11768	11575
40	13969	13360
50	18213	19877

My: Health Suraksha Vs. Optima Restore



Based on certain factors such as age, medical expenses, treatment cost, medical history, gender, profession, and any addiction, the insurer develops a profile of clients and offers various benefits through insurance plans.

So, based on all these factors discussed in the table, we can say that both are the ideal plans but what to choose, solely depends on your requirements. However, before buying, it is always advisable to go through your insurance company policies, plans, and brochures.

What is not covered in HDFC Ergo My: Health Suraksha - Permanent Exclusions ?

• The plan does not cover accidents encountered while participating in sports. Sports can give you an adrenaline rush, but along with accidents, they can be hazardous.
• Use and abuse of intoxicant or hallucinogenic substances such as consuming drugs and alcohol lead to self-inflicted wounds.
• This policy does not cover any claim caused due to war or likable conditions.
• The plan does not provide coverage for Venereal or sexually transmitted diseases.
• Insanity, congenital disease, mental disorders, cosmetic surgery, or treatment of obesity is not covered under this insurance policy.
• Expenses incurred for the treatment of HIV or AIDS or its related illnesses.
• Violating any law with the intent of doing crime. 
• Self inflicted injuries 
• Dental surgeries 
• Congenital disease 
• Plastic surgery or cosmetic surgery unless it will be performed as an internal part of the treatment. 

*To know all the exclusions of your plan, refer to the product brochure or directly get in touch

with your respective insurer.

How to buy HDFC Ergo Health Insurance?

For a quick and smooth process, consider buying plans from the company. Let’s have a look at how to sign up below:

Company's website

• Visit the official website of HDFC Ergo and click on ‘Health Insurance'.
• Fill in all the required details and choose the sum insured. Click on the option ‘Buy Now'.
• Once you have filled in all the necessary details in the proposal form of HDFC Ergo, select the premium amount of your choice.
• Pay the premium online and your policy document will be mailed to your registered email address.

You can also visit the nearest HDFC ERGO branch to buy health insurance.

What personal details and Documents are required for buying HDFC Ergo Health Insurance Policies?

• KYC Documents
• 1 Passport size photograph
• Medical records
• Family medical history and all the current medical records
• Application form

How can I renew HDFC Ergo My : Health Suraksha Plan?

Online process for Renewal - Online process is a hassle free and easy process. Here's a step by step guide for a smooth renewal process- 

• Visit the official website of HDFC Ergo www[dot]hdfcergo[dot]com and click on "instant renewal".
• After this, enter all details about your policy. 
• You can look for add on covers that increase your coverage for protecting your asset. 
• Fill all the required details, and your premium for renewal shall get produced. 
• Now, the last step is to make the payment and renewal for your policy. 
• When doing it offline, you are required to visit the branch office or can approach an agent to do all the formalities on your behalf. 
• In online you can pay using debit and credit card whereas in offlines premiums can be paid through cheques.

What is the claim procedure of HDFC Ergo Health Suraksha Plan?

There are two ways to file a claim. Let's take a look at it

Cashless Claim Settlement Process

• One can avail of the cashless facility only at network hospitals of HDFC ERGO.
• Reach the insurance desk of the hospital and show your health card.
• Download the pre-authorization form from the company's website. Fill in the details and submit the form. The hospital will share the details with HDFC ERGO.
• The company will then scrutinize all the documents and convey their judgment.
• On successful verification and acceptance of the claim, the insured can enjoy a cashless treatment facility.

Reimbursement Claim Settlement Process

• Reach the nearest non-network hospital and get the treatment done.
• Pay all the bills by yourself and then file a claim for reimbursement.
• Submit all the required documents.
• The company will verify all the information and process the claim.
• If approved, you will receive the amount in your registered bank account.

Note : Do not forget to carry your Identity proof or photo ID proof. If in case, the documents are not submitted, the claim can not be processed. This will not stop the treatment process as the insured can pay to the hospital by reimbursement process.