Health Insurance 2324 views January 9, 2021

HDFC ERGO my:health Koti Suraksha is a health insurance plan that comes with two sections of cover- Hospitalization Cover and Personal Accident Cover. You can have either of the two based on your health requirements. And if you want to customize your HDFC ERGO my:health Koti Suraksha, you can choose from the optional cover or add-on covers. Let’s read this page below and know more about this HDFC ERGO health insurance plan.

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Section I: Hospitalization Cover

Under this HDFC ERGO my:health Koti Suraksha plan, you will get coverage for the following medical expenses.

  1. In-patient hospitalization
  2. Domiciliary Hospitalization
  3. Pre-hospitalization up to 60 days before admission to the hospital
  4. Post-hospitalization up to 180 days after discharge from the hospital
  5. Home Healthcare
  6. Day care Procedures
  7. Road Ambulance cover
  8. Alternative Treatment
  9. Organ Donor Expenses

Note:- Medical Expenses for a minimum of 24 hours of hospitalization is valid for the claim.

Added Service

You will get added benefits under this cover, which are Health coach expenses cover and Wellness service expenses cover.

And with my:health Active, you will get the cost of Preventive Health Checkup covered along with benefits like Fitness discount, Health Incentive and Cumulative Bonus.

Optional Covers Under HDFC ERGO my:health Koti Suraksha Section I

By paying an additional premium amount beside the base policy cover premium, you can customize the HDFC ERGO my:health Koti Suraksha plan section I with the following optional covers:-

  1. Non-Medical Expenses Coverage – By adding this optional cover to your HDFC ERGO health insurance, you will get the following covered – baby, baby utility charges, beauty services, belts/braces, buds, cold/hot pack, carry bags, email/internet charges, food charges (other than the patient’s diet), leggings, laundry charges, mineral water, sanitary pads, telephone charges, attendant charges, etc.
  2. Aggregate Deductible – Sum Total of all the claims made by the insured during a policy period.
  3. Emergency Worldwide Coverage – With this optional cover, you will be covered everywhere around the world.
  4. Overseas Treatment – This optional cover allows you to take treatment for illness or injury outside India if the doctor recommends it to you.
  5. Waiver of disease capping – On availing this option, Procedure Sub-Limits regarding certain diseases stand deleted
  6. Waiver of room rent cap – Limits that are specified to Room Rent, Boarding and Nursing charges shall stand deleted under the policy.
  7. Waiting period modification option – With this, all the waiting periods will modify as per your schedule of coverage. Whereas all other terms and conditions shall remain unaltered.
  8. Medical Evacuation – HDFC ERGO will pay the Air Ambulance transportation expenses for an airplane or helicopter for Emergency Care. But HDFC ERGO shall not be liable to pay for the return transportation.
  9. Sum Insured Rebound – Add an amount to your Sum Insured that is equivalent to the claim amount that is paid under the Basic Sum Insured.
  10. Waiver of Copayment – Copayments will be waived under HDFC ERGO my:health Koti Suraksha section I.
  11. Cumulative Bonus – Booster – On availing of this optional cover, your Cumulative Bonus percentage will be modified.

Exclusions Under HDFC ERGO my:health Koti Suraksha Section I

  1. Investigation & Evaluation
  2. Obesity/Weight Control
  3. Rest Cure, rehabilitation and respite care
  4. Change-of-Gender
  5. Unproven Treatments
  6. Cosmetic or plastic surgery
  7. Injury or Illness due to participation in Hazardous or Adventure Sports
  8.  Breach of Law
  9. Treatments at Excluded Providers
  10. Sterility and Infertility
  11. Maternity Expenses
  12. War or any act of war
  13. Circumcisions
  14. Vaccination, Inoculation and Immunisations

Section II: Personal Accident Cover

The base coverage for HDFC ERGO my:health Koti Suraksha Section II is as follows:-

