HDFC ERGO Optima Restore Plan

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      HDFC ERGO Optima Restore Plan

      HDFC ERGO Optima Restore provides enhanced medical coverage to safeguard the health of individuals and families with the help of the restore benefit. It pays for the emergency and planned medical expenditures incurred on hospitalization, ambulance services, day care procedures, domiciliary treatment, etc. It also has other attractive benefits like the multiplier benefit, daily cash for choosing shared accommodation, preventive health check-ups, etc.

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      HDFC ERGO Optima Restore Plan: Key Highlights

      Categories Specifications
      Sum Insured Rs 3 lakh to Rs 1 crore
      Policy Tenure 1 year, 2 years, 3 years
      Network Hospitals 12000+
      Incurred Claim Ratio (2021-22) 97.47%
      Pre-existing Diseases Waiting Period 3 years
      Specific Diseases Waiting Period 2 years
      Initial Waiting Period 30 days
      Discount 10% family discount
      7.5% multi-year discount
      5% online discount
      2.5% loyalty discount

      Benefits of HDFC ERGO Optima Restore Plan

      Here are the benefits of buying an HDFC ERGO Optima Restore plan:

      1. Restore Benefit

        Policyholders can restore their base sum insured by 100% immediately after their first claim with the restore benefit. This benefit is available once a year and gets activated on both partial or complete utilization of the base sum insured.

      2. Multiplier Benefit

        This unique benefit doubles the coverage amount of an HDFC ERGO Optima Restore policy in 2 years by increasing the sum insured by 50% every time no claim is raised during a policy year.

      3. No Room Rent Limit

        Unlike most health plans, this HDFC ERGO health insurance plan comes with no restriction on room rent limit, allowing policyholders to stay in a hospital room of their choice.

      4. Preventive Health Check-up

        The insurance company pays for the preventive health check-up of the insured regardless of claims so that the onset of any disease or medical condition can be detected at the right time.

      5. Stay Active Benefit

        The HDFC ERGO General Insurance Company also promotes the overall well-being of the policyholders by offering a renewal discount of up to 8% on achieving the average step count target.

      6. Tax Benefits

        Policyholders can also earn tax benefits on the premium paid to buy the Optima Restore policy under Sec 80D of the Income Tax Act.

      HDFC ERGO Optima Restore Plan Eligibility Criteria

      Check out the eligibility criteria for buying an HDFC ERGO Optima Restore plan:

      Parameters Eligibility Criteria
      Minimum Entry Age Adult – 18 years
      Child – 91 days
      Maximum Entry Age Adult – 65 years
      Child - 25 years
      Coverage Type Individual/ Family floater
      Types of Relationships Covered Self, spouse, dependent children, dependent parents and dependent parents-in-law
      Renewability Lifelong

      Inclusions of HDFC ERGO Optima Restore Plan

      The following medical expenses are included under an HDFC ERGO Optima Restore plan:

      • In-patient Treatment – It pays for the cost of hospitalization of at least 24 hours, including room rent, doctor’s fees, nursing fees, OT expenses, etc.
      • Pre-hospitalization Expenses – It covers medical expenses incurred for up to 60 days before being admitted to a hospital.
      • Post-hospitalization Expenses – It pays for the medical expenses incurred for up to 180 days after hospital discharge.
      • Day Care Procedures – It covers the cost of medical procedures and treatments requiring less than 24 hours of hospitalization.
      • Domiciliary Treatment – It pays for the medical expenses incurred on home hospitalization if being admitted to a hospital is not possible.
      • Organ Donor Expenses – It covers the cost of harvesting the organ donated for the transplant surgery of the insured.
      • Ambulance Cover – It pays for the medical expenses incurred by availing the road ambulance services to transport the patient to the nearest hospital.
      • Daily Cash for Choosing Shared Accommodation – It pays a daily cash allowance to the insured for choosing a shared room at the hospital.
      • E-Opinion for Critical Illness – It allows the insured to avail e-opinion from a qualified doctor for a critical illness once a year.
      • Emergency Air Ambulance Cover – It covers the cost of availing air ambulance services to transport the insured to the nearest hospital during a medical emergency.
      • Modern Treatments – It pays for the medical expenses incurred on treatments using technologically advanced methods.

      Optional Covers:

      • Unlimited Restore Benefit – It restores the base sum insured of the policy by unlimited times in a policy year regardless of partial or complete exhaustion of the sum insured.

      Exclusions of HDFC ERGO Optima Restore Plan

      HDFC ERGO Optima Restore plan excludes the following:

      • Dental treatments
      • Maternity expenses
      • Hospitalization due to abuse of intoxicants like drugs and alcohol
      • External aids and appliances
      • Hospitalization due to war or acts of war
      • Non-allopathic treatments
      • Congenital external diseases
      • Cosmetic surgery
      • Intentional self-injury
      • Unproven or experimental treatments

      You may also like to read - HDFC ERGO Optima Secure Plan


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