About HDFC ERGO Optima Super Insurance Plan
HDFC ERGO Optima Super Insurance is an aggregate health plan designed to help the policyholder increase the sum-insured amount as per their requirement. The insured can convert the plan into a regular one with zero deductibles. Therefore, it is a good choice for individuals already having a group cover with low-sum insured guaranteed policies.
HDFC ERGO Optima Super Insurance Plan: Key Highlights
| Categories | Specifications |
|---|---|
| Sum Insured | ₹5 lakh to ₹10 lakh |
| Pre-policy Medical Check-up | From 45 to 60 years |
| Pre-existing Diseases Waiting Period | 3 years |
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Key Benefits of HDFC ERGO Optima Super Insurance Plan
HDFC ERGO Optima Super Insurance Plan Inclusions & Exclusions
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Hospitalization expensesThe HDFC ERGO Optima Super Insurance plan offers coverage for any illnesses or injuries upto the sum insured limit. COVID-19 hospitalization is also covered.
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Daily Hospital CashAnyone insured with this policy will be offered Rs. 1000 per day as out-of-pocket hospital expenses.
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E-OpinionHDFC ERGO Optima Super Insurance Plan provides the insured with e-Opinion facility for nearly 51 different illnesses and health issues. It helps in getting opinions from all the empanelled health providers.
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Alternative TreatmentsThis plan provides coverage for expenses incurred on Ayurveda, Naturopathy, Unani, Siddha, Homeopathy and Yoga up to the sum-insured limit.
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Emergency Air AmbulanceThe purchase of HDFC ERGO Optima Super plan also ensures that the expenses incurred on emergency air ambulance are reimbursed up to Rs 5 lakh.
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Preventive Health CheckupPurchasing HDFC ERGO Optima Super Plan also ensures that the insured receives a free health check-up facility at the time of policy renewal.
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Any treatments undertaken within the first 30 days of purchasing the Optima Super insurance plan, except accidental injuries.
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In case the insured or any of their dependents has a congenital disease or has undergone cosmetic surgery.
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Any experimental, investigative or unproven treatment or research methods.
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Hospitalization resulting from an act of war or any form of warfare done through nuclear, chemical or biological methods.
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In case of a pregnancy of the insured or the dependent or in the case of external appliances or aids.
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Misuse of alcohol, intoxicant drugs or any hallucinogens.
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 Super Insurance Plan: FAQs
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Q1. Is purchasing the HDFC ERGO Optima Super Health Insurance plan a good choice?
Ans: Yes. The purchase of HDFC ERGO Optima Super Health Insurance plan is a good choice. The plan provides the insured with a wide range of benefits like in-patient treatment, pre-hospitalization, and organ donor benefits, among many others. -
Q2. Does the HDFC ERGO Optima Super Health Plan provide a free look period?
Ans: Yes. The HDFC ERGO Optima Super Health Plan provides a free look period of 30 days only for purchases. The free look period is applicable from the date of purchase of the new policy. -
Q3. Are there any tax benefits on purchasing the HDFC ERGO Optima Super Health Plan?
Ans: Yes. Tax benefits are provided on the premium amount paid for the HDFC ERGO Optima Super Health Insurance Plan. The tax benefits are applicable under Section 80D of the Income Tax Act.
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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
