HDFC ERGO Health Insurance

HDFC ERGO Health Insurance - BimaBandhu

When it is about safeguarding your well-being, the quest for a reliable health insurance partner becomes paramount. Since uncertainties loom large these days, having a suitable health insurance plan is a necessity. This is where HDFC ERGO Health Insurance steps in as a guardian of your health and financial security.

HDFC ERGO General Insurance Company Limited was established in 2002 as a collaborative effort between India’s HDFC Ltd. and Germany-based ERGO International AG. With a focus on delivering comprehensive medical coverage, the company caters to the diverse needs of individuals, families, and women by presenting a range of plans at competitive prices.

What sets HDFC ERGO Health Insurance apart is its commitment to addressing specific health concerns. The array of customized plans extends coverage to critical illnesses. Notably, the Value Buy benefit adds a distinctive dimension, allowing policyholders to enjoy discounts of up to 50% through a voluntary deductible option.

Beyond its offerings, HDFC ERGO also ensures a swift claim process, settling cashless claims in the least time. As evidenced by an incurred claim ratio of 97.47% in the year 2021-22, HDFC ERGO Health Insurance can be a reliable partner in times of health-related uncertainties.

List of HDFC ERGO Health Insurance Plans

Plan Name Target Audience Min. Age Max. Age Min. Coverage Max. Coverage
HDFC ERGO my:health Koti Suraksha Individuals 91 days 65 Years ₹ 50 Lakh ₹ 1 Crore
HDFC ERGO Optima Secure Individuals 91 days 65 Years ₹ 5 Lakh ₹ 2 Crore
HDFC ERGO Critical Illness Insurance Plan Critical Illness 5 Years 65 Years ₹ 1 Lakh ₹ 50 Lakh
HDFC ERGO Day2Day Care Plan OPD 91 days 65 Years ₹ 5000 ₹ 8000
HDFC ERGO Dengue Care Health Insurance Dengue 91 days 65 Years ₹ 50000 ₹ 1 Lakh
HDFC ERGO Energy Health Insurance Plan Diabetes & Hypertension 18 Years 65 Years ₹ 2 Lakh ₹ 50 Lakh
HDFC ERGO Easy Health Insurance Plan Family 91 days 65 Years ₹ 1 Lakh ₹ 50 Lakh
HDFC ERGO Health Wallet Insurance Plan Individuals 91 days 65 Years ₹ 3 Lakh ₹ 50 Lakh
HDFC ERGO Health Suraksha Top Up Pro Top-up 5 years 65 Years ₹ 2 Lakh ₹ 10 Lakh
HDFC ERGO Health Suraksha Top Up Plus Super Top-up 5 Years 65 Years ₹ 2 Lakh ₹ 10 Lakh
HDFC ERGO iCan Insurance Plan Cancer 5 years 65 Years ₹ 5 Lakh ₹ 50 Lakh
HDFC ERGO Maxima Health Insurance Plan Family 91 days 40 Years ₹ 3 Lakh ₹ 3 Lakh
HDFC ERGO My:health Suraksha Plan Family 91 days No age limit ₹ 1 Lakh ₹ 5 Crore
HDFC ERGO my:Health Women Suraksha Women 18 years 65 Years ₹ 1 Lakh ₹ 1 Crore
HDFC ERGO my:health Medisure Super Top Up Super Top-up 91 days 65 Years ₹ 3 Lakh ₹ 20 Lakh
HDFC ERGO Optima Restore Plan Individuals 91 days 65 Years ₹ 3 Lakh ₹ 1 Crore
HDFC ERGO Optima Senior Plan Senior Citizens 61 years No age limit ₹ 2 Lakh ₹ 5 Lakh
HDFC ERGO Optima Super Plan Top-up 91 days 65 Years ₹ 5 Lakh ₹ 10 Lakh
HDFC ERGO EquiCover Health Persons with Disability 1 day 75 years ₹ 4 Lakh ₹ 5 Lakh
HDFC ERGO Hospital Cash Insurance Plan Hospital Cash 91 days 65 Years ₹ 500 per day ₹ 2500 per day
HDFC ERGO my:Credit Comprehensive Suraksha Insurance Persons with Disability 16 years 65 Years ₹ 1 Lakh ₹ 5 Crore
HDFC ERGO Optima Cash Insurance Plan Hospital Cash 91 days 65 Years ₹ 500 per day ₹ 5000 per day
HDFC ERGO my:Health Critical Suraksha Plus Critical Illness 18 years 65 Years ₹ 1 Lakh ₹ 5 Crore

*Plan-specific information is taken from the official website and/or aggregator platforms; may change over time. Standard T&C apply.

