HDFC ERGO Optima Restore Plan

HDFC ERGO Optima Restore Plan - BimaBandhu

In an era where securing comprehensive health coverage is must for everyone, selecting the right health insurance plan can provide assurance for individuals and families alike. As the uncertainties surrounding health continue to prevail, having a robust insurance plan becomes imperative. The Optima Restore Plan, offered by HDFC ERGO, is a comprehensive solution designed to safeguard your well-being.

With a focus on enhancing medical coverage, HDFC ERGO Optima Restore Plan addresses both emergency and planned medical expenditures incurred during hospitalization, ensuring a holistic approach to health protection. This plan goes the extra mile in securing your health on multiple fronts, from covering ambulance services to day care procedures, domiciliary treatments, and beyond.

Beyond its core offerings, the Plan also offers additional features that elevate its appeal. These include the restore benefit, multiplier benefit, daily cash for selecting shared accommodation, and similar others.

In this detailed guide of the HDFC ERGO Optima Restore Plan, we will cover the nuances of its coverage, benefits, and the peace of mind it can provide in times of medical need. 

HDFC ERGO Optima Restore Plan: Key Highlights

  • Sum Insured: Ranging from Rs 3 lakh to Rs 1 crore
  • Policy Tenure: 1, 2, and 3 years
  • Network Hospitals: 12,000+ hospitals
  • Pre-existing Diseases waiting period: 3 years
  • Specific Diseases waiting period: 2 years
  • Initial Waiting Period: 30 days from the policy commencement date
  • Possible Discounts: 10% discount on the premium for families, 7.5% discount for a policy with a longer tenure, or a 5% discount for online policy purchase (if available)

Also Read: All About HDFC ERGO My:health Suraksha Plan

Benefits of HDFC ERGO Optima Restore Plan

  • Restore Benefit

It allows policyholders to restore their base sum insured by 100% after the first claim. This benefit, applicable annually, activates upon partial or complete utilization of the base sum insured.

  • Multiplier Benefit

Uniquely, the policy’s coverage amount doubles in two years by increasing the sum insured by 50% after each claim-free year (as per policy terms).

  • No Room Rent Limit

Unlike most health plans, HDFC ERGO’s Optima Restore Plan has no restriction on room rent limits. Policyholders can choose a hospital room according to their preference.

  • Preventive Health Check-up

The insurance company covers the cost of preventive health check-ups for the insured, irrespective of claims.

  • Tax Benefits

Policyholders can avail tax benefits under Sec 80D of the Income Tax Act on the premium paid for the Optima Restore policy.

Inclusions of HDFC ERGO Optima Restore Plan

  • Hospitalization costs exceeding 24 hours, including room rent, doctor’s fees, nursing fees, and OT expenses
  • Pre-hospitalization expenses incurred up to 60 days before hospital admission
  • Post-hospitalization expenses incurred up to 180 days after hospital discharge
  • Day care procedures requiring less than 24 hours of hospitalization
  • Domiciliary treatment for home hospitalization when admission to a hospital is not feasible
  • Organ donor expenses related to harvesting organs donated for insured’s transplant surgery
  • E-Opinion for critical illness to obtain e-opinion from a qualified doctor for critical illness once a year, and others

Recommended Read: All About HDFC ERGO Health Super Top-up Suraksha Plan

Exclusions to Keep in Mind with HDFC ERGO Optima Restore Plan

While the HDFC ERGO Optima Restore Plan has got your back in many situations, it’s essential to know what’s not covered. Here’s what is not covered:

  • Dental treatments
  • Maternity expenses
  • Hospitalization due to abuse of intoxicants
  • External aids and appliances
  • Non-allopathic treatments
  • Congenital external diseases
  • Cosmetic surgery
  • Intentional self-injury

Knowing these inclusions and exclusions can help you make informed choices about your health coverage. It’s like having a good friend who tells you what’s in and what’s not on the menu before you pick your meal.

HDFC ERGO Optima Restore Plan Eligibility Criteria

  • Minimum Entry Age: 18 years for adults, 91 days for children
  • Maximum Entry Age: 65 years for adults, 25 years for children
  • Coverage Type: individual and family floater policies
  • Types of Relationships Covered: Self, spouse, children, parents, and parents-in-law (as per policy terms)
  • Renewability: Lifelong 


Does the Optima Restore plan include coverage for cataract surgery?

HDFC ERGO Optima Restore policy comprehensively covers the expenses associated with cataract surgery but after a waiting period of 2 years. Understanding the specifics of coverage ensures that policyholders are well-informed about the benefits and waiting periods associated with cataract surgery under the Optima Restore plan.

Is coverage provided for accidents under the Optima Restore plan?

HDFC ERGO Optima Restore policy offers coverage for hospitalizations resulting from accidental injuries right from day 1. This assurance can ensure policyholders can rely on the Optima Restore plan for prompt coverage and assistance in times of accidental injuries.

What is the mechanism of operation for Optima Restore?

The functioning of the HDFC ERGO Optima Restore policy revolves around its unique restore benefit. This benefit reinstates the base sum insured by 100% in the event of partial or complete utilization. It’s important to note that this restoration feature is available once a year, unless policyholders opt for the unlimited restore benefit.

How do I find out how much I’ll be paying for the HDFC ERGO Optima Restore policy?

You can check the premium chart thoughtfully laid out by HDFC ERGO. This handy resource breaks down all the details about the premiums, helping you wrap your head around the financial side of getting the policy.

Do I get complimentary health check-ups with the HDFC ERGO Optima Restore policy?

Your Optima Restore policy comes with the perk of free preventive health check-ups. It’s like a little extra care included in your coverage – ensuring you can stay ahead of your health game without any additional expenses.

Is it possible to view the premium for HDFC ERGO Optima Restore before making a purchase?

Before making any commitments, you can utilize the HDFC ERGO Optima Restore premium calculator. This tool allows you to estimate the premium amount you’ll be required to pay, giving you a clear picture of the financial aspect associated with purchasing the policy.

Are there waiting periods with HDFC ERGO Optima Restore?

Ans: Indeed, there are waiting periods associated with the HDFC ERGO Optima Restore plan, designed to ensure smooth policy implementation:

  • Initial Waiting Period: 30 days
  • Specific Disease Waiting Period: 2 years
  • Pre-existing Disease Waiting Period: 3 years

Read BimaBandhu’s Insurance Guides


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.