In today’s world, living without the protection of a health insurance plan is unthinkable. But increase in premiums for even a modest base sum insured is making it unaffordable for the majority in our country, especially for people living in tier 2 & tire 3 cities. At HDFC ERGO, we always believed in making health insurance accessible and affordable for one and all. So, we are introducing my:Optima Secure Lite, our latest addition to our health insurance lineup, designed to deliver accessible and effective coverage.
This new-age health insurance plan comes with an option to choose from two base sum insured – 5 lac & 7.5 lac. The my:Optima Secure Lite plan covers hospital expenses, day care procedures, pre- and post-hospitalisation services and other benefits as mentioned in the policy. It also comes with features like automatic unlimited restore, cumulative bonus and preventive health check-ups on renewal to ensure you get access to quality healthcare without any compromise. This plan is an ideal for people living in 2 tier and 3 tier cities looking for comprehensive coverage at affordable premiums.
You can opt for the two available options
my:Optima Secure Lite gives you the freedom to choose a base sum insured of 5 lac or 7.5 lac ensuring comprehensive coverage at affordable premiums.
Encompasses all day care procedures
All Modern Treatments and Robotic Surgeries are covered up to Sum Insured under this plan.
Avail unlimited restore for a policy year
Instant addition of 100% of Base SI upon complete or partial utilization of Sum Insured.
Keep track of your health status
Avail of annual health check-ups after completion of 1st policy year on both individual and family floater plans.
You can choose the below options while creating wholesome protection for you and your family with my:Optima Secure Lite plans.
You can work out a lower premium for the base sum insured you choose by choosing to pay a little during your claim settlements. With my:Optima Secure Lite you can avail up to 40% discount on your premium with the deductible amount mentioned in your policy.
By paying a little extra on your premiums you can be secured for coverage for 68 Non-Medical expenses listed by IRDAI so that your claims are paid to the last penny. Items like nebulizer kits, gloves, masks and others will be included in your claims.
To ensure comprehensive protection in the years that follow, you can opt for Plus Benefit where your base sum insured doubles post 2 policy Years. You can opt for this benefit during inception or renewal.
Get more protection with the promise of my:Optima Secure Lite plan
This feature promises a lump sum payout to the policyholder in case of accidental death, or permanent or partial disability for a nominal increase in the premium providing IPA Rider 5 times the base plan sum insured max. up to INR 1 Crore.
This add-on feature provides an integrated cashless OPD healthcare solution where you can get unlimited in-clinic & tele consults with networked GPs, home sample collection, unlimited access to fitness classes and more. You can avail of these features exclusively through Here. app.
For a little increase in your premium, you can get a lump sum payout on diagnosis of any of the listed 51 critical illnesses including various types of cancers, stroke, paralysis and more.
Essential Coverage Benefit
Unlimited Restore Benefit
Savings on your premiums
Backed by the trust of #1.6 crore+ happy customers over the past 18 years. At HDFC ERGO, we consistently strive to make insurance affordable, easier and dependable. Here, promises are kept, claims are fulfilled and lives are nurtured with utmost commitment.
Choose your preferred base sum insured
my:Optima Lite, is the latest addition to our health insurance lineup, designed to deliver accessible and effective coverage. This new-age health insurance plan comes with an option to choose from two base sum insured – 5 lac & 7.5 lac. It is thoughtfully designed to ensure comprehensive health coverage for an adequate base sum insured.
For your preferred base sum insured plan, you get extensive coverage for hospital expenses and other benefits as mentioned in the plan.
100% increase in coverage after 2 Years
We love the fact that you are choosing us to be your partner on your health journey. And, hence we would love to reward you for your trust and loyalty by offering a 50% increase in base cover at first renewal and a 100% increase post-2nd-year renewals irrespective of any claims made.
When Mr Sharma renews his Optima Secure Health Insurance Plan for 1 year, Plus Benefit increases his base cover of ₹10 lacs by 50% and in 2nd year by 100%, making it ₹15 lacs and ₹20 lacs respectively. Plus benefit and secure benefit together takes the total coverage to ₹30 lacs.
100% Restore Coverage~
Optima Secure plan restores up to 100% of your base sum insured for subsequent claims, for any illness or accidental hospitalisation. This benefit comes in handy when you exhaust your existing sum insured due to one or several claims.
Imagine a situation where Mr. Sharma claims partial or total ₹10 lacs base cover, it gets 100% restored, making it ₹30 + ₹10= ₹40 lacs. So, he does not have to limit his claims to ₹10 lacs base cover or ₹20 lacs secure benefit, he will get an additional ₹10 lacs as a restore benefit to settle claims.
Zero Deductions on Non-medical expenses'*
It is the non-medical expenses that really end up burning a hole in your pocket. Well, we have got your back. Go cashless with our my:Optima Secure health plan which has an in-built coverage for listed non-payable items like gloves, masks, food charges, and other consumables during hospitalisation. Usually, these disposable items are not covered by insurance policies or offered as an optional cover at an additional cost. However, with this plan, all your expenses for 68 listed non-medical items that are commonly used during hospitalisation are covered at no extra premium.
During hospitalization, his non-medical expenses that add up to 10-20% of the total bill amount also get covered by Protect Benefit. With Optima Secure plan you can rest assured that as many as 68 non-medical expenses will be taken care of. Mr. Sharma won't have to shell extra pennies for these non-medical expenses. Items like disposables, consumables, and non-medical expenses such as gloves, food charges, diapers, belts, braces etc will all be covered under this plan.
No restriction on procedures
Cost for advanced medical treatments or surgeries taken under general or local anesthesia completed within 24 hours are covered. The plan also covers all modern treatments and robotic surgeries excluding cosmetic & experimental procedures.
