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Home / Health Insurance

Health Insurance

Podcast cover image for Health Insurance 101 by HDFC ERGO

Health insurance provides financial support during medical emergencies. When you go through a medical emergency, health insurance pays for the various treatment costs, so you can focus on recovery. It lets you have a financial backup and helps you avoid struggling to secure money in times of emergencies and ill health. [1] It is the financial way of applying the age-old saying ‘prevention is better than the cure’

What is Health Insurance?

In health insurance, the insurance company agrees to pay financial compensation in case a particular event (such as hospitalisation, daycare surgery, medical emergency) happens with the insured. Health insurance can protect you from rising healthcare costs and can help you get quality treatment without draining your savings.

A good health insurance policy pays for key expenses, such as hospitalisation, treatments, medicines, and other medical needs, and gives you access to trusted hospitals across the country. You also get added support like annual health checkups, OPD coverage, diagnostic tests, cashless treatment, preventive care, and tax benefits.

With HDFC Ergo health insurance policies, you can protect your savings, maintain your lifestyle, and stay prepared for medical emergencies with confidence.

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What are the Types of Health Insurance Plans?

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Individual Health Insurance

Individual Health Insurance

An individual health insurance plan protects one person. It covers hospitalisation, treatments, medicines, and other medical costs based on the value of the sum insured chosen by the buyer. It can suit young professionals and anyone who wants personal financial protection during health emergencies. Premiums are usually affordable, and benefits like preventive check-ups and tax savings add extra value.

View Plans Know more
Family Floater Health Insurance

Family Floater Health Insurance

A family floater plan brings multiple family members under one policy with a shared sum insured. It usually covers a spouse, children, and parents. Since the sum insured is shared, these plans offer good value for families with varied needs. They are easy to manage and ensure that everyone can access care without buying separate policies.

View Plans Know more
Senior Citizen Health Insurance

Senior Citizen Health Insurance

For people above 60, medical needs rise and costs can rise higher. Senior citizen health insurance plans are designed with this in mind. They cover treatments for age-related illnesses, frequent hospital visits, and longer recovery times. Many plans also include lower waiting periods for certain conditions.

View Plans Know more
Top-Up and Super Top-Up Plans

Top-Up and Super Top-Up Plans

A top-up or super top-up plan increases your total coverage while keeping premiums affordable. These plans activate after the receival of a chosen deductible amount. They are ideal if you already have basic coverage, either from an employer or an individual plan, and want to boost protection without paying for a full second policy.

View Plans Know more
Critical Illness Insurance

Critical Illness Insurance

A critical illness plan pays a lump sum amount when the insured is diagnosed with a listed serious illness such as cancer, heart attack, stroke, kidney failure, or major organ transplant. The payout helps manage treatment costs, income loss, and lifestyle adjustments. It is especially helpful for families with a history of serious illnesses.

View Plans Know more
Disease-Specific Plans

Disease-Specific Plans

Some plans focus on particular medical conditions like diabetes, cancer, or cardiac issues. By opting for the best health insurance policy for a diabetic individual or for a cancer patient, you can ensure early-stage and advanced-stage coverage, regular screenings, and support for long-term care.

View Plans Know more
Women-Centric Plans

Women-Centric Plans

Some plans offer wider protection for women-specific illnesses and wellness needs. Women’s health insurance plans are ideal for women planning to start or grow a family.

View Plans Know more
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Each type of health insurance plan has a clear purpose. It is important you understand the different offerings, so that you can find the best plan for your needs.

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What to Keep in Mind Before Buying a Health Insurance Policy?

Choosing the right health insurance policy takes more than just comparing premiums. Use this checklist to make sure you pick the best health insurance plan for your family.

Start by understanding your medical history, lifestyle, and family health patterns. If you have chronic conditions or a family history of illnesses, look for health insurance plans that offer wider coverage.

Your sum insured decides how much financial support you get during treatment. Higher costs in metro citfaies mean you may need a higher cover. A low sum insured can leave you under-protected, so compare options before you buy health insurance.

Every health insurance plan has waiting periods for pre-existing diseases, maternity benefits, and specific treatments. Review these timelines carefully, especially if you have known conditions.

A strong cashless network lets you access treatment without paying up front. Look for insurers with a wide network. Cashless access is one of the biggest strengths of a good medical insurance policy.

Do not skip the fine print. Check what your health insurance policy covers and what it excludes. Remember to look out for day care procedures, organ donor expenses, non-medical consumables, and alternative treatments. Knowing the finer details helps you avoid surprises during claims.

A cheaper plan is not always better. Compare premium vs coverage. Look at the long-term value to find the best health insurance in India for your budget.

Add-ons such as maternity cover, OPD cover, room rent waiver, or critical illness riders help you customise your medical insurance policies. These allow you to shape your plan on the basis of your needs instead of settling for a generic one.

An insurer with a high claim settlement ratio offers reliability during emergencies. Check how fast they settle claims and how smooth the claim process is when buying medical insurance.

If you choose a long-term medical insurance plan for two or three years, you may receive discounts and avoid annual price hikes.

Co-payment in health insurance means you share a part of the bill. Deductibles define the amount you pay before the insurer contributes. Sub-limits cap certain costs.

A good insurer offers a transparent process, helpful customer service, and reliable plans. It makes your journey smoother from buying to renewal to making claims.

Following this checklist ensures you pick the best health insurance plan that keeps you financially protected and gives peace of mind for years.

Benefits of 0% GST on Health Insurance!

From 22 September 2025, health insurance premiums no longer carry GST. One can expect an immediate 18 percent reduction in the estimate of total amount the customer pays. It is applicable across all insurance plans, including riders and personal accident cover.[4]

Scenario Before GST ExemptionAfter GST Exemption What This Means for You
Base premium for a health insurance plan is ₹40,000 ₹40,000 + 18%GST (7,2000) = ₹47,2000 GST exempt, so you have to pay ₹40,000 only.You save ₹7,200 instantly
Base premium for a health insurance plan is ₹40,000 ₹40,000 + 18%GST (7,2000) = ₹47,2000 GST exempt, so you have to pay ₹40,000 only.You save ₹7,200 instantly
If you buy an add-on worth ₹5,000(₹40,000 + ₹5,000) + 18% GST (₹8,100) = ₹53,100 GST exempt, which means you only pay ₹40,000 + ₹5,000 = ₹45,000Add-on increases premium, but no GST applies, so total cost stays much lower
ImpactBudget limited you to lower coverageNow the same budget can buy more.You can upgrade coverage without extra cost.

More families can secure better protection, and the industry can reach people who were previously uninsured.

Read more on GST Reduction in Health Insurance.

