HDFC ERGO Health Insurance 2026 – Optima Plans & Premiums

Explore the Range of Coverage Plans Available

Listed here are the health insurance policies offered by HDFC ERGO.

1. Medisure Classic
2. Health Suraksha Silver
3. Health Suraksha Silver with Regain & ECB
4. Health Suraksha Gold
5. Health Suraksha Gold with Regain & ECB
6. HDFC ERGO Critical Illness Silver
7. HDFC ERGO Critical Illness Platinum

Optima Secure – Features, Benefits & Coverage Details

Medisure Classic – An Affordable Entry-Level Coverage Option

• Basic sum insured per policy year: Individual Policies: Rs.1 lakh to Rs.5 lakh Floater Policies: Rs.2 lakh to Rs.5 lakh
• Cashless hospitalization: In authorized hospitals in the 6000+ network across India

• Basis: Individual and family floater
• Policy term: 1 or 2 years
• Cumulative bonus: Cumulative bonus of 5% for each year that is claim-free subject to a maximum cumulative bonus of 50%
• Tax benefit: Under Section 80D of the Income Tax Act, 1961
• Medical test: Mandatory above 51 years of age

 Health Suraksha Silver – Who Is It Best Suited For?

• Key Features: Sum insured Rs. 3–7.5 lakh/year | Individual & family floater | 1 or 2-year policy term

• Coverage: In-patient, day care, domiciliary, pre & post-hospitalisation, ambulance, organ donor & AYUSH treatments

• Network & Cashless: 6,000+ authorized hospitals across India

• Bonuses & Benefits: 5% cumulative bonus per claim-free year (max 50%) | Tax benefit under Section 80D

• Other Details: No maximum entry age | Medical test mandatory after 45

Gold Plan with Maternity & Newborn Benefits at a Glance

• Key Features: Sum insured Rs. 3–10 lakh/year | Individual & family floater | 1 or 2-year policy term

• Coverage: In-patient, day care, domiciliary, pre & post-hospitalisation, ambulance, organ donor & AYUSH treatments

• Network & Cashless: 6,000+ authorized hospitals across India

• Bonuses & Benefits: 10% enhanced cumulative bonus per claim-free year (max 100%) | Tax benefit under Section 80D

• Other Details: No entry age limit | Medical test mandatory after 45

Maternity, Newborn & Beyond – What the Gold Plan Offers

• Sum Insured: Rs. 3–10 lakh/year | Basis: Individual & Family Floater | Term: 1–2 years

• Key Benefits: Cashless hospitalization (6000+ network hospitals), In-patient & domiciliary treatment, Pre & post-hospitalization, Maternity & newborn cover, Day care, Ambulance, Organ donor, AYUSH & e-opinion for critical illnesses, Convalescence benefit (10+ continuous days)

• Extras: 5% cumulative bonus/claim-free year (max 50%) | Tax benefit u/s 80D | No entry age limit | Medical test mandatory after 45

Silver Plan with Regain & Enhanced Cumulative Bonus Explained

• Sum Insured: Rs. 3L – 10L per policy year
• Cashless Hospitalization: 6,000+ network hospitals across India
• Basis: Individual & Family Floater | Term: 1 or 2 years
• Cumulative Bonus: 10% per claim-free year (up to 100%)
• Tax Benefit: Section 80D | Medical Test: Required above 45 years | Entry Age: No limit

• Coverage Includes: Newborn & Maternity, Day Care, Ambulance, Domiciliary, In-patient, Pre/Post-Hospitalization, Organ Donor, AYUSH & Critical Illness E-opinion

Critical Illness Silver – Coverage for 8 Serious Conditions

• Sum Insured: Rs. 5L – 10L per policy year
• Cashless Hospitalization: 6,000+ network hospitals across India
• Basis: Individual | Term: 1 or 2 years
• Tax Benefit: Applicable | Medical Test: Required above 45 years | Entry Age: 5 – 65 years

• Coverage: 8 specific illnesses

Critical Illness Platinum – Wider Protection Across 15 Illnesses

Reach Out – Helpline, Email & Support Channels

HDFC ERGO is another of India’s leading general insurance company which was established following a joint venture between HDFC and ERGO International AG. The company provides a number of general insurance products which include motor insurance, health insurance, travel insurance, etc., which they offer via their network of 108 branches. In addition to providing some of the best health insurance plans, HDFC ERGO Health Insurance Customer Care is also known to provide excellent service to their clients via multiple channels.

To enable customers to get in touch with the HDFC health insurance customer care and support staff and resolve their policy-related queries, grievances, and issues, HDFC ERGO has set up a dedicated phone-based helpline and a fax line as well. Customers can also write in to the support team via email for authorisation-related issues, network hospital related issues, and queries related to claims. They can also write in to the insurer’s corporate office address via mail to receive a response to their queries.

Find a Cashless Treatment Hospital Near You

HDFC ERGO offers cashless facility at over 6,000 network hospitals across the country. Insured members can get admitted in a network hospital of the insurer to avail cashless treatment. The insurance company will settle the hospitalisation expenses incurred by the insured member directly with the network hospital. To locate a network hospital nearest you, select your state and city from the drop-down box on the online Network Hospital Locator tool. You will get a list of network hospitals in your area with contact details.

Step-by-Step Guide to Raising a Claim

HDFC ERGO is one of the top health insurance providers with a dedicated in-house claim service team to provide smooth claim servicing to the customer

• Cashless Claim: (Network Hospitals) Present your cashless/policy card, fill the pre-authorisation form with your doctor, and submit it to the TPA for approval. For unplanned hospitalisation, complete this within 24 hours.

• Reimbursement Claim: (Non-Network Hospitals) Pay bills upfront, submit the claim form with medical documents within 7 days of discharge. Approval confirmed within 30 days of document receipt.

Why Policyholders Prefer This Insurer – Key Advantages

• HDFC ERGO offers a wide range of health insurance policies — individual, group, critical illness, and top-up plans — catering to diverse customer needs.
• Policyholders can choose to get treated at any of the 6000+ network cashless hospitals located across the country.
• Health insurance plans offered by HDFC ERGO also offer the benefit of an enhanced No-Claim Bonus.
• Policyholders can choose from a range of premium payment options, as per their convenience.
• These health insurance plans provide hospitalisation cover not only for illnesses or accidents, but also for other related treatments like pre and post-hospitalisation expenses, domiciliary treatment, and a number of day care procedures, among other expenses.
• Policyholders are eligible to avail attractive tax benefits for premiums paid towards a health insurance policy under the provisions of Section 80D of the Income Tax Act, 1961.