HDFC Ergo Insurance Plans

HDFC ERGO Medisure super top up

Compare India Health insurance quotes

Coverage type
Coverage amount
Date of birth
  OR age    years
* Get insurance updates

Key highlights of Medisure super top up

  • Insured’s Age
    • Adults – 18 years to 65 years
    • Children – 91 days to 23 years
  • Insured’s Parents and Parents-in-law can be covered under the same policy on Individual Sum Insured basis or under a Separate Policy on Floater basis
  • Other Family Members who can be covered under a Single Policy on an Individual Sum Insured basis include : Grand Mother, Grand Father, Grand Son, Grand Daughter, Brother, Sister, Nephew, Niece

HDFC ERGO Health Insurance Review

HDFC ERGO Health Insurance
HDFC ERGO Health Insurance sum insured
3 lacs − 75 lacs options available
Incurred Claims Ratio *
62.00%
HDFC ERGO Insurance tenure options
2 years
Claims Settlement Ratio **
85.97%
List of network hospitals
10,000+ hospitals
Number of policies issued *
1,066,395
Maximum family floater coverage
Self, Spouse + dependent (children (upto 25 yrs) + parents)
Number of lives covered *
96,05,000
* As per IRDAI report for 2018-19   |   ** As per NL25 data published on the Insurance Company website

HDFC ERGO Medisure super top up benefits

  • Key Features
  • Coverages
  • Sum Insured & Deductible Options
  • Exclusions

Features of HDFC ERGO Medisure super top up Insurance

  • Room Rent :Payable at Actuals upto Sum Insured
  • Co-pay : NIL for all treatment upto 80 yrs / 10% Co pay for insured > 80 yrs
  • Restoration Benefit: NIL Rebound Benefit under this plan
  • High Sum Insureds with range of Deductible options at extremely competitive premiums
  • Entry age is 65 years with lifetime renewal option
  • Hospitalisation cover limit upto Sum Insured – No Sublimits
  • Coverage under the Family Option is provided for entire family that include parents, in-laws, niece, nephew, spouse and kids
  • Constant premiums from Age 61 – this means that even in a plicy year in which there have been claims, the base premium (without GST) at the time of renewal will remain the same
  • No health checkupsuptothe insured age of 55 years – ensure no time spent in unnecessary pre policy check ups. However proposed insureds above the age of 55 years and those with declared pre existing medical conditions irrespective of age will need to undergo medical tests
  • Pay less, Get more - Opt for a long-term policy of 2 years and get a 5% discount on the premium. If one wishes to cover a family of more than 2 members on individual Sum Insured basis, they can avail 10% discount.
  • HDFC Service Guarantee – 6 hour turn around time for cashless claims guarantee to Network hospitals, 6 day turn around time for reimbursement claims on submission of complete documents
  • Free Look Period of 15 days

Covered of HDFC ERGO Medisure super top up Insurance

The Critical Illnesses covered are dependant on the option chosen by the insured.
In Patient Hospitalisation If any Insured Person suffers an Illness or Accident during the Policy Period requiring Inpatient Hospitalization, the insurer will pay the MedicalExpenses (upto SI) incurred for
  • Room Rent/ Boarding & Nursing
  • Cost of Operation Theatre, diagnostic tests, medicines, blood, oxygen and cost of prosthetic and other devices or equipment if implanted internally like pacemaker during a surgical procedure
  • Fees of Surgeon, Anaesthetist, Nurses and Specialists
  • ICU Charges
Occurrence of same illness after a lapse of 45 days will beconsidered as fresh illness for the purpose of this Policy
Pre Hospitalisation Medical Expenses The Medical Expenses incurred in the 30 days immediately before the insured was Hospitalized is payable under the policy upto SI, provided that:
  • Such Medical Expenses were in fact incurred for the same condition requiring subsequent Hospitalization, and
  • The insurance company has accepted the Claim under Scope of Cover "In-patient Hospitalization expenses”.
Post Hospitalisation Medical Expenses The Medical Expenses incurred in the 60 days immediately after the insured is discharged is payable under the policy upto the SI, provided that:
  • Such Medical Expenses were in fact incurred for the same condition for which Your Hospitalization was required, and;
  • The insurer has accepted the Claim under Scope of Cover”In-patient Hospitalization expenses”.
Day Care Treatment The Medical Expenses for a day care treatment is covered where the procedure or surgery:
  • is undertaken under General or Local Anaesthesia in a Hospital/Day care centre for less than 24 hours because of technological advancement, and
  • does not cover any treatment in an outpatient department or diagnostic procedures
  • which would have otherwise required hospitalization of more than 24 hours

Sum Insured and Deductible Options

Aggregate Deductible (₹) Sum Insured (₹)
2 lacs 3 lacs 8 lacs
3 lacs 7 lacs 12 lacs
4 lacs 6 lacs 11 lacs 16 lacs
5 lacs 5 lacs 10 lacs 15 lacs 20 lacs

