Health Insurance 544 views April 27, 2021

HDFC ERGO my-health Critical Suraksha Plus is designed to cover your medical expenses arising from critical illnesses. Here, you can choose your cover from the following options –

  1. Cancer Suraksha
  2. Cardiac Suraksha
  3. Smart Suraksha
  4. Comprehensive Suraksha
  5. Multi Pay Suraksha Elite
  6. Multi Pay Suraksha Supreme
  7. Multi Pay Suraksha Comprehensive

Continue reading this page below and see which HDFC ERGO my-health Critical Suraksha Plus Cover is suitable for you and your family.

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Cancer Suraksha

If you suffer from any of the following critical illnesses or undergo any of the surgical procedures, you will get 100% of the Sum Insured or a percentage of the sum insured.

  1. Malignant Cancer of specified Sites – Breast, Cervix, Uterus, Fallopian Tube, Ovary, Vagina/Vulva (for female), and Head and Neck, Lung, Stomach, Colorectal and Prostate (for male).
  2. Cancer of specified severity
  3. Aplastic Anemia
  4. Major Organ Transplant – (Bone Marrow)
  5. Early Stage Cancer
  6. Carcinoma in situ

The coverage will start after the waiting period of 90 days, and 100% of the sum insured is payable in case any of the above-mentioned critical illnesses occurs after the waiting period. However, the waiting period is 180 days and only 25% of the Sum Insured, up to INR 10 lakh will be payable for Early Stage Cancer and Carcinoma in situ.

Cardiac Suraksha

The insurer will pay the entire Sum Insured or a percentage of it on the occurrence of the following illnesses or treatment –

  1. Open Chest CABG
  2. Myocardial Infarction (First Heart Attack of specified severity)
  3. Open Heart Replacement or Repair of Heart Valves
  4. Major Organ Transplant – Heart
  5. Surgery of Aorta
  6. Primary (Idiopathic) Pulmonary Hypertension
  7. Other serious coronary artery diseases
  8. Dissecting Aortic Aneurysm
  9. Cardiomyopathy
  10. Eisenmenger’s Syndrome
  11. Infective Endocarditis
  12. Angioplasty
  13. Balloon Valvotomy or Valvuloplasty
  14. Insertion of Pacemaker

Note – The above-mentioned critical illnesses or surgeries shall be covered after a waiting period of 90 days, except for Balloon Valvotomy or Valvuloplasty and Insertion of Pacemaker as these have a waiting period of 180 days. And only 25% of the sum insured, up to INR 10 Lakh, will be payable when claiming for Balloon Valvotomy or Valvuloplasty and Insertion of Pacemaker.

Smart Suraksha

You’ll get coverage for the following critical illnesses and surgeries under this HDFC ERGO my-health Critical Suraksha Plus plan –

  1. Open Chest CABG
  2. Myocardial Infarction (First Heart Attack of specified severity)
  3. Open Heart Replacement or Repair of Heart Valves
  4. Major Organ Transplant – Heart
  5. Surgery of Aorta
  6. Primary (Idiopathic) Pulmonary Hypertension
  7. Other serious coronary artery diseases
  8. Dissecting Aortic Aneurysm
  9. Cardiomyopathy
  10. Eisenmenger’s Syndrome
  11. Infective Endocarditis
  12. Angioplasty
  13. Balloon Valvotomy or Valvuloplasty
  14. Insertion of Pacemaker
  15. Multiple Sclerosis with persisting symptoms
  16. Permanent Paralysis of Limbs
  17. Stroke resulting in permanent symptoms
  18. Benign Brain Tumour
  19. Coma of specified severity
  20. Parkinson’s Disease
  21. Alzheimer’s Disease
  22. Motor Neurone Disease with permanent symptoms
  23. Muscular Dystrophy
  24. Apallic Syndrome
  25. Bacterial Meningitis
  26. Creutzfeldt-Jakob Disease (CJD)
  27. Encephalitis
  28. Major Head Trauma
  29. Progressive Supranuclear Palsy
  30. Brain Surgery Major
  31. Loss of Speech

Note – The coverage will start after the expiry of the waiting period. It is 180 days for Balloon Valvotomy or Valvuloplasty and Insertion of Pacemaker and 90 days for the remaining illnesses or surgeries. Also, the claim amount is capped at 25% of the sum insured, up to INR 10 Lakh, for Balloon Valvotomy or Valvuloplasty and Insertion of Pacemaker, whereas it is 100% of the sum insured for the remaining illnesses or surgeries.

