How does Reserve Benefit work?

There is a coverage limit on Reserve Benefit under the plan. This benefit covers the OPD expenses incurred by the policyholder on consultations, diagnostic tests, medicines, etc. After the end of the policy year, if the Reserve Benefit coverage is not utilised in full, the unused amount is carried forward to the next year. This accumulation continues every year there is an unused balance. Moreover, 6% bonus is also added on the carried forward balance. The accumulated balance can then be used to pay the premium or for OPD expenses.

What is the multiplier benefit?

Multiplier benefit is a no claim bonus which is allowed if no claim is made in a policy year. For every claim-free year, the sum insured increases by 50% and, therefore, doubles after two claim-free policy years.

What are the eligibility requirements of buying the plan?

Individuals aged 91 days and above and up to 65 years can buy the plan. Children aged 91 days to 5 years are allowed coverage only when either parent is insured under the plan

Which family members can be covered under the plan?

Self, spouse, dependent children, dependent parents and dependent parents-in-law can be covered.

For how long can the policy be renewed?

The policy offers lifelong renewals without a maximum limit on exit age.

What are the waiting periods under the plan?

There is an initial waiting period of 30 days after buying the policy during which illnesses suffered would not be covered. Thereafter, specific ailments like hernia, cataract, etc. are covered after a waiting period of 2 years. For pre-existing illnesses, the waiting period is 3 years.

What is the limit of coverage on ambulance costs?

Ambulance costs are covered for up to Rs. 2000 per instance of hospitalisation.

What is AYUSH Treatment?

AYUSH treatments mean treatments taken under non-allopathic medical practices like Ayurveda, Unani, Siddha and Homeopathy.

Are medical check-ups required before buying the policy?

Pre-entrance medical check-ups might be required depending on the age of the insured and the sum insured opted for. If the tests are conducted and the policy is accepted by the insurance company, the cost of the medical check-ups would be reimbursed fully.

What does worldwide emergency care cover?

Under worldwide emergency care, if the insured suffers a medical emergency when travelling abroad and is hospitalised in an international hospital, the cost of treatments are covered.

HDFC ERGO Health Wallet Insurance Wordings

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Highlights

Cashless Approval TAT	Within 37 mins
Claim Settlement Ratio	99.80%
Network Hospitals	13,000+
PED Coverage Starting From	3 year
Special Benefits	2X Cover from Day 1
Starting Premium	Rs. 1090/month

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HDFC ERGO Health Wallet Brochure

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Nov 09, 2020

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HDFC ERGO Health Insurance Plan List

Family (3)
Individual (4)
Cancer (1)
Critical Illness (2)
Diabetes (1)
Parents (1)
Senior Citizen (1)

Name of Plan	Sum Insured
Optima SecureMin: 91 Days, Max: 65 YearsPopular		Check Premium
Optima RestoreMin: 91 Days, Max: 65 YearsPopular	3 Lakh	Check Premium
my: health SurakshaMin: 91 Days; Max: No LimitPopular	3 Lakh	Check Premium
Health Suraksha Top-Up Plus PolicyMin: 91 days; Max: 65 years	3 Lakh - 10 Lakh	Check Premium
my:Health Women Suraksha PolicyMin: 18 years; Max: 45 years	1 Lakh - 1 Crore	Check Premium
Dengue Care Policy Min: 91 Days; Max: 65 years	50 Thousand - 1 Lakh	Check Premium
Easy Health PolicyMin: 91 days; Max: 65 years	1 Lakh - 50 Lakh	Check Premium
my:Health Koti SurakshaMin: 18 years; Max: 65 years		Check Premium
Maxima PolicyMin: 91 Days; Max: 65 years		Check Premium
Day2Day Care PolicyMin: 91 Days; Max: 65 years		Check Premium
iCan CancerMin: 5 Years; Max: 65 Years	5 Lakh	Check Premium
Health WalletMin: 91 Days; Max: 65 Years	3 Lakh	Check Premium
EnergyMin: 18 Years, Max: 65 Years	2 Lakh	Check Premium
Optima SeniorMin: 61 Years; Max: No Limit	2 Lakh	Check Premium
Corona Kavach PolicyMin: 1 day ; Max: 65 years	50,000 - 5 lakh	Check Premium
Arogya Sanjeevani PolicyMin: 3 months; Max: 65 years	1 Lakh - 5 Lakh	Check Premium
Critical Illness PlanMin: 5 Years; Max: 65 Years	5 Lakh	Check Premium

