Health Insurance
HDFC Ergo
HDFC ERGO is a joint venture between India's HDFC and Germany's ERGO International AG. It offers policies across motor, travel, health and other sectors. It recently acquired Apollo Munich Health Insurance company and now has the largest network of cashless hospitals in the country. It's health insurance policies offers a coverage of 3 lacs to 75 lacs.
HDFC Ergo Health insurance plans
myHealth Suraksha Gold
my Health Suraksha Gold policy covers most use cases. You get a large cover (7.5 lakhs-15 lakhs) You won't have to worry about hidden T&C's. You get really comprehensive coverage. A host of benefits to go along with it. And it's a pretty good policy overall. No complaints!
Optima Restore
Optima Restore is one of the most popular products within Apollo Munich's stable (now HDFC Ergo). And for good reasons. It covers most bases. It's economical. It doesn't have any unsavoury conditions. And it offers a whole host of benefits that are particularly useful. All in all, a solid pick.
Optima Secure
Optima Secure is a great policy. There are no restrictions on the kind of room you can pick, you get a healthy loyalty benefit (50% increase in sum insured on every renewal until 100% of sum insured), and the heavily talked about Secure benefit. All things put together, you can get 3X the cover you originally paid for, once the loyalty benefit is fully accumulated. In many ways, this is a worthy successor to Optima Restore.
Energy Gold
If you're diabetic or suffering from Hypertension, then Energy is for you, considering the fact that the insurer covers all complication arising out of these chronic diseases from Day 1. However, if you aren't diabetic maybe you could look at the other options since this policy is fairly expensive.
myHealth Suraksha Silver
my Health Suraksha Silver might only offer you a cover totalling 5 lakhs. But make no mistake, it offers pretty extensive coverage. It has decent benefits. It doesn't include any absurd conditions. And the only other policies within the HDFC Ergo stable, that offer a higher cover include Health Suraksha Gold and Platinum.
myHealth Koti Suraksha
Koti Suraksha offers you a grand cover of 1 Crore unless you have a kidney stone, or a benign tumour, or some such similar complication at which point they will only offer you 75,000 in total. In other words it's a great plan for those who want to cover the rare diseases that can weigh heavily on your pockets.
EquiCover
The EquiCover Plan from HDFC Ergo is a basic plan with a unique target audience - potential policyholders with disabilities (40% or more) & HIV/AIDS. Now, while this is a commendable stance from the stable of HDFC Ergo, the EquiCover policy has a long list of caveats, including - Room restriction (1% for Room, 2% for ICU) - 20% mandatory co-payment, no restoration perk, no bonus, no domiciliary coverage, sub-limits on cataracts coverage & modern treatment, and an extensive waiting Period: (2 years for Pre-Existing Disability and 3 years for PEDs other than HIV/AIDS and Disability). All of this, makes EquiCover a unique and yet not-recommendable policy, unless this comes off as a last resort.
Energy Silver
If you're diabetic or suffering from Hypertension, then Energy is for you, considering the fact that the insurer covers all complication arising out of these chronic diseases from Day 1. However, if you aren't diabetic maybe you could look at the other options since this policy is fairly expensive.
myHealth Medisure Super Top-up
While it is a decent super top up plan, you don't really get a disproportionately large cover with myHealth Medisure. The plan allows you to top up your base policy only by about 20 lakhs tops. So if you are ever hospitalized for a rare condition, then the cover might not suffice.
Optima Secure Global
HDFC Ergo Optima Secure Global is the second most expensive product within HDFC Ergo’s stable. It offers pretty much all the benefits offered by Optima Secure (HDFC Ergo’s best-selling insurance policy) and also covers international emergency treatments for 45 days per trip (excluding pre/post expenses). If you’re a routine traveller outside India, this could make more sense than Optima Secure. Otherwise, you can opt for other alternatives, considering the premiums you’ll be expected to pay here.
myHealth Suraksha Platinum
my Health Suraksha Platinum is a premium policy. And it shows. You get a massive cover (20 lakhs-75 lakhs). No outrageous conditions. Comprehensive coverage. And extra bonus cover compared to the less expensive HDFC ERGO Gold. In summary, it really is Platinum grade.
