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Individual Health Insurance Plans
HDFC ERGO Optima Secure Plan
HDFC ERGO has recently launched My: Optima Secure Plan, a magnificent health insurance policy that offers 4X coverage at no additional cost. This plan can be opted as an individual plan and also as a family floater policy that provides its customers multiple benefits and lucrative discounts. This plan has come up with a wide range of sum insured options to suit every person. This is an incredible customer-friendly, flexible health plan that only offers a sack full of benefits but also different profit benefits to save more and secure more.
|Minimum entry age||Dependent child: 91 days|
|Maximum entry age|
Dependent child: 25 years
Adults: 65 years
|Policy tenure||1 year, 2 years, and 3 years|
Individual – A maximum of 6 adults and a maximum of 6 children are allowed to be included in a single policy with a separate sum insured.
Family floater – A maximum of 4 adults and a maximum of 6 children are allowed to be included in a single policy under the same sum insured.
|Sum insured options||Rs. 5 lakhs, Rs. 10 lakhs, Rs. 10 lakhs, Rs. 15 lakhs, Rs. 20 lakhs, Rs. 25 lakhs, Rs. 25 lakhs, Rs. 50 lakhs, Rs. 1 crore, and Rs. 2 crores.|
|Tax exemption benefit||Available, under Section 80D of the Income Tax Act of India|
Initial – 30 days
Specific illnesses and surgical procedures – 24 months
Pre-existing diseases – 36 months
Key Details of HDFC ERGO Optima Secure Plan
This plan is a wonderful health policy presented by HDFC ERGO General Insurance that can offer you almost all possible benefits and facilities to secure you and your family financially in the case of any medical emergency. The key details of the policy are mentioned in the following table.
Sum insured less than Rs. 50 lakhs: Up to single AC private room
Sum insured Rs. 50 lakhs and above: All room types are covered
|Hospitalization expenses, AYUSH treatment, home health care, organ donor expenses, pre, and post-hospitalization expenses||Up to sum insured|
|Pre-hospitalization costs||Up to 60 days|
|Post-hospitalization costs||Up to 180 days|
|Secure benefit||100% of the base sum insured|
|Protect benefit||Up to sum insured|
|Plus benefit||Irrespective of claim status, on first renewal the base cover is increased by 50% after 1 year and 100% after 2 years|
|Restore benefit||Up to 100% of the base sum insured for any illness for any insured person|
|Emergency road ambulance cover||Up to sum insured|
|Emergency air ambulance cover||Up to Rs. 5 lakhs|
|Preventive health check-up||Yes, after the completion of every policy year, irrespective of your claim status|
|Daily cash for choosing shared accommodation||Rs. 800 per day subject to a maximum of Rs. 4800|
|E-Opinion for critical illnesses||Once per insured person for 51 defined major critical illnesses|
General Exclusions of HDFC ERGO Optima Secure Plan
To understand a plan thoroughly and to avoid future complexities, it is very important to know the exclusions of an insurance policy. So, for your better understanding, here are the general exclusions of the HDFC ERGO Optima Secure Plan.
- Investigation and evaluation purposes are excluded from the policy coverage.
- Any treatments or healthcare procedures related to obesity control are not covered.
- If you undergo any cosmetic surgery or plastic surgery, the expenses of that are not paid by the policy.
- If the insured person takes part in any kind of hazardous activity or adventurous sports that falls under the category of exclusions.
- Participation in any kind of illegal activity or unauthorized cats is not covered.
- If you need any medical treatments due to the consumption of alcohol, unauthorized drugs, or any intoxicating substances, the costs incurred are not covered.
- The policy does not compensate for any unproven treatments or unrecognized medical procedures.
- Maternity care and newborn child care expenses are not covered by the plan.
- The company does not take any responsibility for the treatments related to fertility and sterility.
Premium Calculation of HDFC ERGO Optima Secure Plan
When you want to buy an insurance plan, it is very important to find out the premium amount that you need to pay for the chosen policy so that you can plan your finances according to that. Hereby, for your clear understanding of the HDFC ERGO Optima Secure Plan, here is an example of premium calculation.
Suppose, Mr. Ray has bought a 36-years-old businessman has bought HDFC ERGO Optima Secure Plan for himself, his wife, and their daughter. Let us find out how much premium amount he has to pay for given details for choosing the different sum insured options.
|Age of the insured person||Age of his wife||Age of their daughter||Sum insured||Policy tenure||Premium amount including GST|
|36 years||34 years||4 years||Rs. 20 lakhs||2 years||Rs. 56,503|
|Rs. 25 lakhs||Rs. 58,867|
|Rs. 50 lakhs||Rs. 70,294|
Frequently Asked Questions
Whereas for other health insurance policies, there is a waiting period for accidental cases, but with HDFC ERGO Optima Secure Plan, there is no waiting period. You are eligible to file a claim for an accidental case, right after the inception of the plan.
If the policy is withdrawn in the future, the insured person will be sent an intimation about the same 3 months prior to the expiry of the policy on behalf of the policy. The insured person may migrate to a similar indemnity health insurance policy available with the insurer at the time of renewal with all the benefits. This is subject to the IRDAI guidelines related to the migration of an insurance policy.
This is a benefit option that helps you to increase your sum insured according to your need at a lower cost. The company will pay for any claim amount over and above the chosen deductible amount in a policy year and also in this way, you can down your premium amount by 50%. Here is the illustration.
|Deductible amount||Base sum insured up to Rs. 20 lakhs||Base sum insured above Rs. 20 lakhs|
|Rs. 1 lakh||50%||40%|
Yes, you can port with all accrued benefits at the time of renewal that is subject to the underwriting guidelines laid out by IRDAI for portability. In that case, you can avail of the benefits of the plan, after a certain waiting period.
What is the protection benefit of HDFC ERGO Optima Secure Plan?
It is an in-built benefit that offers coverage for non-medical expenses such as gloves, masks, food charges, and other consumables during hospitalization. Under this plan, there are 68 listed non-medical items that are covered.
Yes, this plan offers coverage for various support devices such as a cervical collar, braces, belts, etc.