HDFC ERGO Health Insurance Plans

HDFC ERGO Health Insurance is a very big name in the Indian health insurance industry. The company is one of the oldest private health insurance providers in the country. It is also one of the most trusted and reliable health insurers. The company has a wide variety of medical insurance plans to offer. The plans are economically priced, and so finding an ideal cover becomes very easy. HDFC ERGO Health Insurance has a very strong online presence, and so one can buy, renew and service their health insurance plans online in a smooth and convenient manner.

Benefits of HDFC ERGO Health Insurance Plans

When you buy a health insurance plan from HDFC ERGO, you get the following benefits:

Easy Online Access

HDFC ERGO Health Insurance has a very good and helpful website. You can buy your health plans online, after reading about them. You can also renew the plans online. Additionally, you can also initiate a claim online. And finally, you can contact customer care online as well. These digital benefits make HDFC ERGO a very good health insurance provider to get associated with.

Lifetime Renewability

Once you buy a good health insurance policy from HDFC ERGO Health Insurance, you can stay insured for the rest of your life, or for as long as you wish. The company offers the benefit of lifetime renewal on most of the health insurance plans.

No Limit on Upper Entry Age

Most of the HDFC ERGO Health Insurance plans allow people of all ages to get enrolled in the policies. If you have old parents, you can get them covered under the family floater health insurance plans without any troubles whatsoever. The company also offers dedicated senior citizens health insurance plans, which help people over the age of 60 to stay covered. 

Cover for Organ Donation

If you undergo an organ donation or restoration process, you can make a claim on the HDFC ERGO Health Insurance policy that you have.

Easy Claim Process

The claim process is very simple. You can opt for the cashless claims in any of the network hospitals. It is a simple and hassle-free process and the claims get settled very quickly. You can also opt for the reimbursement claim system and get your amount reimbursed in a simple manner.

No Claim Bonus

The company offers a no-claim bonus if you do not make claims in a particular policy period. You can get a handsome discount on the premium of the next policy tenure as a result of this.

Approachable Customer Care

HDFC ERGO has a very efficient customer care service. The executives are customer-friendly and are proactive in their service. In case of a query, a concern or a complaint, you can either speak or write to the customer care and an executive will soon get in touch with you. 

Tax Benefits

The premium that you pay towards your HDFC ERGO health insurance plan can be claimed for tax benefits under Section 80D of the Income Tax Act, 1961.

Installment Benefit

Various HDFC ERGO health insurance plans are made all the more affordable as they come with the option of payment in instalments. Depending on your budget you can pay your health insurance premium on a monthly, quarterly, half-yearly and yearly basis.

Cashless Hospitals

With HDFC ERGO health insurance, you get the advantage of getting treated in a network hospital. Network hospitals have a collaboration with the company and thus, offer you a cashless treatment. Such a treatment can save you the anxiety of raising money for a treatment at the last minute.

With these benefits in place, you do get a lot of value out of an HDFC ERGO Health Insurance plan.

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What is Covered? 

If you are wondering what covers you can get when you buy a health plan from HDFC ERGO, you can take a look at the points mentioned below:

  • Cover for Critical Illness – You get coverage for critical illnesses under many of the HDFC ERGO Health Insurance plans. There are also some plans that exclusively offer coverage against a list of critical illnesses such as cancer and stroke, among others.  
  • All Medical Expenses Covered – All medical expenses such as inpatient care, pre and post-hospitalisation, pharmacy bills, ambulance bills, physicians’ fees, etc are covered under the comprehensive health plans from HDFC ERGO Health Insurance. If you need to get admitted to a hospital following an accident or ailment, you can expect to get wholesome coverage under the media CIM plan you have. 
  • Alternative Treatments Covered – If you wish to get treated under alternative forms of medicine such as homoeopathy or AYUSH, you can make a claim on your HDFC ERGO Health Insurance plan.
  • Maternity Expenses Covered – Many of the maternity health insurance plans from this insurance provider have provisions for maternity expenses, including the delivery costs and newborn costs.
  • Mental Illnesses Covered – Mental illnesses are covered under any of the health insurance policies offered by HDFC ERGO Health Insurance.
  • Accidents Covered – You can get coverage for injuries arising out of accidents. These include death and disability benefits as well.
  • Daycare Procedures Covered – If you need to get admitted to the hospital for just a few hours and get a daycare procedure such as cataract or dialysis done, you can make a claim on your HDFC ERGO Health Insurance plan.
  • Domiciliary Health Care Covered – You get coverage for home health care needs such as physiotherapy, the services of a full-time nurse, etc.
  • No Medical Tests – When you invest in an HDFC ERGO health insurance plan before turning 45, you do not need to undergo a pre-policy medical screening.
  • Free Health-checkups – The company also offers preventive health check-ups for free. This can greatly help in diagnosing any hidden ailment and finding a cure as soon as possible.
  • Recovery Benefit – If your stay in the hospital was for more than 10 consecutive days, you will receive a recovery benefit. This amount can help in recovering from the financial losses that you have had to bear because of your hospitalisation.
  • Cumulative Bonus –  In case you did not make  a claim during the entire policy year, you would be rewarded for maintaining good health. You can avail of an additional 10% to 25% sum insured upto a limit of 200%. The bonus depends on the kind of policy that you have opted for.

