HDFC Ergo Optima Restore Health Insurance Plan - features, benefits, buy online and renew (2023)

Quick Summary: HDFC Ergo Optima Restore Health Plan

HDFC Ergo is a P&C insurer established in the year 2017. A collaboration between HDFC and ERGO International, Germany, HDFC Ergo occupies a prominent position in the Indian insurance industry as the third largest P&C insurer in the private sector.

Over the years, the company has maintained a very high record of claims settlement. HDFC Ergo has received the 'AAAA' rating from ICRA. He has a long list of awards and recognitions to his name.

HDFC Ergo offers various insurance products such as auto, travel, home and health. In this article, we are going to discuss HDFC Ergo Optima Restore Plan and all its features.

(Video) Best Health Insurance 2022| HDFC ERGO Health Insurance Review| Optima RESTORE Vs Optima SECURE

Best Features of HDFC Ergo Optima Restore Health Plan

The HDFC Ergo Optima Restore Plan is designed to meet your healthcare needs. The plane is aaffordable health planwhich provides coverage for the cost of treating injuries and illnesses. Let's take a quick look at the highlights of this plan:

  1. The plan is available with coverage from INR 5 to 50 lakhs
  2. Your hospitalization expenses due to illness or injury are covered
  3. All your daycare procedures would be covered
  4. Ambulance costs are covered up to INR 2000
  5. The plan offers full coverage on the room rental.
  6. The plan offers replacement of 100% of the insured capital, in case of exhaustion
  7. If you don't complain, you can take advantage of renewal incentives that can increase your coverage by up to 100%.
  8. Availability of preventive health checks up to INR 5,000
  9. Expenses incurred 60 days before and 180 days after hospitalization would be covered
  10. Get up to INR 1000 cash benefit per day and up to INR 6000 per hospitalization
  11. With HDFC Ergo Optima Restore Plan you can save up to INR 75,000 as tax benefits
  12. Procedures such as robotic surgeries, oral chemotherapy, and stem cell therapy are covered
  13. You can enjoy premium discounts ranging up to 10%

HDFC Ergo Optima Restore Health Plan Benefits

  1. In hospital benefits
    Optima Restore Health Plan covers your hospital stay that may be due to illness or injury.
  2. restoration benefit
    After the first claim, you can claim 100% of the insured amount when your coverage is partially or totally exhausted. This benefit can be very useful if your medical expenses are depleted.
  3. ambulance expenses
    Emergency ambulance charges up to INR 2,000 are covered in case a member needs to be rushed to a hospital.
  4. profit multiplier
    You can enjoy a 2X multiplier benefit when you don't make a claim. You can get up to 100% coverage increase as a no-claims benefit.
  5. Hospital Daily Cash
    When you are admitted to a hospital, there are numerous direct expenses that can affect your finances. You can get daily cash benefit up to INR 1000 per day and INR 6000 per hospital stay.
  6. Pre and Post-hospitalization
    Monitoring and diagnostic costs before and after hospitalization are also covered by the Optima Restore Health Plan. Expenses for 60 days before and 180 days after admission are covered.
  7. daycare procedures
    Treatments that require hospitalization for less than 24 hours are also covered by the HDFC Ergo Optima Restore Plan.
  8. Organ Donation
    Medical and surgical expenses for organ donation are covered at the time of obtaining a larger organ.
  9. lifetime renewal
    Your health coverage can protect you for life without the hassle of regular renewals. The Optima Restore Plan gives you eligibility for life.
  10. room rental
    HDFC Ergo Optima Restore Plan does not put any sub-limits on the room rent, helping you have a comfortable stay in the hospital room.
  11. health checks
    With the Optima Restore health plan, you can get up to INR 5,000 medical checkups to check your health and wellness.
  12. modern treatments
    The Optima Restore plan also covers advanced treatments like robotic surgeries, oral chemotherapy, and stem cell therapy.
  13. discounts
    • By adding 2 or more members to an Optima Restore policy, you can get up to a 10% discount on the premium amount.
    • By opting for the 2-year plan, you can get a 7.5% premium discount.
    • Get a Stay Active benefit and enjoy up to 8% off when you renew. You need to walk a daily average of steps that are counted in the Health Jinn mobile app.
  14. Fiscal benefits
    Ohealth insurance premiumswho pay for the HDFC Ergo Optima Restore Plan are eligible for a tax exemption of up to INR 75,000.
  15. recovery benefit
    With the HDFC Ergo Optima Restore Plan, if you are hospitalized for more than 10 consecutive days, you will be paid a fixed amount to help you recover from any financial loss you may have suffered due to your hospital stay.

