HDFC ERGO Health Insurance 2026 – Optima Plans & Premiums

What Is Covered Under HDFC ERGO Health Insurance?

• Domiciliary hospitalisation
• Day-care procedures
• Hospitalisation due to accidents
• Pre-existing diseases (after the waiting period)
• Maternity and newborn baby benefits
• In-patient hospitalisation expenses
• Pre & post-hospitalisation expenses
• Ayurvedic treatments

Types of Health Insurance Policies by HDFC ERGO

Listed here are the health insurance policies offered by HDFC ERGO.

1. Medisure Classic
2. Health Suraksha Silver
3. Health Suraksha Silver with Regain & ECB
4. Health Suraksha Gold
5. Health Suraksha Gold with Regain & ECB
6. HDFC ERGO Critical Illness Silver
7. HDFC ERGO Critical Illness Platinum

HDFC ERGO Optima Secure Health Insurance Plans

HDFC ERGO my: health Medisure Classic Health Insurance Policy

• Basic sum insured per policy year: Individual Policies: Rs.1 lakh to Rs.5 lakh Floater Policies: Rs.2 lakh to Rs.5 lakh
• Cashless hospitalization: In authorized hospitals in the 6000+ network across India

• Basis: Individual and family floater
• Policy term: 1 or 2 years
• Cumulative bonus: Cumulative bonus of 5% for each year that is claim-free subject to a maximum cumulative bonus of 50%
• Tax benefit: Under Section 80D of the Income Tax Act, 1961
• Medical test: Mandatory above 51 years of age

 HDFC ERGO Health Suraksha Silver Plan - Coverages & Benefits

• Basic sum insured per policy year: Rs.3 lakh to Rs.7.5 lakh
• Cashless hospitalization: In authorized hospitals in the 6000+ network across India

• Basis: Individual and family floater
• Policy term: 1 or 2 years
• Cumulative bonus: Cumulative bonus of 5% for each year that is claim-free subject to a maximum cumulative bonus of 50%
• Tax benefit: Under Section 80D of the Income Tax Act, 1961
• Medical test: Mandatory after the age of 45
• Benefits: Day care procedures, Ambulance expenses, Domiciliary expense, In-patient treatment, Pre- and post-hospitalisation expenses, Organ donor’s treatment expenses, AYUSH treatments
• Entry age: No maximum age limit

HDFC ERGO Health Suraksha Gold Plan With Maternity Coverage

• Basic sum insured per policy year: Rs.3 lakh to Rs.10 lakh
• Cashless hospitalization: In authorized hospitals in the 6000+ network across India

• Basis: Individual and family floater
• Policy term: 1 or 2 years
• Cumulative bonus: 10% Enhanced Cumulative Bonus for each claim-free year up to a maximum of 100% of the sum insured
• Tax benefit: Under Section 80D of the Income Tax Act, 1961
• Medical test: Mandatory after the age of 45
• Benefits: Day care procedures, Ambulance expenses, Domiciliary expense, In-patient treatment, Pre- and post-hospitalisation expenses, Organ donor’s treatment expenses, AYUSH treatments
• Entry age: No entry age limit

HDFC ERGO Health Suraksha Gold Plan - Maternity Benefits

• Basic sum insured per policy year: Rs.3 lakh to Rs.10 lakh
• Cashless hospitalization: In authorized hospitals in the 6000+ network across India

• Basis: Individual and family floater
• Policy term: 1 or 2 years
• Cumulative bonus: 5% of the sum insured at the end of each claim-free year subject to a maximum cumulative bonus of 50%
• Tax benefit: Under Section 80D of the Income Tax Act, 1961
• Medical test: Mandatory after the age of 45
• Benefits: Convalescence benefit for hospitalizations that exceed 10 continuous and consecutive days, Newborn cover, Maternity cover, Day care procedures, Ambulance expenses, Domiciliary expense, In-patient treatment, Pre- and post-hospitalisation expenses, Organ donor’s treatment expenses, AYUSH treatments, E-opinion for diagnosis of critical illnesses
• Entry age: No limit

HDFC ERGO Health Suraksha Gold Regain & ECB Explained

• Basic sum insured per policy year: Rs.3 lakh to Rs.10 lakh
• Cashless hospitalization: In authorized hospitals in the 6000+ network across India

