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HDFC ERGO Optima Super Health Insurance

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HDFC ERGO Health Insurance
Optima Super
Cashless Approval TAT45 mins Cashless Claim Processing
Claim Settlement Ratio100%
Network Hospitals12,000+
PED Coverage Starting From3 year
Special Benefits2X Cover from Day 1
Starting Premium Rs. 1090/month

About HDFC ERGO Optima Super Health Insurance

The regular health insurance plan provides coverage for treatment expenses up to a predefined limit but with the ever-rising cost of treatment, many times the sum assured seems insufficient. HDFC ERGO General Insurance' Optima Super top-up plan enhances the existing insurance coverage on a cost-sharing basis.

It comes with varied sum insured options and deductible combinations so you can choose the coverage as per your requirements. The policyholders get the benefit of high deductible, wherein throughout the year all treatment expenses are considered. If the sum of all the expenses is above the threshold limit, one can claim for the coverage above the limit. It is one of the most cost-effective plan. During retirement, one can easily consider this plan if one is covered under a group health insurance, as it can be easily converted into a normal health plan.

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Key Inclusions and Exclusions of the Plan

What's Included

  • Ambulance service expenses up to actual expenses or Rs. 2000, whichever is lower
  • Daycare procedures and organ donor expenses
  • Post-hospitalisation expenses up to 90 days after hospitalisation
  • Pre-hospitalisation expenses up to 60 days before hospitalisation
  • In-patient treatment is covered under the policy

What's Not Included

  • Expenses for devices like prosthetics, etc. which are not implanted internally
  • Treatment availed outside India
  • Day care procedures at a facility which is not a hospital
  • Pre and post hospitalisation expenses of organ donor
  • Hospitalisation for evaluation, investigation only

9552 HDFC ERGO Cashless Network Hospitals in India

Choose HDFC ERGO Critical Illness Plan

Optima Super User Reviews

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What users are saying
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  • Clarify queries through Whatsa...

    The Whatsapp contact number provided on InsuranceDekho is very convenient. The response is also personalised. I posted my question regarding top-up benefits of my HDFC Ergo General Insurance’s Optima Super plan. I received a detailed reply immediately.

    N
    By Naren Banik
    On: Dec 16, 2020

HDFC ERGO Optima Super Brochure

  • 212.66 KB
  • PDF Document
  • Nov 10, 2020

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 Super Health Insurance Plan

  • Why should I buy Optima Super plan?

    Optima Super is the only top-up health plan that increases your existing coverage and also provides you the benefit of converting your top-up plan to a full-fledged health plan at the time of retirement.  

  • What are the sum insured and deductible options available under Optima Super?

    Optima Super comes with the sum insured options as Rs. 5 Lakh, Rs. 7 Lakh and Rs. 10 Lakh with the deductibles of Rs. 1 Lakh, Rs. 2 Lakh, Rs. 3 Lakh, Rs. 4 Lakh, Rs. 5 Lakh, Rs. 6 Lakh, Rs. 7 Lakh and Rs. 10 Lakh.  

  • What are the features of the Optima Super plan?

    The Optima Super plan has the following USPs: Coverage for hospitalisation expenses throughout the year Nominal premium Coverage for in-patient expenses, after deductible in both individual and family floater plan Lifelong renewability You can covert the top-up plan into a full-fledged plan by “Waiver of Deductible” benefit Once deductible is waived off, the coverage is provided from the very first rupee Cashless hospitalisation in a wide network hospitals

  • What is the minimum entry age for Optima Super plan?

    The minimum entry age adults for Optima Super plan is 18 years.  

  • What is the maximum entry age for Optima Super plan?

    The maximum entry age for adults Optima Super plan is 65 years.  

  • How many day care procedures are covered under Optima Super plan?

    The plan covers 144 day care procedures, which do not require 24 hours hospitalisation.  

  • Can children be covered under Optima Super plan?

    Dependent children between 91 days to 5 years can be covered under Optima Super plan provided either of the parent is covered under the plan.  

  • How many members can be included in a single Optima Super plan?

    Maximum of 6 members can be included in a single policy. In a family floater policy, maximum of 2 adults and maximum of 2 children can be included in a single policy and in an individual policy, maximum of 4 adults and maximum of 5 children can be included in a single policy. 

  • What is the renewability age under the Optima Super plan?

    The Optima Super plan can be renewed for lifetime.  

  • What is the free-look period under the Optima Super plan?

    There is a free look period of 15 days from the receipt of the policy document to review terms and conditions of the policy.   

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