Comprehensive Suraksha

You will get the combined benefit of Cancer Suraksha, Cardiac Suraksha & Smart Suraksha under this plan. Plus, the coverage for the following is up to 100% of the sum insured –

  1. Multiple Sclerosis with persisting symptoms
  2. Permanent Paralysis of Limbs Major
  3. Stroke resulting in permanent symptoms
  4. Benign Brain Tumour
  5. Coma of specified severity
  6. End Stage Lung Failure
  7. Fulminant Hepatitis
  8. Chronic Adrenal Insufficiency (Addison’s Disease)
  9. Progressive Scleroderma Major
  10. Chronic Relapsing Pancreatitis
  11. Elephantiasis
  12. HIV due to blood transfusion and occupationally acquired HIV
  13. Terminal Illness
  14. Myelofibrosis
  15. Pheochromocytoma
  16. Crohn’s Disease
  17. Severe Rheumatoid Arthritis
  18. Severe Ulcerative Colitis
  19. Deafness Major
  20. Blindness Major
  21. Third Degree Burns
  22. Severe Osteoporosis (waiting period – 180 days, coverage up to 25% of the sum insured, up to INR 10 Lakh)

Note – The coverage under this plan starts from the date of expiry of the 90-day waiting period, except for Severe Osteoporosis.

Multi Pay Suraksha Elite

If you suffer from any of the following critical illness or undergo such surgeries, the insurer will pay the entire sum insured or a percentage of the same –

  1. Cancer of Specified Severity
  2. Aplastic Anemia
  3. Major Organ Transplant – Bone Marrow
  4. Open Chest CABG
  5. Myocardial Infarction (First Heart Attack of specified severity)
  6. Open Heart Replacement or Repair of Heart Valves
  7. Major Organ Transplant – Heart
  8. Surgery of Aorta
  9. Primary (Idiopathic) Pulmonary Hypertension
  10. Other serious coronary artery diseases
  11. Dissecting Aortic Aneurysm
  12. Cardiomyopathy
  13. Eisenmenger’s Syndrome
  14. Infective Endocarditis
  15. Angioplasty (covered up to 25% of the sum insured)

Note – The cover will start from the expiry of the 90-day waiting period, except for Angioplasty where the waiting period is 180 days.

Multi Pay Suraksha Supreme

You’ll get coverage for the same critical illness/surgery as mentioned in Multi Pay Suraksha Elite. Plus, you will get coverage up to the sum insured for the following under HDFC ERGO my-health Critical Suraksha Plus Multi Pay Suraksha Supreme Plan –

  1. Multiple Sclerosis with persisting symptoms
  2. Permanent Paralysis of Limbs
  3. Stroke resulting in permanent symptoms
  4. Benign Brain Tumour
  5. Coma of specified severity
  6. Parkinson’s Disease
  7. Alzheimer’s Disease
  8. Motor Neurone Disease with permanent symptoms
  9. Muscular Dystrophy
  10. Apallic Syndrome
  11. Bacterial Meningitis
  12. Creutzfeldt-Jakob Disease (CJD)
  13. Encephalitis
  14. Major Head Trauma
  15. Progressive Supranuclear Palsy
  16. Brain Surgery Major
  17. Loss of Speech

Multi Pay Suraksha Comprehensive

If you opt for this HDFC ERGO my-health Critical Suraksha Plus Plan, you’ll get coverage same as Multi Pay Suraksha Supreme & Multi Pay Suraksha Elite. Plus, the coverage for the following is up to the sum insured –

