HDFC Ergo Health Easy Premium Plan Product Benefit Table

HDFC Ergo – Health Easy Premium Plan – Product Benefit Table

Benefits Easy Health
Sum Insured (in Lakhs) 4 Lac & 5 Lac 7.5 Lac & 10 Lac 15 Lac, 20 Lac, 25 Lac & 50 Lac 4 Lac & 5 Lac 7.5 Lac & 10 Lac
Plans Premium
Policy Type Individual Family Floater
Entry age 91 days to 65 years 91 days to 65 years
Policy Term 1, 2 years 1, 2 years
Relationship members covered under one policy 6 members 6 members
Inpatient Treatment Covered Covered
Day Care Procedures Covered Covered
Pre-Hospitalisation 60days 60days
Post-Hospitalisation 90days 90days
Domiciliary Treatment Covered Covered
Organ Donor Covered Covered
Ambulance Upto Rs. 2000 per hospitalisation Upto Rs. 2000 per hospitalisation
Emergency Air Ambulance Not Covered Upto Rs.2.5 Lacs per hospitalisation Not Covered
Recovery Benefit Not Covered Rs. 10,000 (> 10 days of hospitalisation) Not Covered
AYUSH Benefit Upto Rs. 20,000 Upto Rs. 50,000 Upto Rs.25,000
Daily Cash for choosing shared accommodation’s Rs.500 per day, Maximum Rs.3,000 Rs.800 per day, Maximum Rs.4,800 Rs.1000 per day, Maximum Rs.6,000 Rs.500 / day, maximum Rs.3,000 Rs.800 per day, Maximum Rs.4,800
Daily Cash for accompanying an Insured child Rs.300
per day,
Maximum
Rs.9,000
Rs.500 per
day,
Maximum
Rs.15,000
Rs.800 per day, Maximum Rs.24,000 Rs.300
per day,
Maximum
Rs.9,000
Rs.500 per
day,
Maximum
Rs.15,000
Out-Patient Treatment Cover after waiting period of 3 years Not Covered Covered
a) Out-patient Consultation Not Covered Not Covered
b) Diagnostic Tests Not Covered Not Covered
c) Dental Treatment Upto 1 % of Sum insured
subject to a
Maximum of Rs. 5,000
Upto 1 % of Sum insured subject to a Maximum of Rs. 7,500
d)Spectacles, Contact Lens, Hearing Aids Upto Rs. 5,000 Upto
Rs. 7500
E-Opinion in respect of a Critical Illness Covered Covered
Convalescence Benefit
Maternity Expenses Normal
Delivery
Rs. 15,000*
Caesarean
Delivery
Rs. 25,000*
(*Including
Pre/Post
Natal limit
of Rs.1,500
and New
Born limit of
Rs. 2,000)
[Waiting
Period of
6 years]
Normal
Delivery
Rs. 25,000*
Caesarean
Delivery
Rs. 40,000*
(*Including
Pre/Post
Natal limit
of Rs. 2,500
and New
Born limit of
Rs. 3,500)
[Waiting
Period of
6 years]
Normal
Delivery
Rs. 30,000*
Caesarean
Delivery
Rs. 50,000*
(*Including Pre/
Post Natal limit
of Rs. 5,000
and New Born
limit
of Rs. 5,000)
[Waiting Period
of 4 Years]
Normal Delivery
Rs.15,000*
Caesarean
Delivery
Rs.25,000*
(*Including Pre/
Post Natal limit
of Rs.1,500 and
New Born limit of
Rs.2,000) [Waiting
Period 4 years]
Normal Delivery
Rs.25,000*
Caesarean
Delivery
Rs.40,000*
(*Including Pre/
Post Natal limit
of Rs.2,500 and
New Born limit of
Rs.3,500) [Waiting
Period 4 years]
New Born Baby Cover Additional Benefit on payment of additional
premium
Additional Benefit on payment of additional
premium
Restore Benefit Not covered Not covered
Cumulative Bonus  10% for every claim-free year accumulating up to 100%
(in the event of a claim, CB will be reduced by 10% of SI on the next renewal).
 10% for every claim-free year accumulating up to 100%
(in the event of a claim, CB will be reduced by 10% of SI on the next renewal).
Health Check-up Upto 1% of Sum Insured subject to a
Maximum of Rs. 5,000 per Insured Person,
only once at the end of a block of every
continuous two policy years
Upto 1% of Sum Insured / Policy subject to a
Maximum of Rs.5,000 / Insured Person, only
once at the end of a block of every continuous
two policy years.
Critical Illness Optional, if opted then the
Critical Illness Sum Insured
50% or 100% of In-patient
Sum Insured
Optional, if
opted then
the Critical
Illness Sum
Insured 50%
or 100% of
In-patient Sum
Insured upto a
maximum of
Rs. 10 Lacs
Optional, if opted then the
Critical Illness Sum Insured
50% or 100% of In-patient
Sum Insured
Critical Advantage Rider Offered (where base Sum Insured is Rs.10 lacs & above) Offered (where base Sum Insured is Rs.10 lacs & above)
Family Discounts 5% if 2 members are covered and 10% if 3 or more family members NA
Long Term Discount 7.5% Discount on premium if Insured Person is paying premium of 2 years 7.5% Discount on premium if Insured Person is paying premium of 2 years
Stay Active Upto 8% discount on renewal premium subject to insured member achieving the average number of
steps in each time interval prescribed in the grid by either walking or running regularly to keep fit. The discount will
be accrued by the customer at defined time intervals and cumulated at the end of the policy period and offered as a
discount on renewal premium.
Upto 8% discount on renewal premium subject to insured member achieving the average number of
steps in each time interval prescribed in the grid by either walking or running regularly to keep fit. The discount will
be accrued by the customer at defined time intervals and cumulated at the end of the policy period and offered as a
discount on renewal premium.
Pre-existing diseases 36months 36months