What Makes HDFC ERGO Health Insurance Plans Suitable for Policybuyers?

1. Attractive Benefits

HDFC ERGO health insurance plans provide a plethora of unique benefits like the Value Buy benefit, Secure Benefit, Reduced Premium Benefit, and more. They enhance the overall value proposition, making the insurance plans a lucrative choice for many.

2. In-House Claims Team

One of the standout features of HDFC ERGO is its efficient claim settlement process. With an in-house claims team, the company ensures cashless claims are settled timely, providing policyholders with a hassle-free experience during challenging times.

3. 24×7 Customer Support

HDFC ERGO General Insurance Company takes pride in its responsive customer support team which is available round the clock. This ensures customers receive prompt assistance and guidance at any hour.

4. Tax Benefits

Policyholders can claim deductions on the premium paid, providing a dual benefit of financial protection and tax savings.

Also Read: Sum Insured: Meaning, Importance, Selection, and More

How to File a Claim Under an HDFC ERGO Health Insurance Plan?

Here’s a step-by-step guide to assist you in filing a claim:

1. Get Hospitalized

In the event of requiring medical attention, choose a network hospital affiliated with HDFC ERGO General Insurance Company for cashless treatment. 

2. Gather Documents

Present your HDFC ERGO health card along with a valid photo ID at the hospital’s admission counter. 

3. Proceed with Cashless Pre-authorization

The network hospital will initiate the cashless treatment process by submitting a pre-authorization form to the insurance company, formally requesting approval for your treatment. Upon receiving the pre-authorization request, the company will review and approve the cashless treatment, informing the hospital of the authorization.

4. Get the Required Treatment 

Following your discharge after getting the required treatment, the hospital will compile the final bill and all necessary documents related to your treatment, and submit the, to the insurer for further processing.

5. Get Final Authorization

The insurer will review all submitted documents and grant the final authorization to the hospital, completing the claim settlement process.

Documents Required for HDFC ERGO Health Insurance Claim

  1. Duly filled claim form along with policy number
  2. Hospital discharge summary
  3. Hospital bill with a detailed break-up of items
  4. Original payment receipts
  5. Diagnostic test reports
  6. Detailed reports of all scans performed include MRI, CT scans, X-rays, etc.
  7. Implant sticker for any implanted medical devices
  8. Invoice for implants, and others

HDFC ERGO Health Insurance Network Hospitals

HDFC ERGO General Insurance Company facilitates policyholders to access cashless medical treatment at its extensive network of hospitals situated across India. Below is a compiled list of HDFC ERGO health insurance network hospitals:

City Hospital Name
Mumbai Apollo Hospitals, Navi Mumbai
Mumbai Lilavati Hospital and Research Centre
Mumbai Hinduja Healthcare Surgical, Khar
Mumbai Fortis Hiranandani Hospital, Vashi
Delhi Indraprastha Apollo Hospital, Sarita Vihar
Delhi Fortis Escorts Heart Institute, Okhla Road
Delhi Max Super Speciality Hospital, Saket
Delhi Sir Ganga Ram Hospital, Rajendra Nagar
Bangalore Manipal Hospital, HAL Airport Road
Bangalore Fortis Hospital, Bannerghatta Road
Bangalore Columbia Asia Referral Hospital, Yeshwanthpur
Bangalore Apollo Hospital, Bannerghatta Road
Chennai Apollo Hospitals, Greams Road
Chennai Fortis Malar Hospital, Adyar
Chennai MIOT International Hospital, Manapakkam
Chennai Billroth Hospitals, Shenoy Nagar
Kolkata Apollo Gleneagles Hospital, Salt Lake
Kolkata Fortis Hospital, Anandapur
Kolkata AMRI Hospital, Salt Lake City
Kolkata Ruby General Hospital, Kasba Golpark
Hyderabad Apollo Hospital, Jubilee Hills
Hyderabad Continental Hospitals, Gachibowli
Hyderabad Yashoda Hospitals, Secunderabad
Hyderabad Care Hospitals, Banjara Hills
Pune Ruby Hall Clinic, Pune
Pune Jehangir Hospital, Pune Cantonment
Pune Sahyadri Hospital, Karve Road
Pune Deenanath Mangeshkar Hospital, Erandwane

