HDFC ERGO Maxima Health Insurance Plan

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      HDFC ERGO Maxima Health Insurance Plan

      HDFC ERGO Maxima Insurance is a unique health plan that provides coverage to the policyholder and his/her dependent family members. The insurer recompenses the expenses incurred on hospitalization within India, dental treatment as well as out-patient treatment expenses among others. Moreover, the insured can claim up to 4-doctor consultations during the policy term.

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      HDFC ERGO Maxima Health Insurance Plan: Key Benefits

      Categories Specifications
      Sum Insured Up to Rs. 3 Lakhs
      Policy Tenure 1 year
      Network Hospitals 12000+
      Incurred Claim (2021-22) 97.47%
      Pre-policy Medical Check-Up May be required
      Pre-Existing Disease Waiting Period 3 years
      Specific Disease Waiting Period 2 years
      Initial Waiting Period 30 days
      Discounts 10% Family Discount

      Benefits of HDFC ERGO Maxima Health Insurance Plan

      The following are the benefits of purchasing the HDFC ERGO Maxima Insurance Plan:

      • In-Patient Hospitalization Cover - The HDFC ERGO Maxima Insurance Plan provides the insured with in-patient hospitalization benefits. These include room rent, nursing ICU charges, medical practitioner fees, medical supplies and medicines, nursing and other related costs.
      • Pre-Hospitalisation - The policy covers medical expenses before the hospitalization begins. The costs incurred will be paid 60 days before hospitalisation by showcasing medical documents related to the health condition and the hospitalisation date, time and location.
      • Post-Hospitalisation - Through the HDFC ERGO Maxima Insurance Plan, any medical expenses occurring within 60 days of the discharge of the insured individual will be paid. It is done concerning the condition for which the individual was hospitalised and after the medical documents stating the illness, date and location of the hospitalisation have been submitted.
      • Daily Cash for Shared Accommodation - HDFC ERGO Maxima Insurance Plan provides the insured individual with a per day cash amount ranging from Rs. 500 to a maximum of Rs. 3000. It is possible only when the individual is placed in a shared hospital accommodation for 24 to 48 hours.
      • Maternity Expenses - The policy will offer coverage of a minimum of Rs. 300 (per day) to a maximum of Rs. 9000 for all medical expenses at the time of delivery, both regular and caesarean. The benefits are also offered at the time of a medical termination of a pregnancy. Additionally, the maternity expenses benefit would offer coverage for both prenatal and post-natal expenses and termination up to the amount mentioned in the policy wording.
      • Domiciliary Treatment - HDFC ERGO Maxima Insurance Plan also offers individuals benefits for any medical treatments at home. It is done only when the individual cannot go to the nearest medical facility due to the unavailability of beds or on the medical practitioner's advice.

      HDFC ERGO Maxima Insurance Plan Eligibility Criteria

      Parameters Eligibility Criteria
      Minimum Entry Age Adult -NA
      Child - 91 Days
      Maximum Entry Age Adult - 65 years
      Child - NA
      Coverage Type 1 member, 2 members, 2 Adults + Up to 2 Children
      Renewability Lifelong

      Inclusions of HDFC ERGO Maxima Health Insurance Plan

      All the inclusions provided under the HDFC ERGO Maxima Insurance Plan has been mentioned as follows:

      • Inpatient Consultations - The policy offers coverage for any expenses incurred at during in-patient consultation.
      • Outpatient Consultations - It covers for the expenses incurred on outpatient consultation.
      • Domiciliary Hospitalisation - The policy covers any serious medical treatment or medication availed at home.
      • Ambulance services - It ensures that the expenses for ambulance services are covered up to a sum of Rs. 2000.

      Exclusions of HDFC ERGO Maxima Health Insurance Plan

      The following are the exclusions under the HDFC ERGO Maxima Insurance Plan:

      • Expenses caused due to diseases like HIV/AIDS or related health issues.
      • Health issues caused due to the consumption of addictive substances.
      • Treatment of injuries caused due to self-inflicted injuries.
      • Any treatment done with non-allopathic medication.
      • Illnesses arising due to acts of war, nuclear, chemical or biological radiation.


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