HDFC ERGO Optima Secure Plan Health Insurance

HDFC ERGO Optima Secure is a comprehensive health insurance plan designed for both individuals and families. The plan's sum assured ranges from Rs. 5 Lakh to Rs. 2 Crore, providing flexibility and security for your healthcare needs. This new HDFC ERGO plan gives you four times more coverage without charging you extra. And, this changes how much you get from health insurance. It not only ensures your current well-being but also protects your future.

The health insurance plan comes with a unique feature that automatically increases your base cover by 50% after one year and 100% after two years, regardless of any claims made. Another standout benefit of the HDFC ERGO Optima Secure plan is the Restoration Benefit, ensuring that if you don't claim during the year, 100% of your base cover is automatically restored at no additional cost. Moreover, the plan includes a Protection Benefit that covers essential items like gloves and masks.

HDFC ERGO Optima Secure Health Insurance At a Glance

Check the highlights of HDFC ERGO health insurance company's Optima Secure insurance in the table below:

Coverage	Both Individual and Family Floaters
Riders	Health Critical Illness, Unlimited Restore, etc.
Key features	Secure Benefit, Plus Benefit, and more
Policy Tenure	1, 2 and 3 Years
Inclusion	Room Rent, ICU Charges, Pre and Post-hospitalisation, etc.
Exclusion	Adventure Sport Injury, Breach of Law, etc.
Renewability	Lifelong

Riders Available With HDFC ERGO Optima Secure Health Insurance

Rides available with Optima Secure Plan by HDFC ERGO Health Insurance include the following:

• Health Critical Illness Add-On: Choose from Sum Insured options ranging from Rs. 100,000 to Rs. 500,00,000, in multiples of Rs. 100,000.
• Health Hospital Cash Benefit Add-On: Select from Sum Insured options of Rs. 500, Rs. 1000, Rs. 1500, Rs. 2000, Rs. 2500, Rs. 3000, Rs. 5000, Rs. 7500, and Rs. 10,000, to cover your out of pocket expenses.
• Individual Personal Accident Rider: Get coverage up to 5 times the Sum Insured of the Base Plan, with a maximum limit of Rs 1 Crore.
• Unlimited Restore: Get unlimited restoration within a Policy Year for added peace of mind.

Key Features of HDFC ERGO Optima Secure Health Insurance Plan

The following are the key features of the HDFC ERGO Optima Secure Health Insurance Plan:

• Secure Benefit: Imagine your health coverage doubling as soon as you purchase the Optima Secure health insurance plan. It's not just an idea but it's a reality. The Secure Benefit instantly increases your base cover 2X at no extra cost.
• Plus Benefit: The Plus Benefit rewards your trust and loyalty under which you receive a 50% increase in the base cover after the first renewal and a remarkable 100% increase after the second-year renewal, regardless of any claims made.
• Automatic Restore Benefit: The Optima Secure plan ensures peace of mind. The Automatic Restore Benefit restores up to 100% of your base sum insured for subsequent claims, covering any illness or accidental hospitalisation. This is handy when you've used up your existing sum insured due to one or several claims.
• Zero Deduction on Non-Medical Expenses: Enjoy a cashless experience with built-in coverage for non-payable items like gloves, masks, food charges, and other consumables during hospitalisation. All expenses for 60+ listed non-medical items are covered at no extra premium.
• No Sub Limit: There are no restrictions on room categories or hospitals. This feature helps you minimise out-of-pocket expenses and gives you the freedom to choose the hospitalisation room that suits your preferences.

Eligibility Criteria of HDFC ERGO Optima Secure Health Insurance Plan

The eligibility criteria for the HDFC ERGO Optima Secure Health Insurance plan are as follows:

Parameters	Eligibility Criteria
Minimum entry age	Child: 91 Days Adult: 18 Years
Maximum entry age	Child: 25 Years Adult: No Age Limit
Sum insured	Rs. 5, 10, 15, 20, 25 and 50 Lakhs, Rs. 1 and 2 Crores

Benefits of HDFC ERGO Optima Secure Health Insurance Plan

This health insurance plan offers the following benefits:

• No Splitting Bills: With Optima Secure plan, you'll never have to worry about splitting the bill for your treatment. The insurance covers the entire cost, up to the sum insured. You won't have to pay anything out of your pocket, as there's no co-payment required.
• Full Cover for All Diseases: You get full coverage regardless of the disease. If your insurer hasn't specifically excluded a certain illness, you can claim the full amount up to the sum insured. This policy doesn't have those tricky disease-wise sub-limits.
• Restoration Benefit: There's a special Restoration Benefit under which even if you've claimed part of the cover once, you get 100% of the cover restored if you're hospitalised again for a different complication in the same year.
• Special Renewal Bonus: Your sum insured increases by 50% each year, regardless of your claim status in the current year. The sum insured keeps increasing until the Loyalty Benefit sum insured reaches 100% of the sum insured.
• Coverage for Alternative Medicine: If you are interested in Ayurvedic, Homeopathic, or other alternative treatments then this insurer has you covered fully, up to the sum insured.