Recommended Read: Types of Health Insurance in India

How to Buy HDFC ERGO Health Insurance Plans?

Follow these steps for a seamless buying experience:

  1. Visit the official HDFC ERGO website or an aggregator platform, and navigate to the ‘Health Insurance’ section.
  2. Select your gender and provide your full name as it appears on official documents.
  3. Select the people to be insured and enter their age.
  4. Specify your city or provide the pin code, and enter your contact phone number for communication.
  5. If any of the individuals to be insured has a medical history, choose the appropriate option.
  6. Browse through the available health insurance plans and select the one that aligns with your requirements.
  7. Make the payment for the chosen plan online
  8. Upon successful receipt of the premium, HDFC ERGO General Insurance Company will issue the health insurance policy.

How to Renew HDFC ERGO Health Insurance Plans?

  1. Start the policy renewal process by visiting the official HDFC ERGO website.
  2. Go to the ‘Renew Your Policy’ option.
  3. Select the ‘Health Renewal’ option 
  4. Log in by entering your registered mobile number and the OTP sent for authentication.
  5. Select the specific HDFC ERGO health insurance renewal plan that suits your needs. 
  6. Make the payment for the renewal premium securely.
  7. After successful payment, the insurance company will promptly renew your health insurance policy.

How to Calculate HDFC ERGO Health Insurance Premium?

Use a health insurance premium calculator to estimate the premium for your medical insurance coverage. Here are the generic steps involved:

  • Utilize the dedicated HDFC ERGO health insurance premium calculator available on the official website.
  • Input essential details into the calculator, including the residence city and the desired sum insured.
  • Verify that all provided details are accurate before proceeding to the next step. 
  • Based on the given information, the calculator will generate an estimate of the premium for the selected HDFC ERGO health insurance plan.


What exclusions exist in HDFC ERGO Health Insurance coverage?

HDFC ERGO health insurance plans exclude coverage for cosmetic surgery, dental treatments, external congenital diseases, intentional self-injury, drug addiction, and more. The comprehensive list of exclusions can be referred to in the policy’s terms and conditions for detailed information.

Which waiting periods are associated with HDFC ERGO health insurance?

With HDFC ERGO health insurance, a preliminary waiting period of 30 days is applicable. In addition, there exists a waiting duration of 2 to 4 years for pre-existing diseases, a 2-year waiting period for specific ailments, and a 90-day waiting period for critical illness insurance. 

What is the best HDFC ERGO health insurance policy?

HDFC ERGO General Insurance Company provides a diverse range of health insurance plans designed to meet the specific needs of individuals. Since the best policy varies from person to person, it is advisable to compare different HDFC ERGO health plans. 

Does HDFC ERGO health insurance cover In Vitro Fertilization (IVF)?

No, HDFC ERGO health insurance does not provide coverage for IVF procedures.

What is the process to inquire about the status of my HDFC ERGO health insurance policy?

To check the status of your HDFC ERGO health insurance policy, simply reach out to their customer care team. If you acquired your policy through an insurance aggregator, you can contact their customer care team for assistance in obtaining the current status of your policy.

How can I locate a network hospital for cashless facilities under my HDFC ERGO health insurance policy?

To identify network hospitals providing cashless facilities in your city, you may visit the official HDFC ERGO health insurance website. This ensures convenient access to cashless facilities in accordance with the provisions of your health insurance policy.

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The information presented on this blog regarding insurers, their products, services, or offerings is exclusively for informational purposes. It may be subject to updates without prior notification and should not be construed as professional advice or a suggestion to obtain any specific insurance product or service. Your reliance on such information is entirely at your own discretion and risk.