Compare HDFC ERGO Health vs HDFC ERGO Health Insurace
| HDFC ERGO Health | HDFC ERGO | |
|---|---|---|
| Claims Settlement Ratio ** | 89.50% | 85.97% |
| Number of Lives Covered * | 51,16,000 | 96.05,000 |
| Network Hospitals | 10,000 + | 10,000 + |
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| Easy Health | Optima Restore | Arogya Sanjeevani | Health Suraksha | Health Suraksha Silver | Arogya Sanjeevani |
| In-patient Treatment | |||||
| Covered up to sum insured | Covered | Covered | Covered | Covered | Covered |
| Room Rent | |||||
| Covered | Covered | Up to 2% of the sum insured subject to maximum of Rs.5,000 per day | At actual | Capping on room rent | Up to 2% of the sum insured subject to maximum of Rs.5,000/day. |
| ICU Charges | |||||
| Covered | Covered | Up to 5% of the sum insured subject to maximum of Rs.10,000 per day | At actuals | Covered | Up to 5% of sum insured subject to maximum of Rs.10,000/day. |
| Pre-hospitalization | |||||
| Covered up to 60 Days | Covered up to 60 Days | 30 days before the date of admission to the hospital | 60 days before the date of admission to the hospital | 60 days before the date of admission to the hospital | 30 days before the date of admission to the hospital |
| Post-hospitalization | |||||
| Covered up to 90 Days | Covered up to 180 Days | 60 days after discharge from the hospital | 180 days after discharge from the hospital | 180 days after discharge from the hospital | 60 days after discharge from the hospital |
| Day care Procedures | |||||
| Covered | All day care treatments covered | All day care treatments covered | Covered | Covered | Covered |
| Domiciliary Treatment | |||||
| Covered | Covered upto sum insured | Not Covered | Covered | Covered | Covered |
| Emergency Ambulance | |||||
| Up to Rs.2,000 per hospitalisation | Up to Rs.2,000 per hospitalisation | Up to Rs.2,000 per hospitalisation | Silver Smart: Rs.2,000; Gold Smart: Rs.3,500; Platinum Smart: Sum insured 20 to 50 lakhs: Rs.3,500; Sum insured 50 & 75 lakhs: Rs.15,000 |
Covered | Maximum of Rs. 2,000/hospitalisation |
| Dental Treatment | |||||
Individual - Standard & Exclusive: Not Covered Platinum (4 lakhs to 10 lakhs): Up to 1% of Sum insured subject to a maximum of Rs.5,000 Platinum (15 to 50 Lakhs): Up to 1% of Sum insured subject to a maximum of Rs.7,500 Family - Standard & Exclusive: Not Covered Platinum (4 to 10 Lakhs): Up to 1% of Sum insured subject to a maximum of Rs.5,000 Platinum (15 to 50 Lakhs): Up to 1% of Sum insured subject to a maximum of Rs.10,000 (waiting period : 3 years) |
Not Covered | Dental treatment, necessitated due to disease or injury | Not Covered | Not Covered | Dental treatment, necessitated due to disease or injury |
| Bariatric Surgery | |||||
| Not Covered | Not Covered | Not Covered | Not Covered | Not Covered | Not Covered |
| Ayush Benefit | |||||
Standard: Up to Rs.20,000 Exclusive & Platinum (3 to 10 Lakhs): Up to Rs.25,000 Exclusive & Platinum (15 to 50 Lakhs): Up to Rs.50,000 |
Not Covered | Covered | Covered | Covered | Expenses incurred for inpatient care treatment under Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy. |
| Maternity Benefits | |||||
Standard: Not Covered Exclusive & Platinum (3 to 10 Lakhs): Normal Delivery Rs.15,000, Caesarean Delivery Rs.25,000 Exclusive & Platinum (15 to 50 Lakhs): Normal Delivery Rs.30,000, Caesarean Delivery Rs.50,000 (Waiting Period: 4 Years) |
Not Covered | Not Covered | Covered (Waiting period: 3 years) |
Not Covered | Not Covered |
| New Born baby cover | |||||
Standard: Not Covered Exclusive & Platinum: Additional Benefit on payment of additional premium |
Not Covered | Not Covered | Up to parent care sum insured(Optional) | Not Covered | Not Covered |
| Daily Cash for Accompanying an Insured Child | |||||
Standard: Not Covered Exclusive & Platinum (3 to 5 Lakhs): Rs.300 per day, maximum Rs.9,000 Exclusive & Platinum (7.5 to 10 Lakhs): Rs.500 per day, maximum Rs.15,000 Exclusive & Platinum (15 to 50 Lakhs): Rs.800 per day, maximum Rs.24,000 |
Not Covered | Not Covered | Covered up to sum insured | Covered up to sum insured | Not Covered |
| Organ Donor Expenses | |||||
| Covered | Covered up to sum insured | Not Covered | Covered | Covered | Not Covered |
| Vaccination (In case of post bite treatment) | |||||
| Not Covered | Not Covered | Not Covered | Not Covered | Not Covered | Not Covered |
| Health Check-up | |||||
Standard: Every 4 years 1% of sum insured, up to Rs.5,000, irrespective of claim Exclusive: Every 3 years 1% of sum insured, up to Rs.5,000, irrespective of claim Platinum: Every 2 years 1% of sum insured, up to Rs.5,000, irrespective of claim |
Individual - 3 Lakhs: Not Covered 5 Lakhs: Up to Rs.1,500 10 Lakhs: Up to Rs.2,000 15 Lakhs: Up to Rs.4,000 20 to 50 Lakhs: Up to Rs.5,000 Family - 3 Lakhs: Not covered 5 Lakhs: Up to Rs.2,500 10 Lakhs: Up to Rs.5,000 15 Lakhs: Up to Rs.8,000 20 to 50 Lakhs : Up to Rs.10,000 |
