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HDFC ERGO offers health insurance plan for individuals with a host of benefits such as cashless network hospitals, vast coverage and no sub limits on room rents. With the steady improvement in medical technology, there’s a hike in treatment as well as hospitalization expenses. These medical expenses are bound to rise at a much faster pace. For meeting these medical expenses you may have to drain away your savings. To cope up with growing medical expenses and keep yourself financially prepared against unexpected medical expenses, it is crucial to opt for a health insurance plan.
Health Suraksha Gold Insurance Plan
Health Suraksha Gold is uniquely designed to meet your individual coverage needs. It provides maximum coverage at an affordable cost. Choosing Health Suraksha Gold will indeed give you complete protection and safeguards you from spiralling medical expenses. You can also add Health Suraksha Gold plan with your existing employee health insurance for a larger cover.
- No restrictions on hospital expenses such as room rent, doctor fees, investigations and medicine costs.
- No entry age restriction
- Maternity Benefit along with New Born baby cover
- Free health check-ups on completing 4 claim-free years
- Lifelong renewability
- Massive chain of 6000+ network hospitals for cashless treatment
- Tax savings upto Rupees 60,000 under Section 80D of the Income Tax Act
- Minimum Documentation
- 10% discount if one opts for two year policy tenure
- 10% discount for more than 2 family members on individual Sum Insured basis
- Avail 5% Cumulative Bonus at the end of each claim-free year
- Add-ons are available to suit individual needs
- Hassle-free claim settlement procedure
- Anyone over 18 years of age can buy this policy
- More than two family members on individual Sum Insured basis is also available
What is covered?
(T&C apply. For detailed information on covers, please refer the policy wordings.)
- In-patient Treatment due to illness and accident
- Pre-hospitalization costs incurred 60 days prior hospitalization
- Post-hospitalization costs incurred 90 days post discharge
- Day care treatment, that do not require 24hrs hospitalization
- Domiciliary Treatment, as advised by medical practitioner
- Organ Donor Treatment
- Emergency Ambulance
- Non Allopathic Treatment under AYUSH - Ayurveda, Unani, Siddha and Homeopathy
- Maternity expenses and New Born baby covered upto limits specified
What is not covered?
HIV/AIDS, medical expenses arising due to intoxication, plastic or cosmetic surgery, self-inflicted injuries, War related injuries. (T&C apply. For detailed information on exclusion, please refer the policy wordings.)
Individual Health Insurance FAQs
- What do you mean by annual Sum Insured?
The annual Sum Insured is the maximum amount that an Insurance Company will pay you, according to the insurance contract, in the event of a claim.
- What are the eligibility criteria for purchasing the policy?
HDFC ERGO's Health Suraksha Gold plan is open for all above the age of 91 days. There’s no limit on age.
- Do these health policies offer any tax exemptions?
Yes absolutely, you can avail tax exemptions up to a sum of Rs. 25,000 as tax benefit under 'Section 80D'. In case of senior citizens, you are allowed to avail tax exemption up to a sum of Rs. 35,000 under Section '80'.
- Are there any medical tests that I need to undergo to enrol myself?
Ans - No pre-policy medical check-up is required for individuals’ up to 55 years* of age, subject to no health adversity.
- What are Pre and Post Hospitalization expenses?
Pre-hospitalization expenses means the medical expenses incurred for specified number of days prior to hospitalization for any disease / illness / injury sustained which is covered under the health insurance Policy. And post-hospitalization expenses means the medical expenses incurred for a specified number of days after discharge from the Hospital. In ‘Health Suraksha’ the pre-hospitalization period is 60 days while the post-hospitalization period is 90 days.
- What is meant by Day Care Procedures?
Day care procedures are the medical procedures/surgeries wherein the person does not need to get hospitalized for more than 24 hours due to technological advancement. Health Suraksha Gold covers 144 day care treatment.
- What are Domiciliary Hospitalization or in home treatment expenses?
The Medical Expenses incurred by an insured Person for medical treatment taken at his home, on the advice of the attending Medical practitioner, the insured Person could not be transferred to a Hospital or a Hospital bed was unavailable.
- What is meant by Organ Donor Expenses?
Organ donor expenses include all hospitalization expenses incurred by the donor for donating an organ (excluding the cost of the organ) to the insured during the course of an organ transplant.
- What is covered under the AYUSH Benefit?
Under AYUSH benefit HDFC ERGO Health Suraksha Gold reimburses expenses for inpatient treatment taken under Ayurveda, Unani, Sidha or Homeopathy.
- What do you mean by Pre-Existing Diseases?
Pre-Existing Disease means any condition, ailment or injury or related condition(s) for which there were signs or symptoms, and / or were diagnosed, and / or for which medical advice / treatment was received within 48 months prior to the first policy issued by the insurer and renewed continuously thereafter.
