Health Insurance 481 views January 11, 2021

HDFC ERGO my:health Suraksha is a health insurance plan that provides financial protection to the insured and his/her family members. Under this, you will get multiple sum insured options, covers for air ambulance, recovery benefit, Infertility cover, and features like fitness discounts at renewals, health incentives for good health maintenance. You should know that there is an option of choosing room rent capping and co-payment, so you can get discounts on premium. Other than that, there are various discount options like a family discount, long-term policy discount and loyalty discount. This is a long-term policy with a tenure of up to 3 years with an attractive premium rate. Let’s know more about HDFC ERGO my:health Suraksha Plan coverage and exclusions on this page below.

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HDFC ERGO my:health Suraksha Hospitalization Coverage

The company will pay for the following expenses under this HDFC ERGO health insurance plan.

  1. Medical Expenses such as room rent, boarding and nursing charges, ICU charges, consultation fees, cost of anesthesia, blood, oxygen, operation theatre charges, surgical appliances, medicines, drugs and consumables.
  2. Mental healthcare if prescribed by a medical practitioner for mental illness or if it is done at a mental health establishment.
  3. Home healthcare for gastroenteritis, bronchopneumonia, respiratory tract infection, chemotherapy, pancreatitis, dengue, COPD management, hepatitis and fever management.
  4. Domiciliary Hospitalization
  5. pre-hospitalization cover for up to 60 days
  6. Post-Hospitalization cover for up to 180 days
  7. Daycare Procedures
  8. Road Ambulance
  9. Organ Donor Expenses
  10. Alternative Treatments
  11. Air Ambulance Cover, except for the return transportation
  12. Recovery Benefit if the hospitalization of an Insured Person exceeds 10 consecutive and continuous days.
  13. Sum Insured Rebound Facility

HDFC ERGO my:health Suraksha Renewal Benefits

On each renewal of HDFC ERGO my:health Suraksha, you will get the following benefits:-

  1. Cumulative Bonus – Get 10% or 25% of the Basic Sum Insured under the policy in the expiring year. Cumulative Bonus can be accumulated up to 100% or 200% of the Basic Sum Insured.
  2. Preventive Health Check-Up – Booster – Insured can get Preventive Health Checkup every year at HDFC ERGO network service provider for the following tests: Chest X-Ray, 2D Echo or 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.
  3. Fitness Discount @ Renewal – Insured Person can avail of a discount on Renewal Premium by accumulating healthy weeks.
  4. Health Incentive – This benefit encourages you to maintain good health and get incentives.
  5. Wellness Service – Under this, you will get discounts on OPD, pharmaceuticals, pharmacy, diagnostic centers, etc.

HDFC ERGO my:health Suraksha Optional Covers

Pay a little extra besides your premium to avail of the following benefits:-

  1. Parent and Child Care Cover – Parents will be covered against maternity, expenses for delivery (including cesarean section),. OPD treatment in the pre-and post-natal period, infertility treatment like IVF. Childcare expenses such as newborn baby cover and vaccination charges.
  2. Waiting Period modification Option – Under this, you can modify the waiting period for Parent and Child Care Booster to 3 years.
  3. Non-Medical Expenses upon hospitalization if they are admissible.
  4. Extended Cumulative Bonus – Enhance cumulative bonus cover with this option. However, if you opt for this, you cannot opt out of it at subsequent renewals.
  5.  Room Rent Modification Option – On availing this option, the specified room rent, boarding and nursing limits will stand modified.

General Exclusions under HDFC ERGO my:health Suraksha

HDFC ERGO will make no payment for any claim in respect of the following:-

  1. War or any act of war, invasion, an act of a foreign enemy, warlike operations, civil war, public defense, rebellion, revolution, insurrection, military or usurped acts, nuclear weapons/materials, chemical and biological weapons, radiation of any kind.
  2. Breach of law with criminal intent
  3. Intentional self-injury attempted suicide or suicide
  4. Participation or involvement in naval, military or air force operation
  5. Racing, Diving, Aviation, Scuba Diving, Parachuting, Hand-gliding, Rock or Mountain climbing
  6. Abuse or the consequences of tobacco, drugs and alcohol.
  7. Treatment of Obesity and any weight control
  8. Sleep-apnoea, Parkinson and Alzheimer’s disease
  9. General debility or exhaustion (“run-down condition”)
  10. Congenital external diseases, defects or anomalies
  11. Stem cell harvesting or growth hormone therapy
  12. Venereal diseases
  13. Sexually transmitted diseases or Illness
  14. Pregnancy (including voluntary termination), miscarriage, maternity or birth
  15. Treatment for infertility, fertility, sub-fertility or assisted conception procedure
  16. Dental treatment and surgery
  17. Treatment and supplies for analysis and adjustments of spinal subluxation
  18. Diagnosis and treatment by manipulating the skeletal structure
  19. Circumcisions
  20. Plastic surgery or cosmetic surgery
  21. Experimental, investigational or Unproven treatment
  22. Convalescence, cure, rest cure, sanatorium treatment, rehabilitation measures, private duty nursing, respite care, long term nursing care or custodial care.
  23. Preventive care
  24. Any physical, psychiatric or psychological examinations or testing
  25. Vaccination including inoculation and immunizations
  26. Non-Medical expenses
  27. Non-prescribed vitamins and tonics unless vitamins and tonics
  28. Outpatient treatment
  29. Hearing aids, spectacles or contact lenses
  30. Treatment for alopecia, baldness, wigs, or toupees, and similar products. optometric therapy.
  31. Artificial limbs, crutches or any other external appliance
  32. Non-disclosure of Pre-existing Illness or Material fact

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