HDFC ERGO Optima Senior Plan

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      HDFC ERGO Optima Senior Plan

      HDFC ERGO Optima Senior has been designed to provide comprehensive coverage to senior citizens above the age of 60 years. It pays for the cost of hospitalization along with ambulance services and organ donor treatment. Moreover, the plan also offers coverage for domiciliary hospitalization and e-opinion taken for a critical illness.

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      HDFC ERGO Optima Senior Plan: Key Highlights

      Categories Specifications
      Sum Insured Rs 2 lakh, Rs 3 lakh, Rs 5 lakh
      Policy Tenure 1 year, 2 years, 3 years
      Incurred Claim Ratio (2021-22) 97.47%
      Pre-Policy Medical Check-ups Required
      Pre-existing Diseases Waiting Period 3 years
      Specific Diseases Waiting Period 2 years
      Initial Waiting Period 30 days
      Discount 5% family discount
      Up to 10% long-term policy discount
      Co-payment 15% on all claims
      30% on opting for a higher room category

      Benefits of HDFC ERGO Optima Senior Plan

      Check out the benefits of buying an HDFC ERGO Optima Senior plan:

      1. Customized for Senior Citizens

      The HDFC ERGO senior citizen health insurance plan has been tailor-made to suit senior citizens’ medical needs. Thus, it provides coverage for home hospitalization, organ donor treatment, emergency ambulance services and second medical opinion.

      2. No Claim Discount

      Policyholders can reduce their renewal premium by 5% by earning a no claim discount if no claim is raised in the previous policy year.

      3. Tax Benefits

      The premium paid for the HDFC ERGO Optima Secure policy can be used to get tax deductions under Sec 80D of the Income Tax Act.

      HDFC ERGO Optima Senior Plan Eligibility Criteria

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

      Parameters Eligibility Criteria
      Minimum Entry Age 61 years
      Maximum Entry Age No age limit
      Coverage Type Individual/ Family
      No. of family Members Covered 2
      Types of Relationships Covered Self, spouse
      Renewability Lifelong

      Inclusions of HDFC ERGO Optima Senior Plan

      The following medical expenses are included in an HDFC ERGO Optima Senior plan:

      • In-patient Treatment – This HDFC ERGO health insurance policy pays for treatment costs incurred during hospitalization of at least 24 hours, such as room rent, doctor fees, etc.
      • Pre-hospitalization Medical Expenses – It covers the cost of doctor consultations, medicines and diagnostic tests for up to 30 days before hospital admission.
      • Post-hospitalization Medical Expenses – It pays for the medical expenses incurred on follow-up consultations and diagnostic tests for up to 60 days after hospital discharge.
      • Day Care Procedures – It covers the cost of all day care procedures that requires less than 24 hours of hospitalization.
      • Domiciliary Treatment – It pays for the medical treatment taken at home on the advice of a doctor, provided hospitalization is not possible.
      • Organ Donor Expenses – It covers the treatment cost of a donor for harvesting the organ for a transplant surgery of the insured.
      • Emergency Ambulance Cover – It pays for the ambulance services availed for transporting the insured during a medical emergency.
      • E-Opinion – It covers the cost of a second medical opinion taken by the insured once a year for a critical illness.

      Exclusions of HDFC ERGO Optima Senior Plan

      The HDFC ERGO Optima Senior plan excludes the following:

      • OPD treatment
      • Dental treatment
      • Non-medical expenses
      • Treatments due to drug or alcohol abuse
      • External aids and appliances
      • Cosmetic surgery
      • Pregnancy
      • Congenital external diseases
      • Experimental or unproven treatment
      • Hospitalization due to war or nuclear perils


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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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