Most health insurance plans offer coverage of Rs. 2,00,000 to Rs. 3,00,000 which may not be adequate considering rising inflation and the increasing medical expenses for people of all ages. However, it a base health insurance plan with higher coverage may not be affordable for most people. This is exactly where you need a Health insurance top-up that gives you the financial support you need to meet unexpected medical expenses in the future. The HDFC Ergo My: Health Medisure Super Top-up Insurance policy gives you the option to add a top-up insurance cover to your base plan whether it is an individually-bought insurance plan or corporate insurance plan.
Eligibility Criteria
This health insurance top-up is ideal to enhance cover for medical expenses offered by the base plan. You can also use this top-up plan as your health insurance plan if you do not have any other health insurance plan subject to the policy terms. Here are the eligibility details of the My: Health Medisure Super Top-up:
- The proposer must be between the age of 18 to 65 years
- Can be chosen in both individual or family floater basis
- Children between the age group 91 days to 23 years can be added to the plan if both the parents are covered under the policy
- Medical tests not required up to the age of 55 years
Features and Benefits
This health insurance top-up plan by HDFC Ergo offers a range of features and benefits to the policyholders including:
| HDFC Ergo My: Health Medisure Super Top-up | Features & Benefits |
| High Sum Insured | With the My: Health Medisure Super Top-up, you get to choose high Sum Assured at a low premium with an option to choose from a wide range of deductibles. This gives you the option to enhance coverage of your base insurance plan |
| Comprehensive Coverage | You can avail pre-hospitalisation and post-hospitalisation expenses and day-care treatments without any sub-limits. The best part is that if you do not have a health insurance plan, you can still avail the benefits of this top-up. All you need to do is pay Rs. 2 lakh – Rs. 3 lakh of the medical expenses incurred and get up the balance reimbursed (up to Rs. 8,00,000) through this Super Top-up plan |
| 6 Hours Response Guarantee | It is important that the policyholders get a response on time from the insurer for a cashless claim. HDFC Ergo guarantees a response time of 6 hours for cashless claims if the claim is made within 9 am to 9 pm from Monday to Saturday. The company pays a penalty of Rs. 1,000 if it fails to deliver on the 6-hour response guarantee. For claims made on holidays, Sunday or outside the 9 am – 9 pm window on Monday-Saturday, the company responds within 8 hours of receiving the claim. |
| Lifetime Renewability Option | You get the option to renew this policy throughout your life by paying renewal premium before the end of the policy term or within a maximum of 30 days from the end of the policy term |
| Portability Option | The company offers portability option on this policy in accordance with IRDAI guidelines. However, to avail this feature, you need to contact the company at least 45 days before the expiry date of the policy to ensure coverage without any break. The portability option can be availed subject to the acceptance of the proposal by the company |
| Tax Benefits | You are eligible to avail Tax Benefits for the premium paid towards the HDFC Ergo My: Health Medisure Super Top-up under Section 80D of the Income Tax Act, 1961. It is important to note here that no Section 80C benefits are payable under this plan |
To know more about NAV, premium paying term, breakup of premium, etc. about this HDFC Ergo Super Top-up, call 1800 1600 / 1800 2600 (toll-free).
Coverage and Exclusions
HDFC Ergo My: Health Medisure Super Top-up offers plenty of benefits to the policyholders. However, there are few instances where the benefits under this plan are not payable. Here is a table containing information about the medical expenses covered and excluded under My: Health Super Top-up:
| Coverage | Exclusions |
| · Hospitalisation expenses are covered under this super top-up plan without any limits
· Day-care treatment that does not require hospitalisation is also covered with no static list · Expenses attributed to pre-existing diseases are covered post 3 continuous renewals of the plan |
· Expenses incurred due to the treatment of HIV/AIDS and related conditions
· Hospitalisation and other medical expenses arising due to the consumption of liquor and drugs · Expenses attributed to non-allopathic treatments |
Claim Process
The health insurance company follows a customer-centric approach to make the claim process an easy one. Look at the table shown below to know more about the claim as well as the reimbursement process of this top-up plan:
| Claim Process for Cashless Hospitalisation | Claim Process for Reimbursement |
| · Contact the company and inform them about a planned treatment at one of the 6000+ network hospitals 7 days in advance. For emergency treatment, inform the company within 24 hours of getting admitted to the hospital.
· Show ID proof of the Insured at the network hospital along with the health card issued by the Insurer to avail cashless treatment facility. · Wait for the hospital to contact HDFC Ergo for authorisation and get approval. · When the Insured gets discharged from the hospital, HDFC Ergo will scrutinise the documents received to convey the final stand on the claim requested within 6 hours. · Make co-payments, inadmissible expenses and deductions no covered under your health insurance and top-up. |
· Visit your nearest network hospital for your treatment.
· After your treatment, get original bills, receipts, prescriptions, discharge sheet, etc. when you get discharged. · Fill out the claim form and send it to the company’s Noida office along with other documents required for the claim process. Make sure to submit original invoices, bills, receipts and prescriptions to support the claim · The Insurer will verify the documents received and approve/reject the claim. The company may ask for other documents to support the claim, if required. Submit the documents within the stipulated time · The insurer will update you through emails and SMS regarding the claim status. If all the documents are in order, the company will approve the claim and process the reimbursement claim by releasing funds into your bank account through NEFT |
Also Read: HDFC ERGO Critical Illness Policy
FAQ’s
Q1-What are the Health Insurance plans offered by HDFC Ergo company?
HDFC Ergo offers a wide range of health insurance plans to fulfill the needs of its customers. Here are some health insurance plans currently offered by the company:
- HDFC Ergo Health Suraksha Gold Insurance Plan
- HDFC Ergo Health Suraksha Insurance Plan
- HDFC Ergo Critical Illness Insurance Plan
- HDFC Ergo My: Health Medisure Classic Insurance Plan
It also offers top-up plans to help customers enhance cover based on their needs.
- HDFC Ergo My: Health Medisure Super Top-up
- HDFC Ergo Health Suraksha Top-up Plus
Q2-What are the documents required to submit a claim for the HDFC Ergo My: Health Medisure Super Top-up?
Here are the documents that you need to submit for a claim for In-patient or Day Care treatments at one of the network hospitals of HDFC Ergo:
- Duly filled and signed Claim Form
- Original Discharge summary
- Original hospital bill and payment receipt with the break-up of all expenses (duly signed by the insured)
- First consultation letter and subsequent prescriptions
- Original bills, payment receipts and medical reports of investigation
- Original medical bills and receipts with prescription
- Original invoice with payment receipts
Q3-What are the Medical tests required for this health insurance top-up?
Medical tests are not required for the proposer or insured (if insured and proposer are different) who are younger than 55 years of age at the time of entry. However, if the insured is older than 55 years then here are the medical tests required before he/she is granted coverage under this health insurance top-up:
- Medical Examination Report
- Treadmill Test/ECG
- Lipid profile
- HbA1C
- Serum Creatinine
- Complete Blood Count, Urinalysis
Q4-Can I get HDFC Ergo My: Health Medisure Super Top-up even if I do not have a Health Insurance Plan?
Yes, you can opt for the HDFC My: Health Super Top-up plan even if you do not have any other health insurance plan. For instance, if your medical expenses turn out to be Rs. 10 lakh then you can pay Rs. 2 lakh and claim the balance with the company through your My: Health Medisure Super Top-up plan.