Optima Restore
  • Get recovery benefit of 10K
  • 100% SI restoration
  • Reduce waiting period by 1yr
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HDFC ERGO Optima Restore

HDFC ERGO Optima Restore Policy is the best-selling plan of HDFC ERGO since its launch. It offers comprehensive health cover to you and your family under two variants i.e. Optima Restore Individual and Optima Restore Family. The two unique advantages of HDFC ERGO health insurance optima restore are: Restore benefit and 2X Multiplier benefit.

HDFC ERGO Optima Restore Benefit allows a 100% restoration of your cover immediately after the first claim. Multiplier benefit offers a 100% increase in your SI amount in 2 claim-free years. Other major coverage benefits included under HDFC ERGO health optima restore are renewal discounts, recovery benefits, organ donor cover, etc.

HDFC ERGO Optima Restore Plan Specifications

HDFC ERGO Optima Restore plan is packed with incredible benefits at no additional cost. To give you a better idea about the HDFC ERGO Optima Restore and its eligibility, take a look at the specifications of the plan:

Sum Insured

3 | 5 | 10 | 15 | 20 | 25 | 50 Lakhs

Entry Age

Min: Adult: 91 Days Child: 91 Days Max: Adult: 65 Years Child: 5 Years

Policy Term

1 | 2 Years

Renewability

Lifelong

Initial Waiting Period

30 Days

*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.

For HDFC ERGO Optima Restore brochure.

Choose your HDFC ERGO Optima Restore Plan

HDFC Optima Restore comes in a two plan type i.e. individual and family plans. Optima Restore HDFC ERGO offers a wide range of coverage under its plan types. Take a look at the coverages offered under both the plan type.

What is Room Rent?

Room rent limit is the maximum amount of bed charge that you can claim if you are hospitalized.

Common Room categories covered under room rent are:

  • Private Single AC Room
  • Twin Sharing
  • General Ward

Coverage status under HDFC ERGO Optima Restore Plan?

The room rent expenses are covered up to your selected SI amount under this policy.

What are ICU Charges?

It is a special department in the hospitals where patients with serious medical conditions are treated.

Coverage status under HDFC ERGO Optima Restore Plan?

ICU charges are not covered under this plan.

What is Pre Hospitalization?

Medical expenses incurred before the hospitalization of the policyholder.

Coverage status under HDFC ERGO Optima Restore Plan?

This plan covers medical expenses of up to 60 days before your hospitalization.

What is Post Hospitalization?

Medical expenses incurred after the discharge of the policyholder from the hospital.

Coverage status under HDFC ERGO Optima Restore Plan?

This plan covers medical expenses of up to 180 days after you get discharged from the hospital.

What is Domiciliary Hospitalization?

Home hospitalization arrangement for the insured person due to unavailability of medical amenities in hospitals. The treatment should last equal to or more than 72 hrs to get the financial coverage.

Coverage status under HDFC ERGO Optima Restore Plan?

Under this plan, the domiciliary hospitalization that exceeds 3 days is covered up to your selected Sum Insured.

What is Daycare Treatment?

Treatments that can be treated in less than 24 hours of hospitalization like blood dialysis, cataract, etc.

Coverage status under HDFC ERGO Optima Restore Plan?

This plan covers all day care procedures.

What are OPD charges?

The cost of doctor consultation and prescribed medical tests that may not require hospitalization.

Coverage status under HDFC ERGO Optima Restore Plan?

OPD charges are not covered.

What is COVID-19 Treatment?

Covers the cost of treatment for COVID-19 with a confirmative diagnosis from Govt. approved Centre.

Coverage status under HDFC ERGO Optima Restore Plan?

COVID-19 treatment is covered under this plan.

What is Cataract Treatment?

A common eye condition in which your vision gets blurred.

Coverage status under HDFC ERGO Optima Restore Plan?

This plan offers coverage for Cataract treatment after 2 years of the waiting period.

What is a No-Claim Bonus?

For every claim-free year, insurance companies reward policyholders with an increase in the Sum Insured amount as no-claim bonus on policy renewal. However, in the case of claim, this bonus amount either lapses or is reduced by a certain percentage that varies from plan to plan.

Coverage status under HDFC ERGO Optima Restore Plan?

This plan offers a 100% increment in the sum insured after 2 claim-free years. In case of a claim, the bonus amount added to your SI will be decreased by 50%.

What is Automatic Restoration?

Automatic restoration is a benefit in which the insurance company restores the total sum insured after it gets fully exhausted in treatments.

Coverage status under HDFC ERGO Optima Restore Plan?

Automatic restoration equal to 100% of your selected SI amount is provided under this plan.

What is Daily Hospital Cash?

It is a cash amount that you will get each day during the time of hospitalization.