Optima Secure Global Plus
HDFC Ergo Optima Secure Global Plus is the most expensive product within HDFC Ergo’s stable. It offers pretty much all the benefits offered by Optima Secure (HDFC Ergo’s best-selling insurance policy) and also covers both planned and emergency treatments abroad including pre/post hospitalization expenses. If you’re a routine traveller outside India, this could make more sense than Optima Secure. Otherwise, you can opt for other alternatives, considering the premiums you’ll be expected to pay here.
Optima Super Secure
Optima Super Secure works exactly like Optima Secure. There are no restrictions on the kind of room you can pick, you get a healthy loyalty benefit (50% increase in Sum Insured on every renewal until 100% of Sum Insured), and the heavily talked about Secure benefit. The only difference is that within the secure benefit you get 3x the cover you pay for (as opposed to 2x in Optima Secure). And it's only slightly expensive, available on a 3 pay option. Meaning you have to commit for 3 years minimum when you buy the policy.
Health Wallet
Like most of the plans from the HDFC Ergo stable, the Health Wallet policy is a great pick, too. The plan is comprehensive and extends multiple features; however, one unique perk deserves a special mention - Reserve Benefit. Under this feature, you are covered for OPD services like diagnostic tests, vaccinations, pharmacy, dental expenses, special health foods & supplements and consultations with a medical practitioner, physiotherapist, dietician, speech therapist, and psychologist. The coverage cap varies as per the base sum insured. Unfortunately, this plan has a drawback - the in-built restoration perk is only available in case if you completely exhausted your cover amount and can be used to cover for the treatment of various ailments.
HDFC Ergo Health insurance claim process
HDFC Ergo claims can be of different types based on the hospital in which you are getting the treatment. If it’s part of HDFC Ergo's network hospitals, you can get a “Cashless claim” in which insurance company directly pays the bills to the hospital. But if your choice of hospital is not part of their network, then you have to pay the bills and apply for reimbursement claim. Here’s a brief process for both types of claims:
Cashless Claims
Inform the Hospital Desk
All network hospitals have an insurance desk. You can submit your policy copy (even soft copy works), ID proof, initial diagnosis report and the insurance desk will request the insurance company for “pre-authorization”. In case of planned treatments, you need to do this process 2 days before hospitalization
Insurer’s decision
Based on the provided documents, insurance company approve the claim and the hospital will start the treatment and they will co-ordinate with insurer for the treatment costs. In case of Cashless claim rejection, you can still go ahead with the treatment. In this case, you will need to pay the bills initially and can file for a reimbursement claim later
Discharge
If your cashless claim is approved, at the time of discharge, the insurance company will do the final settlement with the hospital and once that is sorted, you are good to go.
Reimbursement Claims
Inform the insurance company
For any planned treatments, you need to inform the insurance company 2 days before hospitalisation. In case of emergency, you can inform within 24 hours of admission. Insurance company will acknowledge the intimation.
Hospitalization
You need to submit a insurance claim form along with original copies of hospital bills, doctor consultation reports, and diagonstic reports.
File the claim
Within 30 days post discharge, you can initiate the claim online or at any of the registered offices of the insurance company. You need to fill a claim form and attach all the reports and bills.
Insurer’s decision
Based on the claim form and submitted documents, insurance company will settle the claims as per policy terms and conditions.
HDFC Ergo Health Insurance Renewal
Firstly, if you’ve purchased the policy online, you’ll always receive an intimation e-mail from the insurer around 30 days before the renewal date. The e-mail will have a renewal link that will directly take you to the page where you can make the payment and check policy details. And it’s done. You’ll receive the policy document via e-mail.
However, in case you choose to do it on your own, here’s what you need to do:
Visit the website
Visit the HDFC Ergo website and then go to the Renewal section here.
Enter details
You’d be asked to provide your current policy number which you can find in the policy soft copy. You may as well be asked to enter your mobile number, email ID, Date of Birth or policy expiry date.
Review and edit the policy details
Next, you’ll be able to see details of your new policy and the renewal premium you need to pay. Also, you’ll be given the option to make some changes related to sum insured, existing covered members, etc.
Complete the payment and it’s done
Once you confirm the details, you’ll be directed to the payment gateway. Once the payment is complete, you’ll receive your new policy soft copy via e-mail.
Few things to consider when renewing your HDFC Ergo health insurance policy
- If you want to increase your Sum Insured, now is the time. You can’t do it anytime during the year.
- If you didn’t make a claim in the past year, make sure you have been given a no-claim bonus if your policy offers it.
- If you want to add members like your spouse or kids, you have the option to do so only at the time of renewal. So do give this a thought.
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