My:Health Suraksha Silver Smart Plan

You always want to keep yourself fit and healthy and to help you achieve this objective, HDFC ERGO has come up with a customized health insurance plan. My:health Suraksha Silver Smart from HDFC ERGO is a comprehensive health insurance plan that gives you 360 0 protection against soaring medical expenses. This health plan provides the health cover for individuals, families and senior citizens with the cover ranging from 3 lakh to 5 lakh.

Key Features

• Health cover in a range of 3 to 5 lakh
• Sum Insured Rebound option
• No room rent capping
• Free health check-up every year
• No limit on entry age with lifetime renewal
• Discount on choosing family cover, long term policy
• Flexible premium payment options
• Cashless hospitalization in 10,000+ network hospitals
• Quick & hassle-free claims settlement

Policy Benefits

• In-patient hospitalization expenses such as room rent, nursing expenses, ICU, consultation fees, etc., are covered for which the hospitalization for a minimum period of 24 hours is required.
• Pre hospitalization expenses are covered for 60 days prior to hospitalization.
• Post hospitalization expenses are covered till 180 days after discharge from hospital.
• If the insured member suffers from mental illness, its hospitalization expenses get covered.
• If your doctor recommends treatment at home, you can avail the services right at your home that too with cashless facility, if the service is opted from network hospitals.
• Specific 586 day care procedures are covered, for which the hospitalization for less than 24 hours is required.
• Recovery benefit to cover amount upon medically necessary hospitalization of an Insured Person exceeding 10 consecutive and continuous days and for which Claim is admissible.
• Organ donor expenses wherein organ donor’s hospitalization expenses for harvesting of the donated organ is covered.
• AYUSH treatment expenses are covered.

Value Added Benefits

• On each renewal of the policy, you will get 10% of the basic sum insured up to 100% of sum insured, as cumulative bonus. In case of claim, the cumulative bonus is reduced at the same rate.
• You can avail free annual health check-up at one of the network service providers of the insurance company.
• Ambulance charges are covered. The expenses incurred in transferring the insured from home to hospital or hospital to home in an ambulance is covered.
• Under this plan, you will get the discount on renewal premium by accumulating Healthy Weeks.
• You can avail tax benefit under section 80D of Income Tax Act, 1961.

Sub Limits

• Recovery Benefit is payable up to Rs 5,000.
• Ambulance charges are covered up to Rs 2,000.
• Under Parent and Child Care Cover (add-on), up to Rs 15,000/25,000 for normal delivery and Rs 25,000/40,000 for C-section delivery as per cover opted. Vaccination charges are payable up to Rs 5,000.
• Extended cumulative bonus (add-on) is 25%/50% up to maximum of 200% of SI, as per cover opted.
• Hospital cash is payable up to Rs 1,000/2,000 per day, as per cover opted.

Waiting Period Clause

• Initial Waiting Period: Claims arising during first 30 days of the policy start date, except accidental claims.
• Specific Waiting Period: Some illnesses/ surgical procedures such as Pancreatitis, Hernia, Internal congenital diseases, Sinusitis, Cataract, etc. are covered after 24 months from the inception date of the policy.
• Pre-existing Disease Waiting Period: Any pre-existing disease until 36 months of continuous policy coverage, from date of inception of the first policy.
• Parent and Child Care Cover Waiting Period: A waiting period of 48 months for the claims under parent and child care cover.

Who can Buy the Plan?

Exclusions

• War/ Act of war, invasion, act of foreign enemy
• Suicide/ Attempted suicide, intentional self-injury
• Dental Treatment
• Plastic or cosmetic surgery
• Treatment taken on Outpatient basis, etc.