HDFC ERGO Senior Citizen Health Insurance- Types & Eligibility

Updated: 15-02-2024 04:49:29 AM

Turning sixty is a milestone in many aspects. Not only do you celebrate entering into your golden years but as it is the most common retirement age, you can say goodbye to work-related stress and decide to live the life of a retiree. However, this does also mean that you lose your source of regular income – which can have a major impact on your lifestyle. Old age also comes with health issues and associated costs. Managing these expenses with lower income can start to upset your budget and eat up your savings. Therefore, it is important to find ways to offset these risks. A health insurance plan specially designed for senior citizens can fit the bill, quite literally. HDFC ERGO Senior Citizen Health Insurance offers such insurance products designed for senior citizens.

Types of Senior Citizen Health Insurance Plan

Here are the three senior citizen health insurance products offered by HDFC ERGO: 

• HDFC ERGO My: Health Medisure Classic Insurance
• HDFC ERGO Health Suraksha Plan
• HDFC ERGO My: Health Medisure Super Top-up

HDFC ERGO My: Health Medisure Classic Insurance

One of the health insurance plans offered by HDFC ERGO that is ideal for senior citizens is the My: Health Medisure Classic Insurance plan. This plan offers large cover for safeguarding the medical necessities for senior citizens. Reduced financial burden as well as protective cover are the main advantages for availing the My: Health Medisure Classic Insurance plan.

Features of My: Health Medisure Classic Insurance

There are some of the basic features available for the policyholders as mentioned below:

1. This plan comes with large cover and minimum amount of payment of premium
2. Waived off room rent capping
3. Individuals are provided with the option to choose the tenure of the policy which can be opted for one or two years.
4. Free-look period of 15 days is allowed, if individual is not satisfied with the policy
5. Ambulance charges for maximum up to Rs. 1,500 per hospitalization

Eligibility details of My: Health Medisure Classic Insurance

Here are the eligibility details: 

• Lifetime entry is allowed
• Optional Double Sum Insured for Critical Illness up to the age of 65 years

The premium payable towards this insurance plan is based on the age of the policyholder, Sum Assured chosen and the number of people covered under the insurance plan.

Benefits of HDFC ERGO My: Health Medisure Classic Insurance

This health insurance plan by HDFC ERGO offers a range of features and benefits to the policyholders including:

• Lifetime Entry and Renewability Option: This HDFC ERGO insurance plan does not have any upper age limit which means that you can avail the medical assistance benefit offered by the insurance plan even if you are older than 60 years of age. You also get a lifetime renewability option offered under this insurance plan which helps you keep your life sorted since you do not have to worry about searching for a new health insurance plan at the end of each policy term.
• Cashless Treatment at Over 6000 Hospitals:With a wide network of over 6000 hospitals, HDFC ERGO offers you cashless treatment in your city. You do not need to pay anything out of your pocket for your medical treatment since the insurer directly settles your bill with the hospital. All you need to do is to go to the network hospital for your treatment and intimate the insurer about your treatment based on the timeline listed in the policy documents for emergency or planned treatments.
• Unlimited Day Care Treatments: Some health insurance plans for senior citizens only cover hospitalisation and treatment expenses but do not cover day care treatments. This can be an issue since senior citizens may have to avail medical treatments that do not require hospitalisation. Thankfully, this insurance plan steps up to cover expenses for your day care treatments.
• In-patient Diagnostic Charges Coverage: If you undergo Diagnostic tests such as X-ray, MRI, blood tests, etc. during your in-patient treatment at one of the network hospitals of HDFC ERGO then those expenses are covered under this insurance plan subject to the treatment or medical condition being covered in the policy.
• Dedicated Toll-free Number: The company has provided a separate toll-free number 1800 209 5846 to its customers who are above the age of 60 years. This helps them receive help from the insurer promptly.
• Income Tax Benefits:This Senior Citizen Health insurance plan offers income tax benefits under Section 80D of the Income Tax Act, 1961 on the premium paid subject to the terms mentioned therein. Section 80C benefits are not applicable for this health insurance plan.