Illustration
(All figs in INR ₹) Policy Deductible Sum Insured for the Policy Claim Amount Paid by Policy Deductible Claim Payable by Top Up Policy
At Inception 3,00,000 12, 00,000
Claim 1 3,00,000 12,00,000 2,00,000 2,00,000 NIL
Claim 2 3,00,000 12,00,000 5,00,000 1,00,000 4,00,000

Exclusions of HDFC ERGO Medisure super top up Insurance

Some of the key exclusions under this plan are as follows; however please go through the policy wordings for the entire list:
  • All pre-existing diseases / illness / injury / conditions as defined in the Policy, until 36 months of continuous covers have elapsed since inception of the first Policy with us.
  • Any disease contracted and/or Medical Expenses incurred by You in respect of any illness during the first 30 days from the commencement date of the Policy except in case of accidental injuries. This Exclusion doesn't apply for those having any health insurance indemnity policy in India at least for 1 year prior to taking this Policy as well as for subsequent renewals with Us without a break.
  • All expenses along with their complications on treatment towards following ailments/illness are excluded and will be covered after the first two years (24 months) of continuous operation of this insurance cover:
    • Cataract
    • Uterine prolapse including any condition requiring Hysterectomy
    • Polycystic Ovarian Diseases, Myomectomy for Fibroids
    • Osteoarthritis and Osteoporosis
    • Arthritis, Arthroscopic Surgery, Rheumatism, Joint Replacement Surgery (other than caused by accident), Prolapse of Intervertibral discs(other than caused by accident)
    • Congenital internal anomaly
    • Fistula in anus, Piles, Fissure
    • Gastric and duodenal ulcer, any type of Cysts/Nodules/Polyps, and any type of Breast lumps, benign ear, Nose and Throat disorders and surgeries Chronic Nephritis and Nephropathy (Kidney diseases).
    • Fibroids, Dilatation & Curettage for treatment purposes, Pilonidal sinus, Chronic Suppurative Otitis Media (CSOM)
    • Hypertension, Diabetes and related complications
    • Deviated Nasal Septum, Sinusitis and related disorders
    • Surgery on tonsils/Adenoids

Under cashless hospitalization, the insured person does not settle the hospitalization expenses at the time of discharge from hospital. The settlement is done directly by us for treatment that the insured person is eligible to receive under the terms of his/her policy. This is for your convenience. However, it is important to note here that prior approval is required from us before admission into the hospital. In some cases, you may have to pay for all or part of the treatment if it is not fully covered under the terms of the policy. However, in case of emergency hospitalization, you can obtain approval post-admission. Please note that the cashless facility is available only at our Network Hospitals.

HDFC Ergo has an extensive network of 10,000+ network hospitals across India growing steadily over the years. One must get admitted to a network hospital in order to avail cashless treatment for their illness. One can get the hospital closest to them by going through theHDFC Ergo network hospital list

There is no upper limit on the number of claims during the policy period. However, the total cumulative claim amount cannot exceed the Policy Sum Insured.

A pre - existing disease is any condition, ailment or injury or related condition(s), for which the insured person had signs or symptoms, and /or were diagnosed, and / or received medical advice / treatment within 36/48 months prior to 1st health insurance policy issued by Us under which the insured person was covered.

Brochure

Review HDFC ERGO Medisure super top up insurance brochure to understand coverage details.

Know more »

Proposal form

Fill the online HDFC ERGO Medisure super top up insurance proposal form.


Know more »

Policy wordings

Review HDFC ERGO Medisure super top up insurance policy wordings which explains the terms and conditions.

Know more »

Get quotes for HDFC ERGO health insurance!

Review and compare the best health insurance.
Compare health insurance quotes
Find the best HDFC ERGO health insurance

HDFC ERGO health insurance useful links

How to buy online?

You can buy insurance online by using a credit/debit card, direct funds transfer using NEFT or RTGS or by using a cheque

Know more »

Network hospitals

HDFC ERGO Network hospitals list. Cashless & Hassle-free direct claim settlement with us at 10,000+ Hospitals

Know more »

Compare health plans

Compare Indian health insurance policies, Health insurance India comparison

Know more »

Health insurance benefits

Insurance customers can quickly compare the details of benefits offered under Indian mediclaim insurance policies.

Know more »

Portability

Portability Information for Mediclaim Insurance in India

Know more »

Health insurance FAQ

FAQ related to Indian health insurance. Get answers for any health insurance questions

Know more »

Search for HDFC ERGO health insurance

Health Insurance Priority

India health insurance blogs and articles

Tips for buying best mediclaim insurance

India health insurance tips and tricks to choose the best medical insurance in India Click here to read more

Top reasons for health insurance claims rejection

Find out the different reasons why a medical insurance claim is rejected, Cashless hospitalization, Reimbursement. Click here to read more

India health insurance coverage, factors and premium calculator

Factors for medical insurance in India, How much is the premium and the coverage offered by India health insurance plans..Click here to read more

Resourceful Indian health insurance links

CIN: U66000KA2018PTC117713 | IRDAI Web aggregator License Code Number: IRDAI / INT / WBA /53/ 2018, Valid till 07/08/2025