Optima Secure is HDFC ERGO's flagship health plan combining four industry-first guaranteed benefits: Secure, Plus, Restore, Protect. Together these deliver up to 4X the base Sum Insured — starting with 2X from day one.
- Guaranteed 2X coverage from Day 1 via Secure Benefit.
- Automatic cover growth: +50% after 1 year, +100% after 2 years via Plus Benefit.
- 100% restore of base SI on any claim via Restore Benefit.
- Zero deduction on listed non-medical consumables via Protect Benefit.
🛡 Secure Benefit — 2X from day 1
Immediately on buying the policy the base SI you choose is doubled (e.g., ₹10L base → ₹20L effective) — at no extra cost and without activation or claims.
➕ Plus Benefit — automatic growth
Your base SI increases automatically irrespective of claims: +50% after 1 year and +100% after 2 years. (So ₹10L base → +5L after year1 → +10L after year2.)
♻ Restore Benefit — restore cover after claims
If any partial or full claim is made in a policy year, 100% of the base SI is restored automatically (no extra charge) so you can claim again during the year.
💊 Protect Benefit — zero deduction on consumables
Consumables and listed non-medical expenses (gloves, masks, nebulizer kits, etc.) are covered with zero deductions during hospitalization.
🏥 Hospitalisation cover
Room rent at actuals (sub-limits apply as per plan), ICU, surgeon fees, nursing charges, road ambulance and all day-care procedures covered.
🩺 Pre / Post & Home Healthcare
Pre-hospitalisation up to 60 days and post-hospitalisation up to 180 days. Home healthcare (cashless in select cities) is covered when it replaces hospital admission.
🌿 AYUSH & E-Opinion
Inpatient AYUSH treatments covered. Get e-opinion for 51 critical illnesses from network providers.
💸 Daily Cash
Daily cash of ₹800/day (max ₹4,800) for shared accommodation when hospitalization exceeds 48 hours in a network hospital.
Example: Mr. Sharma (age 35) selects Base Sum Insured = ₹10,00,000 (10L). See how Optima Secure builds 4X coverage in 2 years.
| Step | What happens | Calculation (₹) | Effective cover (₹) |
|---|---|---|---|
| 1 — Purchase | Base SI purchased | Base SI = 10,00,000 | Base = 10,00,000 |
| 2 — Secure Benefit (day 1) | Secure doubles base instantly | Secure = Base = 10,00,000 | Base + Secure = 20,00,000 |
| 3 — After 1 year (Plus Benefit) | Plus adds +50% of base (irrespective of claims) | Plus Year1 = 0.5 × 10,00,000 = 5,00,000 | Total = 20,00,000 + 5,00,000 = 25,00,000 |
| 4 — After 2 years (Plus Benefit) | Plus adds +100% (i.e., +Base) making Plus total = 10L | Plus Year2 = 10,00,000; Total (Base+Secure+Plus) = 30,00,000 | Before Restore = 30,00,000 |
| 5 — Claim & Restore | If any claim (partial/total) occurs in policy year, Restore reinstates 100% base for subsequent claims | Restore = Base = 10,00,000 | With Restore applied total = 30,00,000 + 10,00,000 = 40,00,000 (4X) |
Notes: A single claim in a policy year cannot exceed the sum of Base SI + Plus (if remaining) + Secure (if remaining). Protect Benefit additionally reduces non-medical deductions during hospitalization.
Base + Secure
+50% Plus
+100% Plus
Restore applied
Standard sub-limits & examples (illustrative)
| Benefit | Limit / Sub-limit (example) | Notes |
|---|---|---|
| Room rent | At actuals (subject to plan terms) | Room & ICU covered; check room rent capping in policy wording |
| ICU & hospitalisation | Up to Sum Insured (subject to admissibility) | Includes surgical fees, nursing, medicines |
| Pre-hospitalisation | 60 days | Tests, medicines prior to admission |
| Post-hospitalisation | 180 days | Follow-up care, medicines, investigations |
| AYUSH | Up to Sum Insured (in-patient) | Ayurveda, Yoga, Unani, Siddha, Homeopathy |
| Daily cash (shared) | ₹800/day (max ₹4,800) | Payable if shared room and hospitalization >48 hours |
| Preventive health check-up | Up to ₹15,000 (per policy details) | Once per insured per policy year |
| Organ donor expenses | Up to Sum Insured | Donor's in-patient treatment for harvesting covered |
| Emergency air ambulance | Up to ₹5,00,000 (example) | Subject to policy terms |
Available add-on covers (optional)
- my:Health Critical Illness — covers 51 defined critical illnesses. SI options ₹1L to ₹2Cr (multiples of ₹1L).
- my:Health Hospital Cash Benefit — daily cash options ₹500 to ₹10,000.
- Unlimited Restore (Add-on) — unlimited restorations in a policy year (subject to add-on terms).
- Individual Personal Accident Rider (IPA) — lump sum for accidental death or permanent disablement.
- Optima Wellbeing — outpatient expenses and wellness benefits (additional premium).
- Deductible discounts: Choose aggregate deductible (e.g., ₹25,000, ₹50,000, ₹1,00,000...) to get up to 65% premium discount depending on amount and base SI.
- Family discount: 10% when two or more family members included (individual policy option).
- Long-term discount: 7.5% (2-year), 10% (3-year) discount on policy premium for multi-year purchase.
- Loyalty discount: 2.5% if you have an active retail policy with premium > ₹2,000.
- Policy options: Individual (max 6 adults + 6 children) and Family Floater (max 4 adults + 6 children).
- Renewal: Lifelong renewal subject to terms; waiting periods reduce by 1 year for each continuous renewal.
- Network & support: 15,000+ network hospitals, 24×7 call centre in 10 languages, 1.4 Cr+ customers (data as per insurer).
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