HDFC ERGO My: Health Medisure Classic Insurance: Coverage and Exclusions

HDFC ERGO Health Suraksha Plan is one of the best senior citizen health insurance plans in the market. Here is a table containing information about the medical expenses covered and excluded under this insurance plan:

Coverage

Exclusions

· In-patient treatment due to illness or accident · Pre-hospitalisation expenses incurred for up to 60 days prior to hospitalization · Post-hospitalization expenses incurred for up to 90 days post discharge · Day care treatment that does not require hospitalisation · Domiciliary Treatment as advised by a Medical Practitioner · Organ Donor Treatment · Emergency Ambulance Charges · AYUSH treatments such as Ayurveda, Unani, Siddha and Homeopathy

· Expenses incurred due to the treatment of HIV/AIDS and related conditions · Medical expenses arising due to the consumption of liquor and drugs · Expenses attributed to attempted suicide or other self-inflicted injuries · Cost of the treatment of war-related injuries

Renewal Process of My: Health Medisure Classic Insurance

Individuals can easily renew their policy simply by making a request before the expiry date of the policy. Individuals can also get their policy renewed within 30 days of the expiry date of policy, only when the premium for the renewal has been paid within the same period.

Filing claim with HDFC ERGO My: Health Medisure Classic Insurance

Policyholders can file claim through different methods as mentioned below:

For Cashless Hospitalization: As this facility can only be availed at network hospitals, policyholders need to follow the below mentioned steps:

• Contact HDFC ERGO  by using the number provided on your health card immediately
• Submit the Cashless Request Form along with the documents subjected to illness as required
• Post submission a representative will guide you will help to further process the request

For Reimbursement Expenses:

Policyholders will be required to submit the original bills along with the specified documents and then submit it to the address mentioned in the policy schedule.

Surrender of My: Health Medisure Classic Insurance Plan

1. In case any of the policyholder  wants to surrender their policy, they need to inform the company by giving 15 days notice in writing. After this, company will refund the premium amount of the unexpired term.
2. In case policyholder wants to surrender the policy before the completion of 1 year, then first year and second year premium will be refunded completely.
3. In case the policyholder wants to surrender the policy after the completion of 1 year, then premium on second year will be calculated as the on annual premium without any long term policy discount.

HDFC ERGO Health Suraksha Plan

HDFC ERGO Health Suraksha Plan is highly designed to safeguard your parents against medical expenses. This plan provides maximum cover available at an affordable premium cost.

Also Check: HDFC ERGO Parents Health Insurance

Eligibility details of Health Suraksha Plan

This insurance plan is ideal to protect senior citizens against the medical expenses that come with increasing age. Here are the eligibility details:

• No entry age restriction
• Can be chosenas individual or family floater basis

Features of HDFC ERGO Health Suraksha Plan

This plan comes with major features as mentioned below:

1. No restriction on entry age
2. Lifetime renewability
3. More than 6000 network hospital for cashless treatment
4. Income tax benefits up to Rs. 60,000 under section 80D of the Income Tax Act, 1961

Benefits of HDFC ERGO Health Suraksha Plan

This health insurance plan by HDFC ERGO offers a range of benefits to the policyholders including:

• Minimum Documentation Required: Sometimes, it can feel stressful to complete the paperwork mandatory for certain health insurance plans since the list of documents required for application can be quite long. However, this HDFC ERGO Senior Citizen Health Insurance plan requires minimum documentation and makes it easy for you to apply for this insurance plan.
• 5% Cumulative Bonus at the End of Each Claim Year: HDFC ERGO Insurance plan rewards you for your healthy lifestyle habits and good health. It offers you a 5% cumulative bonus at the end of each claim-free year during the policy term.
• Additional Discounts: You would be amazed to know that you can get a 10% discount if you opt for a 2-year policy tenure. You can also avail additional 10% discount if you add two family members on an Individual Sum Assured
• No Restrictions on Hospital Expenses: Unlike insurance plans where your hospital expenses are restricted, there are no restrictions on hospital expenses on things like room rent, doctor fees, medicine costs, etc. This means that you only to worry about getting better instead of worrying about room rent, type of room, etc.
• Free Health Check-ups: Regular health check-ups are essential in old age to find medical issues before they transform into diseases. However, they can be expensive. Thankfully, HDFC ERGO offers free health check-ups to senior citizens who have opted for the Health Suraksha plan on completing 4 claim-free years.
• Easy Claim Settlement Procedure: Claim settlement procedure for a few insurance plans can be a bit confusing for many people. However, the HDFC ERGO Health Suraksha plan has an easy and straight-forward settlement procedure that policyholders find easy to follow. This makes it one of the popular health insurance products in India.