Compare Our Best Health Insurance Plans At A Glance

  • No Cost Installment Available*^
    optima Secure health insurance policy

    Optima Secure

  • Just Launched
    Optima Lite

    Optima Lite

  • Just Launched
    optima Secure Global health insurance policy

    Optima Secure Global

  • my:                                         health medisure super top-up plan

    my:health Medisure Super Top-up

  • critical health insurance policy

    Critical Illness Insurance

  • iCan cancer insurance

    iCan Cancer Insurance

Just launched
tab1
Optima Secure
Cashless hospitals network
4X Coverage*
Wider Pre & Post Hospitalisation
Wider Pre & Post Hospitalisation
free preventive health check-ups with optima restore
Free preventive health-check ups

Key Features

  • Secure Benefit: Get 2X coverage from Day 1.
  • Restore Benefit: 100% restores your base coverage
  • No Cost Installment*^ Option: Credit and Debit card holders can now opt for the No cost installment*^ option
  • Aggregate Deductible: You can enjoy up to 50% discount every year by choosing to pay a little bit more. You also have the super power to waive your opted deductible at renewal post completion of 5 years under this Policy@
Just launched
tab1
Optima Lite
Preferred Choice of Base Sum Insured – 5 Lac or 7.5 Lac
Preferred Choice of Base Sum Insured – 5 Lac or 7.5 Lac
All Day Care Procedures Covered
All Day Care Procedures Covered
Unlimited Automatic Restore
Unlimited Automatic Restore

Key Features

  • Base Sum Insured Option: Choose a 5 Lac or 7.5 Lac plan according to your needs
  • Automatic Restore: Instant addition of 100% of Base SI upon complete or partial utilization of Sum Insured
  • Cumulative Bonus: Bonus of 10% of Base SI every year max. upto 100% once you renew the Policy
  • Protect Benefit: Coverage for 68 Non-Medical expenses listed by IRDAI
Just launched
tab1
Optima Secure Global
Cashless hospitals network
4X Coverage for claims made in india
Wider Pre & Post Hospitalisation
Overseas Treatment Covered
free preventive health check-ups with optima restore
Free preventive health-check ups

Key Features

  • Global Health cover: comprehensive health cover for medical expenses in India as well as overseas medical treatment expenses
  • Plus Benefit: 100% increase in coverage after 2 years
  • No Cost Installment*^ Option: Credit and Debit card holders can now opt for the No cost installment*^ option
  • Protect Benefit: Zero deductions on listed non-medical expenses
tab4
my:health Medisure Super Top-up
higher cover at low premium with my: health medisure super top-up plan
Higher cover at low premium
compliments existing health insurance with my: health medisure super top-up plan
Compliments existing health insurance
no premium hike post 61 years with my: health medisure super top-up plan
No premium hike post 61 years

Key Features

  • Works on Aggregate Deductible: This health plan comes in action once your all round total claim amount reaches the aggregate deductible in a year, it’s not necessary for a single claim to meet the deductible unlike other top-up plans.
  • No health checkups upto Age 55 : It’s better to be safe than sorry! Secure your health when you are young to avoid medical tests.
  • Pay less, Get more: Opt for a long-term policy of 2 years and get a 5% discount.
critical health insurance policy
Critical Illness Insurance
covers 15 critical illnesses
Covers upto 15 Critical illnesses
lumpsum payouts benefit
Lumpsum payouts
affordable premiums
Affordable premiums

Key Features

  • No medical Check-ups: No medical check-ups up to the age of 45 years.
  • Lifetime Renewability: The policy can be renewed for a lifetime period.
  • Free Look Period: We provide a free look period of 30 days starting from the date of receipt of the policy document.
iCan cancer insurance
iCan Cancer Insurance
all stages cancer cover
Cancer cover for all stages
lumpsum payouts with iCan plan
Lumpsum Payouts
lifelong renewable
Lifelong renewable

Key Features

  • My Care Benefit: From chemotherapy to stem cell transplantation, iCan offers complete cover for conventional and advanced treatments.
  • CritiCare Benefits: Get an additional 60% of the sum insured, as a lump sum payment if cancer is detected of specified severity.
  • Follow-Up Care: Cancer treatments often have side-effects. Follow up care benefit gives you reimbursement up to ₹3,000 twice a year.
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Say goodbye to one-time premium stress! Pay flexibly with Optima Secure’s no-cost installment plans

Health Insurance Coverage: What is Covered In health Insurance Policy

hospitalization expenses covered by hdfc ergo

Hospitalization Expenses

Just like every other health insurance plan, we too cover your hospitalization expenses such as room rent, ICU charges, investigations, surgery, doctor consultations etc. when hospitalised either due to an accident or for a planned surgery.

mental healthcare covered in HDFC ERGO health insurance

Mental Healthcare

We believe mental healthcare is just as important as physical illness or injury. Our health insurance plans are designed in a way to cover hospitalization expenses incurred for treating mental illnesses.

pre & post hospitalisation covered

Pre & Post Hospitalisation

Our medical insurance policies include all your pre and post hospitalisation expenses up to 60 days of admission and post-discharge expenses till 180 days

daycare procedures covered

Day Care Treatments

Medical advancements help in wrapping up important surgeries and treatments in less than 24 hours, and guess what? We have included daycare treatments in our health insurance plans to cover you for that as well.

cashless home health care covered by hdfc ergo

Home Healthcare

In case of non-availability of hospital beds, if the doctor approves treatment at home our medical insurance policy covers you for that as well. So that, you get medical treatment right in the comfort of your home.

sum insured rebound covered

Sum Insured Rebound

This benefit acts like a magical backup, which recharges your exhausted health cover up to the sum insured even after a claim. This unique feature ensure uninterrupted medical coverage at the time of need.

organ donor expenses

Organ Donor Expenses

Organ donation is a noble cause and at times this could be a life-saving surgery. This is why our health insurance plans cover the medical and surgical expenses of the organ donor while harvesting a major organ from the donor’s body.

recovery benefits covered

Recovery Benefit

If you stay in a hospital for more than 10 days at a stretch, then we pay for other financial losses that might have happened due to your absence at home. This feature in our plans ensure you can take care of your other expenses even during your hospitalization.

ayush benefits covered

AYUSH Benefits

If you are a believer in alternate therapies like Ayurveda, Unani, Siddha, and Homeopathy let your belief system stay intact as we cover hospitalization expenses for AYUSH treatment as well in our health insurance plans.

free renewal health check-up

Free Renewal Health Check-up

Health insurance policies often offer a complimentary annual health checkup to help you stay fit and active and prevent illnesses. These checkups include multiple diagnostic tests, such as liver function tests, lipid profiles, and tests for vitamin deficiencies, among others.

lifetime renewability

Lifelong Renewability

Once you get yourself secured with us, there is no looking back. Our health insurance plans continue to secure your medical expenses for your entire lifetime on break-free renewals.

lifetime renewability

Multiplier Benefit

A multiplier benefit equal to 50% of the base sum insured from the expiring policy will be provided at renewal, regardless of any claims made during the policy term. This benefit can accumulate up to a maximum of 100% of the base sum insured.

adventure sport injuries

Adventure Sport Injuries

Adventures can give you an adrenaline rush, but when coupled with accidents, it can be hazardous. Our health insurance plan does not cover accidents encountered while participating in adventure sports.

self-inflicted injuries not covered

Self-inflicted Injuries

If you ever end up causing injury to your precious self, then unfortunately our health insurance plan will not cover for self imposed injuries.

injuries in war is not covered

War

War can be disastrous and unfortunate. However, our health insurance plan does not cover any claim that is caused due to wars.

