HDFC ERGO Energy Health Insurance Plan

HDFC ERGO Energy Health Insurance Plan - BimaBandhu

In a world filled with various health uncertainties, securing comprehensive insurance tailored to specific health conditions is paramount. Among the myriad options available, the HDFC ERGO Energy Health Insurance plan emerges as a symbol of assurance, addressing the unique needs of individuals grappling with diabetes and hypertension. The significance of such a tailored plan cannot be overstated, considering the rising prevalence of these health conditions.

Crafted with precision, the HDFC ERGO Energy Health Insurance Plan serves as a specialised shield for those with pre-existing conditions, offering coverage from day one. Ambulance charges and organ donor expenses are seamlessly integrated into the plan, alleviating the financial burden associated with these critical aspects of healthcare. The plan goes beyond conventional coverage, introducing enticing benefits such as Hb1AC benefit, shared accommodation benefit, etc.

This guide aims to dive into the intricacies of the HDFC ERGO Energy Health Insurance Plan, covering its features and benefits for those seeking a nuanced understanding of insurance options available for diabetes and hypertension. 

HDFC ERGO Energy Health Insurance Plan: Key Highlights

  • Sum Insured: Ranges from Rs 2 lakh to Rs 50 lakh
  • Policy Tenure: 1 year
  • Plan Types: Silver and Gold
  • Pre-policy Medical Check-ups: Mandatory 
  • Pre-existing Diseases Waiting Period: 2 years (except for diabetes)
  • Specific Diseases Waiting Period: 2 years.
  • Co-Payment: Optional co-payment feature available at 20%

Also Read: All About HDFC ERGO Health Insurance 

Benefits of HDFC ERGO Energy Health Insurance Plan

  • Day 1 coverage for Diabetes/Hypertension
  • In the event of partial or complete exhaustion of the base sum insured upon raising a claim, the restore benefit steps in to reinstate the sum insured by 100%. 
  • The plan offers a 10% cumulative bonus for every claim free year. This bonus enhances the sum insured without any increase in the premium.
  • The HDFC ERGO Energy plan includes a wellness program tailored to meet the specific needs of diabetes and hypertension patients. 
  • Beyond health security, the insured can optimise their financial planning by leveraging tax benefits under Sec 80D of the Income Tax Act. 

Inclusions of HDFC ERGO Energy Health Insurance Plan

  • Covers medical expenses incurred during hospitalisation exceeding 24 hours (including room rent, ICU charges, nursing fees, and related costs)
  • Pays for medical expenses accrued 30 days prior to hospitalisation
  • Extends coverage to medical expenses for up to 60 days following hospitalisation
  • Includes the cost of medical treatments and procedures necessitating less than 24 hours of hospitalisation
  • Provides financial support for ambulance services availed during a medical emergency
  • Covers the treatment cost associated with harvesting organs for transplant surgeries
  • Offers a cash benefit to policyholders opting for shared hospital rooms instead of single private rooms
  • Reimburses medical expenses incurred for HbA1C check-ups, allowing policyholders to claim this benefit twice a year

Exclusions of HDFC ERGO Energy Health Insurance Plan

  • Medical expenses related to pregnancy 
  • Expenses not directly associated with medical treatments or hospitalisation 
  • Costs related to external aids and appliances, such as hearing aids or mobility devices
  • Expenses incurred for cosmetic surgery, which is not deemed medically necessary
  • Hospitalisation resulting from the abuse of drugs or intoxicants 
  • Medical expenses related to congenital external diseases 
  • Costs associated with treatments that are experimental, unproven, or investigative in nature
  • Hospitalisation arising from war, or the use of chemical or biological weapons

Understanding these inclusions and exclusions can help you manage expectations and make informed decisions regarding healthcare expenses. While the HDFC ERGO Energy Health Insurance Plan provides comprehensive coverage, being aware of the limitations ensures a more realistic understanding of the policy and helps in planning for potential out-of-pocket expenses.

HDFC ERGO Energy Health Insurance Plan Eligibility Criteria

  • Minimum Entry Age: 18 years for adults 
  • Maximum Entry Age: up to the age of 65 years
  • Coverage Type: Individual 
  • Renewability: Lifelong 

Recommended Read: Government Health Insurance Schemes: About, Types, Benefits, & More


Who is eligible to purchase the HDFC ERGO Energy plan?

Individuals diagnosed with type 1 diabetes, type 2 diabetes, pre-diabetes (impaired fasting glucose/impaired glucose tolerance), and hypertension are eligible to purchase the HDFC ERGO Energy health insurance plan. This specialised plan is tailored to meet the unique healthcare needs of those dealing with these specific medical conditions. If you or a loved one falls into any of these categories, the HDFC ERGO Energy plan can provide a targeted and comprehensive solution for managing health-related expenses.

Can I receive coverage for treatments outside of India with HDFC ERGO Energy health insurance?

The HDFC ERGO Energy diabetes plan does not extend coverage to treatments taken outside of India. The scope of this health insurance plan is limited to medical expenses incurred within the geographical boundaries of India. 

How much is the maximum wellness discount provided by the HDFC ERGO Energy plan?

The wellness program associated with the HDFC ERGO Energy plan offers a substantial discount, with policyholders eligible for a maximum discount of 25%. 

Is there any waiting period when I first enrol in the HDFC ERGO Energy diabetes plan?

No, there isn’t. The HDFC ERGO Energy policy has no initial waiting period. From the moment you enrol, you can avail the benefits of the plan without any delay, providing immediate coverage for diabetes and related healthcare needs. 

Are all day care procedures covered by the HDFC ERGO Energy diabetes plan?

Yes, they are. The HDFC ERGO Energy plan comprehensively covers all day care procedures. Whether it’s a minor medical intervention or a brief treatment requiring less than 24 hours of hospitalisation, the plan ensures that you receive financial support for all eligible day care procedures. 

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