HDFC ERGO Health Suraksha Plan: Coverage and Exclusions

Here is a table containing information about the medical expenses covered and excluded under this insurance plan:

Coverage

Exclusions

· In-patient treatment or hospitalisation due to illness, accident or injury · Pre-hospitalisation expenses incurred for up to 60 days prior to hospitalization · Post-hospitalization expenses incurred for up to 90 days post discharge · Day care treatment that does not require 24 hours hospitalisation · Ayurvedic treatment expenses · Pre-existing diseases after a waiting period of 3 years from the inception of the policy · Emergency Ambulance Charges

· Expenses incurred due to the treatment of HIV/AIDS and related conditions · Expenses attributed to self-inflicted injuries, attempted suicide, etc. · Cost of the treatment of war-related injuries · Medical expenses arising due to intoxication

Filing Claim with HDFC ERGO Health Suraksha Plan

For reimbursement of medical expenses

1. Register for claim within 7 days of patient’s discharge
2. Submit the duly signed claim form along with the documents within 15 days of the date of incident
3. After the company receives all the documents, they will send the claim settlement statement along with the payment of admissible amount within 30 days in the proposer’s name.

Renewal Process of HDFC ERGO Health Suraksha Plan

Policyholders who want to get their policy renewed should submit the application form before the end of the policy period. Also, policyholders are provided the grace period of 30 days for renewing the policy.

HDFC ERGO My: Health Medisure Super Top-up

This health insurance plan comes with new criteria in which plans for senior citizen can be opted as a new health insurance or can be added as it to your existing health insurance plan. Individuals under this plan can add up to any of the base policies. These base policies may or may not be linked with the HDFC  ERGO Health Insurance.

Eligibility details of My: Health Medisure Super Top-up

This insurance plan top-up is ideal to protect senior citizens against the medical expenses that come with increasing age that are not covered by the base plan. Here are the eligibility details:

• The proposer must be between the age of 18 to 65 years
• Can be chosen as individual or family floater basis
• Medical tests not required up to the age of 55 years

Also Read: HDFC ERGO Critical Illness Policy

Features of HDFC ERGO My: Health Medisure Super Top-up:

This health insurance top-up plan by HDFC ERGO offers a range of features to the policyholders including:

• High Sum Insured: With the Health Medisure Super Top-up, you get to choose high Sum Insured at a low premium with an option to choose from a wide range of deductibles. This gives you the option to enhance coverage of your base insurance plan.
• Comprehensive Coverage: You can avail pre-hospitalisation and post-hospitalisation expenses and day care treatments without any sub limits. The best part is that if you do not have a health insurance plan, you can still avail the benefits of this top-up.
• 6 Hours Response Guarantee: For cashless claims, it is important that the policyholders get response on time from the insurer. HDFC ERGO guarantees a response time of 6 hours for cashless claims. If the company fails to deliver on the 6-hour response guarantee then it promptly pays a penalty.

Customer Care and Contact Details

For inquiring any of the issues, policyholders may contact through below mention details:
Call: 1800 2 700 700 (accessible from India only)
Fax: 1860 2000 600
Email: healthclaims@hdfcergo.com

Mobile App:Register your claim through our mobile app.

FAQs 

Q1. What are the different modes of online payment?

Individuals can pay the premium amount through multiple modes such as debit card, credit card, net banking, e-wallet.

Q2. What is the procedure to top up health insurance for senior citizens?

Individuals can choose HDFC ERGO My: Health Medisure Super Top-up plan and continue with the base policy.

Q3. Is medical test required to get senior citizen health insurance?

Yes, medical test is compulsory to avail the senior citizen health insurance

Q4. What is the eligibility criteria to buy the Health Suraksha Plan?

Any individual, who is above the age of 91 days can purchase the HDFC ERGO Health Suraksha Plan.