Coverage status under HDFC ERGO Optima Restore Plan?

Daily hospital cash feature is available under this plan and the daily allowance amount is based on the sum insured you choose.

Plan Type Individual Family
SI Options 3 5 10 15 20-50  3 5 10 15 20-50
Daily Hospital Cash (in Rs.) INR 800 per day, maximum INR 4.8K INR 1K per day, Maximum 6K INR 800 per day, maximum INR 4.8K INR 1K per day, Maximum 6K
What is an Organ Donor Cover?

Your health plan will cover the cost of the procedure for removing the damaged or malfunctioning organs from the body.

Coverage status under HDFC ERGO Optima Restore Plan?

The plan provides coverage for organ donor expenses up to your selected Sum Insured amount.

What is a Maternity Cover?

It refers to the cover that includes expenses for normal and c-section procedures deliveries.

Coverage status under HDFC ERGO Optima Restore Plan?

Maternity cover is not available under this plan.

*It is generally not covered under most health insurance plans as pregnancy is a planned condition.

What is a New Born Baby Cover?

It takes care of the medical expenses that arise due to the hospitalization of the newborn baby in case of unforeseen circumstances. Some of the common treatments that are covered under the new born cover and these common treatments can vary from plan to plan:

  • Congenital anomaly (conditions since birth)
  • Acute condition
  • Chronic condition
  • Pre-mature delivery
  • Birth asphyxia
  • Day care treatment

Coverage status under HDFC ERGO Optima Restore Plan?

Newborn baby expenses are not covered under this plan.

What is AYUSH Treatment?

Refers to the cost of medicines and procedures used under AYUSH (Ayurveda, Yoga & Naturopathy, Unani, Siddha, and Homeopathy) treatment.

Coverage status under HDFC ERGO Optima Restore Plan?

This plan does not cover AYUSH treatment expenses.

What is IVF Treatment?

In Vitro Fertilization (IVF) is a method of assisted reproductive technology. The common expenses incurred under IVF and infertility treatments are for:

  • Full infertility
  • No fertility
  • Infertility diagnosis
  • Infertility diagnosis and limited fertility treatment
  • Medication (which may or may not include fertility drug prescriptions)

Coverage status under HDFC ERGO Optima Restore Plan?

The plan does not offer coverage for IVF treatments.

What is a Modern Treatment?

Medical treatments that demand the use of modern technology such as robotic surgeries, stem cell therapy, etc.

Coverage status under HDFC ERGO Optima Restore Plan?

This plan covers a wide range of modern treatments such as:

Plan Type: Individual

Modern Treatments
Uterine Artery Embolization and HIFU
Balloon Sinuplasty
Deep Brain Stimulation
Oral Chemotherapy
Immunotherapy
IVF
Robotic surgeries
Stereotactic Radio Surgeries
Bronchial Thermoplasty
Vaporization of the prostrate (Green laser/Holmium laser)
Intra Operative Neuro Monitoring
Stem Cell Therapy
What is an Ambulance Cover?

An ambulance is used to move the patient from home to hospital, transfer to another hospital, and take them for different tests outside the hospitals.

Coverage status under HDFC ERGO Optima Restore Plan?

This plan covers Ambulance charges of up to 2K per hospitalization.

What is an Air Ambulance?

Air ambulances are specially prepared planes that transfer the patient from one place to another in case of a health emergency.

Coverage status under HDFC ERGO Optima Restore Plan?

Air ambulance expenses under this plan are covered up to INR 2.5 lakhs per hospitalization, only for the SI amount of 10 lakhs and above.

What is Compassionate Travel?

Refers to the traveling expenses of a family member of the insured person in case the policyholders get admitted to a hospital outside his/her residential city.

Coverage status under HDFC ERGO Optima Restore Plan?

The policy does not cover compassionate travel expenses.

What is Global Coverage?

Any kind of medical/health emergency when you are outside of India.

Coverage status under HDFC ERGO Optima Restore Plan?

Not available

What is E-Consultation?

If a policy offers E-consultation it allows policyholders to connect with a doctor for medical consultation through video chat, audio call, or chatbot.

Coverage status under HDFC ERGO Optima Restore Plan?

This plan offers one consultation per policy year for critical illnesses.

What is a Health Checkup?

A facility where the policyholder can avail free health check-ups after fulfilling the company's policies.

Coverage status under HDFC ERGO Optima Restore Plan?

Health checkup expenses under this plan are covered based on the sum insured and the plan type you choose.

Plan Type Individual Family
SI Options 3 5 10 15 20-50 3 5 10 15 20-50
Health Check-Up Not Covered Up to 1.5K once in every 2 years Up to 2K once in every year Up to 4K once in every year Up to 5K once in every year Not Covered Up to 2.5K once in every 2 year Up to 5K once in every year Up to 8K once in every year Up to 10K once in every year
What is a Second Medical Opinion?

