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HDFC ERGO Optima Senior Health Insurance

526 reviews Rate This
HDFC ERGO Health Insurance
Optima Senior
Cashless Approval TATWithin 37 mins
Claim Settlement Ratio99.80%
Network Hospitals13,000+
PED Coverage Starting From3 year
Special Benefits2X Cover from Day 1
Starting Premium Rs. 1090/month

About HDFC ERGO Optima Senior Health Insurance

Optima Senior framed by HDFC ERGO General Insurance is a wonderful medical insurance plan that is designed just for seniors. It takes care of you and your spouse by providing them with a life-long hassle-free health cover. The plan offers you to get a cover for up to Rs. 5 Lakh. It ensures that you do not have to pay any additional loading if you fall ill. Any individual who is above 61 years of age can be covered under this plan. Also, you get discounts and other benefits if you cover both, yourself and your spouse.

Under the umbrella of this plan, a huge list of benefits is covered. Some of them are - portability benefits, no claim discount, e-opinion, no maximum entry age, lifelong renewal option and no claim-based loading or claim-based underwriting. Other than this, you can avail organ donor cover, emergency ambulance cover, in-patient hospitalisation expenses.

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Key Inclusions and Exclusions of the Plan

What's Included

  • Domiciliary treatment covered
  • In-patient treatment covered
  • Pre-hospitalisation expenses covered for up to 30 days
  • Post-hospitalisation expenses covered for up to 60 days
  • One e-opinion provided per policy

What's Not Included

  • Expenses arising from HIV and AIDS
  • Treatments within the initial 30 days of cover
  • Expenses on items of personal convenience
  • Pre-existing conditions are not covered until 3 years
  • Waiting period for some specific illnesses such as hernia, cataract, etc.

9552 HDFC ERGO Cashless Network Hospitals in India

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Optima Senior User Reviews

4.7
Rating based on
526 User reviews
Write your review
What users are saying
  • All
  • Quick policy issuance

    I bought the HDFC ERGO Optima Secure health insurance plan from the insuranceDekho website. The buying process was quick and easy. The plan was issued to me in less than 5 minutes. Loved the plan and their services. 

    Read More

    M
    By Manish Yadav
    On: Mar 02, 2022
  • Swift renewal

    Renewing HDFC Ergo General Insurance’s Optima Senior plan was the swiftest service ever. I started by providing the details of my existing health plan. I regenerated my quote and reselected my plan. Then finally I paid for the renewed premium.

    Read More

    I
    By Ishani Sen
    On: Feb 04, 2021
  • All-time accessible customer c...

    The best thing about InsuranceDekho is that they are accessible anytime. Through phone calls or Whatsapp, I know my policy-related queries will be resolved. It is a huge relief during emergencies. I booked an HDFC Ergo General Insurance Optima Senior Health Insurance plan via this website.

    Read More

    F
    By Falguni Mondal
    On: Dec 10, 2020
View All Optima Senior Reviews

HDFC ERGO Optima Senior Brochure

  • 229.34 KB
  • PDF Document
  • Nov 09, 2020
Download PDF

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.

FAQs on Optima Senior Health Insurance Plan

  • Are pre and post-hospitalisation expenses covered under this plan?

    Yes, the plan covers pre-hospitalisation expenses for up to 30 days and post-hospitalisation expenses for up to 60 days. 

  • Does the plan cover daycare procedures?

    Yes, the plan provides cover for 140-day care procedures.

  • Is there any co-payment on daycare procedures under this plan?

    Yes. Co-payment of 15% will be applicable to all the daycare procedures. 

  • Is there any limit on cover for an emergency ambulance under this plan?

    Yes. The plan provides emergency ambulance cover for up to Rs. 2,000 per hospitalisation. 

  • What is the maximum limit of age for entry to this plan?

    There is no maximum age limit for entry to this plan.

  • Does the plan offer lifetime renewability benefit?

    Yes. The plan comes with a lifetime renewability benefit. 

  • Do the policyholders get any discount under this plan?

    Yes. You can avail a discount of 5% if you cover yourself and your spouse under it. Additionally, a discount of 7.5% is offered on the total premium if the policy is purchased for 2 years.

  • What are the sum insured options under this plan?

    The plan comes with sum insured options of Rs. 2 Lakh, Rs. 3 Lakh and Rs. 5 Lakh. 

  • What are the policy term options under this plan?

    The plan can be purchased for a term of 1 year or 2 years.

  • Can I purchase this plan online?

    Yes. You can purchase this online from the official website of HDFC Ergo Health Insurance or contact the health insurance broker, InsuranceDekho at toll-free number 7551-196-989. 

  • What is the eligibility criteria for this plan?

    To be able to purchase this policy, the applicant should be at least 61 years old. There is no restriction on the maximum age. 

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