HDFC ERGO Optima Plus Insurance Plan

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      HDFC ERGO Optima Plus Insurance Plan

      The HDFC ERGO Optima Plus is a health insurance plan that has been created to provide the highest protection in case of hospitalization resulting due to a medical emergency. It is an affordable premium policy that can be used as a standalone zero-deductible health plan or along with an existing HDFC Ergo medical policy.

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      HDFC ERGO Optima Insurance: Specifications

      HDFC ERGO Optima Plus
      Categories Specifications
      Sum insured or dependents
      Policy Tenure 1 year, 2 years
      Network Hospitals 12000+
      Incurred Claim 97.47%
      Pre-Existing Diseases Waiting Period 4 Years
      Specific Diseases Waiting Period 2 Years
      Initial Waiting Period 30 Days

      HDFC ERGO Optima Insurance: Benefits

      The benefits of the HDFC ERGO Optima Health Insurance plan have been explained in detail below:

      • In-Patient Treatment – The medical expenses covered under in-patient benefits are room rent, boarding, and ICU expenses. It also includes costs that accommodate medical professionals, equipment, diagnostic tests, surgical procedures and any prosthetics or devices provided to the insured or dependents.
      • Pre-Hospitalisation Benefit – The pre-hospitalisation benefit covers various illnesses and medical conditions. It is applicable up to 60 days before the insured or dependents have been admitted to the hospital.
      • Post-Hospitalisation Benefit – With the post-hospitalisation benefit, the insured or dependents individual can file for claims 90 days after the insured or dependents have been discharged from the hospital.
      • Day Care Procedures – Any procedure that does not require 24-hour hospitalisation of the insured or their dependents is also covered. The cover is provided for 140 days.
      • Domiciliary Treatment – Through this benefit, the insured or the dependent can avail of medical treatment for their health issues at home. The expenses incurred will be covered through the HDFC ERGO Optima Plus Insurance Plan.

      Eligibility Criteria: HDFC ERGO Optima Plus Insurance Plan

      HDFC ERGO Optima Plus
      Parameters Eligibility Criteria
      Minimum Entry Age Adult - NA
      Child – 91 Days
      Maximum Entry Age Adult- 65 Years
      Child – 5 Years
      Coverage Type Individual
      Renewability Lifelong

      HDFC ERGO Optima Plus Insurance: Inclusions

      The inclusions provided with the HDFC ERGO Optima Plus Insurance plan are as follows:

      • Emergency Ambulance – It provides the insured or the dependents with cash benefits. It provides them with a cover of up to Rs. 2000 for each hospitalisation that requires ambulance services to transport the insured or the dependent to the nearest hospital.
      • Family Discount – The HDFC ERGO Optima Plus Insurance provides the insured with a discount of 10%. It is available if two or more individuals from the same family are covered under the HDFC ERGO Optima Plus insurance policy.
      • Discount on Premium – Another inclusion available for the HDFC ERGO Optima Plus insurance policyholders is the discount on the premium amount. A 7.5% discount on the premium is provided if the insured pays a premium for 2 years in advance.

      HDFC ERGO Optima Plus Insurance Plan: Exclusions

      The following are the exclusions of the HDFC ERGO Optima Plus insurance plan:

      • Any expenses related to diagnostic tests and evaluation.
      • Any rest, care, rehabilitation or custodial care at home.
      • Any form of weight loss or obesity-related surgeries
      • Gender change surgery or treatments.
      • Any form of adventure sports or hazardous activity.
      • Treatment for addiction to alcohol or substance abuse.
      • Vision-related treatments or correction of refractive errors.
      • Any form of reproduction or childbirth treatments and surgeries.


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      Disclaimer: Policybazaar does not endorse, rate or recommend any particular insurer or insurance product offered by an insurer.

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