HDFC Ergo Optima Restore Health Plan Details

Entry age

Minimum: 91 days

Maximum: 65 years

Policy Ownership1 year or 2 years, depending on your choice
policy typeindividual mailHealth insurance for family floats
Waiting period for pre-existing illness3 years
  • Waiting period
    1. Other than accidental hospitalization, no treatment is covered within the first 30 days after the policy is issued
    2. During the first 24 months of the policy, certain treatments such as hernia, cataract, hysterectomy, etc. are not covered.
    3. Established/pre-existing conditions are covered only after 3 years of continuous renewals
  • Free preview period
    With the Optima Restore plan, you get a free period of 15 days from the date of purchase. During this time, you can review the terms and conditions of the policy. If you consider that the policy does not meet your needs, you can return it, as long as there have been no claims. The refund will be processed once the stamp duty and the corresponding risk premium have been deducted from the premium paid by you.

What is not covered by the HDFC Ergo Optima Restore health plan?

When you invest in a health insurance policy, there are certain exclusions. These exclusions are situations where you may not be able to file a claim while you are hospitalized. Some common exclusions are:

  1. The policy does not cover accidents you may encounter while participating in adventure sports.
  2. Surgeries self-inflicted by the insured are not covered
  3. Intoxicating drug/alcohol abuse is not covered
  4. Claims caused by war would not be accepted.
  5. HIV/AIDS infection is not included in the HDFC Ergo Optima Restore health plan
  6. Venereal or sexually transmitted diseases are not covered.
  7. Cosmetic surgery or obesity treatment would not be covered.

HDFC Ergo Optima Restore Health Plan Renewal Process

Depending on the term you choose for yourself, 1 year or 2 years, you would have to renew the policy. For the renewal of your policy, you can follow any of the given options:

  1. You can renew your policy online through the company's official website., go to 'Online renewal' and renew the policy instantly
  2. You can renew your policy online through an insurance aggregator website
  3. Call 022-6234 6234 OR 0120-6234 6234 and speak to a customer service executive who will guide you through the renewal process
  4. You can also send your renewal request by email
  5. Envie um check ou saque para HDFC General Insurance, D-301, 3rd Floor, Eastern Business District (Magnet Mall), LBS Marg, Bhandup (West), Mumbai - 400 078

HDFC Ergo Optima Restore Health Plan - Claim Process

When you invest your hard-earned money in a health insurance policy, your main concern is that, in the moment of need, you will be able to file a claim. HDFC Ergo strives to assist all clients with a quick and easy settlement procedure; however, it is your responsibility as the insured to follow all guidelines carefully. Let's look at the different aspects of the claims process.

(Video) REVISED Changes in HDFC ERGO Optima Secure | *Latest Updates* in Optima Secure | Gurleen Kaur Tikku

  • cashless claim
    if you want to take advantagecashless health insurance treatment, remember that you would have to undergo treatment at a hospital in the network. A network hospital is a hospital that has a partnership with the hospital. The cost of your treatment, depending on the policy and the insured sum, will be paid directly by the insurer. Depending on the plan option you choose, you may have to pay your share for services that are not covered by the plan.
    Remember, when you go for treatment with no money planned, you must get a prior authorization at least 48 hours before the treatment. Once the pre-authorization is received, the treatment must be carried out within a certain period of days.
    However, if it is an emergency treatment, the company must be informed within 24 hours of admission or treatment for the pre-authorization of the treatment.
  • Request for reimbursement
    Due to time constraints or the unavailability of a certain treatment, if you were unable to obtain care at a network hospital, you may still receive reimbursement for your medical expenses. At an out-of-network hospital, you can make advance payments for treatment provided, and once treatment is complete, you can claim reimbursement.
    Be sure to notify the insurance company within 48 hours of hospitalization. You will need to complete and submit the application form along with other requested documents. Generally, the documents listed below are required to file a claim.
  • required documents
    1. Health card issued by the company together with KYC documents
    2. Claim form - duly completed and signed
    3. Nature of the disease and necessary treatment.
    4. Medical prescriptions - medications and/or diagnostic tests
    5. Details of individual medical services
    6. original payment receipts
    7. All diagnostic and pathology reports.
    8. original discharge summary
    9. Transplant invoice, if any.