Participation in defence operations not covered

Participation in Defence Operations

Our health insurance plan does not cover accidental injury while you are participating in defence (Army/Navy/Air Force) operations.

venereal or sexually transmitted diseases

Venereal or Sexually Transmitted Diseases

We do understand the criticality of your disease. However, our health insurance plan does not cover venereal or sexually transmitted diseases.

treatment of obesity or cosmetic surgery not covered

Treatment of Obesity or Cosmetic Surgery

Treatment of obesity or cosmetic surgery is not eligible for coverage under your health insurance plan.

The above mentioned coverage may not be available in some of our Health plans. Please read the policy wordings, brochure and prospectus to know more about our health insurance plans.

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How to Make a Claim for Your HDFC ERGO Health Insurance

The sole purpose of buying a health insurance plan is to get financial support at the time of medical emergency. Hence, it is important to read the below steps to know how Health Insurance claims process works differently for cashless claims and reimbursement claim requests.

Health Insurance Cashless Claims get approved within 36*~ minutes

Fill pre-auth form for cashless approval
1

Intimation

Fill up the pre-auth form at the network hospital for cashless approval

approval status for health claim
2

Approval/Rejection

Once hospital intimates us, we send you the status update

Hospitalization after approval
3

Hospitalisation

Hospitalisation can be done on the basis of pre-auth approval

medical claims settlement with the hospital
4

Claim settlement

At the time of discharge, we settle the claim directly with hospital

We settle reimbursement claims within 2.9 days~*

Hospitalization
1

Hospitalisation at non network hospital

You need to pay the bills initially and preserve the original invoices

claim registration
2

Register a claim

Post hospital discharge send us all your invoices and treatment documents

claim verifcation
3

Verification

We verify your claim related invoices and treatment documents

claim approval
4

Claim Settlement

We send the approved claim amount to your bank account.

Please refer to the Policy Issuance & Servicing TATs

Documents Required for Health Insurance Claim Reimbursement

Below are the documents that you need to keep handy when making a claim against your health insurance policy. However, do read the policy terms and conditions carefully, in order to avoid missing out any important document.

  • The claim form with your signature and valid identity proof.
  • Prescription of the doctor stating hospitalization, diagnostic tests and medicines.
  • Original Hospital , diagnostic , doctors and medicine bills along with receipts.
  • Discharge summary, case papers , investigation reports.
  • Police FIR/medico legal case report (MLC) or post-mortem report if applicable .
  • Proof of named Bank Account like Cheque copy/Passbook/Bank statement
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Did You Know That Your BMI Can Help You Assess Your Risk For Certain Diseases?

How to Choose the Right Health Insurance Plan

Every time you look for a health insurance plan, you wonder which is the best health insurance plan? How to choose the best health plan online? What coverage should it have? To answer all your queries let’s read more to decode the hacks to get the right health insurance plan.

1

Ensure Adequate Sum Insured

If you are looking to insure yourself consider a health insurance plan with a sum insured ranging between 7 lacs to 10 lacs. For a family a policy the sum insured could range between 8 to 15 lakhs on floater basis. Remember, your health insurance plan should be adequate to cover for more than one hospitalisation that may happen in a year.

2

Choose The Right Premium

Health insurance premiums are quite affordable. So when you chose a plan, don’t make a hasty decision of paying low premiums for a smaller sum insured and then co-pay your hospital bills later. You might end up paying hefty amount for your medical bills. Instead, work on a co-payment clause that’s easy on your pocket.

3

Check Network Of Hospitals

Always check if the insurance company has a wide list of network hospitals included in your health insurance plan. Also check, if the nearest hospital or medical facility is listed by the insurance company, so it will help you avail cashless treatment. At HDFC ERGO, we have a huge network of 12,000+ Cashless Health care centers.

4

No Sub-limits Help

Usually your medical expenses depend upon your room type and disease. It is recommended to buy a health insurance plan that does not have sub-limits on hospital room rent so that you can choose the hospital room as per your comfort. Most of our policies also don’t imply disease sublimit; this is also an important factor one must keep in mind.

5

Check Waiting Periods

Your health insurance plan does not come into action while you are waiting period is not completed. Always check health insurance policies with lower waiting periods for pre-existing ailments and maternity cover benefits before buying a health insurance plan online.

6

Choose A Trusted Brand

Always choose a health insurance company that has a good reputation in the market. You must also look at the customer base and claim paying ability to know if the brand will honor the claims that you may make in future. Choosing a health insurance plan is a commitment of both policyholder and insurer, so take a decision calmly.

protect against coronavirus hospitalization expenses

About 28% Indian Households face catastrophic health expenditure (CHE). Protect Your Family with Health Insurance from such financial distress

Why is Having a Mediclaim Policy in Today's World Important?

With the development in technology, treatments and the availability of more effective medicines the cost of healthcare has steeply increased.
All this increase ends up being a burden on your savings, making healthcare unaffordable for many. This is where HDFC ERGO’s health insurance policies come into play, as they take care of the hospitalization and treatment charges, leaving the consumer free of financial woes.

With the development in technology, treatments and the availability of more effective medicines the cost of healthcare has steeply increased. All this increase ends up being a burden for the consumers, making healthcare unaffordable for many. This is where HDFC ERGO’s health insurance policies come into play, as they take care of the hospitalization and treatment charges, leaving the consumer free of financial woes. Get yourself a health insurance plan now.

my: health Suraksha silver health insurance plan

We recommend you my: optima Seucre Plan

This affordable health insurance plan will offer you a large coverage. It will help you save tax as well. In future, you can add your spouse and child to this plan as well.

Rebound Benefit

Acts as a magical tool to bring back the exhausted sum insured in your health insurance policy, covering future hospitalization that may happen in the same policy period. Therefore, you always hold double protection although you pay only for a single sum insured.

Enhanced Cumulative Bonus

If you do not make any claim, your sum insured in your health insurance policy is increased by 10% as a bonus or reward upto a maximum of 100%.

This is our most-recommended plan for all those who are just willing to buy their first insurance plan.

What do you get in this Health Insurance Plan?

  • No hospital room rent restriction
  • Cashless claims approved within 36*~ minutes

Even though your employer covers you, the freedom to customize it as per your growing need does not remain in your hands; additionally, if you ever quit your job then your health insurance cover ends. So, why risk your health cover with an employer, when you can easily get one for yourself.

my: health Suraksha silver health insurance plan

We recommend you my: Optima Secure Plan

However, if you still feel that your employer’s health cover or existing health cover suits well then there is no harm in topping it up for a higher cover at a much lower premium.

medisure super Top-up health insurance plan

We recommend you health Medisure Super Top-up:

This health insurance plan gives you a much higher cover at a lower premium. It acts as a top-up to your existing health insurance.

Why choose Medisure Super Top-up Health Insurance?

  • Hospitalisation covers
  • Day care procedures
  • High cover at a lower premium

We understand that you are deeply concerned about your parent’s growing age and willing to cover them. It’s important to gift then a health insurance plan, so that they don’t dig into their lifelong savings for paying hospital bills.

my: health suraksha silver insurance plan

We recommend you my: Optima Secure Plan

for your parents who may or may not be senior citizens. It is a simple no-fuss health insurance plan that gives all basic coverage at a premium that is pocket friendly.

Why choose my: Optima Secure Plan for Parents?

  • No room rent restrictions
  • Home health care for convenience
  • Alternative treatments covered like Ayurveda, Homeopathy, Unani and Siddha
  • Nearly 15,000+ Cashless hospitals
  • Hospitalisation, pre and post hospitalization expenses covered.

