HDFC ERGO Optima Restore Health Insurance Policy

Medical emergencies can hit anyone at any time. So, you should always choose the right health insurance plan to cover the happiness and wellbeing of your family members. HDFC ERGO Optima Restore Health insurance policy is a highly applauded health insurance plan that comes with exciting features like restore benefits and so on. This plan automatically restores the basic sum assured amount if you consume it during the policy year. This plan is available in individual and family floater options.

Eligibility criteria for HDFC ERGO Optima Restore Health Insurance Policy

Minimum entry age For individual,

Child: 1 day, Adult: 18 years

For Floater,

Child: 1 day, Adult: 18 years

Maximum entry age For individual,

Adult: 65 years

For Floater,

Adult: 65 years

Cover type Individual/family floater
Sum assured options 3 lakh-50 lakh
Policy term 1, 2 years
Premium payment Quarterly, half-yearly, and annually
No. of people covered Maximum 6 members

 Key Highlights of HDFC ERGO Optima Restore Health Insurance plans

  • Optima Restore plan is available in two forms (Optima Restore individual and Optima Restore family)
  • Optima restore is an exclusive health plan that restores your sum insured on partial or complete utilization of your health cover, for your future needs.
  • With this plan, you are eligible for health check-ups up to Rs. 5,000 at the time of renewals.
  • If you don’t make any claim in a year, you will get renewal incentives. 50% increase of your basic sum assured for every claim-free year.
  • You will be eligible for cashless treatment at network hospitals (10,000+ network hospitals)
  • With this health plan, you can get a daily allowance of Rs. 800 per day and a maximum of Rs. 6,000 per hospitalization.
  • You can easily upgrade your health plan to the next level at your convenience.
  • You are eligible for a discount of 10% if 2 or more family members are covered under Optima Restore individual sum insured plan.
  • No co-pay, sub-limits or additional loading on renewals
  • This plan offers lifelong renewability
  • If you are using a health insurance plan from another insurance company, then you can easily migrate to HDFC Ergo Optima Restore health plan.
  • You can enjoy tax benefits for the premium amount paid towards this plan under Section 80D of the Income Tax Act, 1961.

 

Some special features of this plan

  • You can choose your preferred room for your treatment as this plan offers no sub-limit for room rent.
  • This plan offers extended coverage for treatments like neurological disorders, genetic disorders, and injury or illness associated with hazardous activities.
  • The waiting period is 3 years for all pre-existing diseases.
  • By opting for a sum assured above Rs.10 lakhs, you can choose to cover yourself worldwide at the network centers of the insurance company against treatment expenses for eight major illnesses. This rider not only covers your healthcare expenses but also covers all travel costs for the insured and accompanying relatives, accommodation expenses, pre-and post-hospitalization expenses.

 

Inclusions in HDFC ERGO Optima Restore Health Insurance Policy

  • In-hospitalization: This policy plan covers up to your sum assured for in-patient treatment.
  • Ambulance coverage: This plan sponsors all the expenses for ambulance coverage (Rs.2000 per hospitalization) if the policyholder needs any hospitalization in case of a health emergency
  • Pre and Post hospitalization: This plan covers all medical expenses before the hospitalization ( up to 60 days) and after your discharge (up to 180 days) from the hospital.
  • Daycare procedures: This plan covers all types of daycare treatment methods, like cataracts and many more
  • Advanced technology treatment cover: This plan covers advanced treatment methods like robotic surgery, deep brain stimulation, stem cell therapy, oral chemotherapy, etc.  
  • Organ donor expenses: This plan covers all medical expenses for harvesting the organ from the donor for transplantation up to a limit of the sum insured.
  • Daily hospitalization allowance: Depending on the sum insured you have purchased, you can get a daily cash allowance (maximum Rs. 6,000) for a maximum of six days.
  • Domiciliary treatment: This plan offers domiciliary treatment for up to your sum assured amount.

 

Exclusions in HDFC ERGO Optima Restore Health Insurance Policy

  • Pre-existing diseases (waiting period 3 years)
  • Any diseases contracted within 30 days of the policy
  • Treatment of obesity or weight gain, dental treatment, pregnancy, miscarriage, plastic, and cosmetic surgery
  • External congenital disease
  • Drug addiction or alcoholism
  • Self-inflicted injuries from suicide or any suicidal attempt
  • Injuries or accidents under war-like operations, public defence, rebellion, revolution, etc.
  • Medical expenses for the treatment of STD
  • Fertilization treatment and infertility treatment

 

HDFC ERGO Optima Restore Health Insurance Policy cancellation

Policyholders are eligible to cancel their policies within a 15-days free look period. The insurance company will refund the amount minus the proportionate risk premium for the period on cover, medical examination expenses, and stamp duty charges.

FAQs:

Can I purchase HDFC ERGO Optima Restore Health Insurance policy online?

Yes, by visiting the website of the insurance company, you can purchase this health plan. Or you can purchase it through online insurance brokers.

What is the “Stay Active benefit” under this HDFC ERGO Optima Restore plan?

Stay Active benefit under the Optima Restore plan is a feature. If you lead a wholesome and active life, then you will get discounts on your premium under this feature.

What is “Health Jinn”?

“Health Jinn” is a mobile application that is provided by HDFC ERGO Health Insurance to its policyholders. With this application, you can track your progress in staying active.

What if I don’t use the restored sum assured in the given year of policy? Will it be carried forward to next year?

No, the restored amount won’t be carried forward to the next year. You can use it once in every year of policy for a lifetime.

In what situations will the sum assured amount be reinstated under your HDFC ERGO Optima Restore plan?

There are two situations in which the sum assured amount will be reinstated.
· Partial utilization of the base cover
· Complete utilization of the base cover

What is a multiplier benefit?

Multiplier Benefit is a prime feature that offers a 100% increment in the sum assured amount after 2 claim-free years.

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