Health Insurance HDFC ERGO Health Insurance My Health Suraksha Plan

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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

Parameters	Details
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 policy	Individual 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 period	1 year, 2 years, and 3 years
Renewability	Lifelong
Sum insured options	Rs. 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 options	Annually, 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 ICU	At actuals
Pre-hospitalization expenses	Up to 60 days
Post-hospitalization expenses	Up 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 cover	Not covered		Up to Rs. 2 lakhs		Up to Rs. 5 lakhs
Recovery benefit	Rs. 5000		Rs. 15,000		Rs. 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-up	Within 60 days after policy renewal
Pre-policy medical check-up	Not required if you are below 45
my: Health Critical Illness Add on	Optional
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 Active	Covered
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 coach	Available
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 benefit	Applicable 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 Expenses	Up to Parent Care Sum Insured
Maternity Expenses, child care	Covered
Infertility Treatment	Up to 50% of Normal Delivery Sum Insured
New Born Baby Cover	Up to Parent Care Sum Insured
Vaccination Charges	Rs. 5000	Rs. 5000		Rs. 5000 and Rs. 15,000
Waiting Period Modification option	Optional – 3 years
Non-Medical Expenses cover	Optional
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-payment	10% or 20%	15% or 25%		15% or 25%
Parent and Child Care Booster waiting period	4 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 insured	Policy type	Age	Sum insured	All India cover	Policy period	Premium amount excluding taxes
Yes	Individual sum insured	36 years	Rs. 5 lakhs	Yes	1 year	Rs. 10,271
					2 years	Rs. 19,001
					3 years	Rs. 26,962

Frequently Asked Questions

1. Can I avail of the HDFC ERGO My Health Suraksha plan outside India?

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

2. Do I have to pay the expenses of the pre-policy medical check-ups for this policy?

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.

3. I have done an outpatient consultation. Will My Health Suraksha plan cover that?

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

4. What does a health coach do?

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

5. What tests can I do with the facility of preventive health check-up booster of this policy?

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.

6. Is there any fitness discount available under this policy?

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%

7. Are the expenses of spectacles provided by the policy?

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

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