Network hospitals
13000+
Claim settlement ratio
98.49%
Sum insured
2 CR
No. of Plans
7
Solvency Ratio
1.68
Pan India Presence
200+
Network hospitals
13000+
Claim settlement ratio
98.49%
Sum insured
2 CR
No. of Plans
7
Solvency Ratio
1.68
Pan India Presence
200+
HDFC Ergo Optima Secure is a versatile healthcare plan that is available as an individual and family floater basis. It is a unique health plan launched to equip individuals and families with the right coverage options in order to safeguard their future and be prepared in the face of any medical adversity. HDFC Ergo Optima Secure redefines the value policyholders get from their health insurance plan. HDFC Optima Secure claims to provide 4X coverage at no additional cost and provides policyholders with installment benefits. HDFC Ergo Optima Secure installment benefit is available to all policy tenures however, long-term discounts will not be valid for the installment benefit. HDFC Ergo Optima Secure comes in 3 different variants namely, Optima Suraksha, Optima Secure, and Optima Super Secure.
HDFC Optima Secure offers various benefits and one such benefit offers policyholders double the amount of coverage since day 1. Under HDFC Optima Secure health coverage doubles up as soon as you buy an Optima Secure health insurance plan. HDFC Optima Secure provides pre & post hospitalization coverage, daycare treatments, e-opinion for 51 critical illnesses, home healthcare, and more unique features.
HDFC Ergo Health Insurance Plan Detailed Review
Minimum: Children- 91 Days to 25 years Adult: 18 years
Maximum: No age limit
1/2/3 Years
Individual/ Family Floater
5 L | 10 L | 15 L | 20 L | 25 L | 50 L | 1 Cr | 2 Cr
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.
With comprehensive coverage options, HDFC Ergo Optima Secure Plan lets you customize your health insurance plan as per your requirements:
Coverage for SI: 5 L - 2 Cr
Room Rent
Covered
ICU Charges
Covered
Pre-Hospitalization
Covered up to 60 days
Post-Hospitalization
Covered up to 180 days
Domiciliary Hospitalization
Covered
Daycare Treatment
Covered
OPD Charges
Not covered
COVID-19 Treatment
Covered
Cataract
Covered
No Claim Bonus
Applicable
Automatic Restoration
Applicable
Daily Hospital Cash
Available
Organ Donor
Covered up to SI
Maternity Cover
Not Covered
New Born Baby Cover
Not Available
AYUSH Treatment
Covered up to SI
IVF Treatment
Not Available
Modern Treatment
Not Covered
Ambulance
Covered
Air Ambulance
Available
Compassionate Travel
Not Available
Global Coverage
Not Available
E-Consultation
Available
Health Check-Up
Available
Second Medical Opinion
Not Available
Vaccination
Not Available
Co-payment
Not Applicable
Sub-limits
Not Available
The 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:
Coverage status under HDFC Ergo Optima Secure?
Under HDFC Ergo Optima Secure Plan, the room rent is covered up to the actual amount.
It is a special department in the hospitals where patients with serious medical conditions are treated.
Coverage status under HDFC Ergo Optima Secure?
Under HDFC Ergo Optima Secure Plan, ICU charges are covered up to the Sum Insured.
Medical expenses incurred before the hospitalization of the policyholder.
Coverage status under HDFC Ergo Optima Secure?
Under HDFC Ergo Optima Secure Plan medical expenses incurred during pre-hospitalization are covered for up to 60 days.
Medical expenses incurred after the discharge of the policyholder from the hospital.
Coverage status under HDFC Ergo Optima Secure?
Under HDFC Ergo Optima Secure Plan medical expenses incurred during pre-hospitalization are covered for up to 180 days.
Home hospitalization arrangements for the insured person due to the unavailability of medical amenities in hospitals. The treatment should last equal to or more than 72 hrs to get financial coverage.
Coverage status under HDFC Ergo Optima Secure?
Under HDFC Ergo Optima Secure, domiciliary hospitalization is covered up to SI.
Treatments that can be treated in less than 24 hours of hospitalization like blood dialysis, cataract, etc.
Coverage status under HDFC Ergo Optima Secure?
HDFC Ergo Optima Secure covers the expenses of daycare treatment up to SI.
Covers the cost of doctor consultations and prescribed medical tests that may not require hospitalization.
Coverage status under HDFC Ergo Optima Secure?
HDFC Ergo Optima Secure does not cover OPD charges.