HDFC Ergo Optima Restore health plan - Policy network hospitals

The HDFC Ergo Optima restoration plan helps you gain access to more than 10,000 hospitals where you can receive treatment without cash. With such a wide network, you can file cashless claims almost anywhere in the country. As the company has its own claims settlement cell, executives are available at the hospital and will assist you with claims processing. The claim would be resolved as soon as possible without letting you go through any trouble.

HDFC Ergo Optima Restore Health Plan Review

You can't always plan for your hospitalization expenses, and for such unforeseen circumstances, you need to have a health insurance policy that not only helps you avoid a financial setback, but also provides comprehensive coverage. The HDFC Ergo Optima Restore Health Plan provides you and your family with complete health care coverage. You can purchase the plan with minimal paperwork in just a few minutes.

When it comes to claims, the company has maintained an excellent claim settlement record over the last 16 years of its establishments. As HDFC Ergo has an internal claims settlement cell, the process is transparent and fast. If you're looking for an easy-to-understand health insurance plan that offers comprehensive coverage along with an affordable premium, the HDFC Ergo Optima Restore Health Plan is definitely a plan worth considering.

HDFC Ergo Optima Restoration Plan FAQ

  • 1. In the Optima Restore Plan, what is the maximum coverage that I can opt for?

    HDFC Ergo Optima Restore Plan provides health cover up to INR 50 lakhs.

  • 2. How many times can I request the Restore Benefit in the Optima Restore Plan?

    The reinstatement benefit can be used once per lifetime policy year if you continue to renew the policy.

    (Video) Optima Restore HDFC ERGO | Optima Restore Apollo Munich | Full Plan Review | in Hindi | #27

  • 3, What premium do I have to pay for the HDFC Ergo Optima Restore Plan?

    Depending on the amount insured, the plan you choose and the number of people insured will determine the premium to pay.

  • 4. What does the preventive health check mean?

    In the HDFC Ergo Optima Restore Health Plan, insureds receive a medical check-up at the time of renewal, regardless of the situation of the claim. Once every two years, a checkup is arranged for the insured amount of INR 5 lakhs or more. For policies above INR 10 lakhs, the review benefit is available on an annual basis.

    (Video) Hdfc Ergo Optima Secure - Is it suitable for you? By Health Insurance Sahi Hai

  • 5. In the HDFC Ergo Optima Restore Health Plan, do I have the possibility of increasing my coverage?

    If you can. With the easy upgrade option, you have the option to upgrade your roof to a higher slab. This can be done at the time of your policy renewal.



What is the difference between HDFC Ergo Optima Restore and Optima Secure? ›

However, on some occasions, you may want to pursue alternative treatments including homoeopathy, Ayurveda, Unani and Siddha. These treatments are collectively categorized as Ayush treatments. And in this case Optima Restore doesn't extend coverage for Ayush treatments whereas Optima Secure covers Ayush treatments.

What is HDFC Ergo Optima Restore bonus? ›

2.5 Lacs per hospitalisation, whichever is lower; upto basic sum insured limit for a year. Section II. a. Restore Benefit Instant addition of 100% Basic Sum Insured on complete or partial utilization of Your existing Policy Sum Insured and Multiplier Benefit (if applicable) during the Policy Year.

What is unlimited restore benefit in HDFC Ergo? ›

This Add-on cover will be providing instant addition of 100% Basic Sum Insured on complete or partial utilization of Your Sum Insured rebound or Restore benefit (as applicable) during the Policy Year. This Add-on will trigger unlimited times and is available for all subsequent claims in a Policy Year.

Is Optima Restore good in health insurance? ›

Optima Restore ranks top in health insurance plan ratings

These ranks were achieved among the top 15 health insurance plans for people below 65 years. The plans were judged on the basis of lowest out-of-pocket expenses, smoothest claim settlement, premium affordability.

How does health insurance benefit restore work? ›

Restoration benefit is a benefit wherein the insurance company restores the original sum insured after it gets fully exhausted for the treatment of the illnesses.

Why HDFC Ergo premium is high? ›

The reason for premium hike in the the current year is due to claim registration. As a result, you are not eligible for NCB discount, which usually decreases the premium . Adding to the same, depreciation also leads to increase in premium.

