HDFC ERGO Health Insurance – Plans & Benefits Guide

Everything About HDFC ERGO Health Insurance Plans in India

Sampurn Insurance Advisor 2026-01-08 7 min read

HDFC ERGO General Insurance भारत की सबसे बड़ी निजी क्षेत्र की सामान्य बीमा कंपनी है, जो HDFC Ltd और ERGO International AG का संयुक्त उपक्रम है। 13,000+ नेटवर्क अस्पतालों और 95%+ क्लेम सेटलमेंट रेशियो के साथ, यह स्वास्थ्य बीमा के लिए एक विश्वसनीय विकल्प है।

HDFC ERGO: Joint venture between HDFC (India's leading housing finance company) and ERGO (Munich Re Group company, Germany). One of the highest claim settlement ratios in the industry.

Why Choose HDFC ERGO Health Insurance?

HDFC ERGO Health Insurance के लाभ:

  • Highest Claim Settlement: 95%+ ratio - among the best in industry
  • Wide Network: 13,000+ cashless hospitals across India
  • HDFC Brand Trust: Backed by trusted HDFC Group
  • Digital-First: Easy online claims and policy management
  • Restore Benefit: Unique sum insured restoration feature
  • 24/7 Support: Round-the-clock customer assistance

Best HDFC ERGO Health Insurance Plans 2026

1. HDFC ERGO Optima Secure (Most Popular)

सबसे लोकप्रिय व्यापक स्वास्थ्य योजना:

  • Coverage: ₹3 lakhs to ₹1 crore
  • Age: 18-65 years entry (lifelong renewability)
  • Key Benefits:
    • Multiplier benefit - doubles sum insured
    • Wellness rewards up to 30% discount
    • No sub-limits on room rent
    • Air ambulance cover up to ₹5 lakhs
    • Second e-opinion from global experts
    • Covers 588+ daycare procedures
  • Premium: Starting from ₹7,000/year

2. HDFC ERGO Optima Restore

सम इंश्योर्ड रिस्टोर के साथ प्लान:

  • Coverage: ₹3 lakhs to ₹50 lakhs
  • Unique Features:
    • 100% Sum Insured Restoration - unlimited times
    • Restoration even for same illness
    • 50% NCB per claim-free year
    • Covers pre and post hospitalization
  • Best For: Families who want restoration benefit

3. HDFC ERGO My:Health Suraksha

किफायती बेसिक प्लान:

  • Coverage: ₹2 lakhs to ₹10 lakhs
  • Age: 5-65 years
  • Highlights:
    • Affordable premiums
    • 10% family discount
    • 10% NCB per claim-free year
    • Covers modern treatments (AYUSH)
  • Premium: Starting from ₹4,000/year

4. HDFC ERGO Health Shield

सीनियर सिटीजन और फैमिली के लिए:

  • Age: 5-75 years entry
  • Coverage: ₹2 lakhs to ₹25 lakhs
  • Benefits:
    • Covers pre-existing diseases after 3 years
    • No medical test up to certain sum insured
    • Covers modern treatments

HDFC ERGO Claim Process

Cashless Claim Steps:

  1. Network Hospital Visit: Go to any of 13,000+ network hospitals
  2. Show Health Card: Present HDFC ERGO health card at admission desk
  3. Pre-Authorization: Hospital sends request to HDFC ERGO
    • Planned hospitalization: 48 hours before admission
    • Emergency: Within 24 hours of admission
  4. Approval: Received within 2-4 hours typically
  5. Treatment: Get treatment without paying (within covered amount)
  6. Discharge: Pay only non-covered expenses (if any)

Reimbursement Claim:

  1. Inform HDFC ERGO about hospitalization
  2. Collect all original documents post discharge
  3. Submit claim online through HDFC ERGO website/app
  4. Track claim status online
  5. Receive payment within 7 working days

HDFC ERGO vs Star Health vs Care Health

Feature HDFC ERGO Star Health Care Health
Network Hospitals 13,000+ 14,000+ 10,500+
Claim Settlement ~95% ~94% ~91%
Restore Benefit Unlimited (Optima) 100% Unlimited
Premium (₹5L) ₹7,000/year ₹5,500/year ₹4,500/year
Digital Experience Excellent Good Good

HDFC ERGO Health Insurance Premium Calculator

Plan Sum Insured Individual (30 yrs) Family Floater (4)
Optima Secure ₹5 Lakhs ₹7,000/year ₹14,000/year
Optima Restore ₹5 Lakhs ₹6,500/year ₹13,000/year
My:Health Suraksha ₹5 Lakhs ₹4,500/year ₹9,000/year

HDFC ERGO Network Hospitals in Madhya Pradesh

Indore:

  • Bombay Hospital
  • CHL Hospital
  • Choithram Hospital
  • Medanta Indore
  • Sri Aurobindo Hospital

Bhopal:

  • AIIMS Bhopal
  • Hamidia Hospital
  • Bansal Hospital

HDFC ERGO Customer Care

HDFC ERGO संपर्क विवरण:

  • Toll-Free: 1800-2666 (24/7)
  • Email: healthclaims@hdfcergo.com
  • Website: www.hdfcergo.com
  • Mobile App: HDFC ERGO App

Buy HDFC ERGO Through Sampurn Insurance

Sampurn Insurance Advisor के माध्यम से HDFC ERGO Health Insurance खरीदें और पाएं:

  • Expert comparison with other insurers
  • Help choosing right sum insured and plan
  • Assistance with medical tests (if required)
  • Quick policy issuance
  • Lifetime claim support

Contact: +91-9425051306 | Offices in Indore & Dhamnod

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