COVID-19 treatment includes the cost of treatment for COVID-19 with a confirmative diagnosis from Govt. approved Centre.
Coverage status under HDFC Ergo Optima Secure?
COVID-19 treatment is covered by HDFC Ergo Optima Secure Plan.
A common eye condition in which your vision gets blurred.
Coverage status under HDFC Ergo Optima Secure?
HDFC Ergo Optima Secure Plan does cover cataract treatment.
For every claim-free year, insurance companies reward policyholders with an increase in the Sum Insured amount as a no-claim bonus on policy renewal. However, in the case of a 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 Secure?
The cumulative Bonus is available under HDFC Ergo Optima Secure, 10% of the Base Sum Insured, up to a maximum of 100% for each claim-free year.
Automatic restoration is a benefit in which an insurance company restores the sum insured amount completely or up to a certain percentage after it gets fully exhausted in treatments. This restoration amount may vary from plan to plan.
Coverage status under HDFC Ergo Optima Secure?
Under HDFC Ergo Optima Secure automatic restoration is available up to base SI.
It is a cash amount that you receive each day during the time of hospitalization.
Coverage status under HDFC Ergo Optima Secure?
The daily hospital cash is available under HDFC Ergo Optima Secure as an add-on benefit Starting from INR 500 per day up to INR 10,000 per day.
It is a cover that includes the cost of the procedure for removing the damaged or malfunctioning organs from the body.
Coverage status under HDFC Ergo Optima Secure?
Under HDFC Ergo Optima Secure, organ donor expenses are covered up to SI
It refers to the cover that includes expenses for normal and c-section procedure deliveries.
Coverage status under HDFC Ergo Optima Secure?
Under the HDFC Ergo Optima Secure Plan, maternity expenses are not covered.
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 newborn cover and these common treatments can vary from plan to plan:
Coverage status under HDFC Ergo Optima Secure?
Under HDFC Ergo Optima Secure Plan, the newborn baby cover is not available
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 Secure?
Covered Under HDFC Ergo Optima Secure up to SI.
In Vitro Fertilization (IVF) is a method of assisted reproductive technology. The common expenses incurred under IVF and infertility treatments are for:
Coverage status under HDFC Ergo Optima Secure?
Under HDFC Ergo Optima Secure IVF treatment is not covered.
Medical treatments that demand the use of modern technology such as robotic surgeries, stem cell therapy, etc.
Coverage status under HDFC Ergo Optima Secure?
Under HDFC Ergo Optima Secure modern treatments are not covered.
An ambulance is used to move the patient from home to the hospital, transfer to another hospital, and take them for different tests outside the hospital.
Coverage status under HDFC Ergo Optima Secure?
Under HDFC Ergo Optima Secure Plan, Ambulance expenses are covered up to SI.
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 Secure?
Under HDFC Ergo Optima Secure Plan, Air Ambulance is covered up to INR 5 Lakh.
Refers to the traveling expenses of a family member of the insured person in case the policyholder gets admitted to a hospital outside his/her residential city.
Coverage status under HDFC Ergo Optima Secure?
Under HDFC Ergo Optima Secure compassionate plan is not covered.
Any kind of medical/health emergency when you are outside of India.
Coverage status under HDFC Ergo Optima Secure?
Under HDFC Ergo Optima Secure Global coverage is not available.
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 Secure?
Under HDFC Ergo Optima Secure e-consultation is covered for 51 critical illnesses.
A facility where the policyholder can avail of free health check-ups after fulfilling the company's policies.
Coverage status under HDFC Ergo Optima Secure?
Under HDFC Ergo Optima Secure, a health checkup is covered for each Insured individual above 18 years of age.
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 Secure?
Under the HDFC Ergo Optima Secure second medical opinion is not covered.
Coverage against the expenses incurred on vaccinations is provided by the insurance companies.
Coverage status under HDFC Ergo Optima Secure?
Under HDFC Ergo Optima Secure Plan, vaccination expenses are not covered.
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.
Status under HDFC Ergo Optima Secure?
Not Applicable under HDFC Ergo Optima Secure
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 be paid by the policyholder.
Status under HDFC Ergo Optima Secure?
Not Applicable under HDFC Ergo Optima Secure.
HDFC Ergo entails a wide network of cashless Hospitals that impact millions of lives PAN India. A well connected network of over 13,000+ cashless hospitals, HDFC Ergo ensures that you are medically secured, irrespective of the city you reside in.