For all those confident and self-reliant women,

my: women health Suraksha silver health insurance plan recommendation

we have designed my:health Women Suraksha

to take care of women related 41 critical illnesses, cardiac ailments, and cancer cover.

Why choose my: Optima Secure Plan?

  • Offers lump-sum benefit
  • Continue even after a minor illness claim is paid.
  • Includes almost all women-related ailments.
  • Extremely affordable premium.
  • Optional covers like loss of Job, Pregnancy & New-born baby complications, and Post-diagnosis support.

A single critical illness is enough to put a pause to your life be it due to the long treatment course or the financial requirements. We help you cover the medical expenses so that you focus only on recovering.

critical health insurance plan

We recommend you to buy a critical illness health insurance plan

for securing 15 major critical illnesses, which include stroke, cancer, kidney-liver failure, and many more.

Why choose HDFC ERGO Critical Illness Insurance?

  • Lump Sum payment in a single transaction
  • Helps in supporting in case of job loss
  • You can pay for your debts and fulfill financial responsibilities.
  • Tax benefits.

Why Should You Buy Health Insurance Online?

Buying a health insurance plan online comes with several benefits.

Quick & Hassle-Free Buying

Quick & Hassle-Free Buying

Purchasing a health insurance plan online lets you compare options, review benefits, and make decisions instantly, as there are no agents, no appointments, no paperwork. It is the fastest way to choose the right medical insurance plan for your needs. Check your premium now!

Safe & Easy Digital Payments

Safe & Easy Digital Payments

Pay securely using credit/debit cards, UPI, or net banking. Digital payments make buying a health insurance policy simple, transparent, and completely cashless. Start your online health journey today!

instant quotes & policy issuance

Instant Quotes & Policy Issuance

Check premiums, customise plans, add family members, and get instant quotes - all in one place. Once you pay, your health insurance policy is issued within seconds. Get an instant quote now!

 Immediate Access to Policy Documents

Immediate Access to Policy Documents

Your digital health insurance policy copy is delivered straight to your inbox. What you see online is exactly what you get. Buy your plan online right away.

Wellness Tools at Your Fingertips

Wellness Tools at Your Fingertips

Track health metrics, book online consultations, and access all policy documents through user-friendly apps. Your health insurance plan becomes a convenient wellness companion, anytime, anywhere. Explore online health plans today.

How to Buy Health Insurance Online?

The easiest and most convenient way of buying the best health insurance is to purchase it online. Here’s how you can buy a HDFC ERGO health insurance policy online:

  • Visit the health insurance page of HDFC ERGO.
  • Right on top, you will find the form. Type your basic information such as contact details, the type of plan etc. Then click on view plans button
  • Once you have seen the plans, customize your policy by choosing the preferred sum insured, policy terms, and other information.
  • Choose an online payment mode and make the payment through our secure payment gateway.
Explore our health insurance premium rates

Prioritising Health Insurance Needs Planning. Let Us Help you.

What is a Mediclaim Policy?

Mediclaim insurance

It is a type of health cover that pays for hospitalisation expenses when you are admitted for treatment.

Mediclaim insurance focuses mainly on inpatient care. It covers costs like room rent, doctor visits, medicines, and basic procedures done during the hospital stay. These mediclaim policies are designed to handle immediate medical expenses. A mediclaim policy helps you avoid paying large hospital bills out of pocket.

While coverage is limited when compared to full health insurance, a mediclaim policy still offers essential financial protection during a critical situation.

What Is the Difference between Mediclaim and Health Insurance?

Mediclaim insurance and health insurance are often mixed up, but they serve different purposes.

Mediclaim policy - It is designed to cover hospitalisation expenses only. It pays for costs like room rent, doctor consultations, medicines, and procedures that require you to be admitted. It is a straightforward plan meant for basic medical needs and emergency care.

Health insurance - It offers wider and more flexible protection. A health insurance plan covers hospitalisation but also supports you before and after admission with tests, scans, consultations, and medicines. It includes day care procedures that do not require 24-hour admission and may cover home healthcare, AYUSH treatments, and preventive checkups.

Here’s a deeper dive into the differences between mediclaim and health insurance:

Feature Mediclaim Policy Health Insurance
Scope of Coverage Covers only hospitalisation expenses during an inpatient stay. Offers broad medical coverage including hospitalisation, pre-hospitalisation and post-hospitalisation, day care treatments, home care, and wellness benefits.
Critical Illness Cover Does not include critical illness protection. Includes critical illness cover in many plans; provides a lump sum payout for listed serious conditions.
Pre-Hospitalisation and Post-Hospitalisation Usually limited to a small number of days and may not cover many tests or follow-up visits. Covers a wider range of tests, scans, consultations, and medications before admission and after discharge.
Day Care Procedures Covers very few short-duration procedures, usually only if specified in the policy. Covers a large list of day care treatments that do not require 24-hour hospitalisation.
Add-on Options Very few or none; not much scope for personalisation or extended protection. Multiple add-ons like OPD and consumables allowed.
Flexibility Basic structure with limited benefits; little room to adjust coverage. Highly flexible; buyers can curate their plan for broader and long-term medical support.

How to Save Tax with Section 80D?

tax deduction on medical insurance premium paid

Tax Deduction on the Premium Paid for Self and Family*

When you buy a health insurance plan for yourself, your spouse, and your dependent children, the premium you pay qualifies for a tax deduction under Section 80D. If all the four members are under 60 years of age, the maximum you can claim is ₹25,000 per financial year. [10]

Additional Deduction for Parents

Additional Deduction for Parents

If you pay the medical insurance premium for your parents, you can claim an additional deduction of up to ₹25,000 every financial year. If one or both parents are senior citizens, this limit increases to ₹50,000. [10]

Deduction on Preventive Health Check-ups*

Deduction on Preventive Health Check-ups*

Under Section 80D, you can also claim tax benefits for preventive health check-ups. You can claim up to ₹5,000 each financial year as expenses incurred for these tests. [10]

By choosing the right health insurance policy, you protect your health, your family, and your taxes in one step.

Note: The above benefits are only applicable to the old regime. Those who have opted for the new regime are not eligible for these tax benefits.

Tax benefits are subject to terms and conditions, as well as changes in tax laws.

Common Reasons People Delay Buying Health Insurance

Many people still postpone buying a health insurance plan, even when medical costs are rising and illnesses are becoming more common. Below are the most common reasons people avoid buying health insurance, along with why these reasons should not hold you back.

Rohit relies on the health insurance provided by his company and feels there’s no need for a separate policy. When he switches jobs, he realises his coverage has ended, leaving him uninsured.

my: health Suraksha silver health insurance plan

Why this reason is not valid

Employer-provided insurance is temporary and limited. A personal health insurance policy stays with you regardless of job changes, career breaks, or retirement.

Meera prioritises EMIs and investments, assuming she can handle medical expenses from her savings if needed. When her loved one has to undergo a heart bypass surgery, which can cost up to ₹8 lakhs@, she has no option, but to dip into long-term savings.

my: health Suraksha silver health insurance plan

Why this reason is not valid

A health insurance policy protects your long-term savings from being disrupted by unexpected medical expenses, which makes it a key part of financial planning

Amit chooses a low sum insured to keep premiums minimal. A single hospital stay of 3 to 5 days in a metro city exhausts his coverage.

my: health Suraksha silver health insurance plan

Why this reason is not valid

Medical costs are rising quickly. A higher sum insured ensures your family is prepared for rising medical costs and longer treatments.