What is the waiting period for Optima Restore? ›

Waiting Period • • • 30 days for all illnesses (except accident) in the first year and is not applicable in subsequent renewals 24 months for specific illness and treatments in the first two years and is not applicable in subsequent renewals Pre-existing Diseases will be covered after a waiting period 36 months.

Is tooth implant covered by HDFC Ergo? ›

No dental insurance does not cover dental implantation procedures.

How do I get my no claim bonus from HDFC ERGO? ›

After you have completed your first claim free year, you will get 20% NCB. If your second year goes without any claim, the discount will go up to 25%. Another 10% is added upon the third claim free year, making it 35% discount.

How many illnesses does HDFC ERGO cover? ›

HDFC ERGO's Critical Illness Insurance Cover, which covers 15 critical illnesses, will be your perfect partner during difficult times.

How much is no claim bonus HDFC ERGO? ›

NCB starts at 20% discount during the second year, i.e. policy renewal year. This may go up to a maximum of 50% during the sixth year. During the second year, you may be awarded 20% discount, 25% during the third year, 35% during the fourth year, 45% during the fifth year, and 50% during the sixth year.

What is the highest rated health insurance company? ›

Kaiser Permanente is the top-rated health insurance company in the U.S., according to available state data from the National Committee for Quality Assurance (NCQA). Good insurance companies include Blue Cross Blue Shield, UnitedHealthcare, Humana, Aetna and Cigna.

Which health insurance is best in India? ›

Best Health Insurance Plans In India March 2023
  • Best Health Insurance Policies.
  • Aditya Birla Activ Health + Multiply Fit Combo.
  • ICICI Lombard- Complete Health Insurance Policy.
  • STAR Health's Senior Citizens Red Carpet Health Policy.
  • HDFC ERGO My: Health Women Suraksha.
  • Care Youth Health Insurance plan.

Which healthcare company has the best benefits? ›

Healthcare Companies With Great Employee Benefit Programs
  • Baylor, Scott & White. ...
  • CVS Health. ...
  • Kaiser Permanente. ...
  • Novo Nordisk. ...
  • Roche Diagnostics. ...
  • Sage Therapeutics. ...
  • Scripps Health. ...
  • Texas Health Resources.

What is restoration of unused benefits? ›

Restoration of benefits provides you the opportunity to have your lifetime benefit amount restored to its original amount after you've recovered from your illness and gone a period of time (180 days with most companies) without receiving any more benefits from your policy.

What are restoration benefits? ›

The restoration benefit helps the sum insured of your health insurance policy to be restored up to the maximum limit as soon as it gets exhausted after a claim. This benefit is offered under health insurance plans available for individuals as well as families.

What kind of insurance pays you back? ›

But there's one exception: return-of-premium life insurance. Also known as ROP life insurance, this type of coverage reimburses you for the money you paid in premiums if you don't die during the term.

What is the waiting period of HDFC ERGO? ›

Survival period. For critical illness insurance there is a survival period of usually 30 days. With HDFC ERGO critical illness insurance you have a survival phase of 30 days before receiving the lump sum payment.

Do insurance premiums increase with age? ›

Younger drivers pay considerably more than older drivers for car insurance, but rates also rise after age 60. Age is one of the primary factors insurance companies consider when coming up with a car insurance quote. To an auto insurance company, a driver's age measures their driving experience and accident risk.

How can I get HDFC ERGO health insurance discount? ›

On taking 10,000+ steps a day, on an average, you get rewarded with the complete 8% discount on premium at the time of renewal.

How do I renew my Optima? ›

Call Cover Virginia at 1-855-242-8282 (TTY: 1-888-221-1590). Available Monday through Friday from 8:00 a.m. to 7:00 p.m. or on Saturday from 9:00 a.m. to 12:00 p.m. Mail: Complete the paper renewal form and return it to your local Department of Social Services.

Does Optima Restore cover diabetes? ›

A comprehensive health insurance policy covers for pre-existing diseases including diabetes with a waiting period of 2-4 years. For instance, in Optima Restore policy from HDFC Ergo Health, the pre-existing waiting period is 36 months. You can reduce your pre-existing disease waiting period if you feel it is too long.

Is dental treatment covered in HDFC ERGO Optima Secure? ›

This cover is applicable only if opted by the insured as per plan type, in this we will pay 50% of Medical Expenses incurred by Insured Person towards Dental Treatment after three consecutive and continuous Policy years with Us only if prescribed by Medical Practitioner up to the amount mentioned in the Schedule of ...