Covered | Covered | 1% of sum insured after every 4 consecutive and continuous claim free years with us (Subject to a maximum up to Rs.5,000) |
Not Covered |
| Hospital daily allowance | |||||
Standard: Rs.500 per day, maximum Rs.3,000 Exclusive & Platinum (3 to 5 Lakhs): Rs.500 per day, maximum Rs.3,000 Exclusive & Platinum (7.5 to 10 Lakhs): Rs.800 per day, maximum Rs.4,800 Exclusive & Platinum (15 to 50 Lakhs): Rs.1,000 per day, maximum Rs.6,000 (Choosing shared accommodation) |
3 to 15 Lakhs: Rs.800 per day, maximum Rs.4,800 20 to 50 Lakhs: Rs.1,000 per day, maximum Rs.6,000 (Choosing shared accommodation) |
Not Covered | Covered up to sum insured | Covered up to sum insured | Not Covered |
| Co-pay | |||||
| NIL Co-pay under this plan | NIL Co-pay under this plan | 5% Co-pay applicable on all claims | Silver Smart: No co-pay for all treatment, Optional Co pay available between 10%/20%; Gold Smart: No co-pay for all treatment, Optional Co pay available between 15%/25%; Platinum Smart: No co-pay for all treatment, Optional Co pay available between 15%/25% |
NIL / co-pay applicable up to 20% for treatment in higher class cities | 5% co-pay on all claims |
| Pre-existing diseases coverage | |||||
| Covered after a waiting period of 3 years | Covered after a waiting period of 3 years | Covered after a waiting period of 4 years | Pre-existing diseases covered after 3 years of continuous coverage | Pre-existing diseases covered after 4 years of continuous coverage | Pre-existing diseases covered after 4 years of continuous coverage |
| Restore Benefit | |||||
| NIL Restoration Benefit under this plan | Up to 100% of Base Sum Insured per year | NIL Restoration benefit | Sum Insured Rebound up to 100% of sum insured per year | Not Covered | Not Covered |
| General waiting period | |||||
| 30 days | 30 days | 30 days | 30 days | 30 days | 30 days |
| Renewal Benefit / Cumulative Bonus | |||||
| 10% on base sum insured for every claim free year and up to 100% | 50% for every claim free year up to 100% of basic sum insured | 5% for every claim free year up to 50% of sum insured | Silver Smart & Gold Smart: 10% on base sum insured for every claim free year and up to 100%; Platinum Smart: 25% on base sum insured for every claim free year and up to 200%. |
5% on base sum insured for every claim free year and up to 50% | 5% on base sum insured for every claim free year and up to 50% |
| Emergency Air Ambulance | |||||
Standard: Not Covered Exclusive & Platinum (3 to 10 lakhs): Not Covered Exclusive & Platinum (15 to 50 Lakhs): Up to Rs.2.5 lakhs per hopsitalisation |
3 to 5 Lakhs: Not Covered 10 to 50 Lakhs: Covered up to Rs.2.5 lakhs per hospitalization and maximum up to sum insured in an year |
Not Covered | Silver Smart: Not Covered; Gold Smart: Up to 2 lakhs; Platinum Smart: Up to 5 lakhs. |
Not Covered | Not Covered |
| Available sum insured options | |||||
Individual - Standard Plan: Rs.1 to 15 Lakhs Exclusive Plan: Rs.3 to 50 Lakhs Platinum Plan: Rs.4 to 50 Lakhs Family - Standard Plan: Rs.2 to 15 Lakhs Exclusive Plan: Rs.3 to 50 Lakhs Platinum Plan: Rs.4 to 50 Lakhs |
Individual: Rs.50,000 to 10 Lakhs Floater: Rs.2 to 10 Lakhs |
Rs.1 to 5 Lakhs | Silver Smart: Rs.3 to 5 Lakhs Gold Smart: Rs.7.5 to 15 Lakhs Platinum Smart: Rs.20 to 75 Lakhs |
Rs.3 to 50 Lakhs | Rs.1 to 5 Lakhs |
| Policy can be purchased for | |||||
| 1/2 years | 1/2 years | 1 year | 1/2/3 Years | 1/2/3 Years | 1 Year |
| Eligibility criteria | |||||
| 5 years onwards, Dependent children between 91 days to 5 years can be covered only if both parents are covered under the policy | 5 years onwards, Dependent children between 91 days to 5 years can be covered only if both parents are covered under the policy | Adults from 18 to 65 years (dependents 91 days to 17 years) | Adults from 18 Years to lifetime entry (dependents 91 days to 25 years) | Adults from 18 Years to lifetime entry (dependents 91 days to 25 years) | Adults from 18 to 65 years (dependents 91 days to 25 years).If the child above 18 years of age is financially independent, he or she shall be ineligible for coverage in the subsequent renewals |
| Renewability | |||||
| Renewal for whole life | Renewal for whole life | Renewal for whole life | Renewal for whole life | Renewal for whole life | Renewal for whole life |
| Claims loading | |||||
| Loading | Loading | No Loading | Loading | Loading | No Loading |
| Portablity (At the time of renewal) | |||||
| Yes | Yes | Yes | Yes | Yes | Yes |
| Tax Benefits Limit | |||||
| Income tax benefit under section 80D | Income tax benefit under section 80D | Income tax benefit under section 80D | Income tax benefit under section 80D | Income tax benefit under section 80D | Income tax benefit under section 80D |