Neha selects a low-premium policy without checking coverage details. During a claim, she comes to know about room rent limits and exclusions and has to pay from her own pocket.

my: health suraksha silver insurance plan

Why this reason is not valid

The best health insurance plan balances affordability with meaningful benefits. It comes with long-term value and fewer restrictions, so that you have less stress in times of need.

Vikram buys a health insurance policy mainly to claim tax deductions under Section 80D and does not review the benefits. When he has to undergo hospitalisation, his health insurance policy falls short of covering his medical expenses.

my: women health Suraksha silver health insurance plan recommendation

Why this reason is not valid

Tax benefits are a bonus, but the true value lies in financial support during medical emergencies.

Priya, in her late 20s, delays buying a health insurance policy because she rarely falls sick. Later, she faces waiting periods and higher premiums when she finally applies.

critical health insurance plan

Why this reason is not valid

Buying health insurance at an early age means lower premiums, cleared waiting periods, and higher no-claim bonuses in future years. In addition, with rising chronic diseases amongst young people, health insurance is crucial for them as well.

Understanding these reasons helps you avoid costly delays and choose the best health insurance plan in India that genuinely protects your health and finances.

Health Insurance at a Glance

Feature What Is It
Premium The amount you pay for your health insurance plan
Sum Insured Maximum amount your policy will pay in a year
Pre-Hospitalisation & Post-Hospitalisation Expenses Medical costs before admission and after discharge
ICU Charges Expenses for intensive care
Pre-existing Diseases Coverage for illnesses you had before buying the policy
Room Rent Limit Maximum amount provided for hospital room
Waiting Period Time before certain benefits become active
Cashless Claims Direct payment to hospital without paying upfront
Tax Benefits Savings under Section 80D*
Network of Hospitals Partner hospitals for cashless treatment
AYUSH Treatment Alternative medicine like Ayurveda, Yoga, Unani, Siddha, Homeopathy
Global Cover Treatment abroad for planned hospitalisation
OPD Cover Outpatient treatment without hospitalisation
Maternity Cover Pregnancy and childbirth expenses
Cumulative Bonus Increase in sum insured for claim-free years

Comparing HDFC ERGO’s Health Insurance Plans

To make sure you choose the best health insurance plan that meets your needs, it is important to be aware of the options available. Here is a list of the major health insurance plans offered by HDFC ERGO, along with the features they come with.

Parameter Optima Secure Optima Lite Optima Restore Optima Secure Global my:health Medisure Super Top-up Critical Illness Insurance iCan Cancer Insurance
Coverage Area India India India India + Overseas India India India
Plan Type Comprehensive medical insurance Base health insurance Comprehensive medical insurance Global medical insurance Super top-up Lump sum critical illness plan Cancer-specific insurance
Base Sum Insured Multiple options + 4X coverage ₹5 lakh or ₹7.5 lakh Multiple SI options with 100% Restore + optional Unlimited Restore, as per policy wordings Multiple options + 4X India coverage High cover (based on deductible) Lump sum only Lump sum only
Core Benefits 4X coverage, wide hospitalisation cover, preventive check-ups All day care, unlimited restoration benefit, cumulative bonus 100% Restore Benefit, 2X Multiplier Benefit, daily hospital cash, complimentary health check-ups Global treatment, 4X India coverage, pre-post cover Higher cover at low premium, activates after deductible Covers 15 critical illnesses with lump sum payout Covers all stages of cancer with lump sum payout
Cashless Network Yes, wide network Yes Yes Yes Yes NA (payout-based) NA (payout-based)
Pre-Hospitalisation & Post-Hospitalisation Wider coverage Included as per policy terms Included as per policy terms Yes, across the globe Follows base health policy Not applicable Treatment-based payouts, not hospitalisation-linked
Automatic Restore / Refill 100% restore benefit Unlimited automatic restore 100% Restore + optional Unlimited Restore (activates unlimited times) Global restore benefit NA NA NA
Preventive Health Check-ups Free annual check-ups Available Complimentary annual health check-up up to ₹10,000 Free preventive health check-ups No No No
Special Features 2X Secure Benefit from Day 1, Restore Benefit, No Cost Installment, Aggregate deductible discount Protect Benefit (covers 68 non-medical expenses), Cumulative Bonus 2X Multiplier Benefit, Daily Hospital Cash, Family Discount, Modern Treatments (robotic surgeries, stem cell therapy, oral chemotherapy, and so on) covered Global Cover, Plus Benefit (100% increase in coverage), Protect Benefit No checks up to 55, discount for long-term policy, no premium hike post 61 years of age No medical tests up to 45, free look period, lifetime renewability MyCare for advanced treatments, 60% additional payout, Follow-up care benefits
Premium Moderate-to-high (depending on 4X benefit) Affordable, budget-friendly Mid-range Higher due to global cover Low (top-up model) Very affordable Moderate (depending on stage coverage)
Suitability Families needing high coverage, individuals wanting multi-layer protection First-time buyers, small families needing affordable yet strong coverage Individuals & families seeking restoration benefits and enhanced coverage at reasonable premiums. Frequent travellers, NRIs, people wanting global protection Anyone wanting higher cover at low cost alongside an existing plan Those seeking income protection from major illnesses Individuals wanting complete cancer protection across all stages
Requirement of Medical Tests May require depending on age Depends on age & sum insured Depends on age & sum insured May require for higher global cover None up to age 55 None up to age 45 Depends on age & underwriting

What are the Health Insurance TermsYou Need to Know About?

Understanding key terms makes it easier to compare health insurance plans and choose the coverage that fits your needs.

1

Dependents

Dependents refer to the family members you can include in health insurance policies, such as your spouse, children, or parents.

2

Deductibles

Deductibles are the fixed amounts you must pay from your pocket before the insurer starts covering your medical expenses. [17]

3

Sum Insured

Sum Insured is the maximum amount your insurer will pay for all claims in a policy year. Choosing the right sum insured is crucial because it determines your financial protection.

4

Co-payment

Co-payment means you share a certain percentage of the medical cost with the insurer. For example, with a 10 percent co-pay, you pay 10 percent of every eligible bill, and the insurer pays the remaining 90 percent. [14]

5

Critical Illness

Critical Illness coverage offers a lump sum payout when you are diagnosed with a listed serious illness such as cancer, heart attack, or kidney failure. The amount helps you manage treatment and lifestyle expenses.

6

Pre-existing Diseases

Pre-existing Diseases are health conditions you already have before buying the policy. PEDs usually come with a waiting period before you can make a claim.

7

Riders

Riders are optional add-ons you can include to enhance your coverage, such as maternity cover, room rent waiver, or OPD benefits.

8

No Claim Bonus (NCB)

No Claim Bonus (NCB) rewards you for not filing any claims during a policy year. The bonus usually increases your sum insured without increasing your premium.

9

Restoration Benefit

Restoration Benefit refills your sum insured if it gets exhausted during the year. It is especially helpful during multiple treatments or back-to-back medical emergencies.

