HDFC ERGO Health Insurance Benefits: Plan Inclusions & Exclusions

Top Features From HDFC ERGO Health Plans

Key features of HDFC Ergo health insurance plans

A range of health insurance policies is issued by the company. You can buy a policy to cover yourself, your family members and also dependent senior citizen parents
Critical illness policy is also offered by the company which covers a list of critical illnesses and pays a lump sum benefit on their diagnosis
Personal accident plans are also available which cover accidental injuries and pay a lump sum benefit at the time of claims
All health plans offered by the company allow lifelong renewals
There are optional coverage benefits too which can be added to your policy for a more inclusive scope of cover

Benefits of HDFC Ergo medical insurance plans

The company offers you round the clock assistance for your grievances and product related queries
90% of the pre-authorised cashless claims which are made under HDFC Ergo health insurance plans are approved by the company within 20 minutes. This ensures that your claim settlement is easy and quick
HDFC Ergo health insurance plans offer the facility of a Wellness Application which can be downloaded on your Smartphone. This application helps you lead a healthy lifestyle and also rewards you for doing so
HDFC Ergo medical insurance policies are issued online without the need of lengthy paperwork. This makes buying the policies an easy affair
The company has a network of more than 10,000 hospitals across India to cater to cashless claim settlements

Coverage benefits

Inpatient hospitalisation expenses which include the cost of room rent, doctor’s fee, nurse’s fee, treatment costs, etc.
Pre hospitalisation expenses
Post hospitalisation expenses
Daycare treatments
Cost of road ambulance
Domiciliary treatments which are taken at your home
Organ donor treatments where the cost of harvesting the organ is covered
Free health check-ups at specified intervals during the policy

Pre-existing illnesses are not covered from the start of the policy. They are covered after a specified waiting period
Illnesses incurred within the first 60 to 90 days of buying the policy are not covered
Pregnancy-related costs and expenses are not covered unless they are specifically included in the plan’s coverage benefits
Cosmetic treatments, LASIK surgery, dental treatments, etc. are not covered
Unproven and experimental treatments are not covered
Self-inflicted injuries and attempted suicides are excluded from coverage
Injuries or illnesses due to war, radiation, nuclear contamination, etc. are not covered
Participation in defence-related activities or any other hazardous activities would not be covered
HIV/AIDS and other sexually transmitted illnesses are not covered

HDFC ERGO Premium Calculator

Use the HDFC ERGO health insurance premium calculator to estimate your health insurance premiums.

Premium Calculator

Enter just a few details to calculate your health insurance premium within 30 seconds.

Know More About HDFC ERGO Health Insurance

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FAQs

If you already have existing health insurance coverage and are looking to increase it without paying expensive premiums, you can choose top-up and super top-up health insurance plans. These plans have a deductible and a sum insured. Claims above the deductible limits are paid and so the premiums are low. When you have existing coverage, you can choose a deductible matching the existing plan’s sum insured so that any excess claim would be paid by the top-up or super top-up plan

You can get numerous tax benefits when you buy a health insurance plan. These benefits are allowed under Section 80D of the Income Tax Act, 1961 and are as follows

Premiums paid for a plan covering you, your spouse and dependent children would be allowed as a deduction up to INR 25,000
If you are a senior citizen, the deduction limit would increase to INR 50,000
Premiums paid for a plan covering your dependent parents would be allowed as an additional deduction for up to INR 25,000
If your parents are senior citizens, the deduction limit would increase to INR 50,000
If you buy two policies, one for yourself and your family and the other for your parents, you can claim a deduction of up to INR 50,000. If you or your parents are senior citizens, the limit increases to INR 75,000. If both you and your parents are senior citizens, the limit would be INR 1 lakh

Yes, a free-look period of 15 days is allowed from the date of policy issuance under HDFC Ergo health insurance plans. During this period you can cancel the policy if you want and avail the refund of the premium paid

The claim process of HDFC Ergo health insurance plans has been explained earlier. You need to intimate the insurance company of your claim and then follow the above-mentioned steps to get the settlement of your claims faster

You can buy HDFC Ergo health insurance plans online either from the website of the company or from Turtlemint itself. When you buy through Turtlemint, you can compare HDFC Ergo’s plans with other health insurance plans and then choose the best one. The process of buying the policy has been explained earlier above

HDFC Ergo’s health insurance plans do not cover specific illnesses and treatments some of which include the following

Self-inflicted injuries
Cosmetic treatments
Congenital illnesses
HIV, AIDS and venereal diseases
Pre-existing conditions during the waiting period
Injuries suffered due to war or nuclear perils
Unproven or experimental treatments, etc.

There are online premium calculators offered both by HDFC Ergo as well as by Turtlemint which allows you to calculate the premium of HDFC medical insurance plans. You can enter the relevant details which affect the premium calculation and find the premium rates. These details include the following

Age
Sum insured
Number of members to be covered
Medical history
Pre-existing illnesses
Term of the plan
Add-ons if needed

Based on these factors, the premiums would be calculated and displayed

A health card is issued for all insured members when you buy HDFC Ergo health insurance plans. This health card is needed at the time of cashless claims as the card contains a unique customer identification number. When you are admitted to a networked hospital, you need to present the health card to avail cashless treatments. Thus, you should get a health card from HDFC Ergo health insurance

HDFC Ergo is a leading name in the general insurance segment and its health insurance plans are comprehensive plans at affordable premiums. The company offers a range of health insurance plans for your coverage needs and you can find a suitable policy easily. The plans offered by the company offer optimal coverage levels and benefits and are also light on your pockets. So, HDFC Ergo health insurance is a good choice for your health insurance needs.