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HDFC ERGO Health Insurance is offered by HDFC ERGO General Insurance Company Limited, a joint venture between HDFC Ltd. and ERGO Group AG. The general insurance company offers a broad portfolio of health insurance solutions for individuals, families, senior citizens, critical illness protection, and super top-up coverage.
With over 16,000 cashless network hospitals, coverage of up to ₹2 crore under select plans, digital policy servicing, and a 97.8% health claims payout ratio (FY25), it caters to a wide range of healthcare needs.
HDFC ERGO offers different categories of health insurance plans to suit varying healthcare needs and life stages.
| Plan Type | Suitable For |
|---|---|
| Individual Health Insurance | Individuals looking for standalone medical coverage with their own sum insured |
| Family Floater Health Insurance | Families seeking a single policy with a shared sum insured for all insured members |
| Senior Citizen Health Insurance | Individuals aged 60 years and above requiring age-specific health coverage |
| Critical Illness Insurance | Those seeking a lump-sum payout on diagnosis of specified critical illnesses |
| Super Top-up Plans | Individuals with an existing health policy who want additional coverage at a lower premium |
| Disease-Specific Plans | People looking for specialised cover for conditions such as cancer, diabetes, dengue, or women-specific healthcare |
HDFC ERGO general insurance company offers a mix of comprehensive health insurance, super top-up, critical illness, cancer-specific, and global health insurance plans. Below are some of its key offerings.
| Plan | Suitable For | Key Highlights |
|---|---|---|
| Optima Secure+ | Individuals and families | Infinite restore benefit, long-term renewal discounts, chronic care rider for asthma, BP, cholesterol, and diabetes. |
| Optima Secure | Individuals and families | 2X Secure Benefit from Day 1, up to 4X coverage, restore benefit, no-cost instalment option. |
| Optima Lite | First-time buyers | Budget-friendly plan with unlimited restoration, cumulative bonus, and Protect Benefit covering eligible non-medical expenses. |
| Optima Secure Global | Frequent travellers | Global treatment cover along with India coverage and preventive health check-ups. |
| my:health Medisure Super Top-up | Existing policyholders | Additional coverage beyond the deductible at an affordable premium. |
| Critical Illness Insurance | Individuals seeking critical illness protection | Lump-sum benefit on diagnosis of 15 listed critical illnesses. |
| iCan Cancer Insurance | Individuals seeking cancer-specific protection | Covers multiple stages of cancer with lump-sum payouts and follow-up care benefits. |
| my:health Koti Suraksha | Individuals and families | Coverage up to ₹1 crore with personal accident benefits, home healthcare, wellness benefits, and multiple optional covers. |
HDFC ERGO combines comprehensive medical coverage with digital-first services and customer-friendly policy features. Here are some of the key highlights offered across its health insurance plans.
Access cashless treatment at one of the largest hospital networks across India.
Reflects the insurer's claim settlement performance for health insurance.
High sum insured options are available under select health insurance plans.
Available under selected plans, allowing greater flexibility during hospitalisation.
Covers eligible medical expenses incurred before admission and after discharge as per the selected plan.
Covers approved treatments under Ayurveda, Yoga, Naturopathy, Unani, Siddha, and Homeopathy.
Covers eligible treatments that do not require 24-hour hospitalisation.
Continue your health insurance policy for life by renewing it within the prescribed timelines (available under eligible plans).
Complimentary health check-ups are available under eligible plans.
Buy, renew, manage policies, and register claims through the website and mobile app.
Premiums paid towards eligible policies qualify for deductions under Section 80D of the Income Tax Act.
Choosing the right health insurance goes beyond comparing premiums. HDFC ERGO focuses on making healthcare more accessible through broad coverage, efficient claims support, and digital policy management.
Choose from individual, family, senior citizen, critical illness, global, and super top-up plans based on your healthcare requirements.
Selected plans cover home healthcare, mental healthcare, organ donor expenses, global treatment, and preventive care.
Purchase policies, renew coverage, download documents, and manage claims through digital channels with minimal paperwork.
Depending on the plan, enhance your coverage with optional benefits such as OPD cover, critical illness protection, and wellness features.
Features such as restoration benefits, cumulative bonuses, and lifetime renewability help maintain comprehensive protection over time.
Cashless claims are supported through an extensive hospital network, with an average cashless claim approval time of under 36 minutes, subject to document submission.
Coverage under HDFC ERGO Health Insurance varies depending on the selected plan. However, most comprehensive plans include the following benefits.
In-patient hospitalisation expenses.
Pre-hospitalisation expenses.
Post-hospitalisation expenses.
ICU charges.
Day care procedures.
Emergency ambulance expenses.
AYUSH treatments.
Organ donor expenses.
Home healthcare (under eligible plans).
Mental healthcare.
Preventive health check-ups.
Coverage for pre-existing diseases after the applicable waiting period.
Global treatment benefits under selected plans.
Room rent, doctor's fees, nursing charges, medicines, and other eligible hospital expenses.
Like all health insurance policies, HDFC ERGO Health Insurance also comes with certain exclusions. Some of the commonly excluded situations are listed below.
Pre-existing diseases during the applicable waiting period.
Specified illnesses during the waiting period.
Cosmetic or aesthetic procedures unless medically necessary.
