HDFC ERGO Parents Health Insurance
HDFC ERGO Parents Health Insurance is a unique health insurance policy that offers exclusive coverage for parents at an affordable price. This policy covers all the expenditures incurred due to hospitalization. HDFC ERGO Parents Health Insurance also provides coverage against various daycare services, pre-hospitalization expenditures, domiciliary treatment, and post-hospitalization expenditures. The health insurance company offers different rewards. This reward is in the form of a renewal bonus if any claims are not made for an entire year.
What is the HDFC ERGO Parents Health Insurance Plan?
HDFC ERGO Parents Health Insurance Plan, which is offered by HDFC ERGO, is designed to pay the soaring high medical costs of the hospital bill. There are various sum insured options offered in this policy to fulfill the needs of policyholders according to their budget. Some of the policy's main features are its 360-degree insurance coverage plan, i.e., no cap on the hospital room rent and no sub-limits.
The plan provides coverage for AYUSH treatments and covers more than 144 daycare treatments. If more than two members are covered in the policy, then a rebate is available. The policy covers sum assured options ranging between Rs 3 lakh and Rs 10 lakh. Also, one of the great benefits of the plan is there are no age restrictions for availing this plan. Also, there is no maximum sum insured for a particular disease. There are wellness services available for promoting a healthy lifestyle.
Benefits and Features of the HDFC ERGO Parents Health Insurance plan
The features of HDFC ERGO Parents Health Insurance Plan are:
- There is no need for a medical checkup to buy the plan if the person insured is below 45 years of age.
- The cashless treatment available in all network hospitals.
- A cumulative bonus of 5% is available on the sum insured if the person insured makes a no claim bonus in a particular policy year.
- There is no limit of spending available on any disease as well as attending surgeon and hospital expenses.
- If more than two family members are covered in a particular health insurance plan on an individual sum basis, one can make a family rebate of around 10% on the premiums paid.
*All savings are provided by the insurer as per the IRDAI approval. Standard T&C apply.
- The policy tenure is 1 year and 2 years which can be chosen according to the policyholder's preference.
- The plan covers pre-hospitalization charges for up to a maximum of 60 days before the date of hospitalization.
- The plan covers post-hospitalization charges for up to a maximum of 90 days from the date of discharge of hospitalization.
- The plan covers various daycare procedures. The policyholders will get compensation for over 144 daycare procedures for which hospitalization is not essential.
- There is a waiting period of 30 days available in the policy. During this period, the person insured is not eligible to apply for any claim except in case of accidental injury.
- There is a free look period available with the policy. Under this period, if the person insured is not satisfied with the terms & conditions of the policy, he or she can return the plan within 15 days from the plan's receipt date. All premiums paid will be returned to the policyholder after deducting a few taxes.
- The Parents Health Insurance policy gives the option of lifelong renewability so that one remains covered in the plan for years & the plan can be renewed at any age.
- Cashless treatments, as well as reimbursement facilities, are available along with the policy.
- As per section 80D of the Income Tax Act 1961, the premium amount paid under various health insurance policies is eligible for tax benefits.
The benefits of HDFC ERGO Parents Health Insurance Plan are:
- Hospitalization Expenditure- The plan covers hospitalization expenditures up to the sum insured for the policyholders.
- Organ Donor- The plan provides coverage against the various costs which may be incurred during harvesting an organ.
- Emergency Ambulance - All the expenditures incurred for the use of an emergency ambulance for hospitalization can be paid back under this plan.
- AYUSH Benefit - The plan covers all the expenditures for all in-patient treatment taken under Non-Allopathic treatment like Sidha, Homeopathy, Unani, or Ayurveda
- Cumulative Bonus - A policy bonus of 5% on the sum insured is paid to the policy for every no-claim policy year. This cumulative bonus which can be availed up to a maximum of 50%.
Health Checkups – Up to a maximum of 1% of the sum insured amount, which can be used for various health checkups after 4 continuous claim free policy years. The amount can be up to a maximum of Rs 5,000.
