Overview
HDFC ERGO’s my:health Suraksha Gold is a solid step up if you want broader coverage without going ultra-premium. It covers hospitalisation (including mental health), day care, organ donor costs, home care, AYUSH, and ambulance—mostly at actuals, with no room rent or ICU limits. You can choose a sum insured between ₹7.5 lakhs, ₹10 lakhs, and 15 lakhs, ideal for urban families Plus, the “my:Health Active” program gives up to 10% fitness-based discounts—all managed easily via their mobile app.
Experts Review
Written by Nikhil Nair
Senior Writer
If you’re after a plan that gives premium-grade coverage without the premium price tag, HDFC ERGO’s my:health Suraksha Gold is a strong contender. It bridges the gap between basic and high-end health insurance, offering features that are typically reserved for pricier plans.
You get comprehensive base coverage: hospitalisation (including mental health), all day care, pre- and post-hospitalisation (60/180 days), AYUSH, organ donor costs, domiciliary care, and more. The best part? No room rent or ICU limits—costs are paid at actuals, so you're not stuck in a shared room due to percentage-based caps. In addition, a 10% cumulative bonus for every claim-free year (up to 100%) keeps your coverage inflation-proof.
Wellness perks are a big plus: up to 10% discount at renewal for tracking fitness or managing conditions like diabetes via the my:Health Active app. But there are a few things to plan for. The main one is: Suraksha Gold applies a 20% co-pay if you have a Tier 2 premium but get treated in a Tier 1 hospital.
Pros
Feature set is satisfactory.
Insurer has a solid track record with great claim and service metrics.
Cons
Premiums are relatively high.
Maternity benefits not offered, which is a notable gap.
Doctor consultations are not covered, which could be a drawback for some.
HDFC Ergo
Key Insights
Founded
2002
HDFC Ergo was established 23 years ago and has built strong credibility over time, backed by its long-standing presence in the market.
Claims Experience
98% claims settled in 30 Days
HDFC Ergo settles 98% of all claims it receives demonstrating strong credibility.
Network Hospitals
13,000+
HDFC Ergo has a strong network with over 13,000 hospitals, ensuring wide accessibility and convenience for policyholders.
Complaints
7 complaints per 10,000 claims registered
HDFC Ergo maintains a low volume of complaints, reflecting strong customer satisfaction and effective service.
Features
All
Great
Good
Co-payment
The insurer will bear the entire cost of treatment (up to the sum insured). You won’t have to pay a single penny. Meaning this policy has no co-payment.
Room Rent
Shared room, single room, deluxe room or any room that’s available. The insurer won’t nitpick on your choice of room since the policy has no restrictions on room rent.
Disease sub-limit
No funny business here. If your insurer hasn’t explicitly stated they won’t cover a certain illness, you can claim the full amount up to the sum insured, irrespective of the disease you’re dealing with. Meaning this policy doesn't impose the dreaded disease wise sub-limits.
Pre existing diseases waiting
If you’re already dealing with diabetes, cardiovascular problems or any such illnesses, the insurer will cover all costs arising out of these pre-existing problems after you wait for 3 years.
Pre/Post hospitalization
No worries if the doctor had to run a host of diagnostic tests before or after hospitalizing you. The insurer has your back. They will cover this amount in full for a pretty reasonable duration - 60 days before you are hospitalized and 180 days after discharge. This includes the cost of medication by the way.
Permanent Exclusions
Conditions or treatments that the policy clearly says it will not cover.
Any Convalescence, sanatorium treatment, private duty nursing, or long-term nursing care.
Expenses related to any admission primarily for diagnostics and evaluation purposes are excluded.
Diagnostic expenses not related or incidental to current diagnosis and treatment are excluded.
Expenses for admission primarily for bed rest and not for treatment are excluded.
Custodial care at home or in a facility for help with daily activities is excluded.
Disclaimer: For illustration purposes only - exact terms are in the policy wording.
Specific Illness
The following illnesses are not covered under the policy for 2 years.
Diseases of gall bladder (including cholecystitis)
Non-infective arthritis
Pancreatitis
Urogenital stones (kidney, ureter, urinary bladder)
All forms of cirrhosis
Waiting Period
30 days Initial waiting period
2 years Specific illness waiting period
3 years Pre-existing disease waiting period
Ditto's Take
◦ Standard ◦
After a close look at the waiting periods, it’s safe to say they are fairly standard.
What's missing in the policy
Maternity benefits not offered.
Doctor consultations are not covered.
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Frequently Asked Questions
Does myHealth Suraksha Gold have waiting periods?
- 30-Day Waiting Period: Hospitalizations won’t be covered for the first 30 days of the policy unless it’s an accident.
- Specific Illness Waiting Period: There’s a 2-year waiting period for a list of diseases which is a mandate before you can start claiming.
- Pre-Existing Disease Waiting Period: There's a 3-year waiting period for any pre-existing disease you may have while buying the policy.
Does myHealth Suraksha Gold have room rent restrictions?
Does myHealth Suraksha Gold offer a restoration benefit?
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