HDFC ERGO My Health Medisure Super Top-up Insurance Plan
HDFC ERGO My: Health Medisure Super Top-up Insurance plan gives one the option to include top-up insurance cover in the base plan. With the soaring medical expenses, a regular health insurance plan may not suffice the financial needs at times. That’s why plan like this can be a boon for backing the main health insurance plan, if the sum insured falls short.
What’s the HDFC ERGO My: Health Medisure Super Top-up Insurance Policy?
The HDFC ERGO My: Health Medisure Super Top-up plan is a top-up plan designed to provide coverage for hospitalization expenses incurred due to injuries from accidents and illnesses. This plan can be incorporated into one's portfolio as a floater, individual regular plan or as a corporate insurance plan. This plan is activated when the base plan's limit is exhausted after paying various instalments.
Why Do You Need the HDFC Ergo My: Health Medisure Top-up Plan?
Most of the health insurance policies offer coverage of around Rs 2 lakh to Rs 3 lakhs which might prove to be inadequate considering the rising medical expenditures and increasing cost of hospitalisation. For choosing a health insurance policy with greater coverage, one has to opt for a higher premium which might not be affordable for everyone. To provide efficient coverage, a health insurance top-up plan is very useful as the premium is more affordable in comparison to a base plan with a higher sum insured. The top-up plan increases the sum insured of the plan without creating a hole in the pocket.
Features of the HDFC ERGO My: Health Medisure Super Top-up Insurance
Some of the features of HDFC ERGO My: Health Medisure Super Top-up policy are:
- Sum Insured: The HDFC ERGO My: Health Medisure Super Top-up provides the option to choose from the various sum insured amounts at a very low premium rate and also offers a wide range of deductibles and rebates. It enhances the coverage of the existing health insurance plan.
- 6 Hours Response Time: While filing the claim, the policyholder is left in a dilemma if the claim will be accepted or not. So to avoid such hassle, HDFC ERGO health insurance provides a 6-hour response time, in which it will convey the decision made. The six-hour claim feature can be availed only if the claim is made from 9 am to 9 pm on working days, i.e. Monday to Saturday. For claims made during the off-hours or on holidays, the company responds within 8 hours. For 6-hour response time, the insurer pays a penalty of Rs 1,000 if it fails to deliver the message within the time as mentioned above.
- Comprehensive Coverage: This health insurance top-up plan ensures that the person insured can get cover for pre & post-hospitalisation charges and daycare expenses without any limits. For those who don't have a base, the plan can still avail the coverage of the plan. In such a case, the policyholder needs to pay medical expenditures up to Rs 2 lakh to Rs 3 lakh and the expenses are reimbursed up to Rs 8 lakh through this plan.
- Lifetime Renewability Option: This plan comes with a lifetime renewability option in which a policyholder can choose to renew the policy by paying the renewal premium before the policy term ends or before the grace period ends which is usually 30 days from the end of the policy term.
- Portability Option - There are plan portability options available with this plan. The portability is done according to the norms mentioned by IRDAI. To avail, this option, one needs to contact the company 45 days before the policy expiry date for ensuring maximum coverage without any break. The portability availed depends on the company's acceptance.
Tax Benefits - Policyholders can avail tax benefits under Section 80D of the Indian Income Tax Act, 1961, on the premiums paid towards policies. But benefits cannot be availed under Section 80C.
Benefits of the HDFC ERGO My: Health Medisure Super Top-up Insurance
Benefits of HDFC ERGO My: Health Medisure Super Top-up Plan are:
- The plan covers the cost of in-patient hospitalisation of the policyholder.
- HDFC ERGO covers both pre & post-hospitalisation charges for 30 and 60 days respectively.
- The policy covers daycare expenses
- It covers various expenditures for illness covered in one's previous policy.
- There is an option of a family floater.
- The policy can be renewed after 2 years as compared to 1-year policy renewal
- Policyholders can terminate the health insurance plan any time by notifying the company 15 days prior in a written notice.
- If no claim is made before termination of the policy, then a part of the premiums paid is refunded back.
- The policy has affordable premiums when compared online to other such health insurance plans.
- If a policyholder is not satisfied with the terms of the policy, they can cancel the policy within 15 days from the commencement of the policy. The premiums paid will be returned.
Inclusions of the HDFC ERGO My: Health Medisure Super Top-up Insurance Plan
The following are covered in this plan:
- All hospitalization expenses are covered in this plan with no limit on the amount paid.
- Daycare treatments without hospitalisation are covered in this plan.
- All charges related to pre-existing illness is covered after continuous three renewals of plan.
Exclusions of the HDFC ERGO My: Health Medisure Super Top-up Insurance Plan
All expenses incurred due to the following treatments are not covered under this plan:
- Treatment of HIV or AIDS and other related conditions
- Hospitalization and other medical expenditures due to the consumption of drugs and liquor
- Expenses due to non-allopathic treatments
Eligibility Criteria to Buy the HDFC ERGO My: Health Medisure Super Top-up Insurance
Eligibility criteria for HDFC ERGO My: Health Medisure Super Top-up Insurance are:
- Minimum entry age of the policyholder - 18 years
- Maximum entry age of the policyholder - 65 years
- Minimum entry age of the child - 91 days
- Maximum entry age of the child - 23 years
Children can only be added if both parents are covered under this policy
- The policies can be chosen as an individual or family floater plan
- Medical tests are required after 55 years of age
Below is a table for the deductibles and sum insured offered by the plan.
