HDFC Ergo
Optima Secure
Optima Secure is a great policy. There are no restrictions on the kind of room you can pick, you get a healthy loyalty benefit (50% increase in sum insured on every renewal until 100% of sum insured), and the heavily talked about Secure benefit. All things put together, you can get 3X the cover you originally paid for, once the loyalty benefit is fully accumulated. In many ways, this is a worthy successor to Optima Restore.
What's good here?
Secure Benefit
You get 2x the cover you pay for: When you buy a policy with a cover of 10 lakhs for instance, you are automatically entitled to a cover of 20 Lakhs starting from day 1.
You get 2x the cover you pay for: When you buy a policy with a cover of 10 lakhs for instance, you are automatically entitled to a cover of 20 Lakhs starting from day 1.
You’ll never have to split the bill
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.
You always have full cover irrespective of the disease
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.
Good Restoration Benefit
Even after you claim part of the cover on one occasion, you will have 100% of the cover restored, so that you can use this benefit in the event you have to endure multiple hospitalizations.
Special bonus for renewing the policy
Your sum insured increases by 50% each year irrespective of your claim status in the current year. However, the sum insured keeps increasing as long as the Loyalty benefit sum insured reaches 100% of the sum insured.
Full coverage even if you are forced to hospitalize at home
The insurer will bear the costs even if you are hospitalized at home due to a condition or the hospital running out of beds. In insurance lingo, they call this a policy with domiciliary cover.
You can pick any room you like
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.
Pre & Post hospitalization expenses covered
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.
Day Care treatments covered
If you’re hospitalized for less than 24 hours in lieu of a minor procedure, then the insurer will cover these costs too. Think dialysis, chemotherapy or minor surgeries.
Free Health Checkups
If you’re planning on getting a full body checkup every year just to make sure you’re in fine working condition, the insurer will cover the costs. (Note: This is not available for plan with 5L aggregate deductible.)
Covers Alternative Medicine
Think of getting Ayurvedic, Homeopathic or other alternative treatments to cure an illness? Your insurer will cover you fully, up to the sum insured.
What's okay here?
Reasonable waiting period for pre-existing diseases
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.
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.
Add-ons
Hospital Daily Cash
The insurer pays a lumpsum by adding a fixed sum (daily cash) every day until the day of discharge so you can deal with any potential loss in income during this time. The money will be reimbursed to you after you submit the required documents post-discharge, and while this looks like a neat benefit to have, we don’t recommend it since the benefit doesn’t compensate for the extra premium you pay.
Unlimited Restore
Unlimited Restore will restore your cover in full every time a claim is settled.
Individual Personal Accident
The add-on pays a portion of the cover amount to customers in the event the policy holder had to deal with deaths, injuries, and partial or total disability resulting from an accident.
Critical Illness
You’ll be entitled to receive the full cover once you’re diagnosed with any of the 51 critical diseases listed in the policy brochure. However, since the premiums here keep changing as you grow older, it may make more financial sense to buy a critical illness cover with term plans at better rates.
Aggregate Deductible
If you ever have to make a claim, then you’ll be expected to pay a sum before insurance company settles the claim. This amount is called the deductible. So if you want to buy a policy at a better price, you can opt to pay a higher deductible i.e. you can pay lower premiums by offering to pay a sum (a deductible) when a claim comes up.
Optima Well-being
With this add-on, each insured member can avail of unlimited tele and in-clinic consultations with General Physicians from network-partnered facilities. Additionally, one can avail of free home sample collection and discounts on tests taken from partnered facilities. They can also take unlimited online fitness classes, counselling sessions for mental health, diet and nutrition from partnered facilities.
Frequently Asked Questions
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