HDFC ERGO Individual Health Insurance- Types and Benefits

Updated: 01-09-2023 10:21:20 AM

HDFC ERGO Individual Health Insurance Plans

Medical technology is evolving with leaps and bounds and so as the expenses. For meeting all those rising medical costs and keeping the customers financially prepared against several unexpected expenses, HDFC ERGO provides some good options to its customers in form of HDFC ERGO Individual Health Insurance. These options provide its customers with individual health insurance plans along with a host of countless benefits that include – cashless network of hospitals, no sum limit on the rental rooms, vast coverage and even more.

Types of HDFC ERGO Individual Health Insurance Plan

Health insurance plans for individuals offered by HDFC ERGO include the following:

• Health Suraksha Gold Insurance Plan
• my:healthMedisure Super Top Up Insurance for Individual (for additional cover)

Health Suraksha Gold Insurance Plan

This plan is designed so that customers can meet their individual coverage needs with ease. This plan provides them with the maximum coverage at the most reasonable premium rates. This health plan gives the policyholders comprehensive financial protection and safeguards them from spiralling medical costs. An individual can add this plan to their existing health plan for a larger coverage.

Also Check: HDFC ERGO Maternity Health Insurance and its Types, Features and Benefits

Features of Health Suraksha Gold Insurance Plan

There are some of the basic features of Health Suraksha Gold Insurance Plan mentioned below:

• No restriction on entry age
• No capping on hospital expenses which include- Room rent, doctor fees, consultation fees, investigation reports and medicinal costs
• New born baby cover
• Easy claim settlement procedure
• Add-ons according to the individual needs

 Eligibility details of Health Suraksha Gold Insurance Plan

• There is no restriction on entry age. Anyone who is 18 years of age and above can buy this individual health plan for themselves or for their loved ones
• This insurance plan is also available on individual sum insured basis for more than 2 family members.

Benefits of Health Suraksha Gold Insurance Plan

The health insurance plan for individuals offered by HDFC ERGO comes with a range of features and benefits and they are listed here:

• Cashless Hospitalisation and Treatment:This feature of this individual health insurance plan makes it popular among its target masses. The policy owners can visit the massive network of more than 6,000 HDFC ERGO hospitals (list is available on the website of HDFC ERGO) and avail cashless treatment without spending time on arranging cash for it. In addition to this massive chain of hospitals, there is no limit on hospital expenses such as doctor fee, room rent, medicine and examinations costs.
• Maternity Benefits:Health insurance plans usually not cover the expenses incurred due to maternity or childbirth. However, this individual health plan covers all the expenses related to maternity and newborn baby.
• Special Discounts and Add-Ons: The health insurance plan also offers a number of special discounts to its customers. The plan gives 10% discounts if opted for 2 years (policy term). More 10% discount is also provided is opted on the basis of individual sum assured/ insured for more than two family members. In addition to this, customers can also avail addition 5% of cumulative bonus at the end of every claim-free year. Add-ons are also available to meet the diversified needs of HDFC ERGO’s extensive customer’s base. 

• Free Health Check-Ups:This health insurance plan for individuals also provides the customers with free health and medical check-ups on the completion of 4 claim-free policy years. One can contact the insurance company to avail more information on the same or visit their nearest branch office of HDFC ERGO. 

• Income Tax Benefits:A policy owner can avail income tax benefits on the premiums paid towards this individual health insurance plan. This benefit is provided as per the latest provisions of section 80D of the Income Tax Act, 1961. The savings can be up to Rs. 60,000. However, these benefits are subject to certain terms and conditions listed therein. It is advisable to read the policy documents and consult an expert for more details. Income Tax Act, section 80C benefits are not provided. 

• Lifetime Renewal:The health insurance plan designed for individuals comes with lifetime renewability feature. This makes this plan a good investment option for the health. 

• Minimum Documentation:Generally, to buy a health insurance plan, one has to present a bunch of documents including health check-up and medical examination certificates. On the other hand, minimal documents required to buy this plan.

Exclusions under Health Suraksha Gold Insurance Plan

The following are the exclusions of this health plan for individuals:

• Medical expenses arising due to cosmetic or plastic surgery
• Treatment costs of HIV AIDS and related issues
• Intentional self-injuries treatment costs are not covered
• Expenses incurred due to the treatment of intoxication and war-related injuries.

