Hospitalization Expenses
Hospitalization Expenses
Just like every other health insurance plan, we also cover your hospitalization expenses such as room rent, ICU, investigations, surgery, doctor consultations etc due to illnesses and injuries seamlessly.
Mental Healthcare
We believe mental healthcare is just as important as hospitalization due to physical illness or injury; hence, we cover hospitalization expenses incurred for treating mental illnesses.
Pre & Post Hospitalisation
It means all your pre hospitalization expenses up to 60 days before the date of admission and post-hospitalization expenses up to 180 days after discharge from the hospital are covered.
Day Care Treatments
Medical advancements help in wrapping up important surgeries and treatments in less than 24 hours, and guess what? We cover you for that as well.
Home Healthcare
Cashless Home Healthcare for medically necessary treatment of Illnesses, if prescribed by treating medical practitioner.
Sum Insured Rebound
This benefit adds to the Sum Insured, an amount equivalent to the claim amount, up to basic sum Insured, on subsequent Hospitalization.
Organ Donor Expenses
Organ donation is a noble cause and we cover the medical and surgical expenses of the organ donor while harvesting a major organ from the donor’s body.
Recovery Benefit
If you stay in a hospital for more than 10 days at a stretch, then we pay for other financial losses. It helps to take care of other expenses during your hospitalization.
AYUSH Benefits
Let your belief in alternate therapies like Ayurveda, Unani, Siddha, and Homeopathy stay intact as we cover hospitalization expenses for AYUSH treatment as well.
Preventive Health Check-up
We care for your well-being and hence we offer preventive health check-up at renewal.
Lifelong Renewability
Once you get yourself secured with, our health insurance plan there is no looking back. Our health plan continues to secure your medical expenses for your entire lifetime on break free renewals.
Multiplier Benefit
If there is no claim in the first year, in the next policy year, the sum insured will grow by 50%. It means, instead of ₹ 5 Lakh, your sum insured would now stand at ₹ 7.5 Lakh for the second year.
👉Sum Insured Options: ₹5 lakh to ₹2 crore
👉 Secure Benefit: Instantly doubles your base sum insured from Day 1 at no extra cost.
👉 Plus Benefit: Boosts your base cover by 50% on the first renewal and 100% on the second renewal—taking your coverage to 3X the base sum insured.
👉 Restore Benefit: Automatically restores 100% of the base sum insured if it gets exhausted within a policy year.
👉Protect Benefit: Covers 68 non-medical and consumable items like gloves, masks, and food charges during hospitalization.
👉Pre- & Post-Hospitalization: Expenses covered for 60 days before admission and 180 days after discharge.
👉Day-Care & Domiciliary Treatment: Unlimited coverage for procedures not requiring 24-hour hospitalization, and for home-based treatments.
👉No Room Rent Limit: Freedom to choose any hospital room without restrictions.
👉No Disease Capping: No sub-limits on specific illnesses.
· Ambulance Coverage:
👉 Road ambulance – covered up to sum insured
Air ambulance – up to ₹5 lakh
👉 E-Opinion: Expert medical opinions available for 51 critical illnesses.
👉Organ Donor Expenses: Covered up to the sum insured.
👉AYUSH Treatments: Alternative medicine (Ayurveda, Yoga, Unani, Siddha, Homeopathy) covered up to the sum insured.
👉Preventive Health Check-Ups: Provided free of cost on renewal.
👉Daily Cash Benefit: ₹800 per day (up to ₹4,800) for hospitalization in shared accommodation.
👉30 days: For general illnesses (accidents covered from Day 1).
👉 24 months: For specific listed illnesses and procedures.
👉 36 months (3 years): For pre-existing diseases.
Exclusions include:
👉Injuries from adventure sports
👉Self-inflicted injuries
👉Claims due to war, riots, or criminal acts
👉Deductible Option: Choose a deductible (₹25,000 – ₹1,00,000) to reduce premiums by 25% to 50%.
👉Loyalty Discount: 2.5% discount if you already hold another HDFC ERGO retail policy.
👉Optional Add-Ons:
o Unlimited restore
o Outpatient benefits
o Hospital cash rider
o Personal accident protection
o Wellness & lifestyle benefits
👉Optima Secure Global: Covers hospitalization in India plus emergency medical treatment abroad.
👉 Optima Secure Global Plus: Includes both emergency and planned treatments abroad.
👉Both variants retain all core benefits (Secure, Plus, Restore, Protect) for India.
👉Up to 4X coverage enhancement through Secure, Plus, and Restore benefits.
👉Covers non-medical expenses (a rare feature among health insurance plans).
👉Comprehensive protection without room rent or disease caps.
👉Option to extend coverage internationally with Global and Global Plus variants.
👉 This plan is designed for individuals and families seeking a comprehensive health insurance solution with high coverage flexibility and added protection against out-of-pocket hospital expenses.