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HDFC ERGO Optima Restore Plan
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HDFC ERGO Health Insurance
HDFC ERGO Optima Restore Plan
Comprehensive health insurance covers basic to advanced healthcare ser ...Read More
Up to 2 Cr
Sum insured
1
No. of plans
200+
Pan India presence
95.30%
Claim settlement ratio
🛡️ IRDAI Approved
⭐ 4.4/5 · 2,708 reviews
🏥 15,000+ hospitals
📊 2.00 solvency ratio
✅ 95.30% claim settlement
About HDFC ERGO Optima Restore Plan
A quick read on what this HDFC ERGO Health Insurance plan covers and why it might be a fit for you.
HDFC ERGO Optima Restore Policy is the best-selling plan of HDFC ERGO since its launch. It offers comprehensive health cover to you and your family under two variants: Optima Restore Individual and Optima Restore Family. The two unique advantages of HDFC ERGO health insurance Optima Restore are: Restore benefit and 2X Multiplier benefit.
HDFC ERGO Optima Restore Benefit allows a 100% restoration of your cover immediately after the first claim. The Multiplier benefit offers a 100% increase in your SI amount in 2 claim-free years. Other major coverage benefits included under HDFC ERGO health Optima Restore are renewal discounts, recovery benefits, organ donor cover, etc.
Plan at a glance
Eligibility, sum insured options and policy mechanics — pulled straight from the policy wording.
Entry age
5 to 65 years
Plan type
Individual and Family Health Insurance
Sum insured options
₹3 L, ₹5 L, ₹10 L, ₹15 L, ₹20 L, ₹25 L, ₹50 L
Waiting period
30 days
Renewability
Lifelong
Policy term
1, 2 years
*Initial Waiting Period is the time period between the issuance of the policy and the time it starts actively. During this period, a policyholder has to wait to avail of the benefits offered under a health insurance plan.
Pros & cons
A quick honest summary — the strengths and the trade-offs.
Pros
- Restore benefit
- 2X Multiplier benefit
- Renewal discounts
Cons
- AYUSH not covered
- OPD cover unavailable
- Global health cover
What's covered
Every CMS-driven coverage flag from the plan wording — only items with a published value render below.
Hospitalization
- Room rent Covered
- ICU charges Not covered
- Pre-hospitalization Covered
- Post-hospitalization Covered
- Domiciliary hospitalization Covered
- Day-care treatment Covered
- OPD charges Not covered
- Covid-19 treatment Covered
- Cataract Covered
Bonuses & restoration
- No-claim bonus Covered
- Automatic restoration of SI Covered
- Daily hospital cash Covered
Family & special care
- Maternity cover Not covered
- New-born baby cover Not covered
- IVF treatment Not covered
- AYUSH treatment Not covered
- Organ donor expenses Covered
Modern & preventive care
- Modern treatment Covered
- Road ambulance Covered
- Air ambulance Not covered
- E-consultation Covered
- Health check-up Not covered
- Second medical opinion Not covered
- Vaccination Not covered
Conditions & global
- Co-payment Not covered
- Sub-limits Not covered
- Compassionate travel Not covered
- Global coverage Not covered
Video reviews
Walkthroughs from the PolicyX team — pros, cons, real claim experiences and who should buy.
HDFC Ergo Health Insurance Plan Detailed Review
HDFC ERGO Health Insurance Network Hospital List
HDFC ERGO Health Insurance Network Hospitals are present in 31 states nationwide. With a wide network of hospitals, HDFC ERGO Health Insurance ensures that you are medically secured, irrespective of the city you reside in.
Inclusions & exclusions
What the plan pays for, and what it doesn't.
Exclusions
- Some treatments and medical conditions are generally not included under health insurance policies. Find what is not covered under HDFC ERGO Optima Restore health insurance in the section below:
- Hospitalization due to war, riot, strike, and nuclear weapons
- Intentional self-injury
- AIDS
- Miscarriage and abortion
- Congenital disease
- Infertility and in vitro fertilization
- Certain diseases and treatments are covered under this plan after a certain time period. Read the details below:
- Listed ailments after 24 Months
- Pre-existing diseases after 36 Months
Who can buy this plan
Eligibility criteria pulled straight from the policy wording.
- Entry Age: 18: 65 Years
- Sum Insured: 3 | 5 | 10 | 15 | 20 | 25 | 50L
- Initial Waiting Period: 30 Days
Other features & benefits
- Recovery benefits
- Organ donor cover
- In-patient and out-patient hospitalization
HDFC ERGO Optima Restore Plan: FAQs
The 10 most-asked questions about HDFC ERGO Optima Restore Plan, answered.
In most cases, dental treatments are not covered under the standard health insurance plan. However, if a dental treatment happens due to an accident and it needs a minimum of 24 hours of hospitalization, only then HDFC Optima Restore health insurance will cover dental treatment.
Multiplier benefit is a feature that doubles your sum insured after 2 claim-free years.
No, Maternity related expenses are not covered under this plan.
If the customer wants to discontinue the policy, then he has the option to cancel the policy by giving written notice at any of the HDFC ERGO health insurance branches or he/she can call on the company’s Toll-free number.
The restored amount will not be carried forward to the next year. You can only use it in a policy year.
You can renew your HDFC optima restore policy in these simple steps: Visit the official website Click on Renew tab Enter your policy number/ mobile number/ Email ID Make payment and renew your policy for another year
Sum insured will be reinstated under these situations: Partial use of sum insured Full use of sum insured In all the above situations, the restoration amount will be equal to your base sum insured.
No, you don’t have to send any request to activate the restore benefit. Restore Benefit is completely autonomous and it refills the sum insured amount once a claim is settled.
Optima Restore plan offers a portability option. So, if you have a health insurance policy from another Insurer, you can port to HDFC ERGO Optima Restore with all your accrued benefits and can HDFC Ergo Optima Restore benefits.
Here is the list of additional treatments and conditions that are covered under the plan: Treatment for correction of eyesight due to refractive error beyond +/- 7.5 dioptres Genetic diseases or disorders Neurodegenerative disorders like Parkinson’s, Alzheimer’s Any mental illness, stress, or psychological disorders Peritoneal dialysis Expenses related to any admission primarily for enteral feedings Obesity/Weight control treatment (if specified conditions are met) Post Hospitalization expenses for Domiciliary treatment Age-Related Macular Degeneration (ARMD) Expenses on Artificial life maintenance (including life support machine use) up to the vegetative state, irrespective of whether such treatment results in recovery of restoration of the previous state of health or not
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