HDFC ERGO Health Optima Restore Health insurance

HDFC ERGO Health Optima Restore comprehensive health insurance review

• HDFC ERGO Health Optima Restore Health Insurance Multiplier benefit

  50% increase in your basic sum insured for every claim free year, subject to a maximum of 100%. In case a claim is made during a policy year, the limit under this benefit would be reduced by 50% of the basic sum insured in the following year. However, this reduction will not reduce the Sum Insured below the basic Sum Insured of the policy.

• Optima Restore Individual Health Insurance benefit table

  Coverage Benefits	Optima Restore
  Basic Sum Insured	3Lakhs, 5Lakhs, 10Lakhs, 15Lakhs, 20Lakhs, 25Lakhs & 50Lakhs
  In-patient Treatment	Covered upto sum insured
  Pre-Hospitalization	Covered, upto 60 Days
  Post-Hospitalization	Covered, upto 180 Days
  Day Care Treatment	All day care treatment covered
  Domiciliary Treatment	Covered upto sum insured
  Organ Donor	Covered upto sum insured
  E-Opinion in respect of a Critical Illness	One opinion per policy year
  Restore Benefit	Equal to 100% of Basic Sum Insured
  Emergency Ambulance	Upto Rs.2,000 per Hospitalisation
  Multiplier Benefit	Bonus of 50% of the Basic Sum Insured for every claim free year, maximum upto 100%.In case of claim, bonus will be reduced by 50% of the basic sum insured. However this reduction will not reduce the Sum Insured below the basic Sum Insured of the policy

  Optima Restore Family Health Insurance benefit table

  Coverage Benefits	Optima Restore
  In-patient Treatment	Covered upto sum insured
  Pre-Hospitalization	Covered, upto 60 Days
  Post-Hospitalization	Covered, upto 180 Days
  Day Care Treatment	All day care treatment covered
  Domiciliary Treatment	Covered upto sum insured
  Organ Donor	Covered upto sum insured
  Ambulance Cover	Upto Rs. 2,000 / Hospitalisation
  E-Opinion in respect of a Critical Illness	One opinion per policy year
  Restore Benefit	Equal to 100% of Basic Sum Insured
  Multiplier Benefit	Bonus of 50% of the Basic Sum Insured for every claim free year, maximum upto 100%.In case of claim, bonus will be reduced by 50% of the basic sum insured. However this reduction will not reduce the Sum Insured below the basic Sum Insured of the policy

• Key features of HDFC Ergo Health (Apollo Munich) Optima Restore plan

  • Room Rent: No Room Rent Restrictions across all plans.
  • Co - pay: NIL Co-pay under this plan.
  • Restoration Benefit: Upto 100% of Base Sum Insured per year.

• Optima Restore Health Insurance coverage exclusions

  • Any treatment within first 30 days of cover except any accidental injury.
  • Any Pre-existing diseases/conditions will be covered after a waiting period of 3 years.
  • 2 years exclusion for specific diseases like cataract, hernia, hysterectomy, joint replacement etc.
  • Abuse of intoxicant or hallucinogenic substance like drugs and alcohol.
  • Pregnancy, dental treatment, external aids and appliances.
  • Hospitalization due to war or an act of war or due to nuclear, chemical or biological weapon and radiation of any kind.
  • Non-allopathic treatment, congenital external diseases, cosmetic surgery

• Optima Restore Health Insurance coverage exclusions

  • Any treatment within first 30 days of cover except any accidental injury.
  • Any Pre-existing diseases/conditions will be covered after a waiting period of 3 years.
  • 2 years exclusion for specific diseases like cataract, hernia, hysterectomy, joint replacement etc.
  • Abuse of intoxicant or hallucinogenic substance like drugs and alcohol.
  • Pregnancy, dental treatment, external aids and appliances.
  • Hospitalization due to war or an act of war or due to nuclear, chemical or biological weapon and radiation of any kind.
  • Non-allopathic treatment, congenital external diseases, cosmetic surgery