  1. Accidental Death that includes accidental death, disappearance, comatose, and an optional cover for Burns.
  2. Permanent Disablement that includes permanent and incurable insanity, permanent total loss of two limbs, permanent total loss of sight in both eyes, etc.
  3. Temporary Total Disablement
  4. Broken Bones
  5. Emergency Medical Expenses
  6. Hospital Cash – Accident only
  7. Chauffeur Benefit

Value-added Services:- Health Coach and Wellness Service

Optional Covers Under Section II

  1. Preventive Health Check-up – At HDFC ERGO network hospitals, you can have Chest X-Ray, 2D echo/ Stress test, PSA for Males, PAP smear for Females, Medical Examination Report, Complete Blood Count Urine R, Fasting Blood Sugar, Serum Creatinine, Lipid Profile, Electrocardiogram.
  2. Last Rites – Sum Insured will be payable towards Last Rites of the Insured Person in the event of an admissible claim under accidental death.
  3. Dependent Children Education Benefit – Sum Insured towards the education of Dependent Children will be payable, in the event of an admissible claim under accidental death cover.
  4. Renewal Premium Benefit – In the event of accidental death, HDFC ERGO will pay the amount equivalent to the renewal premium of the coverage.
  5. Parental Care Benefit – It applies only to living dependent parents. Here, the Sum Insured is the total claim amount for both the dependent parents.
  6. Medical Evacuation – Compensation to the Insured Person for Air Ambulance transportation in an airplane or helicopter. The claim under this cover is admissible only once in a Policy Year irrespective of the number of claims.

Exclusions Under HDFC ERGO my:health Koti Suraksha Section II

  1. Investigation & Evaluation
  2. Obesity/Weight Control
  3. Rest Cure, rehabilitation and respite care
  4. Change-of-Gender
  5. Unproven Treatments
  6. Cosmetic or plastic surgery
  7. Injury or Illness due to Hazardous or Adventure Sports
  8.  Breach of Law
  9. Treatments at Excluded Providers
  10. Sterility and Infertility
  11. Maternity Expenses
  12. War or any act of war
  13. Traveling in aircraft other than as a fare-paying passenger
  14. Circumcisions
  15. Vaccination, Inoculation and Immunisation

Discounts on HDFC ERGO my health: Koti Suraksha

If you choose a sum insured of INR 1 crore, you will get some discounts on your premium. But will the discount come by just choosing the stated sum insured amount? NO, you need to ensure a few more to get the same. Let’s check below the conditions for getting discounts.

Discounts on a Long Term Plan

Usually, health insurance policies are issued for a year and get renewed upon the payment of premium on the due date every year. But you can also choose a 2 to 3-year policy and get up to a 10% discount while doing so.

Discounts on Family Members

If two or more family members buy a health insurance plan on an individual sum insured basis, you will get a discount of 10% on the premium.

Fitness Discounts

If you stay fit and healthy, the plan will credit you a 10% discount on your premium. HDFC ERGO will chart out a health routine you need to follow and meet the health parameters as told to get the discount.

Why Should You Buy a 1 Crore HDFC ERGO my health: Koti Suraksha Health Insurance Plan?

Will you buy a 1 crore HDFC ERGO my Health: Koti Suraksha Health Insurance Plan just for getting discounts? Or will you do to meet some important financial milestones? We’re sure you will say the second point! It’s due to the following necessities of life –

Being a Sole Breadwinner If you are a sole breadwinner, your family’s financial situation might deteriorate in the absence of sum insured corresponding to the healthcare expenses. With a 1 crore plan, you can avoid such miseries.

Ladened with Debts – If you are paying the EMIs of home loan, car loan and other debts, you will have less disposable income to meet other needs. And if a health emergency strikes, it could mount worries for you with less disposable income and inadequate sum insured. While not much can be done about the lack of sufficient disposable income due to loans, you can at least get the sum insured to INR 1 crore to meet healthcare expenses adequately.

Poor Medical History If your family has a history of illnesses such as cancer, heart-related ailments and alike, chances of such diseases affecting you or any of your family members are high. The treatment for these illnesses is very expensive and can make it tough for you financially in the absence of an adequate sum insured. So, a 1 crore plan is worth having to address this concern.

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