Does HDFC ERGO cover CT scan? ›

8. Does my policy covers diagnostic charges? Most pre hospitalization and post hospitalization expenses (up to 60 days) are covered under the policy, such as X - rays, CT scan, MRI, ultrasound nursing, physicians, medicines, other diagnostic needs.

Does HDFC ERGO cover cosmetic surgery? ›

Cosmetic treatments

However, costs of a plastic surgery following an accident or injury are covered under medical insurance.

Can breast implants be covered by medical insurance? ›

According to the American Society of Plastic Surgeons, most health insurance plans will not cover cosmetic breast augmentation costs, related complications or revision surgery.

What is Optima Restore Multiplier benefit? ›

Multiplier Benefit rewards you by raising your sum insured after every claim free year up to 2 years. Upto 100% bonus sum insured can be achieved. After one claim free year you get 50% increase of sum insured at the time of renewal. After two claim free years your basic sum insured gets doubled at the time of renewal.

What is the difference between recharge and restore in health insurance? ›

You will be able to claim a full assured sum at any point in the year. You can only claim the restore feature once the assured amount is fully exhausted. You will be able to claim the entire sum again if another health crisis appears in the same year.

Why HDFC ERGO premium is high? ›

The reason for premium hike in the the current year is due to claim registration. As a result, you are not eligible for NCB discount, which usually decreases the premium . Adding to the same, depreciation also leads to increase in premium.

Is MRI covered under HDFC ERGO? ›

Does my policy covers diagnostic charges? Most pre hospitalization and post hospitalization expenses (up to 60 days) are covered under the policy, such as X - rays, CT scan, MRI, ultrasound nursing, physicians, medicines, other diagnostic needs.

Is tooth implant covered by HDFC ERGO? ›

No dental insurance does not cover dental implantation procedures.

Are consumables covered in Optima Restore? ›

Pros & Cons: HDFC Ergo Optima Restore

Covers non-medical expenses or the cost of consumables such as gloves, oxygen masks, nebulization kits, etc.

Is pregnancy covered in HDFC ERGO? ›

Keeping in mind the necessity to offer financial assistance at the time of child delivery, HDFC ERGO offers health insurance with pregnancy coverage with both health Suraksha as well as my:healthmedisure classic.

What is lifetime renewal in health insurance? ›

With the feature of lifetime renewability, the insured can ensure that the policy can be renewed lifelong without any age limit or any other restriction. For senior citizens, the benefit of lifetime renewability takes off the financial pressure in case of any medical emergency.

What is renew in health insurance? ›

Health Insurance Renewal. A Health Insurance Policy is only valid for a certain period of time, the duration of which could be 1-3 years. Beyond this duration, you need to renew your policy to continue availing of the benefits under it.


1. Hdfc ergo optima secure health insurance policy | hdfc ergo optima secure policy | optima secure
2. HDFC ERGO Health Insurance | Latest Plan Updates | Unlimited Restore | in Hindi | #75
(Insurance with Sachin)
3. HDFC ERGO Optima Restore Details | HDFC ERGO Health Insurance | Health Insurance 2022 *REVIEW*
(Gurleen Kaur Tikku)
4. HDFC Ergo Health Insurance 2023| Detailed Review | HDFC My health Suraksha | Silver, Gold & Platinum
5. HDFC ERGO Optima Restore Health Insurance I Best Health Insurance in India- Complete Review in Hindi
(Manoj Jaiswal)
6. HDFC Ergo Optima Restore - Good, But not The Best
(Health Insurance Sahi Hai)
Top Articles
Latest Posts
Article information

Author: Virgilio Hermann JD

Last Updated: 02/09/2023

Views: 6193

Rating: 4 / 5 (41 voted)

Reviews: 80% of readers found this page helpful

Author information

Name: Virgilio Hermann JD

Birthday: 1997-12-21

Address: 6946 Schoen Cove, Sipesshire, MO 55944

Phone: +3763365785260

Job: Accounting Engineer

Hobby: Web surfing, Rafting, Dowsing, Stand-up comedy, Ghost hunting, Swimming, Amateur radio

Introduction: My name is Virgilio Hermann JD, I am a fine, gifted, beautiful, encouraging, kind, talented, zealous person who loves writing and wants to share my knowledge and understanding with you.