Features and Benefits Offered By The Best Health Insurance Plans in India

There are a plethora of options available in the market when it comes to buying health insurance but choosing the best health insurance plan in India is in your hands. Have you ever wondered why some insurance plans have a higher premium and low coverages, while some might have high coverages but a low claim settlement ratio? Finding a health insurance plan which offers comprehensive coverages and affordable premium is ideal, you can find them by researching online. Best health insurance plan must consist of the following:

1

Vast number of network hospitals

When you get admitted in a network hospital your claim process becomes very simple and quick. Always check if the insurance company has a wide list of network hospitals. If the nearest hospital or medical facility is listed by the insurance company it will help you avail cashless treatment.

2

Cashless hospitalisation facility

Having Cashless Health Insurance is must in India in today’s time. You do not have to worry about the bill as the hospital and the insurance company settles it internally.

3

Good claim settlement ratio

What is the use of having a health insurance policy when the claims continuously keep getting rejected? Hence the best health insurance plan in India must have a good claim settlement ratio.

4

Range of sum insured

Having a range of sum insured amount to choose from can be helpful as you can select the amount based on your requirement. Your sum insured amount must able to support you at the time of a medical emergency.

5

Customer reviews

Best health insurance policy is highly recommended by all the customers as they give remarkable reviews and ratings to the health insurance plan. You must go through the ratings and reviews available online for better decision making.

6

Home care facility

Medical science has advanced a lot and there are various diseases can be treated at home. Hence, the best health insurance plan in India must consist of home care facility as the medical expenses incurred at home are also covered.

Health Insurance Policy Documents

Brochure Claim Form Policy Wordings
Get details on various health insurance plans with their key features and benefits. Visit the Health category to know more about HDFC ERGO health insurance policy covers. Want to claim your health insurance? Download the health policy claim form and fill in the required details for faster claim approval and settlement. Please refer the policy wordings to know more about the terms and conditions under health insurance plans. Get more details on coverages and features offered by HDFC ERGO Health Insurance.
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Health Insurance Terms You Need to Know About

1

Dependents

A dependent in health insurance is a person who is related to the policyholder. Any family member whom the insured wants to provide health insurance coverage to in their health insurance plan can be included as a dependent. In simple terms, a dependent is a person who is a family member or relative of an insured person.

2

Deductibles

Having This component of health insurance can reduce your policy premium, but it also means that you have to pay a fixed sum at the time of insurance claim. So, do read the policy documents for the deductible clause and choose the one that does not include it, until you are ready to bear the treatment cost.

3

Sum Insured

The sum insured is the maximum amount an insurance company will pay for the covered medical expenses of the insured individual within a policy period. For example, if your sum insured is ₹5 lakh, the insurer will cover hospital bills and treatments up to ₹5 lakh. If your bills go beyond that, you will have to pay the extra amount yourself.

4

Co-payment

A few health insurance plans have a co-payment or co-pay clause. It is a fixed percentage of a sum the policyholder has to pay to the insurance company before receiving the healthcare service. It is mentioned pre-decided and mentioned in the policy wordings, e.g. if someone agrees to pay 20% co-pay at the time of claim, for each time a medical service is availed, they have to pay that sum.

5

Critical Illness

Critical illnesses medical conditions refer to life-threatening medical diseases like cancer, kidney failure, and cardiovascular diseases. There are separate health insurance plans that cover these illnesses. They can also be purchased as a rider or add-on cover for the same.

6

Pre-existing Diseases

Health issues like COPD, hypertension, diabetes, kidney problems, cardiovascular issues, and other underlying diseases are considered to be risk factors in terms of health insurance. Patients with pre-existing medical conditions as stated above are considered to be at a higher risk and are therefore charged a higher premium.

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Health Insurance Reviews & Ratings

4.4/5 Stars
rating

Our customers have rated us

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Dinesh Garg

Optima Restore

Jan 2025

Customer Executive was professional in communication, knowledgeable & skilled about product policy & website how to queries . Helpful in nature & possess a good attitude. Thank you HDFC ERGO TEAM

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Praveen Chavhan

Optima Restore Insurance

Jan 2025

HDFC ERGO already has Great services, super fast claim process, and full support. So we are Happy to have multiple HDFC ERGO health insurance Policies. Thanks.

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Adesh Kumar

MY: Optima Secure

Jan 2025

I like the HDFC ERGO Service, they always be there and support me and my family , We feel safe and secure With HDFC ERGO Thank you Always

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Sumit Soni

Optima Restore

Jan 2025

The Customer Care Executive Ms. Chandra listened my query and resolved it very well. She also explained many things about my policy and claim related matters and I really appreciate it.

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Anurag Kanaujia

Optima Restore

Jan 2025

Medical Claim processing is good and speedy. Very thankul to HDFC ERGO team for their excellent response time.

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Rashmi Bhalerao

Optima Secure

Jan 2025

HDFC ERGO reimbursement process is very user-friendly. My claims were processed quickly and in 2 days' time. I was also confirmed by the SME once the claims were processed to check. A professional approach. Thanks to entire team.

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Prince

Optima Restore Insurance

Jan 2025

HDFC ERGO is a Best policy giving company and Help customer as soon as they can. I am very thankful to HDFC ERGO for giving me best service and provide all facilities

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Saket Sharma

Optima Secure Family Floater

Jan 2025

Gurgaon / Haryana

I want to take a moment to appreciate Jishan Kazi (EMP ID: 19004), Health Insurance Advisor at HDFC ERGO, for the excellent service he provided. His patience, professionalism, and dedication stood out as he guided me through my health insurance buying journey. Jishan handled my queries with great care, and his ability to address concerns calmly and efficiently was impressive. He truly went above and beyond to ensure a smooth experience. I believe he is a valuable asset to your team and will continue to excel in his role

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Arun A

HDFC Individual Energy Medical Insurance plan

Dec 2024

I am writing to express my sincere appreciation for the outstanding service provided by Mr. Kamlesh K (Employee ID: 24668) in helping me secure a HDFC Individual Energy Medical Insurance plan for my mother. Over the past two months, Mr. Kamlesh has demonstrated exceptional professionalism and dedication. He patiently guided me through the entire process, promptly responded to all my queries, and consistently followed up with me. His thorough knowledge of the insurance products and commitment to customer service made process very straightforward and hassle-free. Please convey my gratitude to Mr. Kamlesh. Thank you for maintaining such high standards of customer service.

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Nilanjan Kala

Optima Super Secure 

Dec 2024

South Delhi, Delhi

I would like to express my sincere thanks to Mr Arvind who has been very helpful during my buying journey which helped me to make up my mind to choose HDFC Ergo as my insurance provider. He explained every minute details with transparency and honesty. It is because of his guidance that helped me make the decision to get a 50 lakh cover for 3 years. We showed immense confidence in his work and I must say, he is a great salesman.

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Sandeep Angadi 

Optima Super Secure

Dec 2024

Bangalore, Karnataka

I would like to express my heartfelt gratitude to Shehnaz Bano. I really appreciate her help with securing my policy. Her knowledge about the plan is great. She explained details of the plan with clarity before making the purchase of the policy. I would want her supervisor to recognise her efforts. Keep up the good work. Thank you!

