Benefits
Launched in 2021, HDFC ERGO’s Optima Secure has quickly gained popularity as a flagship health insurance product. This plan is designed to provide extensive coverage with multiple benefits, making it one of the most comprehensive offerings in the market. Here are the key benefits of the Optima Secure plan:
1. Secure Benefit: Double Coverage from Day One
Optima Secure doubles your coverage from the very first day. For example, if you opt for a policy with a sum insured of ₹10 lakh, you’ll receive coverage of ₹20 lakh immediately.
2. Restore Benefit: 100% Restoration
In case of a claim, Optima Secure restores 100% of the sum insured, ensuring you’re covered even after a significant medical expense.
3. Protect Benefit: Full Hospital Expense Coverage
This plan stands out because it offers 100% coverage for hospital expenses, something that most other insurance providers don’t offer.
4. Plus Benefit: No Claim Bonus (NCB)
Even if you make a claim during the policy year, Optima Secure still rewards you. The NCB adds 50% to your sum insured each year, regardless of claims. For instance, if you start with a ₹10 lakh policy, your coverage increases to ₹15 lakh in the second year and ₹20 lakh in the third year, regardless of whether you’ve made a claim.
How Does It Work?
If you purchase a ₹10 lakh policy:
- Day 1: You have ₹20 lakh coverage.
- Restoration Benefit: You get an additional ₹10 lakh in case of a claim, totaling ₹30 lakh in coverage for the first year.
- Second Year: Your coverage increases to ₹35 lakh.
- Third Year: Your coverage rises to ₹40 lakh, which is four times your original sum insured by the second renewal.
This cumulative coverage growth ensures long-term protection, even with medical inflation or recurring hospitalizations.
Key Features of Optima Secure
- Age Eligibility: Adults aged 18-65, children aged 91 days to 25 years.
- Family Floater: Coverage for up to 2 adults and 4 children.
- Sum Insured Options: ₹5 lakh to ₹2 crore.
- Room & ICU Rent: 100% actuals, with no limits.
- Pre and Post-Hospitalization: Covered for up to 180 days (60 days pre, 120 days post).
- Organ Donor Expenses: Covered up to the sum insured.
- Alternative Medicine: Treatments like Ayurveda, Siddha, and Unani are covered up to the sum insured.
- Domiciliary Treatment: Home treatments covered up to the sum insured.
- Shared Accommodation Cash: ₹800 daily, up to ₹4,800 per year.
- Preventive Health Checkup: ₹5,000 per year for ₹10 lakh coverage.
- Deductible Option: ₹25,000 to ₹5 lakh, making premiums more affordable. Deductibles can be waived after 5 years, unique to HDFC ERGO, for those joining before age 51 and not yet reaching age 61.
Add-Ons Available
- Critical Illness Coverage: If diagnosed with any of the 51 listed illnesses, a lump sum payout will be made directly to your account.
- Unlimited Restoration: Beyond the built-in one-time restoration, you can opt for unlimited restoration for multiple claims.
- Hospital Daily Cash: Receive ₹500 to ₹10,000 daily cash during hospital stays, for up to 30 days.
- Individual Personal Accident: A lump sum payout in case of accidental death or disability.
Plan Variants
- Optima Super Secure: Offers 3x coverage from day one, available only by paying a three-year premium upfront.
- Optima Secure Global: Provides emergency treatment coverage abroad for ₹1 crore and ₹2 crore sum insured.
- Optima Secure Global Plus: Extends beyond emergencies, offering planned treatments abroad for ₹1 crore and ₹2 crore. Note: These plans are not available for NRIs but can be availed by Indian citizens traveling abroad.
Waiting Periods
- Initial Waiting Period: 30 days from policy commencement, during which only accidents are covered.
- Specific Illnesses: Conditions like kidney stones, cataracts, and knee replacements have a two-year waiting period.
- Pre-existing Illnesses: A three-year waiting period applies for pre-existing conditions.
Advantages of Optima Secure
- 100% Cashless Treatment: Ensuring ease and convenience during hospitalization.
- Extensive Add-Ons: Such as Hospital Daily Cash, critical illness coverage, and more, providing flexibility and enhanced coverage.
Disadvantages
- Higher Premium: Optima Secure charges 10-20% more premium compared to similar plans in the market.
- No Maternity Add-On: This plan does not offer maternity coverage, which may be a consideration for some families.
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