Hdfc Ergo Optima Restore Plan
HDFC ERGO
9.4/10
OneAssure Rating
9.4/10
OneAssure Rating
Highlighted Features
No Limit on ICU & Private Room Comfort
Provides a Single A/C Private Room for normal hospitalization and no limit on ICU room rent, ensuring top-quality medical care.
10% Co-Payment for Senior Citizens
Policyholders above 80 years must contribute 10% of each claim, ensuring continued coverage with shared medical costs.
Brochure
Policy Wording
Explore more features
Our Verdict
The HDFC ERGO Health Optima Restore Plan offers comprehensive coverage with unique Restore and Multiplier Benefits. Ideal for families and individuals seeking robust financial protection and rewarding no-claim incentives.
About the Plan
The HDFC ERGO Health Optima Restore Plan offers ₹3 lakh to ₹50 lakh in coverage, including hospitalization, pre-hospitalization (60 days), post-hospitalization (180 days), and daycare procedures. Its Restore Benefit reinstates 100% of the sum insured, while the Multiplier Benefit increases coverage by 50% per claim-free year, doubling in two years. It also provides preventive health check-ups at renewal. This plan ensures comprehensive coverage, financial security, and proactive health management, making it ideal for individuals and families.
About the Plan
Product Stats
Rating
Features of the Product
Room Rent (Normal & ICU)
Normal: Single A/c Private room
ICU: No Limit
Co-payment
All person(s) named in the schedule to this policy above the age of 80 years (age last birthday) shall bear a co-pay of 10% for each and every claim.
Waiting Periods
Initial Waiting Period: 30 days from the policy's inception, applicable to all illnesses except those resulting from accidents.
Specific Diseases and Treatments: 24 months for certain listed illnesses and surgical procedures.
Pre-existing Diseases: 36 months before coverage begins for any pre-existing conditions declared at the time of policy purchase.
Cashless Healthcare Providers
16000+ network hospitals
Day Care Treatments
All day care treatments available. Expenses of Hospitalization for a minimum period of 24 consecutive hours only shall be admissible.
AYUSH Treatment
AYUSH is Covered up to Sum Insured.
Exclusions
No coverage for any illness, except accidental injuries, occurring within the first 30 days of policy commencement.
Conditions existing before policy inception are covered only after a continuous waiting period of 36 months.
Certain ailments and procedures, such as cataract, hernia, and joint replacement, have a 24-month waiting period before coverage begins.
Medical expenses arising from self-harm, including suicide attempts, are not covered under this policy.
Treatment costs related to alcohol or drug misuse and associated complications are excluded from coverage.
Expenses for cosmetic or plastic surgeries aimed at enhancing appearance are not covered unless medically necessary due to injury.
Medical expenses for fertility treatments, assisted conception, or related procedures are excluded from the policy.
Routine dental care, including dentures and oral surgeries, is not covered unless required due to an accident.
Costs for corrective devices like spectacles, contact lenses, or hearing aids are not covered.
Expenses for alternative treatments not recognized by Indian medical councils, except AYUSH (Ayurveda, Yoga, Unani, Siddha, and Homeopathy), are excluded.
Medical conditions resulting from acts of war, invasion, or civil unrest are not covered.
Injuries sustained while engaging in adventure sports or hazardous activities are excluded from coverage.
Expenses related to childbirth, including prenatal and postnatal care, and treatment of the newborn are not covered.
Treatment for congenital anomalies or genetic disorders is excluded from the policy coverage.
Procedures or treatments that are unproven, experimental, or not in line with standard medical practice are not covered.
Exclusions
Unlimited Restore Benefit - Automatically reinstates 100% of the basic sum insured upon partial or complete utilization, applicable multiple times within a policy year.
Add-ons
Looking for a Specific Hospital ?
Why OneAssure?
We help you maximize your coverage over time for stronger protection.
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.
About the Company
Still Confused ?
Frequently Asked Questions
Related Blogs
Comprehensive Guide to HDFC ERGO Health Insurance Plans
Explore the benefits of HDFC ERGO health plans, offering comprehensive coverage, flexible options, and added perks to suit your healthcare needs and budget.
10 Health Insurance Benefits You Should Check for in Your Policy
Discover the 10 advantages of insurance and learn how health insurance can protect your family and finances during unforeseen medical events.
Top 10 Claim Settlement Ratio Health Insurance Companies in India
Compare the top 10 health insurance companies in India with the highest claim settlement ratios, ensuring reliable coverage and hassle-free claim processing.
Top 5 Term Plans with Return of Premium in India 2025
Discover the top 5 term plans with return of premium in India for 2025. Get life coverage with 100% premium refund and secure your financial future.
What is a Single Premium Policy and How Does It Work?
Discover single premium policies, how they function, benefits, and differences between single premium life insurance and a single premium term plan.
HDFC Life Sampoorn Nivesh: A Versatile Investment-Cum-Insurance Plan
Check out our review of HDFC Sampoorn Nivesh for its benefits, features, and investment options.