About HDFC ERGO Optima Secure Plus Plan
HDFC ERGO Optima Secure Plus provides comprehensive coverage with enhanced coverage to help manage medical expenses. It doubles the base sum insured from day 1 of the policy with its Secure Benefit, while the Infinite Benefit adds another 100% of the base sum insured every year, regardless of claim history.
HDFC ERGO Optima Secure: Key Highlights
| Categories | Specifications |
|---|---|
| Coverage | ₹10 lakh to ₹2 crore |
| Pre-existing Diseases Waiting Period | 3 years |
| Discount |
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Benefits of HDFC ERGO Optima Secure Plus Plan
HDFC ERGO Optima Secure Plus Plan Inclusions, Exclusions & Optional Cover
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Hospitalisation TreatmentIt covers medical expenses during hospitalisation of at least 24 hours, including room rent, ICU charges, nursing fees and surgeon's fees.
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Road Ambulance CoverIt pays for road ambulance expenses incurred while transporting the insured to a hospital during an emergency or from one hospital to another.
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Day Care TreatmentsIt covers expenses incurred due to day care procedures that require less than 24 hours of hospitalisation.
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Pre-hospitalisation ExpensesIt pays for medical expenses incurred up to 60 days before hospital admission.
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Post-hospitalisation ExpensesIt covers medical expenses incurred up to 180 days after hospital discharge.
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Home HealthcareIt covers medical treatment received at home that would normally require in-patient treatment if prescribed in writing by the treating doctor.
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OPD TreatmentIt excludes treatment taken on an outpatient basis.
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Maternity ExpensesIt does not cover childbirth and pregnancy-related treatment expenses.
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Hospitalisation for Diagnostic TestsIt does not cover hospital admissions solely for evaluation or diagnostic tests unrelated to the disease/treatment.
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Rest and RehabilitationIt excludes expenses incurred on bed rest, custodial care, personal care or respite care rather than for medical treatment.
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Obesity TreatmentIt does not pay for surgical treatment of obesity that does not fulfil policy’s specific criteria.
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Cosmetic or Plastic SurgeryIt excludes cosmetic or plastic surgery, except for eligible reconstruction after accidents, burns or cancer, or medically necessary procedures to remove an immediate health risk.
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Emergency Air AmbulanceIt pays for air ambulance expenses during medical emergencies.
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Daily Cash for Shared RoomIt provides a hospital daily cash of ₹800, for up to ₹4,800, when the insured stays in shared accommodation at a network hospital for more than 48 hours.
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Protect BenefitIt pays for certain non-medical expenses, such as needles, injections, dietician charges, laundry, etc., during hospitalisation.
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Secure BenefitIt provides 100% additional coverage amount from day 1 of the policy if the base sum insured has been exhausted. This benefit is available once a year.
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Automatic Restore BenefitIt restores the coverage amount upon partial or complete exhaustion unlimited times a year for the same and unrelated illnesses.
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E-Opinion for Critical IllnessIt pays for the cost of availing online medical opinion for 51 major illnesses from a doctor within the insurer’s network.
In case of emergency we are just a call away. Take care of your family, we will do the rest. Our claim specialists will reach your location & complete the formalties from filing the claim to documentation to coordinating with insurer, TPA & hospital. Available in New Delhi and 114+ cities View cities list ›Policybazaar Claim Process
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HDFC ERGO Optima Secure Plus Plan: FAQs
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Q1. Is HDFC ERGO Optima Secure Plus a good policy?
Ans: Yes, HDFC ERGO Optima Secure Plus is considered a good policy as it offers comprehensive coverage to its insured. It covers hospitalisation, day care procedures, pre- and post-hospitalisation, the cost of consumables and air ambulance services, while offering annual health check-ups. It also provides the Secure Benefit that doubles the base sum insured from Day 1 and unlimited restoration of sum insured, giving policyholders additional coverage for eligible medical expenses.
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Q2. Does HDFC ERGO Optima Secure Plus offer cashless hospitalisation?
Ans: Yes, HDFC ERGO Optima Secure Plus offers cashless hospitalisation facilities at hospitals across India with the Cashless Everywhere benefit. Under this facility, HDFC ERGO General Insurance Company settles medical expenses directly with the hospital after claim approval. You do not have to pay the covered hospital bill upfront.
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Q3. Where can I get the HDFC ERGO Optima Secure Plus hospital list?
Ans: You can find the HDFC ERGO Optima Secure Plus hospital list on the official website of HDFC ERGO General Insurance Company. You can also check the list of HDFC ERGO health insurance network hospitals on Policybazaar.com.
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Q. What is the advantage of selecting a policy with a duration of more than 1 year?
Ans: If one buys Aditya Birla Health Insurance for more than a year, one can save 7.5 % and 10% on the 2 and 3 years premium, respectively.
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Q. How is an Individual cover different from a Floater cover?
Ans: In an Individual cover, coverage is offered to each individual in the family separately. In a Family Floater health insurance plan, each family member is covered based on a floater sum insured.
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Q. How is an Individual cover different from a Floater cover?
Ans: In an Individual cover, coverage is offered to each individual in the family separately. In a Family Floater health insurance plan, each family member is covered based on a floater sum insured.
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Q. What is a waiver of a mandatory co-pay cover?
Ans: This benefit is covered on payment of an additional premium. Therefore, any mandatory co-payment that is applicable under the Aditya Birla Activ Health Essential Plan will be waived off.
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HDFC ERGO offers two types of claim settlements – cashless and reimbursement. Follow the steps to raise a claim:
- Find the nearest network hospital of HDFC ERGO
- Get admitted to the hospital
- Notify the insurance company about the hospitalization
- In case of pre-planned hospitalization, intimate the insurer before hospital admission.
- Fill up the pre-authorization form and submit it to the hospital staff
- The pre-authorization form will be sent to HDFC ERGO for approval.
- Once approved, obtain medical treatment.
- At the time of discharge, sign all the medical documents.
- Pay for the items/services not covered under the HDFC ERGO policy
- The network hospital will send the hospital bill to HDFC ERGO.
- After review, the insurance company will pay the bill amount directly to the network hospital.
- Intimate HDFC ERGO about the hospitalization
- In case of planned hospitalization, inform the insurance provider before hospital admission.
- Obtain medical treatment
- During discharge, pay the hospital bill in full.
- Collect all the medical documents, hospital bills and receipts
Our Claim specialists in below cities will reach your hospital or home in 30 minutes to support your health insurance claim