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Mayuresh Abhyankar 

Optima Secure

Dec 2024

Mumbai, Maharashtra

I would like to highlight the efforts taken by your team member Puneet Kumar to help me get my insurance. He was on call with me for 2 hours explaining me the entire process and providing detailed information about the various policies helping me choose the Right one for my needs. He also went out of the way to close the deal on the very call. I think he deserves a pay hike and promotion too. Puneet, keep up the ante and best wishes for your future endeavours.

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Sanoob Kumar 

Optima Secure

Dec 2024

Bangalore, Karnataka

I am writing to express my sincere appreciation for Mr Mohammed Ali who provided invaluable assistance in securing health insurance coverage for my Family (which is my most important priority) with HDFC ERGO. His expertise and guidance throughout the entire process was truly exceptional. He patiently explained the different plans, answered all my questions thoroughly, and helped me understand the nuances of each policy. Thanks to his efforts, I am now confident that my family is well-protected with comprehensive HDFC ERGO health insurance coverage.

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Vijay Kumar Sukhlecha

Optima Secure

Dec 2024

Bangalore, Karnataka

I want to take a moment to appreciate Shubham. I truly admire his in-depth knowledge of the subject and his patience in answering all questions, even when I repeated some to validate his responses. He is a valuable asset to the HDFC family, and I wish him a bright and successful career ahead.

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Batta Mahendra

Optima Secure

Dec 2024

Ananthapur, Andhra Pradesh

I am extremely thankful to Arvind for his explanation and knowledge regarding various policies offered by HDFC Ergo. His comparison has helped me a lot to chose right policy.  As of now I am proceeding with HDFC Optima Secure.

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Frequently Asked Questions on Health Insurance

Yes, having a separate individual health insurance plan is important. Your employee health insurance covers medical expenses only till the time you are working in the organization. Once you quit the company, your policy term ends. Keeping medical inflation in mind, it is important to buy personal health insurance as per your medical needs. Also, a corporate health plan is a common plan designed for all employees.

Health insurance portability helps you to change your health insurance plan without having to go through a fresh waiting period term. There is a smooth transfer from one insurer to another if your current plan is not sufficient to cover rising medical costs.

Network hospitals better known as cashless hospitals have an agreement with your insurance company, because of which you can avail cashless hospitalisation benefit. On the other hand, if you get treated In a non-network hospital, you have to pay the bills first and later  apply for reimbursement claim. So, it is always wise to buy a health insurance company which has a large network hospital tie-up.

Cashless hospitalisation is a procedure in which the policyholder doesn't have to pay medical expenses out of his pocket in case they are admitted to a hospital or have undergone a surgery. However, there are certain deductibles or non medical expenses at the time of discharge, which are not included in the policy terms, have to be paid at the time of discharge.

In case you have to undergo a surgery, there are certain pre hospitalization expenses such as diagnosis cost, consultations etc Likewise, post the surgery, there could be expenses to monitor the health of the policyholder. These expenses are known as pre and post hospitalization expenses.

You can file multiple numbers of claims during a policy term, provided it is within the limit of the sum insured. A policyholder can get coverage up to sum insured only.

Yes, it is possible to buy more than one medical insurance plan. This entirely depends on an individual’s necessity and coverage requirements.

Yes, you can claim medical bills in health insurance, as long as it is within the sum insured. For more information, read the policy wording document.

It usually takes approx.7 working days in settling a claim if documents are in order.

You can check your claim status through self-help portals or mobile apps extended by insurers.

There may be a few medical tests that needs to be taken before buying health insurance. For some health insurance policies, the medical tests are required if there are pre existing illnessed or if someone is above 40 years of age.

At the time of purchasing or renewal of your health insurance policy, you can add your family members.

Yes, children can be added to your health insurance plan. They can be added post 90 days of birth up to the age of 21 or 25 years. It varies from company to company, so please go through plan eligibility from the product brochure.

You are eligible to pay a lower premium and higher benefits. Since the probability of having a pre-existing illness is low, the waiting periods may also not impact you. Apart from that, common diseases such as flu or accidental injuries can happen at any age, so buying a health insurance when you are young is important.

Yes. You can always have more than one health insurance plan based on necessity and coverage requirements as every plan works differently and offer varied benefits.

The time span during which you cannot raise a claim to avail some or all benefits of the health insurance from your insurance provider for a specified illness is known as waiting period. So, basically, you have to wait for a specified amount of time before you request for a claim.

During this free look period, you have the option of canceling your policy without penalty if you feel your policy is not beneficial. Depending on the insurance company and the plan offered, the free look period can be 10-15 days or even longer. Know more, to know more on free look period.

Network hospitals better known as cashless hospitals have an agreement with your insurance company, because of which you can avail cashless hospitalisation benefit. On the other hand, if you get treated In a non-network hospital, you have to pay the bills first and later  apply for reimbursement claim. So, it is always wise to buy a health insurance company which has a large network hospital tie-up.

When a policyholder is in a condition that he/she cannot be admitted to a hospital or the treatment is taken at home due to non-availability of room in the hospital, it is known as domiciliary hospitalisation

In case of a hospitalization cover we cover expenses like pre and post hospitalization expenses for your diagnostic tests, consultations and medicine costs. We also cover ICU, Bed charges, medicine cost, nursing charges and Operation theatre expenses widely.

There is no right or wrong age to buy a health insurance policy. However, it is recommended to buy a health plan early to get lower premiums. Once you turn 18 years old, you can buy a health insurance plan for yourself. Before that a family health insurance plan can cover your healthcare expenses.

No, a health insurance policy cannot be purchased by a minor. But they can be covered under the a family floater health insurance bought by their parents

In case you get admitted at a non-network hospital have to pay the bills from your pocket first and later raise a reimbursement claim from your insurance company. However, your health insurance company will provide reimbursement only up to the amount of Sum Insured. 

The annual sum insured is the maximum amount upto which your health insurance will pay for admissible medical expenses during a given policy year. For example, if the annual sum insured is ₹5 lakh and you are diagnosed with an illness requiring hospitalisation, and the bill amounts to around ₹6 lakh, the insurer will only pay ₹5 lakh.

Yes, waiting periods shall apply afresh to the increased portion of the sum insured [SI] amount. Suppose your original sum insured is ₹5 lakh, and the plan had a waiting period of 3 year for declared pre-existing conditions [PED]. After one year, if at renewal you increase the sum insured from ₹5 lakh to ₹15 lakh, then for the original SI ₹5 lakh PED waiting period of 2 years shall apply while for the increased ₹10 lakh portion afresh PED waiting period of 3 years shall apply.

Whether ₹20 lakh health insurance is enough depends on several factors. These include your age, family size, medical history, lifestyle, and where you live, as healthcare costs vary by city. You must also factor in medical inflation and the average cost of healthcare infrastructure in the city you reside in.

The four most common medical insurance plans are Individual Health Insurance, which covers one person; Family Floater Plans, covering the entire family under a single sum insured; Critical Illness Plans, which provide a lump sum on diagnosis of chronic illnesses; and Senior Citizen Health Plans, designed specifically for people above 60 years.

Yes. Most health insurance plans cover diagnostic charges during hospitalization, pre-hospitalization and post discharge as well.

All HDFC ERGO health insurance plans cover diagnostic charges during hospitalization, pre-hospitalization and post discharge as well.