• Basis: Individual and family floater
• Policy term: 1 or 2 years
• Cumulative bonus: An Enhanced Cumulative Bonus of 10% for each claim-free year subject to a maximum of 100%
• Tax benefit: Under Section 80D of the Income Tax Act, 1961
• Medical test: Mandatory after the age of 45
• Benefits: Newborn cover, Maternity cover, Day care procedures, Ambulance expenses, Domiciliary expense, In-patient treatment, Pre- and post-hospitalisation expenses, Organ donor’s treatment expenses, AYUSH treatments, E-opinion for diagnosis of critical illnesses
• Entry age: No limit

HDFC ERGO Critical Illness Insurance – Silver Plan

• Basic sum insured per policy year: Rs.5 lakh to Rs.10 lakh
• Cashless hospitalization: In authorized hospitals in the 6000+ network across India

• Basis: Individual
• Policy term: 1 or 2 years
• Tax benefit: Applicable
• Medical test: Mandatory after the age of 45
• Benefits: Coverage for 8 specific illnesses
• Entry age: 5 to 65 Years

HDFC ERGO Critical Illness Insurance – Platinum Plan

HDFC ERGO Health Insurance Customer Care

HDFC ERGO is another of India’s leading general insurance company which was established following a joint venture between HDFC and ERGO International AG. The company provides a number of general insurance products which include motor insurance, health insurance, travel insurance, etc., which they offer via their network of 108 branches. In addition to providing some of the best health insurance plans, HDFC ERGO Health Insurance Customer Care is also known to provide excellent service to their clients via multiple channels.

To enable customers to get in touch with the HDFC health insurance customer care and support staff and resolve their policy-related queries, grievances, and issues, HDFC ERGO has set up a dedicated phone-based helpline and a fax line as well. Customers can also write in to the support team via email for authorisation-related issues, network hospital related issues, and queries related to claims. They can also write in to the insurer’s corporate office address via mail to receive a response to their queries.

HDFC ERGO Health Insurance Cashless Network Hospitals

HDFC ERGO offers cashless facility at over 6,000 network hospitals across the country. Insured members can get admitted in a network hospital of the insurer to avail cashless treatment. The insurance company will settle the hospitalisation expenses incurred by the insured member directly with the network hospital. To locate a network hospital nearest you, select your state and city from the drop-down box on the online Network Hospital Locator tool. You will get a list of network hospitals in your area with contact details.

How to File a Claim with HDFC ERGO Health Insurance?

HDFC ERGO is one of the top health insurance providers with a dedicated in-house claim service team to provide smooth claim servicing to the customers.

• Cashless Claim: In the case of a planned hospitalisation at a network hospital, visit the hospital with your cashless card or policy card. This can be downloaded from the TPA website or requested at the hospital’s insurance desk. This has to be filled up by the medical practitioner and the patient. After completing and submitting the form, it will be sent to the TPA. The TPA will issue a letter of authorization if approved. For unplanned hospitalisation, the steps are the same as above but should be completed within 24 hours of hospitalisation.
• Reimbursement Claim: In the case of hospitalisation at a non-network hospital, the insured member will have to pay the medical bills upfront out of his or her pocket and make a reimbursement claim within 7 days of discharge. For reimbursement claims, submit the claim form along with the necessary medical documents after discharge from the hospital. The approval will be confirmed within 30 days of receipt of the documents.

Benefits of HDFC ERGO Health Insurance

• To cater to the needs of their diverse customer base, HDFC ERGO offers a wide range of health insurance policies which include individual plans, group health insurance plans, critical illness plans, and even cover top-up plans. Here are some of the notable benefits which you get on purchasing an HDFC ERGO health insurance plan.
• Policyholders can choose to get treated at any of the 6000+ network cashless hospitals located across the country.
• Health insurance plans offered by HDFC ERGO also offer the benefit of an enhanced No-Claim Bonus.
• Policyholders can choose from a range of premium payment options, as per their convenience.
• These health insurance plans provide hospitalisation cover not only for illnesses or accidents, but also for other related treatments like pre and post-hospitalisation expenses, domiciliary treatment, and a number of day care procedures, among other expenses.
• Policyholders are eligible to avail attractive tax benefits for premiums paid towards a health insurance policy under the provisions of Section 80D of the Income Tax Act, 1961.