Inclusions of HDFC ERGO Optima Secure Health Insurance Plan

Inclusions of the HDFC ERGO Optima Secure Health Insurance are mentioned below:

• Room Rent: You're covered for the actual cost of the room you stay in during hospitalisation.

• ICU Charges: Your coverage extends up to the total amount insured for the ICU charges.

• Pre-Hospitalisation: Medical expenses before your hospital stay, up to 60 days prior, are covered.
• Post-Hospitalisation: After leaving the hospital, expenses for up to 180 days are covered.
• Domiciliary Hospitalisation: If you need to be treated at home, your coverage extends up to the total amount insured.
• Daycare Treatments: All treatments that don't require an overnight stay are covered.
• Cataract Treatment: Expenses related to cataract treatment are covered.
• COVID-19 Treatments: Your plan covers expenses related to COVID-19 treatments.
• No Claim Bonus: If you don't make a claim, you can get a bonus of up to 10% of your Sum Insured.
• Automatic Restoration: Your coverage is restored automatically, without limits.
• Hospital Daily Cash: You receive a daily cash benefit of Rs. 800, up to a total of Rs. 4,800.
• Organ Donor: Costs related to organ donation are covered up to the Sum Insured.
• AYUSH Treatment: Alternative treatments like Ayurveda, Yoga, Unani, Siddha, and Homeopathy are covered up to the Sum Insured.
• Ambulance Cover: Expenses for ambulance services are covered up to the Sum Insured.
• Air Ambulance Cover: Costs for air ambulance services are covered, up to Rs. 5 lakhs.
• E-Consultation: Consultation for 50+ critical illnesses is available through electronic means.

Exclusions of HDFC ERGO Optima Secure Health Insurance Plan

The exclusions in the HDFC ERGO Optima Secure Health Insurance plan are as follows:

• Adventure Sport Injuries: If you get injured while participating in adventure sports, like extreme activities, it's not covered by this health insurance plan.
• Self-Inflicted Injuries: Injuries intentionally caused by yourself are not covered.
• Breach of Law: Any treatment expenses resulting from breaking the law with criminal intent are not covered.
• Injuries in War: Unfortunately, if a claim arises due to war, it's not covered by this health insurance plan.
• Participation in Defence Operations: If you're involved in defense operations, any related medical expenses are not covered.
• Excluded Providers: The insurer won't cover expenses for treatment from specific hospitals, medical practitioners, or providers that are not on their approved list.
• Congenital External Diseases, Defects, or Anomalies: Medical expenses for the treatment of congenital external diseases, defects, or anomalies (birth defects) are not covered.
• Treatment for Obesity or Cosmetic Surgery: Medical expenses for treating obesity or undergoing cosmetic surgery are not covered.
• Treatment for Alcoholism & Drug Abuse: Expenses related to the treatment of alcoholism, drug or substance abuse, or any addictive condition and its consequences are not covered.

Documents Required to Buy HDFC ERGO Optima Secure Health Insurance Plan

You will need the following documents to buy the HDFC ERGO Optima Secure Health Insurance plan:

• Accurately filled application form.
• Show ID proof using an Aadhar card, Passport, Voter ID, or Driver's license.
• Confirm your age with documents like a Birth Certificate, School Leaving Certificate, or Passport.
• Prove your address with Utility Bills, Rental Agreement, or Aadhar Card.
• Provide passport-sized photos.
• Health check-up reports might be required in some cases.
• Any other documents the insurance company asks for.

How to Buy HDFC ERGO Optima Secure Health Insurance?

To buy the HDFC ERGO Optima Secure Health Insurance Plan, you need to follow the steps below:

Step 1: Go to the InsuranceDekho website.

Step 2: Click on "Health Insurance” under the “Insurance” tab at the top"

Step 3: Tap on "HDFC ERGO Health Insurance" from the list of health insurance companies.

Step 4: Now, choose the "Optima Secure" plan.

Step 5: Read the policy document carefully.

Step 6: Upload the required documents for verification.

Step 7: Pay the medical insurance premium online.

Step 8: You will successfully receive the policy document via email.

Claim Process for HDFC ERGO Optima Secure Health Insurance

Below are the ways to claim your HDFC ERGO Optima Secure Health Insurance policy:

Cashless Claim

• Visit a hospital partnered with HDFC ERGO.
• Provide HDFC ERGO Optima Secure plan details and other relevant information.
• Submit necessary documents.
• The insurance company will pay the hospital directly.

Reimbursement Claim

• Choose a hospital within HDFC ERGO’s network.
• Pay medical bills at the hospital.
• Request a reimbursement claim on the insurance company's website.
• Submit the Optima Secure claim form and related information.
• The insurance company will review and reimburse your medical expenses.