HDFC ERGO Optima Secure plan and its features:
1. Core Benefits of Optima Secure:
- Secure Benefit:
- Instantly doubles your base coverage at no extra cost from day one.
- Example: If you purchase a base cover of INR 10 lakhs, it automatically increases to INR 20 lakhs upon policy activation.
- Plus Benefit:
- After the first policy year, the base coverage increases by 50%, and after the second year, it doubles to 100% of the base sum insured.
- This increase applies regardless of any claims made, ensuring continual growth in coverage.
- Example: For a base cover of INR 10 lakhs, this becomes INR 15 lakhs in the second year and INR 20 lakhs in the third year.
- Restore Benefit:
- If a partial or total claim is made, the base coverage is automatically restored to 100% within the same policy year, with no extra charge.
- This applies each time the base coverage is exhausted, ensuring that coverage remains available for multiple claims within a year.
- Example: If a 10 lakh base cover is fully utilized in a claim, it will be restored to 10 lakhs for future claims in the same policy year.
- Protect Benefit:
- Covers non-medical expenses, which typically include items like gloves, masks, and other consumables that are often excluded in health insurance.
- Ensures no out-of-pocket expenses for such consumables during hospitalization.
- Combined 4X Coverage:
- With Secure, Plus, Restore, and Protect benefits, the policy provides four times the coverage of the base sum insured over time.
- Example: With a 10 lakh base cover, these combined benefits can increase the effective coverage to up to 40 lakhs over time.
2. Additional Coverage Options:
- Extended Pre- and Post-Hospitalization:
- Covers medical expenses incurred 60 days before hospitalization and 180 days after discharge.
- Extends beyond the standard 30 days (pre) and 90 days (post) offered by many plans.
- Home Healthcare:
- Covers home-based medical treatments, allowing for cashless treatments at home under certain conditions.
- Includes doctor visits, nursing charges, and other necessary expenses typically covered during hospitalization.
- Daily Cash Benefit for Shared Room:
- Provides a daily cash allowance of INR 800 per day (up to INR 4,800 total) for hospitalization in a shared room exceeding 48 hours.
- Helps cover additional incidental expenses, like food and lodging.
- Emergency Air Ambulance:
- Covers emergency air transportation costs up to INR 5,00,000 within India.
- Organ Donor Coverage:
- Reimburses expenses for organ donor treatments related to the harvesting of an organ.
- AYUSH Treatments:
- Covers inpatient treatments under Ayurveda, Yoga, Naturopathy, Unani, Siddha, and Homeopathy.
3. Add-Ons for Enhanced Coverage:
- Critical Illness Cover:
- Covers 51 critical illnesses, with a sum insured option from INR 1,00,000 up to INR 20,00,000.
- Provides financial support in the case of a diagnosis of major illnesses, like heart attacks or cancer.
- Hospital Cash Benefit:
- Provides a daily cash allowance during hospitalization, with options ranging from INR 500 to INR 10,000 per day.
- Unlimited Restore Benefit:
- Restores the base coverage an unlimited number of times within a policy year.
- Ensures continued availability of the sum insured after every claim throughout the year.
- Personal Accident Rider:
- Offers a lump sum payout in the event of accidental death, permanent total disability, or partial disability.
- Optima Wellbeing:
- Covers outpatient expenses, including doctor visits, diagnostics, and medicines.
4. Discounts and Additional Benefits:
- Premium Discounts:
- Up to a 25% discount on premium if the insured agrees to an annual deductible.
- Loyalty discount of 2.5% if holding an active insurance policy with a premium over INR 2,000.
- Family Discounts:
- A 10% discount if two or more family members are covered under the individual policy option.
- Tax Savings:
- Premiums paid qualify for tax deductions under Section 80D of the Income Tax Act.
- Preventive Health Check-Ups:
- Available annually, irrespective of claims made, for preventive health management.
- E-Opinion on Critical Illnesses:
- Allows consultations for critical illnesses through network providers at no additional cost.
- Domiciliary Hospitalization:
- Covers home treatment costs when hospitalization is not feasible.
- Flexible Policy Tenure and Payment Options:
- Choose from 1, 2, or 3-year tenures.
- Premiums can be paid in installments (monthly, quarterly, or half-yearly) for added flexibility.
Example:
- A 35-year-old customer with a base cover of INR 10 lakhs:
- Instant coverage boost to INR 20 lakhs through the Secure Benefit.
- Coverage restoration to INR 10 lakhs with every claim (Restore Benefit).
- Protection for non-medical consumables (Protect Benefit).
- Base cover doubles to INR 20 lakhs by the third year (Plus Benefit).
- With these benefits, effective coverage can reach up to INR 40 lakhs over time.
HDFC ERGO’s Optima Secure plan offers a highly customizable health insurance solution with extensive coverage, restoration benefits, and add-ons that cater to various needs, from critical illness coverage to accident protection and outpatient care.
1. What is the HDFC ERGO Optima Secure health insurance plan?
- Answer: HDFC ERGO Optima Secure is a health insurance plan offering enhanced coverage, including doubling the sum insured, restoring coverage after claims, covering non-medical expenses, and providing additional benefits like critical illness coverage and home healthcare.
2. How does the Secure Benefit work?
- Answer: The Secure Benefit instantly doubles the base coverage from day one at no additional cost, providing enhanced protection from the start.
3. What is the Plus Benefit in Optima Secure?
- Answer: The Plus Benefit automatically increases the base coverage by 50% after one year and by 100% after two years, regardless of claims made.
4. Does Optima Secure cover pre-existing diseases?
- Answer: Yes, but like most health insurance plans, it has a waiting period for pre-existing conditions, usually 36 months from the start date.
5. What are non-medical expenses in health insurance?
- Answer: Non-medical expenses include consumables like gloves, masks, and other items not directly related to treatment. Optima Secure’s Protect Benefit covers these at no extra cost.
6. What is a deductible in health insurance?
- Answer: A deductible is the amount the policyholder agrees to pay out-of-pocket before the insurance coverage kicks in. Optima Secure offers a premium discount if a deductible is chosen.
7. Is critical illness covered under Optima Secure?
- Answer: Yes, Optima Secure offers an add-on called my
Critical Illness, covering 51 critical illnesses with sum insured options from INR 1 lakh to 2 crores.
8. What are the benefits of choosing Optima Secure for family coverage?
- Answer: Optima Secure offers a family floater option, providing coverage for multiple family members under one policy, plus discounts for covering multiple family members.
9. How does the Unlimited Restore add-on work?
- Answer: The Unlimited Restore add-on reinstates the base sum insured any time it’s exhausted due to a claim, offering unlimited reinstatements within a policy year.
10. Does Optima Secure provide cashless treatment?
- Answer: Yes, it offers cashless hospitalization across 16,000+ network hospitals, making medical expenses manageable without upfront payments.
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