HDFC ERGO Optima Secure Health Insurance Plan

Benefits

HDFC ERGO introduced the Flagship product Optima Secure in 2021. Optima Secure has following benefits:

1) Secure Benefit: 2X coverage from day-1
A 10L policy will cover you for 20L from the first day.

2) Restore Benefit: 100% Restoration 

3) Protect Benefit: 100% hospital expenses coverage that no other insurance provider gives

4) Plus Benefit: No claim bonus even if claims exist in the previous year in the firm of extra 50% sum insured.10L policy sum insured will become 15L in second year and 20L in third year disregarding claim or no claim.

That means, a person who takes a 10L policy will get 20L coverage from Day-1. Additionally, he gets 10L restoration which amounts to 30 L coverage in the first year itself. Claim or no claim 5L coverage will be added as NCB in the second year. That means, 35L coverage will be there in the second year. In this manner, in the third year the coverage becomes 40L. That means, 4x coverage is guaranteed after the second renewal.

Features

Adults Age: 18 – 65

Children: 91 Days – 25

Family Floater: 2A+4C

Sum Insured: 5, 10, 15, 20, 25, 50L, 1, 2 Cr

Room Rent and ICU Rent: Actuals, 100% (No limitations)

Pre and Post Hospitalization: 60 and 120 days (Total 180 days) up to sum insured

Organ Donor Expense: Up to sum insured

Alternative Medicine Treatment (Ayurveda, Siddha, Unani etc.): Up to sum insured 

Domiciliary Treatment (treatment at home): Up to sum insured

Shared accommodation: ₹800 daily cash Maximum up to ₹4,800 in an year

Preventive Health Checkup: for 10L up to ₹5,000 per year. This is covered as reimbursement too.

Deductible: ₹25,000 to ₹5L (25K, 50K, 1L, 2L, 3L, 4L, 5L). This option makes the premium considerably less.

Deductible options need not be lifelong. After 5 years one can waive off deductible options and opt for normal policy if the person joined the policy before 51 age and has not attained 61 age. This is unique to HDFC ERGO.

Add-ons

1) Critical Illness: If detected any of the 51 listed illnesses the chosen coverage amount will be transferred to account immediately.

2) Unlimited Restoration: In addition to one time restoration which is a built-in feature, restoration will happen unlimited times.

3) Hospital Daily Cash: Once admitted to hospital one can opt to receive ₹500 to ₹10,000 as daily cash. This is limited to maximum 30 days. Add-on premium will vary according to the chosen daily cash.

4) Individual Personal Accident: A lump sum payout on accident death or disability.

Variants

Optima Super Secure

3X coverage from day-1. This can be purchased only by paying 3 year premium at a time.

Optima Secure Global

Emergency treatments can be availed in a foreign country. for 1Cr and 2 Cr sum insured.

Optima Secure Global Plus

Not only Emergency treatments but also planned treatments can be availed in a foreign country. for 1Cr and 2 Cr sum insured.

Both Optima Secure Global and Optima Secure Global Plus are not for NRIs. Indian citizens travelling abroad can avail this.

Waiting Periods

30 Days initial waiting

Only from 31st fay coverage will start. First 30 days only accidents will be covered.

Specific illness waiting period 

Kidney stone, cataract, knee replacement etc will have first two years waiting period.

Preexisting illness 

This has 3 years waiting period

Advantages

100% Cashless treatment
Attractive add-ons like Hospital Daily Cash

Disadvantages

  1. 10-20% extra premium is charged
  2. Maternity add-on is not provided

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