About HDFC ERGO Optima Select Plan
HDFC ERGO Optima Select plan provides comprehensive coverage against planned and emergency medical expenses. It doubles your sum insured in 2 years, irrespective of the claims, with the Plus benefit. The plan also restores the exhausted sum insured by 100% unlimited times a year for the same and unrelated illnesses with the Automatic Restoration benefit.
HDFC ERGO Optima Select Plan: Key Highlights
| Categories | Specifications |
|---|---|
| Sum Insured | ₹5 lakh to ₹25 lakh |
| Pre-Policy Medical Check-ups | May be required |
| Pre-existing Diseases Waiting Period | 3 years |
| Discounts | 40% NRI discount Up to 10% long-term policy discount 10% family discount 5% online discount 2.5% loyalty discount |
or select from popular citiessOptima Select Features
Search Optima Select Cashless Network Hospital list
Key Benefits of HDFC ERGO Optima Select Plan
HDFC ERGO Optima Select Plan Inclusions, Exclusions & Optional Cover
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In-patient Hospitalization ExpensesIt covers the cost of obtaining treatment at a hospital by staying for 24 hours or more.
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Road Ambulance ChargesIt pays for road ambulance charges incurred on transporting the insured to and from the hospital.
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Day Care TreatmentsIt covers the cost of all day care treatments that require less than 24 hours of hospitalization.
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Home Health CareIt pays for the medical expenses incurred on obtaining treatments at home.
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Domiciliary HospitalizationIt covers the cost of availing hospital-like medical treatment at home at doctor's suggestion in case shifting to a hospital is not possible.
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AYUSH TreatmentIt pays for in-patient treatments availed by the insured under AYUSH (Ayurveda, Yoga, Unani, Siddha and Homeopathy) systems of medicines.
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Maternity ExpensesIt does not cover childbirth-related costs or expenses for the newborn baby’s treatment.
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Obesity TreatmentsIt excludes costs for fat loss surgery or weight management treatments unless specified by the doctor.
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Treatments for AlcoholismIt does not pay for treatments to curb addictions like alcoholism, drugs, etc. or their consequences.
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Cosmetic or Plastic SurgeryIt excludes plastic surgery or cosmetic procedures done to change appearance unless medically necessary.
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Sterility and InfertilityIt does not cover medical costs for sterilization or assisted reproductive treatments like IVF.
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Injuries due to Adventure SportsIt does not pay for treating injuries resulting from participation in adventure sports like mountaineering, rafting, etc.
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Protect BenefitIt pays for the cost of consumables incurred by the insured during hospitalization, such as gloves, syringes, cotton, etc.
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Plus BenefitIt increases the sum insured by 50% at the time of policy renewal for up to a maximum of 100%.
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Automatic Restore BenefitIt automatically restores the sum insured amount by 100% unlimited times a year for both and unrelated illnesses.
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Aggregate DeductibleIt allows policyholders to reduce their premiums by opting for an aggregate deductible. Moreover, they will have the option to remove the aggregate deductible once in the lifetime of the policy.
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PED Waiting Period ModificationIt reduces the pre-existing disease (PED) waiting period from 3 years to 2 years or 1 year.
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Modification of Room RentIt allows the policyholder to upgrade the hospital room category from a single private AC room to at actuals or reduce it to a shared hospital room.
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 Select Plan: FAQs
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Q. Is HDFC ERGO Optima Select a good plan?
Ans: Yes. The HDFC ERGO Optima Select plan is a good plan for people who want medical coverage for hospitalization expenses, home care treatments, cost of consumables, modern treatments, preventive health check-ups, etc.
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Q. Is HDFC ERGO Optima Select cashless?
Ans: Yes. You can avail cashless treatment at any hospital of your choice across India with the Optima Select plan.
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Q. Where can I check the HDFC ERGO Optima Select plan price?
Ans: You can check the HDFC ERGO Optima Select plan cost by contacting the customer support team of the insurer or checking the policy premium chart. You can also use a health insurance premium calculator to know the price of this mediclaim policy.The contact number of HDFC ERGO health insurance in Kerala is 022 6158 2020 and 011 6158 2020. You can also connect with the insurer on WhatsApp at 8169 500 500.
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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.
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.
- Inform the insurance company about the hospitalization
- In case of planned hospitalization, notify the insurer before hospital admission.
- Receive medical treatment
- At the time of discharge, pay the entire hospital bill in full.
- Collect all the medical documents, bills and payment receipts
Our Claim specialists in below cities will reach your hospital or home in 30 minutes to support your health insurance claim