Documents required to claim Health Suraksha Gold Plan

Mentioned below are important documents to be presented to claim HDFC ERGO Health Suraksha Gold Plan:

• Duly signed and filled claim form along with the HDFC ERGO policy number
• Discharge summary
• Original final bill
• Past treatment documents (if any)
• Investigation report such as X-Ray report, blood reports and others
• KYC form along with KYC documents
• Address Proof
• Identity Proof
• NEFT details for payment

Also Read: HDFC Ergo Health Medisure Super Top-up Policy

My:Health Medisure Super Top-Up Insurance for Individual

This insurance plan is provided for additional coverage for more cover with the existing health plan at a reasonable cost. Considered as the most appealing health product by HDFC ERGO, this insurance plan for individuals covers extensive expenses of treatment effortlessly. The insurance plan offers maximum financial coverage at minimal premiums.

For instance, Rs. 20 lakh of coverage will be provided with Rs. 5 lakh (aggregate) deductible for the customers below age 35 years. They will just need to pay Rs. 2,200 along with applicable taxes for the added benefit.

This individual health plan can be added to any of the HDFC ERGO health plan or the plan purchased from other companies. This will provide equal benefits with all types of health insurance plans.

How to Make Claims for HDFC ERGO Individual Health Insurance Plans?

Here are the steps to follow to make the cashless claim for these plans:

• Policyholders will have to get admitted to one of the 6,000+ HDFC ERGO’s empanelled network hospitals
• Show valid ID proof along with the health card to avail cashless treatment facility at the hospital
• The hospital will then send the request for cashless treatment to the insurer and coordinate with them for authorisation
• At the time of discharge, the insurance company will scrutinise all the document received and convey their final stand on the claim
• The policyholder will get the claim-related updates through email or SMS
• Hospital will send the final bill to the insurance company for authorisation and they will scrutinise the same. Any sort of inadmissible expense, co-payments, deductions, etc. will be paid by the insured only.

Also Check: HDFC ERGO Senior Citizen Health Insurance

Documents required to claim HDFC ERGO my: health Medisure Super Top up Insurance Plan

For the claim process, the insurance policy owner will have to provide a set of documents. And these documents include:

• A duly filled and signed claim form along with the HDFC ERGO individual health policy number
• Summary of original discharge
• Original copies of final bill provided with detailed breakup, receipts of the payment and original invoices (pharmacy bills) supported by the prescriptions
• Original investigation reports e.g. x-ray, blood reports, etc.
• Implant invoices/ stickers e.g. lens cataract, stent in angioplasty, etc. (if used)
• Past treatment documents and reports (if any)
• Medico legal certificate (MLC) or copy of FIR in case of an accident
• Other relevant medical documents (if any)
• NEFT details along with cancelled cheque or copy of passbook
• Copy of any of the KYC document e.g. Aadhaar card, driving license, passport, voter ID, etc. along with duly filled and signed KYC form for claiming amount Rs. 1 lakh and above.

After receiving the documents needed, the claim process would be initiated by the insurer as per the terms and conditions of the policy within 7 working days of the last document received. One notable point here is that if there is any internal verification, the final stand of the insurer will be confirmed within 30 days of the last document received.

Contact HDFC ERGO for More Assistance

The insurance company provides its customers with hassle-free and convenient ways for connecting their customer support team. Look at the table below to know more:

Particular	Details
Contact Number	1800 2 700 700 (toll-free number for Indian residents only)
Fax Number	1860 2000 600 ( Local charges are applicable)
Email ID	Authorisation Issues: preauth@hdfcERGO.com
	Network Hospital Issues: nsp@hdfcERGO.com
	Customer Claims Query: healthclaims@hdfcERGO.com
Address	Noida HDFC ERGO General Insurance Co. Ltd. 5th floor, Tower 1, Steller IT Park, C-25, Sector-62, Noida – 201301   Chennai HDFC ERGO General Insurance Co. Ltd. RR Tower II, 2nd Floor, No: 94/95 T.V.K Industrial Estate, Guindy, Chennai – 600 032.

One can contact through any of the mode listed above to know about the health insurance plans, NAV, policy tenure, premium paying term, breakup of premium, etc.

Also Check: HDFC ERGO Family Health Insurance

FAQs

Q1. What are the eligibility criteria for purchasing Health Suraksha Gold Insurance Plan?

For availing HDFC ERGO Health Suraksha Gold Insurance Plan, there is no such limit on entry age. But, it is open for all the individuals who are above the age of 91 days.

Q2. Are there any medical tests required for availing the Health Suraksha Gold Insurance Plan?

No, there is no such requirement for purchasing the policy up to 55 years of age.

Q3. How can I add new member to my existing family floater policy?

You can easily add new member just by filling up the endorsement form and declaration form.

Q4. Is there any maternity benefit for policyholders under the individual health plan?

Policyholders can easily avail maternity benefit along with new born baby cover.