These are the handy covers you get when you purchase a good and comprehensive medical insurance policy from HDFC ERGO Health Insurance.

What is not Covered? 

Along with the inclusions, there are some exclusions seen in the HDFC ERGO health plans. They are:

  • No claim is paid if the injury or illness happens as a result of self-harm or attempted suicide
  • No claim is given if the policyholder sustains injuries or ailments due to drug, alcohol, tobacco or any other substance abuse
  • No claim is paid if the ailment arises out of a preexisting condition before the waiting period ends
  • No claim is paid if the injuries are sustained while taking part in an adventurous or hazardous sport such as bungee jumping or premium paragliding
  • No claim is paid if the injuries happen due to participation in any illegal activity
  • No claim is paid for dental procedures, including dental surgeries and complications resulting from those
  • No claim is paid out for cosmetic treatments or surgeries such as implants, nose jobs, etc
  • No-claim is paid for accidents in defense operations

You should remember the exclusions. They are clearly mentioned in your policy brochure. Read over the exclusions carefully before you buy the health plan of your choice from HDFC ERGO Health Insurance.

How to Get an HDFC ERGO Health Insurance plan? 

You can get an HDFC ERGO Health Insurance plan in the following ways:

  • From an Insurance Agent – Many people prefer buying health insurance from an insurance agent. You can buy the plan from an HDFC ERGO Health Insurance agent who will explain the features to you, help you with the payment process and also help you at the time of a claim. You will have to pay a brokerage amount to the agent for the service he provides.
  • From the Company’s Branch – Alternatively, you can also buy the health plan from the company directly. Just visit the branch of HDFC ERGO Health Insurance that is closest to you and make the purchase there.
  • Online – The HDFC ERGO Health plans are widely available online. You can buy them directly from the website of HDFC ERGO or from the website of any insurance aggregator. The steps to buying online plans are very simple and the plans are cheaper online as well.

As you can see, there are many ways in which you can get hold of an HDFC ERGO Health Insurance policy. Do your research and then buy the plan that is best suited for you.

The Renewal Process of HDFC ERGO Health Insurance Plans

Renewing your health insurance plan on time is of utmost importance. You need to stay insured without interruption. Thankfully, renewing the HDFC ERGO health plans is a very easy task to do. You can visit the official portal of the company and get the renewal done instantly. You can also do it offline by either handing the renewal check to your insurance agent or to the company directly.

The Claim Process of HDFC ERGO Health Insurance plans

There are two types of claims available here. You can either opt for the cashless claims or get your claim amount reimbursed:

  • Cashless Claim – To avail the cashless claim, you need to get admitted in a network hospital. You need to inform HDFC ERGO about your upcoming hospital stay at least 2 days before getting admitted. If you get admitted under an emergency situation, make sure the insurer is informed in less than 24 hours from the time of admittance. Submit the pre-authorization form to the hospital and they will contact the insurer and get the health insurance claim settled. 
  • Reimbursement – If you choose to go to a non-network hospital, you will have to pay the bill amount out of your own pocket at the time of discharge. Then, you need to submit the bill and the documents to HDFC ERGO and get the amount reimbursed.

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Here is a list of the papers you would need for the job:

  • Original hospital bill
  • Duly filled and signed claim settlement form
  • Copy of policy document
  • Discharge summary
  • Doctor’s prescription stating hospitalization is required
  • Original diagnostic test results
  • Doctors’ prescriptions
  • FIR, if there was an accident

Submit these documents and get the bill amount reimbursed.