HDFC ERGO Health Insurance Top Up List

Top-up (4)
Family (1)
Individual (1)

Name of Plan	Sum Insured
Optima PlusMin: 91 Days; Max: 65 YearsPopular	5 Lakh	Check Premium
my: Health Medisure Super Top-upMin: 3 Months; Max: 65 YearsPopular	3 Lakh	Check Premium
Optima SuperMin: 91 Days; Max: 65 Years	5 Lakh	Check Premium

9552 HDFC ERGO Cashless Network Hospitals in India

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FAQs on Health Wallet Health Insurance Plan

How does Reserve Benefit work?
There is a coverage limit on Reserve Benefit under the plan. This benefit covers the OPD expenses incurred by the policyholder on consultations, diagnostic tests, medicines, etc. After the end of the policy year, if the Reserve Benefit coverage is not utilised in full, the unused amount is carried forward to the next year. This accumulation continues every year there is an unused balance. Moreover, 6% bonus is also added on the carried forward balance. The accumulated balance can then be used to pay the premium or for OPD expenses.
What is the multiplier benefit?
Multiplier benefit is a no claim bonus which is allowed if no claim is made in a policy year. For every claim-free year, the sum insured increases by 50% and, therefore, doubles after two claim-free policy years.
What are the eligibility requirements of buying the plan?
Individuals aged 91 days and above and up to 65 years can buy the plan. Children aged 91 days to 5 years are allowed coverage only when either parent is insured under the plan
Which family members can be covered under the plan?
Self, spouse, dependent children, dependent parents and dependent parents-in-law can be covered.
For how long can the policy be renewed?
The policy offers lifelong renewals without a maximum limit on exit age.
What are the waiting periods under the plan?
There is an initial waiting period of 30 days after buying the policy during which illnesses suffered would not be covered. Thereafter, specific ailments like hernia, cataract, etc. are covered after a waiting period of 2 years. For pre-existing illnesses, the waiting period is 3 years.
What is the limit of coverage on ambulance costs?
Ambulance costs are covered for up to Rs. 2000 per instance of hospitalisation.
What is AYUSH Treatment?
AYUSH treatments mean treatments taken under non-allopathic medical practices like Ayurveda, Unani, Siddha and Homeopathy.
Are medical check-ups required before buying the policy?
Pre-entrance medical check-ups might be required depending on the age of the insured and the sum insured opted for. If the tests are conducted and the policy is accepted by the insurance company, the cost of the medical check-ups would be reimbursed fully.
What does worldwide emergency care cover?
Under worldwide emergency care, if the insured suffers a medical emergency when travelling abroad and is hospitalised in an international hospital, the cost of treatments are covered.

View More Questions

Claim Process at HDFC ERGO Health Insurance

Network Hospital
Non-Network Hospital

1
Claim Assistance
For any assistance or query, call InsuranceDekho at the toll-free number 755 1196 989.
2
Claim Intimation
Emergency hospitalisation needs intimation within 24 hours and for planned hospitalisation intimate within 48 hours prior to admission.
3
Claim Processing
Fill in the pre-authorisation form and hand it over to hospital's insurance/TPA desk to initiate claim request.
4
Claim Settlement
Once your request is approved, claim is settled. If not approved, claim for reimbursement after discharge.

1
Claim Assistance
For any assistance or query, call InsuranceDekho at the toll-free number 755 1196 989.
2
Claim Intimation
Emergency hospitalisation needs intimation within 24 hours and for planned hospitalisation intimate within 48 hours prior to admission.
3
Claim Processing
Submit claim form with original documents such as doctor’s reports, hospital bills, diagnostic tests, etc.
4
Claim Settlement
Once your request for reimbursement of expenses is approved, the claim will be settled.