- There is a free look period available with the policy, under this period if the person insured is not satisfied with the terms & conditions of the plan, then he or she can return the plan within 15 days from the receipt date of the plan. All premiums paid will be returned to the policyholder after deducting a few taxes.
- There is no minimum age of entry for the policyholders.
- The plan has a policy tenure of one year or two years of the plan coverage period.
- The plan can be bought under an individual or family floater sum insured basis.
- The family rebate of 10% can be available if two family members or more are covered under the plan.
- Children aged below 5 years can be added to the policy as well.
- The policy has very affordable premiums as compared to other health insurance plans.
Inclusions of HDFC ERGO Parents Health Insurance Plan
The inclusions of HDFC ERGO Parents Health Insurance Plan are:
- In-patient Treatment - The plan covers various hospitalization expenditures, including nursing expenses, boarding, medicine expenses, room rent, OT charges, drug costs, ICU rent, surgeon's fee, doctor's fee, and other such charges.
- Pre-Hospitalisation: The plan covers various medical expenditures for availing various treatments for up to a maximum of 60 days before the hospitalization.
- Post-Hospitalisation: The policy covers various medical expenditures for availing various treatments for up to a maximum of 90 days after the hospitalization.
- Daycare procedures: It also pays for medical expenditures for up to 144-daycare procedures.
- Domiciliary Treatment: The plan covers various incurred expenditures on treatment availed at home, which could require hospitalization of the policyholder.
- Organ Donor Cover: Expenditures covered for the organ donor's treatment if the policyholder is the doner in the event of organ transplantation.
- Emergency ambulance cover: The emergency cost of transportation in an ambulance is covered in emergency cases.
- AYUSH Treatment Cover: The plan pays for the expenditures while availing various Non Allopathic treatment under Unani, Ayurveda, Homeopathy, or Siddha.
Exclusions of HDFC ERGO Parents Health Insurance Plan
The exclusions of HDFC ERGO Parents Health Insurance Plan are:
Any pre-existing illness has a waiting period of 48 months before the policyholder can be covered for those illnesses.
- Any expenditures which are related to dental treatments and pregnancy.
- Expenditures incurred due to the treatment of AIDS or HIV or sexually transmitted diseases.
- Expenses due to any type of cosmetic treatment.
- Expenditures incurred from any type of unproven or investigational treatment.
- Hospitalization due to war or any act of war.
- Hospitalization due to the use of any chemical, nuclear, or any kind of biological weapon. This also includes radiation of any kind.
- There are some exclusions also for certain specific illnesses for a waiting period of 2 years from the date of receipt of the plan.
- Various mental disorders or other related treatment to mental health.
*This list is not exhaustive. The policyholder can refer to the policy document for the complete list.
Eligibility Conditions HDFC ERGO Parents Health Insurance Plan
The eligibility conditions for HDFC ERGO Parents Health Insurance Plan are:-
- Minimum age of the policyholder in the policy - 18 years
- Maximum age of the policyholder in the policy - No limit
- Minimum age of the child in the policy - 91 days old
- Maximum age of the policyholder in the policy - 21 years
- Policy tenure - 1 year or 2 years
- If both parents are covered, the child can be covered.
- Sum assured - 3 lakh to 10 lakh
- Initial Waiting period - 30 days
- Waiting period for pre-existing illness - 2 years
- Children below 5 years can also be added.
- Renewability - Lifelong renewable policy
- Premium frequency - Monthly, quarterly, semi-annually, or annually.
*The above information is subject to change as per the norms of the insurance provider.
Claim process of HDFC ERGO Parents Health Insurance Plan
The policy can be claimed as cashless and reimbursement claims. The claim process of HDFC ERGO Parents Health Insurance Plan is mentioned below:
Cashless Claim Treatment
- Cashless claim treatment is undertaken when the policyholder gets admitted to a network hospital. For pre-planned hospitalization, the policyholder needs to inform the insurance provider company 7 days before the hospitalization. In case of emergency hospitalization due to any illness or injury, the policyholder must notify within 24 hours of hospitalization.