One can get coverage up to the base sum insured for daycare procedures.
The plan covers medicines, investigative treatments and diagnostic procedures along with surgeon, anaesthetist, medical practitioner, consultants, specialist fees along with other expenses as mentioned in the policy.
Instead of the 30&90 days availed normally, get 60 & 180 days of pre and post-hospitalisation medical expenses covered for seamless recovery.
Medical treatments or surgeries taken under general or local anaesthesia completed within 24 hours are covered under this plan. All modern treatments and robotic surgeries are covered upto Sum Insured under this plan, except for cosmetic or experimental procedures.
The plan covers the cost of the organ donor’s hospitalization for harvesting of the donated organ where an insured person is the recipient.
Respecting your belief in alternate medicine we cover medical expenses for inpatient care* under Ayurveda, Yoga & Naturopathy, Unani, Siddha, Homeopathy in an AYUSH hospital where the stay exceeds 24 hrs.
If prescribed in writing by the treating medical practitioner medical expenses incurred for availing medical treatment at home is covered if the insured cannot be moved/admitted to a hospital or due to non-availability of room in a hospital.
If admitted in a network hospital on shared accommodation for more than 48 hrs, the plan entitles the insured to a fixed daily cash amount for out-of-pocket expenses. It can go up to INR 800 per day max. up to INR 4800.
Under the my:Optima Lite plan road ambulance charges are covered and air ambulance charges up to 5 lac per hospitalisation can be claimed.
We provide a second opinion from our panel, for a listed critical illness suffered during the policy year. This benefit can be availed only once in a policy year. It is available for each insured person in case the policy is issued on a floater basis.
This plan provides unlimited instant addition of 100% of base SI upon complete or partial utilization of the sum insured. The restored amount shall be available only for subsequent claims that may arise during the remainder of the policy year for the same or different illnesses or persons covered under the policy.
Please read the policy wordings, brochure and prospectus to know more about my Optima Secure Lite.
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.
We do not cover expenses for treatment directly arising from or consequent upon any insured person committing or attempting to commit a breach of law with criminal intent.
War can be disastrous and unfortunate. However, our health insurance plan does not cover any claim that is caused due to wars.
We do not cover expenses incurred towards treatment in any hospital or by any Medical Practitioner or any other provider specifically excluded by the Insurer. (Contact us for list of de empanelled hospital)
We understand that treatment towards congenital external disease is critical however, we do not cover medical expenses incurred for Congenital external diseases defects or anomalies.
(Congenital diseases refer to birth
defects).
Treatment for Alcoholism, drug or substance abuse or any addictive condition and consequences thereof remains uncovered.
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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.
Fill up the pre-auth form at the network hospital for cashless approval
Once hospital intimates us, we send you the status update
Hospitalisation can be done on the basis of pre-auth approval
At the time of discharge, we settle the claim directly with hospital
You need to pay the bills initially and preserve the original invoices
Post hospital discharge send us all your invoices and treatment documents
We verify your claim related invoices and treatment documents
We send the approved claim amount to your bank account.
In an Multi-Individual Policy, a maximum of 6 adults and a maximum of 6 dependent children can be included in a single policy on individual sum insured basis. List of relationships which can be included is mentioned below:
• Spouse
• Son
• Daughter
• Father
• Mother
• Father-in-law
• Mother in-law
• Daughter-in-law
• Son-in-law
• Grandfather
• Grandmother
• Grandson
• Granddaughter
• Brother
• Sister
• Sister-in-law
• Brother-in-law
• Nephew
• Niece
In a family floater policy, a maximum of 4 adults and a maximum of 6 dependent children can be included in a single policy on floater Sum insured basis. The 4 adults can be a combination of self, spouse, parents and parents-in-law.
The Sum Insured options available under Optima Lite Plan in Lacs are 5Lac & 7.5Lac only
In the Family floater option, the eldest member of the particular family composition will pay full premium as per the individual premium based on his/her respective age. Thereafter, a floater discount of flat 55% will be applied on the individual premiums of every additional member excluding the eldest member in the Policy.
Premiums in this product are calculated on specific age basis rather than age band basis. Hence there will be a marginal increase in premium every year. This will help to avoid situations of sudden premium jump when age band changes in band wise premiums approach. Such jumps are steep and seen especially at higher ages.
Discount of 7.5% shall be provided if a policy is purchased for 2-year policy tenure and the premium is paid in advance as a single premium. Discount of 10% shall be provided if a policy is purchased for 3-year policy tenure and the premium is paid in advance as a single premium.
Automatic Restore Benefit is an in-built benefit in our Optima Lite Plan. It triggers upon partial or complete exhaustion of sum insured in a policy year. An amount of up to 100% of base sum insured is provided under this benefit. This amount shall be made available only for subsequent claims that might arise during the remainder of the policy year. Restorations of up to sum insured shall be provided unlimited times in a policy year and every time a claim is paid.
Automatic Restore Benefit (unlimited times) triggers every time upon partial or complete exhaustion of sum insured in a policy year by way of an admissible claim.
Yes, Automatic Restore Benefit can be availed for the same illness and for the same person as well.
No. The amount restored shall be made available only for subsequent claims that might arise during the remainder of the policy year. If not utilized, this amount shall not be carried forward to subsequent policy years.
Yes. A single claim in the policy year shall never exceed the cumulative addition of
• Base sum insured (in monetary terms at the start of the year)
• Cumulative Bonus (if applicable and remaining during the policy year),
• Plus Benefit (if applicable and remaining during the policy year)