Hdfc Ergo Energy Silver Plan
HDFC ERGO
9.4/10
OneAssure Rating
9.4/10
OneAssure Rating
Highlighted Features
Room Rent (Normal & ICU)
HDFC ERGO Energy Silver With Co-Pay offers coverage for room rent and ICU expenses without any specific sub-limits, ensuring that policyholders can avail of necessary hospitalization benefits up to the sum insured.
Advanced Treatments
Coverage includes advanced treatments such as coronary angiography, cancer radiotherapy, chemotherapy, and palliative care, ensuring access to essential medical support during critical times.
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Our Verdict
HDFC ERGO Energy Silver With Co-Pay offers coverage for diabetes and hypertension with wellness benefits and a No Claim Bonus. Ideal for cost-conscious individuals, but the 20% co-payment increases out-of-pocket expenses.
About the Plan
HDFC ERGO Energy Silver With Co-Pay is a specialized health insurance plan designed for individuals with diabetes and hypertension. It covers hospitalization expenses, pre- and post-hospitalization costs, and daycare treatments. The plan includes an annual health check-up, wellness coaching, and a wellness discount based on healthy lifestyle choices. A co-payment clause applies, requiring the policyholder to share a percentage of claim costs. Additionally, it offers a No Claim Bonus, enhancing coverage for claim-free years, ensuring comprehensive financial protection.
About the Plan
Product Stats
Rating
Features of the Product
Room Rent (Normal & ICU)
Normal: no capping
ICU: no limit
Advanced Treatments
Robotic surgeries for precise, minimally invasive procedures.
Bariatric surgery for obesity management (as per policy terms).
Modern cancer treatments like immunotherapy and targeted therapy.
Stem cell therapy (for approved conditions).
Proton beam therapy for advanced cancer care.
Advanced cardiac procedures including transplants and minimally invasive heart surgeries.
Co-payment
Includes a 20% co-payment on all admissible claims. This means that the policyholder must bear 20% of the approved claim amount, while the insurer covers the remaining 80%. The co-payment applies to every claim made under the policy.
Waiting Periods
Initial Waiting Period: 30 days from policy inception, except for accidental claims.
Pre-Existing Diseases: Covered after a waiting period of 2 years.
Specific Diseases: Some listed conditions (like hernia, cataract, and joint replacements) have a waiting period of 2 years.
Diabetes & Hypertension: No waiting period; coverage starts from day one.
Maternity Benefits: If applicable, typically a waiting period of 4 years.
Cashless Healthcare Providers
16,000 cashless healthcare providers.
Day Care Treatments
Covered under the policy.
AYUSH Treatment
Covered under this policy
Exclusions
Any pre-existing diseases (other than diabetes and hypertension) not covered during the waiting period.
Expenses related to self-inflicted injuries, suicide, or attempted suicide.
Treatment for alcohol or drug abuse, including rehabilitation programs.
Any illness or injury arising from war, terrorism, or civil unrest.
Injuries or conditions resulting from participation in hazardous sports or activities.
Cosmetic or plastic surgery unless required due to an accident or medical necessity.
Treatment related to obesity, weight control, or bariatric surgery.
Expenses for experimental, unproven, or alternative treatments.
Infertility treatments, assisted reproductive techniques, or pregnancy-related complications unless specifically covered.
Medical expenses related to congenital diseases or genetic disorders.
Treatment for mental disorders, psychiatric conditions, or behavioral problems.
Charges for routine medical check-ups, vaccinations, or preventive treatments unless covered.
Any dental treatment or surgery unless required due to an accident.
Hospitalization primarily for rest, rehabilitation, or respite care.
Any treatment received outside the policy’s geographical coverage area.
Exclusions
OPD Cover - Get coverage for outpatient consultations, diagnostic tests, and prescribed medications, reducing out-of-pocket expenses for routine healthcare needs.
Hospital Daily Cash - Receive a fixed daily allowance for each day of hospitalization to help cover incidental expenses not included in the policy.
Critical Illness Cover - Provides a lump sum payout if diagnosed with a covered critical illness, ensuring financial support during severe medical conditions.
Personal Accident Cover - Offers financial protection in case of accidental death or permanent disability, securing your family’s future.
Alternative Treatments Cover - Covers treatments like Ayurveda, Homeopathy, and Unani medicine, expanding your healthcare options beyond conventional treatments.
Add-ons
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About the Company
HDFC ERGO, a subsidiary of HDFC Bank, offers a comprehensive range of general insurance products, including motor, health, travel, home, and personal accident insurance for individuals, as well as property, marine, and liability coverage for businesses. HDFC ERGO Health Insurance is committed to providing financial protection during medical emergencies, offering a wide range of health insurance plans. With a focus on seamless claims settlement, the company settles a claim every minute*, ensuring prompt and reliable service. Trusted by over 1.6 crore customers, HDFC ERGO’s plans include benefits like cashless hospitalization, outpatient department (OPD) coverage, daily cash allowances, and diagnostic cost coverage. The my:Optima Secure plan offers enhanced coverage at no extra cost.
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