If the policyholder wants, they may opt for a second medical opinion wherein the policyholder can consult another doctor within the company's network of medical practitioners.

Coverage status under HDFC ERGO Optima Restore Plan?

Not available

What is Vaccination cover?

Coverage against the expenses incurred on vaccinations is provided by the insurance companies.

Coverage status under HDFC ERGO Optima Restore Plan?

Not available

What is Co-payment?

In the co-payment clause, policyholders have to pay a portion of the hospitalization expense on their own and the insurer will pay the rest of the amount.

Coverage status under HDFC ERGO Optima Restore Plan?

Not applicable

What is the Sub limit?

Sub limit is a condition in which the insurer will have to pay the medical expense up to a certain percentage and the remaining amount will have to pay by the policyholder.

Coverage status under HDFC ERGO Optima Restore Plan?

No defined sub limits

HDFC ERGO Optima Restore Premium

Optima restore by HDFC ERGO provides various options to choose SI amount and the number of members one can cover under a policy. Consequently, its policy premiums vary according to the customization of HDFC ERGO health optima restore plans at policyholders’ convenience. Therefore, to make the premium calculation easier for you, PolicyX.com has represented some sample premiums of HDFC ERGO optima restore health insurance based on different combinations of SI and insured members for 1-year policy term.

For Individuals

Age (Male)Sum InsuredSample Annual Premium (1A)
30 Years5 Lakhs8852
30 Years15 Lakhs13873
30 Years25 Lakhs17648
30 Years50 Lakhs22691

For Family Floater

Age (Male)Sum InsuredSample Annual Premium (2A)Sample Annual Premium (2A+1C)
30 Years5 Lakhs1593522603
30 Years15 Lakhs2497134017
30 Years25 Lakhs3176743247
30 Years50 Lakhs4084355639
HDFC ERGO Optima Restore Banner

HDFC ERGO Optima Restore Plan Exclusions

Permanent Exclusions

Some treatments and medical conditions are generally not included under health insurance policies. Find what is not covered under HDFC ERGO optima restore health insurance in the section below:

Cosmetic or Plastic Surgery

Injuries resulting from a suicide attempt

Treatment of infertility, birth control, vicarious pregnancy, circumcision

Hospitalization due to alcohol, and drug abuse

Hospitalization due to War and radiation of any kind

Non-allopathy treatment

External congenital diseases

Treatment-related to Venereal or sexually transmitted diseases

Treatment of obesity

Coverage after Waiting Period

HDFC ERGO health insurance optima restore covers certain diseases and treatments after a time period. These are:

Listed ailments after 2 Years

Pre-existing diseases after 3 years

Explore HDFC ERGO Health Insurance

HDFC ERGO Health Insurance offers quality services to its customer with a quick and easy claim and buying process for the HDFC ERGO Health Optima Restore plan.

Claim Process

Click to know HDFC ERGO Optima Restore Claim Process.

Buying Process

Click to know HDFC ERGO Optima Restore Buying Process.

Contact Us

Feel free to contact HDFC ERGO Health Insurance for more details.

Explore other HDFC ERGO Health Plans

There are 9 other plans offered by the HDFC ERGO Health Insurance along with HDFC ERGO Optima Restore Health Insurance. Take a look below to explore them:

HDFC ERGO Critical Illness Policy

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.

Unique Features

  • One-time lump sum payment
  • No medical checkup up to 45 years
  • Lifelong renewability

Designed especially for people with pre-existing diabetes or hypertension. Get coverage for diabetes and hypertension from Day 1 without any waiting period.

Unique Features

  • Stay fit & earn reward points
  • 100% SI restoration
  • Health coach & wellness programs

A flexible and comprehensive health plan, securing your today & tomorrow. With 'Reserve Benefit' features, this plan grows unused policy amount @6% interest rate.*

Unique Features

  • Automatic SI restoration
  • Multiplier benefit
  • Free preventive health checkup

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 ERGO Koti Suraksha

An individual and family health plan providing SI of up to 1 crore to prepare you to meet constantly increasing medical inflation.

Unique Features

  • Free preventive health checkup
  • Multiple wellness services
  • Up to 10% of fitness discount

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

Offers 360-degrees protection to individuals & families along with utmost flexibility by providing multiple SI options (3-75l), EMI facilities, and lifelong entry option.

Unique Features

  • Fitness discounts during renewal
  • Room rent capping and co-pay
  • Loyalty discounts, recovery benefits

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

  • Pregnancy & newborn complications
  • SI options from 3L - 1 Cr
  • Free preventive health checkup

Provides comprehensive medical coverage to individuals and families with different budgets by offering SI options ranging from 5 Lakhs to 50 Lakhs.