- On admission, one must inform the hospital desk about the policy & claim settlement through cashless mode by providing policy documents and health card issued by HDFC ERGO at the helpdesk of the hospital.
- After that, one can choose to fill up the claim form from the hospital or fill it online through the insurance company's website. For filling the claim form, one must provide policy number, name, nature of the claim, amount of the claim, type of treatment undergone, name of the hospital and attending doctor and other such input.
- After filling up the claim form, upload all the important documents like receipts, hospital bills, medicine bills, room charge bills, and other such reports as asked. Within a few hours of submission of the policy claim form, the policy company will notify about the claim approval or rejection. They might also need additional documents for verification.
- On approval of the claim through the verification process, HDFC ERGO will pay for the claims directly to the hospital.
Claim Reimbursement Process
- If the policyholder undergoes treatment in a non-network hospital, then he has to choose a claim reimbursement process. In the process, the policyholder pays for the entire hospital bill, and the insurance provider reimburses the amount to the policyholder's account. For a planned treatment, the person insured must notify the policyholder about the planned admission to the hospital 7 days before hospitalization. For an unplanned one, the policyholder or anyone can notify within 24 hours of hospitalization.
- After the treatment is completed, the policyholder or his family member needs to pay the full hospital bill and collect all the bills and receipts without fail. Then one needs to fill up an online claim form.
- For filling the claim form, the required details are name, policy number, amount of the claim, nature of the claim, type of treatment undergone, name of the hospital, and attending doctor, bank details of the policyholder, and other such input.
- On filling up the claim form, upload all the essential documents like hospital bills, medicine bills, receipts, room charge bills, and other such reports of diagnosis as asked. Within a few days of submission of the policy claim form, the policy company will notify about the claim approval or rejection. They might also need additional documents for verification.
- After the claim's approval, after a strict check, the policyholder will be reimbursed for the necessary amount via NEFT transfer.
Documents Required for Claim Process
The required documents for claim process verification are:
- A medical report
- First consultation letter prescription
- FIR copy for hospitalization due to an accident.
- Indoor case paper
- Medical certificates
- Treatments bill
- Extra documents as asked by the insurer
On submission documents by the policyholder, the person insured will inform about the claim approval.
How to Buy HDFC ERGO Parents Health Insurance Plan?
The stepwise process of the plan are:
- Step 1: Visit Paisawiki.com. Go to the “Get Free Quotes’ option.
- Step 2: Select the plan to buy by entering your mobile number, name of the policyholder, age, and basic medical details. A list of related insurance plans is available on the website to find their ideal plan.
- Step 3: One can also choose to compare with other health insurance plans for parents online. After comparison with other similar plans. Select the buy now button.
- Step 4: Once done, enter all the necessary information asked. Upload all the necessary documents.
- Step 5: Enter bank details to pay the premium.
After the payment of premium, policy documents will be mailed.
Documents Required to Buy the HDFC ERGO Parents Health Insurance Plan
The documents required are:
- Voter ID Card
- Aadhar Card
- PAN Card
- Bank Passbook
- Any Government ID
- Bills of any type for address
- Medical Record
- And other documents as asked.
Renewal Process of HDFC ERGO Parents Health Insurance Plan
Renewing HDFC ERGO Parents health insurance is very easy through Paisawiki.com. The renewal process is as follows:
- Visit Paisawiki.com & go to the renewal section.
- Enter the birth date & policy number. The policy details will be generated.
- One can choose to add riders or members or remove them. Click the next button.
- The renewal premium will be generated.
- Enter bank details & pay the required premium amount. The renewal process is complete.
FAQs About HDFC ERGO Parents Health Insurance Policy
Ans: A health card is essential for getting cashless claims in hospital.
Ans: Yes, for treatments or specific treatment, which is not covered in the policy.
Ans: The other members of the policy will continue to cover the members in the same way.
Ans: If a cashless claim is rejected, then the person can apply for reimbursement.
Ans: Yes, it can be increased at the time of renewal.
Written By: Paisawiki - Updated: 22 September 2020