HDFC Ergo Health Energy

HDFC Ergo Health Energy Insurance Plan is a wellness management program for individuals with Type 2 Diabetes Mellitus, Impaired Fasting Glucose (IFG), Impaired Glucose Tolerance (IGT) and/or Hypertension. It is a unique plan that offers Day 1 coverage for all hospitalisation arising out of Diabetes and Hypertension (with no waiting period). The plan is a combined package providing coverage for Inpatient hospitalisation expenses along with an ecosystem of wellness program & health rewards that help you monitor your health. The plan offers coverage on individual sum insured basis.

How it works – The plan offers coverage from the age of 18 years to 65 years for individuals with Type 2 Diabetes Mellitus, Impaired Fasting Glucose (IFG), Impaired Glucose Tolerance (IGT) and/or Hypertension. The premium at renewal may change due to a change in your age or changes in the applicable tax rate. The policy will be issued for 1 year. The plan has 2 variants – Gold (cost of wellness test included) & Silver (cost of wellness test excluded), both available with/ without the copayment option of 20%.

Comprehensive health coverage

• Day 1 coverage for all hospitalisation arising out of Diabetes and Hypertension (with no waiting period)
• Inpatient hospitalisation coverage with no sublimits, including coverage for pre and post hospitalisation.
• Sum insured options ranging from 2 lacs to 10 lacs.

Health management with a health reward program

• An optional diagnostic monitoring program which includes a doctor consultation, to monitor and manage your health.
• Wellness incentives are offered on good health management through premium discounts and additional coverage for any health expenses

Support through a Health Eco-System

• A personalised health coach to help guide you throughout your journey towards a healthy & active lifestyle and also support you with personalised diet and fitness plans.
• An access to a wellness portal that conducts an HRA, tracks your medical values, stores medical records, provides offers for health service and products.
• Access to a centralised helpline to answer any queries you may have.
• A health market place which offers you healthy discounts on health merchandise, pharmacies, health foods, medical equipment’s like glucometers etc.

• Cashless Service - You need to obtain a pre-authorization for all planned admissions atleast 48 hours prior to actual admission or regularize any ‘emergency’ admission within 24 hours post the admission. The details of the process and the documentation requirements are given in the guide-book sent along with the policy
• Sum Insured Enhancement - Sum Insured can be enhanced only at the time of renewal subject to no claim have been lodged/ paid under the policy. If the insured increases the sum insured one grid up, no fresh medicals shall be required. In cases where the sum insured increase is more than one grid up, the case shall be subject to medicals. In case of increase in the sum insured waiting period will apply afresh in relation to the amount by which the sum insured has been enhanced. However, the quantum of increase shall be at the discretion of the company.
• Portability - If you are insured with some other company’s health insurance and you want to shift to us on renewal, you can. Our portability policy is customer friendly and aims to achieve the transfer of most of the accrued benefits and makes due allowances for waiting periods etc.
• Tax Benefits - With Energy Plan, you can presently avail tax benefits for the premium amount under Section 80D of the Income Tax Act. (Tax benefits are subject to changes in Tax Laws)

• Any pre-existing condition will be covered after a waiting period of 3 years. Any condition or illness, complication or ailment arising out of or connected to the condition of Type 2 Diabetes Mellitus or Impaired Fasting Glucose (IFG) or Impaired Glucose Tolerance (IGT) or Hypertension is not a part of this waiting period.
• 2 years waiting period for specific diseases like cataract, hernia, joint replacement surgeries, surgery of hydrocele etc.
• Expenses arising from HIV or AIDS and related diseases.
• Congenital diseases, mental disorder or insanity, cosmetic surgery and weight control treatments.
• Abuse of intoxicant or hallucinogenic substances like intoxicating drugs and alcohol.
• Hospitalization due to war or an act of war or due to a nuclear, chemical or biological weapon and radiation of any kind.
• Pregnancy, dental treatment, external aids and appliances unless covered under the Plan.
• Items of personal comfort and convenience.
• Experimental, investigative and unproven treatment devices and pharmacological regimens.