Sum Insured Option
3 lakh & 8 lakh
7 lakh & 12 lakh
6 lakh, 11 lakh and 16 lakh
5 lakh, 10 lakh, 15 lakh and 20 lakh
Claim Process of the HDFC ERGO My: Health Medisure Super Top-up Insurance Policy
The policy can be claimed either for cashless or reimbursement benefit. While cashless services can be availed at a network hospital only, the reimbursement claim is registered if the treatment is taken from a non-network hospital.
Cashless Claim Process
Follow the below steps in case of a cashless claim:
- Visit the insurer’s website and inform about the planned treatment that one needs to undergo at the network hospitals 7 days prior. For emergency hospitalisation, inform the policy provider company within 24 hours of hospitalisation.
- At the helpdesk of the hospital, show the ID proof of the person insured, health care, and other documents to avail the cashless treatment policy
- Fill the claim form available at the helpdesk, and the policy provider will intimate the customer within 6-8 hours about the claim.
- Once the person insured is discharged, the original documents are to be left at the hospital. Make required payments which aren't covered by the insured provider before leaving.
Reimbursement Claim Process
To initiate a reimbursement claim, the following steps are to be followed:
- For the reimbursement process, visit the hospital for treatment and notify the policy provider company.
- Once the treatment is over, collect all the original bills, prescriptions, receipts, discharge sheets, and other medical bills and pay the hospital bill.
- Fill the claim form available at the hospital TPA desk and send it to the policy provider, including the documents required for the claim process. Ensure to submit only original bills, invoices, prescriptions, and receipts for the claim
- HDFC ERGO will verify all the necessary documents received to approve or reject the claim. The company if required, may ask for additional documents for the claim. Make sure to submit the necessary documents in time.
- After some days the policy provider will intimate the policyholder about approval or rejection by email or SMS.
If all the documents are submitted, HDFC ERGO will approve the claim. It will process the claim amount by bank account transfer done through NEFT.
Documents Required to claim
The policyholder must inform HDFC ERGO within 7 days before hospitalisation or in case of emergency hospitalisation, within 24 hours of admission to the hospital and needs to submit the following documents:
- Signed up claim form
- Medical record with states that the person insured has no pre-existing illness
- Medical certificates related to treatments
- Second copy of first consultation letter and prescription
- Any type of indoor case paper
- Extra documents as asked by the policy provider company
After submission of required documents, HDFC will notify about the claim approval
How to Buy HDFC ERGO My: Health Medisure Super Top-up Insurance Policy?
HDFC ERGO My: Health Medisure Super Top-up Insurance Plan, can be bought either online or offline.
To buy the policy online, one has to either visit the insurer online or buy it through aggregator websites such as Paisawiki.com. The best part of buying at these platforms is that one can compare different plans. The steps of buying are:
- Step I: Visit the official website from where one can check all plan-related details.
- Step II: Choose HDFC ERGO My: Health Medisure Super Top-up Insurance policy to buy. Select the 'Buy Now' option.
- Step III: After filling up personal details, click on submit.
- Step IV: Confirm the email and phone number provided by generating an OTP
- Step V: After filling the necessary details, the customer has an option available to compare with other health insurance top-up plans or select 'continue.'
- Step VI: In this step, one is required to enter policy related details like the number of policyholders their age, name, etc. Choose the policy tenure, the sum insured, and other policy details. Paisawiki has its premium calculator for easy calculation of premiums. After calculating the premium select the 'proceed' option.
- Step VII: One can add riders for enhanced protection. Select 'proceed' option
- Step VIII: Input other relevant details, if any.
- Step IX: In this step upload the required documents.
- Step X: Check the box which agrees to the terms and conditions of the plan
- Step XI: Enter the debit or credit card details & pay the premium amount.
On payment of the premium, the person insured will be sent the necessary policy documents. For the offline process, one can visit the nearest HDFC ERGO branch to buy the policy.
Documents to Buy the HDFC ERGO My: Health Medisure Super Top-up Insurance Plan
The documents required to apply HDFC ERGO Plan are:
- A colour photograph of passport size
- For Age Proof: School/College Certificate, PAN card, Birth Certificate, Adhaar Card, Passport, Voter Card, and Driving License
- For Address Proof: Ration Card, Electricity Bill, Bank A/C statement, Passport, Utility Bill, Postpaid Bill, Telephone Bill
- Photo Identity Proof: Aadhar Card, Voter ID, PAN Card, Driving License or Passport
Renewal Process of the HDFC ERGO My: Health Medisure Super Top-up Insurance
Renewal of health insurance policies through Paisawiki is very easy and less time-taking. One just has to follow these simple renewal steps here:
- Visit the official website at paisawiki.com.
- Step I: Log into the website by entering the user ID & password, if an existing customer.
- Step II: Select policy renewal from the drop-down menu. Enter the plan details & click on continue.
- Step III: In this page, check the plan details of one's family members.
- Step IV: Click on plan renewal.
- Step V: The website has an option that shows all the available riders, one can add or remove the riders to the policy for added coverage as per their needs. After choosing the necessary option select 'proceed.'
- Step VI: One can choose to add or remove family members.
- Step VII: Add the necessary details if family members are added.
- Step VIII: Choose the next option.
- Step IX: Once completed, the policyholder needs to agree to the changed policy terms and conditions. Also if any other document is required, then upload the documents.
- Step X: Pay the renewal premium.
After the premium is paid, the new plan document is mailed to the customer. One can renew the plan by visiting the HDFC ERGO branch as well.
Ans: No, continuity benefit is not available in this plan.
Ans: Yes, the policy covers the expenditures for the treatment of illness before buying the policy.
Ans: All the people insured above 80 years of age will have to bear a co-payment of 10%.
Ans: Yes, 50% of the medical charges are reimbursed.
Ans: Yes, one can apply for a cashless claim in self-financing.
Written By: Paisawiki - Updated: 12 February 2021