  1. Kidney failure requiring regular dialysis
  2. Major Organ Transplant – Kidney, Lung, Liver and Pancreas
  3. End Stage Liver Failure
  4.  Medullary Cystic Disease
  5. Systemic Lupus Erythematosus with Lupus Nephritis
  6. End Stage Lung Failure
  7. Fulminant Hepatitis
  8. Chronic Adrenal Insufficiency (Addison’s Disease)
  9. Progressive Scleroderma
  10. Chronic Relapsing Pancreatitis
  11. Elephantiasis
  12. HIV due to blood transfusion and occupationally acquired HIV
  13. Terminal Illness Major
  14. Myelofibrosis
  15. Pheochromocytoma
  16. Crohn’s Disease
  17. Severe Rheumatoid Arthritis
  18. Severe Ulcerative Colitis
  19. Deafness
  20. Blindness
  21. Third Degree Burns

HDFC ERGO my-health Critical Suraksha Plus Renewal Benefit

You will get the benefit of a free health check-up on the renewal of the policy. These check-ups shall be carried out at the insurer’s network diagnostic centers or hospitals as per the list of tests mentioned below –

If Insured’s age is 18-40 years 

  1. For a sum insured of INR 1-10 Lakh – Complete Blood Count, Urine R,FBS, Sr Cholesterol
  2. For a sum insured of INR 11-50 Lakh – Complete Blood Count, Urine R,FBS, Sr Cholesterol, Thyroid, USG abdomen and pelvis
  3. For a sum insured above INR 50 Lakh – Complete Blood Count, Urine R,FBS, Sr Cholesterol, Thyroid, USG abdomen and pelvis, Thyroid, USG abdomen and pelvis, Lipid Profile, Renal Profile

If the insured’s age is more than 40 years 

  1. For a sum insured of INR 1-10 Lakh – Complete Blood Count, Urine R,FBS, Sr Cholesterol, SrCreat
  2. For a sum insured INR 11-50 Lakh – Complete Blood Count, Urine R,FBS, Sr Cholesterol, SrCreat, Thyroid, USG abdomen and pelvis
  3. For a sum insured above INR 50 Lakh – Complete Blood Count, Urine R,FBS, Sr Cholesterol, Thyroid, USG abdomen and pelvis, Lipid Profile, Renal profile, ECG

Free Health Checkup also includes additional tests like –

  1. PAP Smear
  2. Mammography
  3. PSA

The additional tests shall be allowed once in two policy years if the age of the insured member is below 40 years. Otherwise, additional tests are allowed once in four policy years.

HDFC ERGO my-health Critical Suraksha Plus Optional Covers

You will get the option of following covers for extra coverage under this HDFC ERGO Plan –

  1. Pre Diagnosis Cover Benefit – Here, you’ll get coverage up to INR 25,000 for the listed diagnostic tests
  2. Post Diagnosis Support – Under this optional cover, you’ll get services like – Second Medical Opinion Second up to INR 10,000, Molecular Gene Expression Profiling Test up to INR 10,000 & Post Diagnosis Assistance up to INR 3,000 per session
  3. Loss of Job Benefit – If you have to resign from your job or lose your job due to diagnosis of any of the covered illness, the insurer will pay up to 50% of the monthly salary to you for up to 6 months.

Add On Covers Under HDFC ERGO my-health Critical Suraksha Plus

If you need extra protection, you can opt for any of the following add on covers –

  1. Hospital Cash Benefit – A daily cash benefit will be paid to you on hospitalization, up to 30 days.
  2. Companion Benefit – The insurer will cover the travel expenses of the accompanying person if the insured is hospitalized.

Free Look Period

A free look period of fifteen days is allowed from the date of receipt of the policy document to review its terms and conditions. During this period, you can return the policy if you disagree with any of the terms and conditions. On such cancellation, you’ll be entitled to a refund of the paid premium less medical expense and stamp duty charges, provided no claim is made during such period. Whereas if the risk has already commenced and the option of return of the policy is exercised, the proportionate risk premium for the period on the cover will be reduced from the refund. And if only a part of the insurance coverage has commenced, such proportionate premium shall be reduced from the refund amount.

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