| Optima Restore – Individual | |||||
|---|---|---|---|---|---|
| Basic Sum insured per insured person per policy year (in ₹ INR) | 3,00,000 | 5,00,000 | 10,00,000 | 15,00,000 | 20,00,000 / 25,00,000 / 50,00,000 |
| In-patient Treatment | Covered | ||||
| Pre-Hospitalization | Covered, upto 60 Days | ||||
| Post-Hospitalization | Covered, upto 180 Days | ||||
| Day Care Treatment | Covered | ||||
| Domiciliary Treatment/Home Treatment | Covered | ||||
| Treatment for Organ Donor | Covered | ||||
| Daily cash for Choosing shared accommodation | 800 per day, Maximum 4,800 | 1,000 per day, Maximum 4,800 | |||
| Emergency Ambulance | Upto Rs.2,000 per Hospitalisation | ||||
| E-opinion in respect of critical illnesses | Covered | ||||
| Emergency Air Ambulance Cover | Not Covered | Covered upto 2,50,000 Lacs per hospitalization and maximum upto sum insured in an year | |||
| 2) Restore Benefit | Equal to 100% of basic sum insured | ||||
| 3) Multiplier Benefit | Bonus of 50% of the Basic Sum Insured for every claim free year, maximum upto 100%.In case of claim, bonus will be reduced by 50% of the basic sum insured. However this reduction will not reduce the Sum Insured below the basic Sum Insured of the policy | ||||
| 4)Health Checkup | Not covered | Upto 1,500 | Upto 2,000 | Upto 4,000 | Upto 5,000 |
| 5) Critical Advantage (Illness) Rider | Offered (where base Sum Insured is 10 lacs & above) | ||||
| Energy - Diabetes Plan | |
|---|---|
| BENEFIT | COVERAGE |
| Basic Sum Insured Per Person Per Policy Year (figs in ₹ INR) | 2,00,000 / 3,00,000 / 5,00,000 / 10,00,000 / 15,00,000 / 20,00,000 / 25,00,000 / 50,00,000 |
| In Patient Hospitalization | Covered |
| Pre-Hospitalization | Covered, 30 Days |
| Post-Hospitalization | Covered, 60 Days |
| Day Care Procedures | 182 daycare procedures |
| Organ Donor | Covered |
| Emergency Ambulance | Upto 2,000 per Hospitalisation |
| Shared Accommodation Benefit | Covered |
| Restore Benefit | Covered |
| Cumulative Bonus | 10% upto a maximum of 100% |
| HbA1c Checkup Benefit | Covered |
| Wellness discount | Upto 25% of Renewal Premium |
| Optima Restore Family Floater | |||||
|---|---|---|---|---|---|
| Basic Sum insured per insured person per policy year( figs in ₹ INR)) | 3,00,000 | 5,00,000 | 10,00,000 | 15,00,000 | 20,00,000 / 25,00,000 / 50,00,000 |
| 1) Inpatient treatment | Covered | ||||
| Pre-hospitalisation | Covered, upto 60 days | ||||
| Post hospitalisation | Covered upto 180 days | ||||
| Day Care procedures | All Day Care Treatment Covered | ||||
| Domiciliary treatment | Covered | ||||
| Organ donor | Covered | ||||
| Daily cash for Choosing shared accommodation | 800 per day, Maximum 4,800 | 1,000 per day, Maximum 4,800 | |||
| Emergency Ambulance | upto 2,000 per hospitalisation | ||||
| E-opinion in respect of critical illnesses | Covered | ||||
| Emergency Air Ambulance Cover | Not Covered | Covered upto 2.5 Lacs per hospitalization and maximum upto sum insured in an year | |||
| 2) Restore Benefit | Equal to 100% of basic sum insured | ||||
| 3) Multiplier Benefit | Bonus of 50% of the Basic Sum Insured for every claim free year, maximum upto 100%.In case of claim, bonus will be reduced by 50% of the basic sum insured. However this reduction will not reduce the Sum Insured below the basic Sum Insured of the policy | ||||
| 4) Health Checkup | Not covered | Upto 2,500 | Upto 5,000 | Upto 8,000 | Upto 10,000 |
| 5) Critical Advantage Rider | Offered (where base Sum Insured is 10 lacs & above) | ||||
Medical examinations may be required in some cases, based on the sum insured and the age of the individual.
Yes, the insurer will pay the admissible amount for the medical expenses incurred subject to the terms and conditions (sum insured) of the policy. The insured might have to pay for the non-medical and expenses not covered under the policy, directly to the hospital prior to being discharged.
HDFC ERGO Health has a hospital network of more than 4650 hospitals pan India where the insured can be treated.
Review HDFC ERGO Health Mediclaim Insurance brochure to understand coverage details.
Know more »Review HDFC ERGO Health Mediclaim Insurance policy wordings which explains the terms and conditions.
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You can buy insurance online by using a credit/debit card, direct funds transfer using NEFT or RTGS or by using a cheque
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