Yes. Once your specified waiting period is over you will get coverage for your pre-existing illnesses. Read this blog, to know more on coverage for pre-existing diseases.

You need to check your policy document and enroll your family members by mentioning their name and age to get them covered.

Buying online health insurance is no different than purchasing it offline. In fact buying online health insurance is quick and hassle-free. A cashless card via courier/postal services is provided to you. To know more, visit the company website or dial customer care number.

Important medical expenses such as blood investigations, diagnostic charges such as CT scan, MRI, sonography etc. are covered. In certain cases, hospital room rent, bed charges, nursing charges, medicines and doctor visits etc can also be covered.

Yes. It depends on the policy terms and conditions. However, most health insurance companies offer coverage for modern treatments and robotic surgeries.

Yes. Your HDFC ERGO Health Insurance Policy covers hospitalization expenses for Corona Virus (COVID-19). We will pay the below medical expenses for hospitalization during the policy period for treatment of COVID-19:

In the event you are admitted to a hospital for over 24 hours, your medical bills would be covered by us. We would take care of:

• Stay Charges (Isolation Room / ICU)

• Nursing charges

• Treating Doctor Visit Charges

• Investigations (Labs/Radiological)

• Oxygen / Mechanical Ventilation Charges (if required)

• Blood / Plasma Charges (if required)

• Physiotherapy (if required)

• Pharmacy (except non-medicals/consumables)

• PPE Kit charges (as per government guidelines)

No, home isolation is not covered in our Health policies. You can only file a claim for medical treatment undertaken at a hospital or nursing home. The treatment should be on the advice of and be actively managed by a qualified doctor.

The testing charges will only be covered in case of hospitalization for each insured member(s) covered under the policy.

You can include your child dependents in a family floater policy after 90 days of their birth and upto the age of 25 years.

It can be done. An endorsement request needs to be raised by the policyholder for a change in nominee details.

Does not worry if your policy expires during hospitalization because you get a grace period of 30 days post the policy lapse. However, if you do not renew your policy within the grace period and hospitalization happens post grace period then you will have to pay for the medical expenses.

At the start of every health insurance policy, waiting periods are applied. This doesn't change with renewal. However, with every renewal , the waiting period is waived off until you reach a time when you have no waiting period and the coverage includes most of the treatments.

If your child is an Indian citizen, then you can purchase a health insurance policy. If not, you should opt for student travel insurance for your child.

Tobacco users are prone to higher health risks. If tobacco is consumed in any form, the chances of an individual developing some health issue later in life is higher, and this means you might have to claim the treatment cost. So, these individuals are categorized as high-risk by the insurance company and high premiums are charged from them.

The bonus/ reward that one gets for remaining fit and not filing a claim is known as a cumulative bonus. The cumulative bonus benefit is given in the renewal year by increasing the sum insured amount only up to a certain year for every claim-free year. This helps you to get a higher Sum Insured without paying anything extra.

Many companies may offer a family discount if you cover 2 or more family members under a single health plan on an individual sum insured basis. Even long term policy discounts can be availed on buying health insurance for more than 2-3 years. Some insurers also give fitness discounts on renewals.

No. Only Indian citizens can purchase Health insurance plans in the country.

If a health insurance plan is cancelled within the free look period ,you will get your premiums refunded, after adjusting underwriting cost and pre-acceptance medical costs, etc.

Yes. There is a pre-decided agreement between your health insurance company and network hospitals and hence cashless treatment facility is available at every network hospital.

You can raise a claim as many times you want, until you exhaust your sum insured amount. The best way is to buy plans that help you by restore the sum insured once it gets exhausted. This helps you register more claims in a year.

Yes. A pre-authorization request for cashless claim can be rejected if the policyholder files a claim for an ailment/disease which is either excluded, falls in waiting period or if the sum insured has been already used up.

In case of reimbursement claims, the insurance company needs to be informed within a period of 30 days post discharge.

The percentage of the number of claims that the insurance company paid out during a financial year out of the total claims incurred is known as claim settlement ratio (CSR). It reflects if the insurer is financially secured enough to pay for its claims.

Your policy period continues as usual, but the amount you claimed for gets deducted from your sum insured. Post renewal of the health insurance plan, your sum insured again gets back to the amount you had opted for at the time of renewal.

It depends on the policy terms and conditions. Say, if you have a health cover of ₹1 crore, this helps you take care of all the possible medical expenses.

A cashless claim request can be raised by contacting the insurance department at the network hospital or your health insurance company. For reimbursement claims, post discharge, you need to send the invoices to your insurance provider.

Within 30 days post-discharge. A claim should be raised with the insurance provider as soon as possible, without any delay.

Mediclaim process is the modern day reimbursement process, wherein you raise a claim post discharge by submitting original invoices and treatment documents.

Waiting periods depend on the policy terms and conditions. There is a waiting period for specific ailments/diseases which could be for 2-4 years.

You can visit www.hdfcergo.com or call our helpline 022 62346234/0120 62346234 Read more on how to claim health insurance for covid-19 here.

Whenever you get admitted at a non-network hospital you have to pay the bills first and later claim for reimbursement. HDFC ERGO has nearly 15000+ˇ cashless network.

The following documents required:

1. Test reports (from Govt Approved Laboratories )

2. Bills for the tests underwent

3. Discharge summary

4. Hospital bills

5. Medicine bills

6. All payment receipts

7. Claim form

Original documents to be submitted

With the development in technology, treatments and the availability of more effective medicines the cost of healthcare has steeply increased. All this increase ends up being a burden for the consumers, making healthcare unaffordable for many. This is where HDFC ERGO’s health insurance policies come into play, as they take care of the hospitalization and treatment charges, leaving the consumer free of financial woes. Get yourself a health insurance plan now.

You can renew health insurance policies within a few minute. Click here to renew instantly.

Yes. You can port your health insurance policy with any other insurer without impacting your waiting periods.

Waiting period is fixed at the inception of the policy it is not dependant on the sum insured. Hence, even if you increase your sum insured your waiting period continues until you keep renewing to get away with the waiting period term.

Yes. If you have not made claims then you get a cumulative bonus, which is increase in sum insured without paying for the same. You can also get fitness discount if your health parameters such as BMI, diabetes, Blood pressure is improved.

Possibly yes. If you have not renewed your policy within the grace period then there are high chances that your policy may lapse.

Yes. You can add or remove optional/add on cover at the time of renewal. This is not permitted during the policy tenure. Read this blog for more information.

Usually it takes not more than 5 minutes but you need to keep details such as your policy number and other information ready.

You get a grace period of 15-30 days to renew your health insurance policy. You need to renew within that period. But, if your grace period is also over then your policy will expire. Then, you have to buy a new policy with a fresh waiting period and other benefits.



Awards & Recognition

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BFSI Leadership Awards 2022 - Product Innovator of the Year (Optima Secure)

ETBFSI Excellence Awards 2021

FICCI Insurance Industry
Awards September 2021

ICAI Awards 2015-16

SKOCH Order-of-Merit

Best Customer Experience
Award of the Year

ICAI Awards 2014-15

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CMS Outstanding Affiliate World-Class Service Award 2015

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iAAA rating

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ISO Certification

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Best Insurance Company in Private Sector - General 2014

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