Self-inflicted injuries or attempted suicide.
Treatment arising from alcohol or drug abuse.
Injuries sustained while participating in adventure or hazardous sports.
Treatment arising from illegal or criminal activities.
War, invasion, civil unrest, nuclear risks, or related events.
Experimental, investigational, or unproven treatments.
Non-medical expenses unless covered under an optional add-on.
Any treatment or condition specifically excluded in the selected policy wording.
Note: Exclusions may differ across HDFC ERGO Health Insurance plans. Always refer to the policy wording for complete details before purchasing or making a claim.
Depending on the selected plan, HDFC ERGO Health Insurance allows policyholders to enhance their coverage through optional add-ons and riders.
Provides a lump-sum payout upon diagnosis of specified critical illnesses.
Covers eligible outpatient consultations, diagnostic tests, and treatments.
Removes or increases room rent restrictions under eligible health insurance plans.
Covers eligible non-medical expenses that are otherwise excluded from a standard health insurance policy.
Provides financial protection against accidental death or permanent disability.
Includes preventive healthcare services and wellness-related benefits under eligible plans.
Covers emergency medical transportation where specified under the policy terms.
Available under selected plans to reduce the waiting period for specified conditions, subject to the insurer's terms and underwriting.
Buying HDFC ERGO Health Insurance through Coverfox allows you to compare plans, customise your coverage, and complete your purchase online in just a few steps.
Provide your age, city, and the details of the family members you wish to insure.
Compare available HDFC ERGO Health Insurance plans based on coverage, sum insured, benefits, premiums, and optional add-ons.
Select the plan, sum insured, policy tenure, and add-on covers that best match your healthcare needs.
Fill in your personal, nominee, and medical information accurately and complete the KYC requirements, if applicable.
Pay the premium securely through Coverfox using your preferred payment method.
After successful verification and approval, your policy will be issued digitally and shared with you via email.
If you're unsure which HDFC ERGO Health Insurance plan is right for you, simply share your details on Coverfox. One of our health insurance experts will get in touch with you, explain the available plans, answer your queries, and help you choose the most suitable coverage for your healthcare needs.
Renewing your HDFC ERGO Health Insurance policy through Coverfox is quick and convenient. Renewing your policy before its expiry helps you maintain uninterrupted coverage and retain continuity benefits available under the policy.
Go to the Coverfox website and navigate to the Health Insurance Renewal section.
Enter your policy number and the required details to retrieve your existing policy.
Verify your policy details, sum insured, policy tenure, and renewal premium. If required, you can compare available plans before renewing.
Pay the renewal premium securely through your preferred online payment method.
Once the renewal is processed successfully, your renewed policy will be issued digitally and shared with you via email.
HDFC ERGO offers access to 16,000+ cashless network hospitals across India, allowing policyholders to receive cashless treatment for eligible medical expenses. During a cashless claim, the insurer settles the approved hospitalisation expenses directly with the network hospital, reducing the need for upfront payments by the policyholder.
Visit Coverfox and open the Network Hospitals section.
Select HDFC ERGO from the list of insurers.
Enter your State and City.
Browse the list of network hospitals available in your location.
Choose your preferred hospital to avail cashless treatment, subject to policy terms and conditions.
Customer Care Helpline: 022 6234 6234 / 0120 6234 6234 (Available 24×7)
WhatsApp Support: 81695 00500
Email Support: care@hdfcergo.com
Health Claims Assistance: Available through the dedicated claims support team and customer helpline.
Online Self-Service: Manage policies, download policy documents, renew policies, register claims, track claim status, and locate network hospitals through the official website.
Mobile App: Access policy services, download your e-card, renew policies, raise claims, and track claim status using the Here by HDFC ERGO app.
Grievance Redressal: Customers can register and track grievances through the insurer's online grievance portal or contact customer support for further assistance.
Yes. It offers individual and family floater plans with flexible sum insured options, cashless hospitalisation, and comprehensive coverage for different healthcare needs.
HDFC ERGO reported a 97.8% Health Claims Payout Ratio for FY25.
Yes. Coverage for pre-existing diseases is available after the applicable waiting period mentioned in the selected policy.
Maternity benefits are available under selected plans or optional covers. Please refer to the policy wording of your chosen plan for eligibility and waiting periods.
Optima Secure+ includes features such as Infinite Restore Benefit, long-term renewal discounts, and the ABCD Chronic Care Rider, while Optima Secure offers benefits like 2X Secure Benefit, restore benefit, and up to 4X coverage.
Yes. Eligible plans cover pre-hospitalisation and post-hospitalisation medical expenses as specified in the policy terms.
Selected plans do not have room rent capping, while others may have limits based on the policy terms.
Yes. Depending on your age, health condition, and the selected plan, a medical test may not be required.
Yes. Cashless treatment is available through a network of 16,000+ hospitals across India.
Yes. Eligible plans cover treatments under Ayurveda, Yoga, Naturopathy, Unani, Siddha, and Homeopathy, subject to policy terms.
Yes. You can port your existing health insurance policy in accordance with IRDAI portability guidelines, subject to underwriting.
Yes. Preventive health check-ups are included under eligible plans as per the applicable policy conditions.
You can download your policy document by logging into the customer portal or through the Here by HDFC ERGO mobile app.
