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HDFC ERGO My Health Suraksha

HDFC ERGO has presented a unique and robust health insurance plan, My Health Suraksha, which is suitable for individuals, families, and even senior citizens for their medical emergencies. Apart from the basic and common covers that a comprehensive health insurance plan provides, this plan offers many exclusive benefits such as recovery benefits, infertility cover, mental healthcare, etc. This is a flexible plan that can be customized according to the needs of the customers. To know more about the plan in detail, have a look at the below mentions.

Eligibility Criteria

ParametersDetails
Entry age for the base cover

Proposer/Adult dependent:

Minimum – 18 years

Maximum – Lifetime entry

Dependent children:

Minimum – 91 days

Maximum – 25 years

Entry age for optional cover

Proposer/Adult dependent:

Minimum – 18 years

Maximum – Lifetime entry

Parent & Child Care Cover – Basic &

Booster – Entry Age Up to 45 Years

Dependent children:

Minimum – 91 days

Maximum – 25 years

Entry age for my health Critical Illness Add on

Proposer/Adult dependent:

Minimum – 18 years

Maximum – 65 years

Type of policyIndividual and Family Floater
Variants

Silver Smart

Gold Smart

Platinum Smart

Who can be covered

Individual sum insured option – Proposer, spouse, dependent children, dependent parents/in-laws, grandmother, grandfather, granddaughter, grandson, sister, brother, sister-in-law, brother-in-law, daughter-in-law, son-in-law, nephew, and niece.

Floater sum insured option – Self, spouse, dependent children, and dependent parents/in-laws.

Policy period1 year, 2 years, and 3 years
RenewabilityLifelong
Sum insured optionsRs. 3 lakhs to Rs. 75 lakhs
Premium tier

Tier 1 – Delhi and NCR region

Tier 2 – Mumbai, Mumbai Suburban and Navi Mumbai, Pune, Surat, Ahmedabad, Vadodara

Tier 3 – Rest of India

Premium payment optionsAnnually, half-yearly, quarterly, and monthly

HDFC ERGO My Health Suraksha Coverages

This plan is everything that you need to have for securing and protecting the health of yourself and your beloved ones. The details of the plan have been discussed in the following table.

Parameters

Silver Smart plan

(Basic sum insured Rs. 3 Lakhs/4 Lakhs/5 Lakhs)

Gold Smart plan

(Basic sum insured Rs. 7.5 Lakhs/10 Lakhs/15 Lakhs)

Platinum Smart plan

(Basic sum insured Rs. 20 Lakhs/25 Lakhs/50 lakhs/75 Lakhs)

Medical expenses, mental healthcare, home health care, domiciliary hospitalization, day care procedures, AYUSH treatment, organ donor expenses,Covered
Sum insured rebound (allows you to recharge your exhausted health cover to treat the next hospitalization for a new ailment or disease)Covered
Room rent and ICUAt actuals
Pre-hospitalization expensesUp to 60 days
Post-hospitalization expensesUp to 180 days
Road ambulance cover

Sum insured Rs. 1 Lakh to Rs. 5 Lakhs

– Rs. 2000

Sum insured Rs.6 Lakhs to

Rs. 50 Lakhs – Rs. 3,500

Sum insured Rs. 6 Lakhs to Rs. 50 Lakhs

– Rs. 3,500

Above Rs. 50

Lakhs – Rs. 15,000

Air ambulance coverNot coveredUp to Rs. 2 lakhsUp to Rs. 5 lakhs
Recovery benefitRs. 5000Rs. 15,000Rs. 25,000
Cumulative bonus

10% at each claim

free year, subject to a maximum of 100%

10% at each claim

free year, subject to a maximum of 100%

25% at each claim

free year, subject to a maximum of 200%

Free Renewal Health Check-upWithin 60 days after policy renewal
Pre-policy medical check-upNot required if you are below 45
my: Health Critical Illness Add onOptional
my: health Hospital Cash Add-on

Rs. 1000, Rs. 2000

per day

Rs. 3,000, Rs. 5,000

per day

Rs. 3,000, Rs. 5,000,

Rs. 7,500 per day

Preventive Health Check Up Booster, and my: Health ActiveCovered
Waiting period

Pre-existing diseases – 48 months

Specified Disease/Procedure – 24 months

Parent & Child Care Cover – Booster – 48 months

Accidents, and enhanced sum insured – 30 days

Room Rent Modification Option

Room Rent, boarding & Nursing – 1% of the Basic Sum Insured, maximum of Rs. 5,000 per day

ICU – 2% of the Basic Sum Insured, maximum of Rs. 10,000 per day

Wellness services, health coachAvailable
Discounts

Family discount – If 2 or more members are covered under an Individual Sum Insured policy, then you are eligible for a 10% discount

Loyalty discount – If you buy more than 1 policy from HDFC ERGO, a loyalty discount of 2.5% is offered on this policy.

Long-term policy discount – If you buy this policy for the policy term of 2 and 3 years with the Annual Premium Payment option, you can avail of a discount of 7.5% and 12.5% respectively, on the premium amount.

