HDFC ERGO Optima Lite Health Insurance Plan
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Optima Lite Health Insurance Plan

HDFC ERGO Optima Lite Health Insurance Plan is an affordable health in ...Read More

Up to 2 Cr
Sum insured
1
No. of plans
200+
Pan India presence
95.30%
Claim settlement ratio
📄 Download brochure
🛡️ IRDAI Approved
⭐ 4.4/5 · 2,720 reviews
🏥 15,000+ hospitals
📊 2.00 solvency ratio
✅ 95.30% claim settlement

About Optima Lite Health Insurance Plan

A quick read on what this HDFC ERGO Health Insurance plan covers and why it might be a fit for you.

HDFC ERGO Optima Lite Health Insurance Plan is an affordable health insurance policy that provides necessary health insurance coverage to individuals and families. HDFC ERGO General Insurance offers this health insurance policy to make health insurance accessible to people, especially in Tier 2 and Tier 3 cities.

The health insurance policy offers a sum insured of ₹5 lakh and ₹7.5 lakh. It can be purchased as an individual or family floater policy for a tenure of 1, 2, or 3 years. It provides necessary health insurance coverage to meet major medical expenses such as hospitalization, day care procedures, pre and post-hospitalization expenses, ambulance, and organ donor fees.

The health insurance policy provides unlimited automatic restore of the sum insured in a policy year. It also provides preventive health check-ups after the first policy year. In addition, policyholders have access to a large cashless hospital network. It also provides AYUSH treatment and domiciliary hospitalization when necessary.

To provide necessary health insurance coverage, policyholders can also opt for optional benefits such as deductible discounts, non-medical expenses, critical illness, and personal accident.

Plan at a glance

Eligibility, sum insured options and policy mechanics — pulled straight from the policy wording.

Entry age
Children: 91 days; Adults: 18 years
Plan type
Individual
Waiting period
30 days
Renewability
Lifelong
Policy term
1/2/3 Years

*Initial Waiting Period is the time period between the issuance of the policy and the time it starts actively. During this period, a policyholder has to wait to avail of the benefits offered under a health insurance plan.

Pros & cons

A quick honest summary — the strengths and the trade-offs.

Pros

  • Affordable premiums
  • Unlimited restore benefit
  • No disease-wise sub-limits

Cons

  • Low sum insured options (₹5L–₹7.5L)
  • Room rent cap (1% SI) causing deductions
  • Not suitable for metro/high-cost treatment needs

What's covered

Every CMS-driven coverage flag from the plan wording — only items with a published value render below.

Hospitalization

  • Room rent Covered
  • ICU charges Covered
  • Pre-hospitalization Covered
  • Post-hospitalization Covered
  • Domiciliary hospitalization Covered
  • Day-care treatment Not covered
  • OPD charges Covered
  • Covid-19 treatment Not covered
  • Cataract Covered

Bonuses & restoration

  • No-claim bonus Covered
  • Automatic restoration of SI Covered
  • Daily hospital cash Covered

Family & special care

  • Maternity cover Not covered
  • New-born baby cover Not covered
  • IVF treatment Not covered
  • AYUSH treatment Covered
  • Organ donor expenses Covered

Modern & preventive care

  • Modern treatment Covered
  • Road ambulance Covered
  • Air ambulance Not covered
  • E-consultation Covered
  • Health check-up Covered
  • Second medical opinion Not covered
  • Vaccination Not covered

Conditions & global

  • Compassionate travel Not covered
  • Global coverage Not covered

HDFC ERGO Health Insurance Network Hospital List

HDFC ERGO Health Insurance Network Hospitals are present in 31 states nationwide. With a wide network of hospitals, HDFC ERGO Health Insurance ensures that you are medically secured, irrespective of the city you reside in.

Delhi Mumbai Bengaluru Chennai Kolkata Hyderabad Pune Ahmedabad Jaipur Lucknow

Know More About Network Hospitals →

Inclusions & exclusions

What the plan pays for, and what it doesn't.

Inclusions

  • HDFC ERGO Optima Lite Health Insurance Plan provides coverage for several medical treatments and healthcare services. Some of the key inclusions under the plan are:
  • Hospitalisation expenses, including doctor fees, medicines, diagnostic tests, and specialist charges
  • Room rent and ICU charges within the specified limits of the base sum insured
  • Pre- and post-hospitalisation expenses for 30 and 60 days respectively
  • Day-care procedures and modern treatments completed within 24 hours
  • Organ donor hospitalisation expenses for the insured recipient
  • AYUSH treatments under Ayurveda, Yoga & Naturopathy, Unani, Siddha, and Homeopathy
  • Domiciliary hospitalisation when treatment is taken at home under medical advice
  • Ambulance charges, including air ambulance up to the specified limit
  • Daily cash benefit for shared room accommodation during hospitalisation
  • Second medical opinion for critical illnesses once per policy year
  • Unlimited automatic restore of the sum insured for subsequent claims within the policy year

Exclusions

  • Like most health insurance policies, the HDFC ERGO Optima Lite Health Insurance Plan has certain exclusions where claims will not be covered. Policyholders should review these exclusions carefully to understand the situations in which the insurer will not provide coverage.
  • Injuries resulting from participation in adventure sports
  • Treatment arising from breach of law with criminal intent
  • Medical expenses caused due to war or war-like situations
  • Treatment related to alcoholism, drug abuse, or substance addiction
  • Injuries during participation in defence or military operations
  • Treatment taken at insurer-excluded hospitals or medical providers
  • Congenital external diseases, defects, or anomalies
  • Cosmetic surgery or obesity treatment (unless medically necessary)

Who can buy this plan

Eligibility criteria pulled straight from the policy wording.

  • Entry age: 91 days (children) to 18 years (adults)
  • No: maximum age limit
  • Available for individual and family floater (self
  • spouse
  • children
  • parents)

Other features & benefits

  • Preventive health check-up every year after 1st renewal
  • Covers non-medical expenses (optional Protect benefit)
  • Daily cash allowance for shared room hospitalisation

HDFC Ergo Optima Lite Health Insurance Plan: FAQ

The 6 most-asked questions about Optima Lite Health Insurance Plan, answered.

The HDFC ERGO Optima Lite Health Insurance Plan offers two base sum insured options: ₹5 lakh and ₹7.5 lakh.
Adults aged 18 years and above can purchase the policy, while dependent children can be covered from 91 days of age.
Yes, the plan can be purchased as an individual policy or as a family floater policy covering multiple family members under a single sum insured.
Yes, the plan provides an unlimited restore benefit that automatically reinstates 100% of the base sum insured if it is used during the policy year.
Yes, the policy includes preventive health check-ups after the completion of the first policy year.
No, the policy offers lifelong renewability with no maximum age limit for renewal.

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Written and reviewed by

PolicyX content is researched in-house and reviewed by an IRDAI-certified insurance specialist before publication.

Written by Anshika Ojha — Health Insurance Reviewed by Apeksha Parsai — Term & Health Insurance
Last updated: 11 May 2026 · Originally published: 11 May 2026

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