Permanent diseases or health conditions that are not included under HDFC Ergo Optima Secure Plan are:
Hospitalization out of war, riot, strike, and nuclear weapons
Intentional self-injury
Miscarriage, and abortion
Congenital disease
Infertility and in vitro fertilization
Certain diseases and treatments are covered under this plan after a certain time period. Read the details below:
Pre-existing diseases after 36 months
Listed/Specific Illness 24 Months
To understand how much premium amount one needs to pay, let us go through the below example wherein we have illustrated the sample premiums.
Age/Coverage opted | Individual Coverage | Individual Coverage for Multiple Family Members | Family Floater Coverage |
35 | 14,500 | 13,050 | 6,525 |
*Premium is calculated for Sum Insured of INR 10 Lakh
HDFC Ergo Optima Secure Plan has multiple advantages that policyholders can avail after the purchase.
Get tax relief under section 80D
Avail Zero Deductions on non-medical expenses
Multiple discount options
Avail 100% increase in coverage
Twice the coverage from Day 1
Amount paid towards the premium of this plan is eligible for tax relief under Section 80D of the Income Tax Act, 1961.
With Hdfc Ergo Optima Secure policyholders get in-built coverage for listed non-payable items like gloves, masks, food charges, and 68 other listed consumables during hospitalization.
HDFC Ergo offers multiple discount options to its policyholders such as a family discount of 10% on covering 2 or more family members under the same policy, and a long-term discount of up to 10% if a policy is purchased for 2 or 3 years.
Policyholders can avail of the plus benefit that offers a 50% increase on 1st policy renewal after 1 year and a 100% increase after 2 years.
When an individual purchases HDFC Ergo Optima Secure the base cover gets doubled instantly upon purchase, without having the need to claim it.
HDFC Ergo Health Insurance offers a wide range of health insurance plans to fulfill the medical needs of individuals, families, and senior citizens.
Comprehensive
Get 4X coverage* without any extra cost under this comprehensive health plan for individuals and families.
Unique Features
Comprehensive
Provides comprehensive medical coverage to individuals and families with different budgets by offering SI options ranging from 5 Lakhs to 50 Lakhs.
Unique Features
Flexible
Offers 360 degrees protection to you and your family with multiple SI options of 3 to 75 Lakhs. Comes with EMI and lifelong entry option.
Unique Features
Comprehensive
An individual and family health plan providing SI of up to 1 crore to prepare you to meet constantly increasing medical inflation.
Unique Features
Disease-specific plan
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
Disease-specific plan
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
Critical Illness
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
Bonus-oriented health plan
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
Top-Up
Avail of extra cover to meet medical expenses without any limitations by purchasing this deductible-based top-up plan.
Unique Features
Women-oriented health
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
See More Health Insurance Articles
See More Health Insurance Articles
Yes, policyholders can avail of the benefit of no-cost installment. This feature is available to one-year policyholders.
When an individual purchases HDFC Ergo Optima Secure the base cover gets doubled instantly upon purchase, without having the need to claim it. If any individual purchases the policy with a sum insured of INR 10 lakh the secure benefit allows the sum insured to double up to INR 20 lakh immediately which can then be used for any number of admissible claims.
When an individual purchases HDFC Ergo Optima Secure they can avail of the plus benefit that offers a 50% increase on 1st policy renewal after 1 year and a 100% increase after 2 years.
Yes, HDFC Ergo Optima Secure covers medical expenses incurred by policyholders on home hospitalization, if advised by the Doctor on a cashless basis.
Yes, policyholders are covered for COVID-19 under HDFC Ergo Optima Secure.
Aniruddh Singh
Chandigarh
May 1, 2023
I am satisfied with the customer service provided to me when I had a small query regarding my HDFC health insurance policy. Thank you to the customer support team of PolicyX
Subhro Jha
Hyderabad
September 14, 2022
It was great experiance with Policyx.com about the claims as i got rejection my claim from HDFC Ergo but after getting support of policyx.com i got my claim and the complete amount is given by...
Vedika Verma
Delhi
May 25, 2022
With several health plans, HDFC ERGO offers looks after the healthcare need of every individual. I am glad that I chose to buy health insurance from HDFC ERGO
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...
Usha Dodiya
Indore
May 20, 2021
Policyx.com give very good insurance policy I will recommend to everyone and manager support is very gool
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
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
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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