Tax exemption benefitApplicable as per Section 80D of the Income Tax Act, subject to a maximum limit of Rs. 75,000.
Optional benefits
Parent and Child Care Cover Booster

Normal delivery – Up to Rs. 15,000

C section delivery – Up to Rs. 25,000

And

Normal delivery – Up to

Rs. 25,000

C section delivery – Up to Rs. 40,000

Normal delivery – Up to Rs. 15,000

C section delivery – Up to Rs. 25,000

And

Normal delivery – Up to

Rs. 25,000

C section delivery – Up to Rs. 40,000

Normal delivery – Up to Rs. 25,000

C section delivery – Up to Rs. 40,000

Termination limit – Up to Rs. 25,000

And

Normal delivery – Up to

Rs. 50,000

C section delivery – Up to Rs. 75,000

Termination limit – Up to Rs. 50,000.

Pre and Post Natal ExpensesUp to Parent Care Sum Insured
Maternity Expenses, child careCovered
Infertility TreatmentUp to 50% of Normal Delivery Sum Insured
New Born Baby CoverUp to Parent Care Sum Insured
Vaccination ChargesRs. 5000Rs. 5000Rs. 5000 and Rs. 15,000
Waiting Period Modification optionOptional – 3 years
Non-Medical Expenses coverOptional
Extended Cumulative Bonus

25% subject to a maximum of 200%.

50% subject to a maximum of 200%

25% subject to a maximum of 200%.

50% subject to a maximum of 200%

50% subject to a maximum of 200%.
Co-payment10% or 20%15% or 25%15% or 25%
Parent and Child Care Booster waiting period4 years

General Exclusions

Before buying an insurance plan, it is very important to know and understand the exclusions of the policy for which it does not offer any coverage to avoid any future problems. So, for your better understanding, here are the general exclusions of HDFC ERGO My Health Suraksha.

  • Expenses related to any preliminary diagnosis and evaluation procedure are excluded.
  • Any self-inflicted injury, suicide, or suicide attempt falls under the category of exclusions.
  • Diagnosis expenses not related to the current diagnosis and treatment are not covered by the plan.
  • If you are having bed rest and do not have any medical treatment for the disease, is not covered by the policy.
  • Any treatment cost related to obesity control will not be compensated by the policy.
  • Any unrecognized or unauthorized medical procedure is to be excluded and the doctor, surgeon, or medical practitioner has to be licensed and registered.
  • Coronary heart disease, severe sleep apnoea, and uncontrolled type 2 diabetes are excluded from the policy.
  • Any treatment or surgery related to gender treatment will not be reimbursed by the company.
  • Cosmetic surgery and plastic surgery are not covered by the plan.
  • If you take part in any kind of hazardous activities or adventurous sports like sky diving, para-gliding, scuba diving, etc., and gain injury from that, that is not covered by the plan.
  • Injury incurred due to the participation in any unlawful act, or due to war, war-like situation, riots, public unrest, etc will not be covered by the policy.
  • Treatments for the consumption of alcohol, drug, or any intoxicating substance are excluded.
  • The costs for dietary supplements and substances that can be purchased without a prescription, will not be compensated by the policy.
  • If you receive treatment for the correction of eye sight due to refractive error less than 7.5 dioptres, it will be under the exclusions.
  • Gestational Surrogacy and reversal of sterilization are excluded.

Premium Calculation of HDFC ERGO My Health Suraksha

Before going for any insurance policy, you need to check how much premium amount you need to pay for the chosen policy to find out its worth. For this policy, the premium calculation is very simple and easy. So, for your better understanding here is an example of it.

Suppose, Mr. Sinha a 36-years-old businessman has bought HDFC ERGO My Health Policy for himself. Let us find out, how much he has to pay as the premium amount for opting for different policy period options, for the given details.

Proposer same as insuredPolicy typeAgeSum insuredAll India coverPolicy periodPremium amount excluding taxes
YesIndividual sum insured36 yearsRs. 5 lakhsYes1 yearRs. 10,271
2 yearsRs. 19,001
3 yearsRs. 26,962

Frequently Asked Questions

No, the plan is only available for the geographical jurisdiction of India.

No, the company will pay the expenses of the pre-policy medical check-ups only if you have done the check-ups from a network diagnostic center of the company. But, if your policy is rejected due to your adverse medical conditions of yours, then 50% of the cost of the pre-policy check-up will be deducted from the premium refund amount.

No, OPD (Out Patient Consultation) is not covered by the policy.

The health coach will provide you with the following services, which are only available through the mobile app of HDFC ERGO:

  • Activity and fitness
  • Nutrition
  • Weight management.
  • Psychological Counselling
  • Depression Counselling

The listed tests are – Chest X-Ray, 2D Echo/ Stress test, PSA for Males, PAP smear for Females, Medical Examination Report, Complete Blood Count Urine R, Fasting Blood Sugar, Serum Creatinine, Lipid Profile, and Electro Cardio Gram.

Yes, a fitness discount is available with this policy for an adult person only, when you renew the plan. Here is the discount rate.

No. of Healthy Weeks Accumulated

Discount on Renewal Premium

1-4

0.50%

5-8

1%

9-12

2%

13-16

3%

17-26

6%

27-36

7.50%

Above 36

10%

 

No, the costs of spectacles, contact lenses, and hearing aids are not covered by the policy.

5/5 - (2 votes)