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HDFC Ergo Health Optima Senior

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HDFC Ergo Health Optima Senior Plan

HDFC Ergo Health Optima Senior Plan is a Senior Citizen Health Insurance Plan which offers comprehensive health coverage exclusively to senior citizen.

How it works – In this plan, premium needs to be paid in a lump sum and can be availed for a period of 12 months or 24 months. This plan has been exclusively designed for Senior Citizen above 61 years of age and can be renewed lifelong.

This plan offers regular benefits like in patient hospitalization expenses over a cashless network of 4000 hospitals, pre and post hospitalization and coverage of 140 day care procedures where there is no requirement of hospitalization.

However, there are some additional benefits of Domiciliary Treatment, expenses for Organ Donor, Emergency Ambulance, E-opinion for all medical complications, etc.


Key Features of HDFC Ergo Health Optima Senior Plan

  • This plan provides comprehensive hospitalization coverage for the senior citizen
  • This plan offers lifelong renewal and has been exclusively created for Senior Citizens at any age after 61 years
  • There is no loading in this plan because of a claim in the previous year
  • This plan has an option to choose a higher insurance cover upto 5 Lakhs
  • There is hassle free lifelong cover for you and your spouse along with this plan
  • In this plan, there is a facility where a free second opinion is provided by the medical panel for listed ‘Critical Illnesses’
  • This plan has no sub limits
  • This plan covers:
    • In-patient Hospitalization
    • Pre-Hospitalization
  • Post-Hospitalization
  • Day Care Procedures
  • This plan has additional benefits of Domiciliary Treatment, Expenses for Organ Donor, Emergency Ambulance, etc
  • This plan offers an additional discount of
    • 5% if 2 members but this plan
    • 7.5% if a 2- year plan is purchased
  • This plan covers pre-existing diseases after 3 years of continuous renewal
  • This plan offers a 5% additional discount for a claim free year



What is covered in HDFC Ergo Health Optima Senior Plan?

 This Comprehensive Health Insurance Plan covers the following:

  • In-patient Hospitalization with no sublimit or co payments
  • Pre Hospitalization coverage for 30 days prior to admission in hospital
  • Post Hospitalization coverage for 60 days post discharge from hospital
  • 140 Day Care Procedures where there is no requirement of hospitalization


Additional Benefits of HDFC Ergo Health Optima Senior Plan

There are certain additional benefits available in this

  • Domiciliary Treatment
  • The expenses for Organ Donor
  • Emergency Ambulance
  • E-opinion for all medical complications


Eligibility and Restrictions of HDFC Ergo Health Optima Senior Plan





Sum Assured (in Rs)

2,00,000 and 3,00,000


Policy Term (in years)



Entry Age of Life Insured (in years)



Renewable till Age (in years)




Family Floater Policy will cover

The Policy is available both as Individual and Family Package covers and an additional 5% discount is provided if 2 members take this plan.




Tax Benefits of HDFC Ergo Health Optima Senior Plan

Health Insurance premiums paid up to Rs. 15,000 in case of individuals and Rs 20,000 for senior citizens are allowed as a deduction from the taxable income each year under section 80D of the Income Tax


Exclusions - What is not covered in HDFC Ergo Health Optima Senior Plan?

  • Waiting period of 30 days except in case of an accident
  • Specific waiting period of 2 yrs for conditions like cataract, hernia, hysterectomy, joint replacement, Hydrocele
  • Pre-existing conditions are covered after 3 policy years
  • HIV, AIDS and related diseases
  • Non-allopathic treatment, congenital diseases, cosmetic surgery, weight control treatments, plastic surgery
  • Abuse of drugs, alcohol, hallucinogens, intoxicant – not covered
  • War. Radiation or nuclear contamination
  • Participation in dangerous sports like scuba diving
  • Psychiatric conditions, Alzheimer Parkinson’s disease, hormone therapy, stem cell implantation etc
  • Pregnancy, dental unless specific plan taken
  • Dental treatments



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