In today’s fast-paced life, it is extremely important to have a strong health insurance plan to avoid sudden health-related expenses. ‘Optima Secure Health Insurance Plan’ offered by HDFC ERGO provides comprehensive protection to you and your family, which helps in addressing your health concerns. In this article, we will do a detailed analysis of the diverse aspects of the plan.
Features of Optima Secure Health Insurance Plan
1. Secure Benefit
A key feature of this plan is the ‘Secure Benefit’, which instantly doubles your basic sum insured without any additional premium. For example, if you have chosen a sum insured of ₹10 lakh, it becomes ₹20 lakh when you buy the policy.
2. Automatic Restore Benefit
This benefit provides the facility to avail protection automatically if the entire or some part of your basic sum insured is used. This means that your coverage will still be available for your next claim.
3. Plus Benefit
Your basic sum insured increases by 50% on the first renewal of the policy, and up to 100% on the second renewal, whether you have made a claim or not. This makes your coverage even stronger.
4. No Room Rent Capping
There is no room rent capping in this plan, meaning you can take admission in any hospital room of your choice without any worries.
5. Pre and Post Hospitalization Coverage
This plan covers medical expenses for the first 60 days of hospitalization and up to 180 days after discharge, which is quite comprehensive in comparison to other plans.
6. Day Care Treatments
Due to modern medicine, there are many treatments which can be cured in less than 24 hours. This plan covers more than 540 day care treatments.
7. AYUSH Treatment
This plan also covers the cost of alternative treatments like Ayurvedic, Homeopathic, Siddha and Unani, giving you the freedom to choose the treatment method of your choice.
8. Preventive Health Check-up
Under the policy, you get the facility of a preventive health check-up every policy year, which helps in keeping a regular eye on your health.
9. Global Coverage
If you travel abroad, this plan also provides coverage for emergency and planned treatments abroad, giving you worldwide protection.
10. Aggregate Deductible Option
You can choose a voluntary aggregate deductible to reduce your premium, which provides flexibility in your financial planning.
Eligibility and Coverage
Major Features
- Entry Age: From 91 days till 65 years. Children under 18 years of age can only be covered with their parents.
- Policy Tenure: 1, 2, or 3 years.
- Sum Insured Options: ₹5 lakh to ₹2 crore.
Coverage Details
- Hospitalization Expenses: Medical expenses incurred for hospitalization for at least 24 hours.
- Pre-hospitalization: Medical expenses up to 60 days before hospitalization.
- Post-hospitalization: Medical expenses up to 180 days after discharge.
- Day Care Procedures: Over 540 day care treatments covered.
- AYUSH Treatments: Alternative treatments like Ayurveda, Homeopathy, Siddha, Unani ke kharch cover.
- Road Ambulance: Covers expenses related to road ambulance in emergency.
- Organ Donor Expenses: Covers medical expenses related to the organ donor.
Optional Add-ons
1. Unlimited Automatic Restore
Through this add-on, you can restore your sum insured without any limit, which is very useful in case of multiple claims.
2. Hospital Cash Benefit
This add-on provides fixed daily cash to cover your personal expenses like food, transportation, loss of pay etc. during hospitalization.
3. Aggregate Deductible Discount
Through this add-on, you can choose a voluntary aggregate deductible to reduce your premium, which provides flexibility in your financial planning.
Waiting Periods
- 30 Day Initial Waiting Period: Waiting period for any illness related claim till 30 days from the inception of the policy.
- Specific Illness Waiting Period: Waiting period of up to 2 years for some specific diseases.
- Pre-existing Diseases (PED) Waiting Period: Waiting period of up to 3 years for pre-existing diseases.
Exclusions
- Maternity and Newborn Expenses: This plan does not cover expenses related to maternity and newborn.
- Cosmetic Treatments: Expenses for cosmetic or plastic surgery
