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• HDFC Ergo my:health Medisure Classic Insurance Plan

HDFC Ergo my:health Medisure Classic Insurance Plan

HDFC Ergo my:health Medisure Classic Insurance Plan - HDFC Ergo General Insurance Ltd. presents my:health Medisure Classic Insurance, a meticulously designed. insurance solution that understands your family's unique health needs and provides you with a step-by-step plan to ensure their complete well-being. Especially designed through a scientific process, my:health plans enables you to quickly bounce back from a medical emergency so that you can continue to spend and cherish your time with your loved ones.

Key Highlights - HDFC Ergo my:health Medisure Classic Insurance Plan

• Entry and renewals are available for a lifetime
• Option to buy a two year policy at a 5 % discount
• Replenishment of Sum Insured - Reinstatement of Sum Insured in case of hospitalization due to an accident
• Maternity and new-born baby cover
• No age limit, however you have to undergo medical tests if your age is >50 yrs or if you have declared any pre-existing diseases
• Cover for Ayurvedic treatment
• Additional recovery benefit of Rs 5000/- is provided (no bills required) only when hospitalization exceeds 10 contiuous days
• Cover for day-care procedures with no static list
• Cover for pre as well as post hospitalisation expenses
• Additional cover for hospital cash and ambulance charges

Features - HDFC Ergo my:health Medisure Classic Insurance Plan

• Hospitalisation Expenses –

  • For treatment of any disease, illness or injury in a Hospital as an in-patient which includes-
    • Fees of Surgeon, Anesthetist, Nurses and Specialists.
    • Cost of Operation Theatre, diagnostic tests, medicines, blood, oxygen and internal appliances like pacemaker as long as these are medically necessary.
  • Treatment should be for a continuous period and includes relapse within 45 days from the date of last consultation at the Hospital/Nursing Home. Occurrence of same illness after a lapse of 45 days will be considered as fresh illness.
  • Hospitalisation as In-patient for a minimum period of 24 hours subject to the limits set below Room Rent/Boarding & Nursing as per actuals limited to 1% of the Sum Insured (excluding cumulative bonus) per day subject to a maximum of `4,000/- per day ICU Rent/Boarding & Nursing as per actuals limited to 2% of the Sum Insured (excluding cumulative bonus) per day subject to a maximum of 6,000/- per day.
  • Expenses on account of Room Rent/ICU Boarding & Nursing if, incurred higher than the limits above, shall be reduced in the same proportion as such actual costs bears to the eligible limits above. Such limits shall not apply where Optional Cover for Waiver of Room Rent Sub-limits has been opted.
• Pre-Hospitalization -Medical expenses 30 days immediately before hospitalization
• Post-Hospitalization - Medical expenses 60 days immediately after hospitalization
• Day care procedures - Medical expenses for existing and upcoming day care procedures which do not require 24 hours hospitalization due to technological advancement in medical science.
• Domiciliary Treatment - Coverage for medical treatment requiring hospitalisation, taken at home on advice of the attending medical practitioner, due to non-availability of a hospital bed, which continues for at least 3 days
• Hospitalisation due to Accident - If, during the term of your policy, the entire Sum Insured gets used up or is not enough to cover your second hospitalisation due to accident, the Sum Insured of your policy is ‘reinstated’ or ‘replenished’ to the extent of the claim amount (but not exceeding the Sum Insured) to cover this hospitalisation. This additional amount will be available only ONCE during the 12-month Policy Year.
• Expenses for Pre-existing diseasesYou can rest assured that expenses incurred towards the treatment of pre-existing diseases that you might have contracted before the inception of the policy will be covered by us. Please note that such expenses will be covered only after 3 continuous renewals with us.
• Maternity and New-born baby Cover - Coverage towards maternity expenses and new-born baby cover up to the limit of Maternity Sum Insured.
• Ayurvedic Treatment - Coverage for cost of (non cosmetic) Ayurvedic treatment upto 25,000 per Policy Year, with prior approval from the Company requiring 24 hours hospitalisation / residential in-patient with government registered hospital for the specified treatments (For details refer the Prospectus).
• Sum Insured (Rs.) - 2, 3, 4 and 5 lacs
• Family Discount - TIf you opt for Individual Sum Insured for each of your family members under a single policy instead of a Family Floater option, we give you a Family Discount of 10% on the total premium payable for covering more than 2 family members. This will include you, your lawful spouse, dependent children and dependant parents only. The Family discount will be available for a maximum of 6 persons only.
• Free-Look Period - : It is possible that you might decide to opt out of the policy after buying it. We give you the option of cancelling the policy within 15 days from the date of receipt of policy documents, if you are not satisfied with the coverage and terms of the policy. We will refund the premium paid after adjusting the amounts spent on stamp duty charges, Medical examination (wherever applicable) and proportionate premium (if policy has already commenced). Refund will not be applicable if you have made a claim against the policy during that period.
• Entry Age - From 91 days till No limit.
• Policy Period -The policy will be issued for 1 year /2 years period.
• Pre-Policy Check up - Required > 50 Yrs of age (Except if PED declared).

* 50% of the standard medical tests charges would be reimbursed, subject to acceptance of proposal and policy issuance.

Operational Covers - HDFC Ergo my:health Medisure Classic Insurance Plan

• Double Sum Insured for Critical Illness:

  • Provides for an additional cover equivalent to the Sum Insured excluding the cumulative bonus for treatment of - Cancer, Kidney Failure, Multiple Sclerosis, Primary Pulmonary Hypertension, Major Organ Transplant, Aorta Graft Surgery, Coronary Artery Bypass Graft, First Heart Attack and Stroke.
  • Expenses arising from HIV or AIDS and related diseases are permanently excluded
  • Additional Sum Insured (excluding cumulative bonus) is exclusively available only for the treatment of the first occurrence of the above Critical Illnesses. - Coverage will not be extended for the same Critical Illness for any subsequent Policy Year, however, the remaining critical illnesses will continue to be covered.
  • This coverage is in addition to the Hospitalisation cover and the cumulative Sum Insured under both could be used for hospitalisation against covered Critical Illness. And both could be used for any Critical Illness event.
  • The option can be availed only up to the age of 65 years (age last birthday) and for Sum Insured of `2 Lacs and above. For customers who avail of such option at or before that age, the cover shall continue to be available in the case of continuous renewals.
• Waiver of Room Rent Sub-limits:

  • If this coverage is opted, the sub limits of Room Rent and ICU under the Basic Cover of Hospitalisation Expenses will be waived however, subject to the overall limit of the Sum Insured.

Exclusions - HDFC Ergo my:health Medisure Classic Insurance Plan

• All pre-existing diseases / illness / injury / conditions as defined in the policy, until 36 months of continuous covers have elapsed since inception of the first policy with us.
• Waiting Periods
• 30 days waiting period will apply to all claims, except if any insured person suffers an accident
• 2 years exclusions for specific diseases
• Permanent exclusions in the policy
• Non-allopathic treatment except Ayurvedic
• Expenses arising from HIV or AIDS and related diseases are permanently excluded
• Mental disorder or insanity, cosmetic surgery, weight control treatment
• Abuse of intoxicant or hallucinogenic substance like drugs and alcohol
• Hospitalization due to war / acts of war, nuclear, chemical / biological weapon & radiation of any kind
• Pregnancy, dental and external aids and appliances unless covered under specific plans
• Experimental, investigational or unproven treatment, devices and pharmacological regimens

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