Unique Features

  • Free health checkup
  • 2X multiplier benefit
  • 100% SI restoration

HDFC ERGO Optima Secure

Get 4X coverage* without any extra cost under this comprehensive health plan for individuals and families.

Unique Features

  • No room rent capping
  • 100% SI restoration
  • E-opinion for 51 illnesses

HDFC ERGO Optima Restore Plan: FAQs

1. Does Optima Restore HDFC ERGO cover dental treatment?

In most cases, dental treatments are not covered under the standard health insurance plan. However, if a dental treatment happens due to an accident and it needs a minimum of 24 hours of hospitalization, only then HDFC Optima Restore health insurance will cover dental treatment.

2. What is the 2x Multiplier under HDFC ERGO optima restore benefits?

Multiplier benefit is a feature that doubles your sum insured after 2 claim-free years.

3. Is maternity covered in HDFC Ergo Optima Restore?

No, Maternity related expenses are not covered under this plan.

4. How do I cancel my Optima Restore policy?

If the customer wants to discontinue the policy, then he has the option to cancel the policy by giving written notice at any of the HDFC ERGO health insurance branches or he/she can call on the company's Toll-free number.

5. Will the restored sum insured be carried forward to next year?

The restored amount will not be carried forward to the next year. You can only use it in a policy year.

6. How do I renew my HDFC Optima restore plan?

You can renew your HDFC optima restore policy in these simple steps:

  • Visit the official website
  • Click on Renew tab
  • Enter your policy number/ mobile number/ Email ID
  • Make payment and renew your policy for another year

7. What are the scenarios under which the Sum Insured would be reinstated under the Restore Benefit?

Sum insured will be reinstated under these situations:

  • Partial use of sum insured
  • Full use of sum insured

In all the above situations, the restoration amount will be equal to your base sum insured.

8. Does one need to send a request for activating the Restore Benefit?

No, you don't have to send any request for activating the restore benefit. Restore Benefit is completely autonomous and it refills the sum insured amount once a claim is settled.

9. Does HDFC Ergo Optima Restore offer a portability option?

Optima Restore plan offers a portability option. So, if you have a health insurance policy from another Insurer, you can port to HDFC ERGO Optima Restore with all your accrued benefits and can HDFC Ergo Optima Restore benefits.

10. What are additional treatments and conditions covered under the Optima Restore plan?

Here is the list of additional treatments and conditions that are covered under the plan:

  • Treatment for correction of eyesight due to refractive error beyond +/- 7.5 dioptres
  • Genetic diseases or disorders
  • Neurodegenerative disorders like Parkinson’s, Alzheimer’s
  • Any mental illness, stress, or psychological disorders
  • Peritoneal dialysis
  • Expenses related to any admission primarily for enteral feedings
  • Obesity/Weight control treatment (if specified conditions are met)
  • Post Hospitalization expenses for Domiciliary treatment
  • Age-Related Macular Degeneration (ARMD)
  • Expenses on Artificial life maintenance (including life support machine use) up to the vegetative state, irrespective of whether such treatment results in recovery of restoration of the previous state of health or not

Read Reviews & Ratings

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Vedantu Singhania

Coimbatore

August 5, 2021

Thanks to HDFC ERGO Health Insurance company for ensuring that all the healthcare needs of your customers are looked after. I am glad that I got in touch with PolicyX.com who helped me at every...

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Usha Dodiya

Indore

May 20, 2021

Policyx.com give very good insurance policy I will recommend to everyone and manager support is very gool

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harish kumar

Delhi

March 16, 2021

thanks to Policyx and HDFC to provide good service at the time of claims he help me two times and provide 100% cashless benefit

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ambika chauhan

Chennai

March 4, 2021

i am happy that i recieved my claim today. got good support. after first rejection i was scared, but i got it due to the sipport of policyx

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Ashu Goyal

Ludhiana

March 4, 2021

I have taken the policy of HDFC ergo by Policy X.Com , Claim settlement Tat is very Good . Policy X.com team is helpful about claim settlement without any issue.

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Meenakshi Singh

Delhi

March 4, 2021

I took this policy from Policyx as this company have helped my friend at his time of need which is claim compensation and I was extremely happy that with so much patience they have helped and e...

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Sarfraz Sadiq Pathan

Mumbai

January 25, 2021

Well co operated by policyx staff I thank them for giving me such a helping hand and hope in future they will give their best to solve any issues related to policy if there is any

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meenakshi singh

Delhi

July 31, 2020

Fantastic service providers, My details got changed within few days after the policy issuance. Efficient employees really.