- What is Cumulative Bonus?
Cumulative Bonus means any increase or addition in the Sum Insured granted by the insurer without an associated increase in premium. Under Health Suraksha, you can avail of 5% cumulative bonus for every claim free year maximum upto 50% of SI.
- What is the procedure for reimbursement of medical expenses with HDFC ERGO Health Suraksha?
Follow three simple steps to get your claim covered:
1. Register your claim with us within 7 days of patient's discharge.
2. Send the duly signed claim form and all the documents mentioned therein to us within 15 days of the occurrence of the incident.
3. After receiving the complete set of claim documents, we will send the payment for admissible amount along with claim settlement statement within 30 days in the name of the proposer.
- What are the benefits of a Health Card?
A health card contains the contact details of the in house claim service team. In case of a medical emergency, you can call on these numbers for queries, clarifications and for seeking assistance. Moreover, you need to display your health card at the time of admission into the hospital.
- Do I need to pay for Hospitalization?
In case you are admitted in any of our network hospitals, you easily can avail cashless facility. We would directly reimburse all the admissible expenses to the hospital. However, in case of non-network hospitals, you will have to settle hospital bills at the time of discharge, and consequently, the same will be reimbursed to you by us as per Policy terms and condition, on submission of relevant document/s in originals
- What is meant by Network Hospitals?
Network Provider means hospitals or health care providers enlisted by an insurer, TPA or jointly by an Insurer and TPA to provide medical services to an insured by a cashless facility. For a complete list of network hospitals, Click here.
- What is meant by Non-Network Hospitals?
Non-Network means any hospital, day care centre or other provider that is not part of the network. The bills are settled by the Insured and the relevant documents and bills are subsequently submitted to the company. The amount, consequently, is reimbursed to the Insured.
- Whom to contact in case of hospitalization?
For hospitalization/claim, customer can contact via
Call: 1800 2 700 700 (accessible from India only)
Fax: 1860 2000 600
Mobile App: Register our claim through our mobile app. Click here to view mobile app.
- can I port my existing health insurance with HDFC ERGO's Health Suraksha?
If you own a health insurance plan issued by an Indian general insurer and you want to shift to HDFC ERGO on renewal, Health Suraksha Gold policy offers portability of accrued benefits and make due allowances for waiting period etc. as per the regulation and guidelines on portability issued by IRDA(Insurance Regulatory Development Authority). If you transfer your health insurance policy from any other Indian insurer and with enhanced coverage, then the portability benefits will be offered on the previous sum insured)
- What is family floater policy?
A family floater policy covers all family members under a single plan wherein they share a common Sum Insured.
- How does it work?
The sum assured is pre-determined and reduces as and when any member avails the benefits under the plan. Such plans cover you, parents, spouses, and children.
- What are documents required?
Some documents required include identity, age, and address proof of all covered members. In addition, the primary holder’s income proof is needed. Certain plans may require medical examination.
- Do I need family floater if already covered in corporate insurance?
Yes, it is recommended because the corporate insurance coverage may be insufficient. Moreover, if you change or lose your job, you will lose the coverage.
- What happens if the primary insured passes away?
If the primary insured passes away, the other adult member included in the policy may continue the policy.
- Can I increase the sum assured for family plans?
Sum insured can be increased at renewal subject to approval.
- What is the claim reimbursement procedure?
You must register the claim within seven days of discharge. You must attach all the documents along with the claim form. When all documents are duly received, you will receive a claim settlement letter within 30 days.
- Does health insurance under family plan ensure cashless hospitalization?
Yes it does.
- Can I change the hospital during the course of treatment?
Yes, most plans allow you to change the hospital during the course of treatment. However, you must provide the necessary information to evaluate your case.
- Will I be covered in case of overseas illness?
Some insurers provide overseas benefits, such as pre-diagnosed planned hospitalization, outpatient treatment, and second opinion in case of sudden illness while travelling.
- What can I do if cashless hospitalization is denied?
You must check if the information provided is accurate and does not have any discrepancy. It may be denied if the condition is excluded from the plan. It is advisable to pay all the expenses and then file a claim.
- How to get multiple insurance and how to claim under multiple plans?
You can get multiple insurance policies from different companies. However, you must provide all information about existing policies to the other insurers.
- How can I get a new member added to my existing family floater?
You can easily add a new member by filling up a health declaration and endorsement form.
Buy Now renew online
Calculate your health insurance premium here. Read more about health insurance here under our articles section.
(If you transfer your health insurance policy from any other Indian insurer and with enhanced coverage, then the portability benefits will be offered on the previous sum insured)
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