HDFC ERGO Health Insurance Covered & not Covered Diseases

HDFC ERGO Health Insurance is the pioneer in the insurance industry, offering several health insurance plans. HDFC health insurance policy covers diseases within a broad spectrum, falling under home care, daycare, and critical illnesses. With nearly 13000+ cashless network hospitals and an impressive claim settlement ratio of 97%, HDFC ERGO health plans are the ideal choice for seeking treatment. 

Several diseases are covered under the HDFC health policy. However, you should also know about the HDFC ERGO health insurance not covered diseases list. 

HDFC ERGO health insurance provides various plans to meet the needs of its customers in terms of comprehensive coverage, flexibility, and affordability. The top health insurance individual and family floater plans of HDFC ERGO include:

1. HDFC ERGO Optima Secure
2. HDFC ERGO Optima Restore
3. HDFC ERGO my: health Suraksha
4. HDFC ERGO Koti Suraksha

The top health insurance disease-specific plans of HDFC ERGO include:

1. HDFC ERGO Energy Diabetes
2. iCan Cancer Insurance

HDFC ERGO’s critical illness, bonus-oriented, top-up, and women-oriented health plans include:

1. HDFC ERGO Critical Illness Policy
2. Health Wallet Family Floater
3. My: health Medisure Super Top-Up
4. My: health Women Suraksha

Not knowing HDFC ERGO critical illness and other diseases could result in surprises when your medical bills for exclusions are not covered. This means you will have to bear the expenses from your pockets. To spare yourself from these unpleasant situations, you must go through inclusions and exclusions before investing in a policy. HDFC ERGO health insurance not covered diseases list include:

1. Adventure Sports Injuries: Injuries caused by adventure sports, such as base jumping, paragliding, snowboarding, etc., are not covered under the HDFC ERGO health plan. 
2. Self-Inflicted Injuries: An insured will not be covered under the HDFC ERGO policy if they harm themselves intentionally as an act of suicide.
3. War-Related Injuries: Damages or injuries caused due to war, nuclear weapons, invasion, or similar activities are excluded from the policy.
4. Venereal or Sexually Transmitted Diseases: Next disease on the HDFC ERGO health insurance not covered diseases list includes sexually transmitted diseases like HIV or AIDS.  
5. Cosmetic Surgery: HDFC health insurance policy does not cover cosmetic surgeries like liposuction, botox, etc., as these are not life-threatening and do not affect the well-being of an individual. 
6. Obesity/Weight Control: The policy does not cover expenses related to treating obesity. 
7. Change of Gender Treatments: Expenses related to any treatment, such as surgical management, to change body characteristics to the opposite sex is not included. 
8. Hospitalisation due to alcohol and drug abuse: HDFC ERGO health plan does not cover treatment for alcoholism, drug or substance abuse or any other addictive condition. 
9. Maternity: Treatment related to childbirth (including emergency caesarean section), except ectopic pregnancy, is not covered under the policy. 
10. Participation in Defense Operations: HDFC ERGO policy does not cover any insured person’s participation or involvement in naval, military, or air force operations.  
11. Supplements: Nutritional and electrolyte supplements taken externally (not as part of the treatment) are not covered under the insurance policy. However, health insurance covers these supplements when given by a physician as part of the healing process or treatment during hospitalisation. 
12. Corrective Devices and External Durable Medical Equipment: Expenses related to hearing aids, spectacles, contact lenses, artificial limbs, wheelchairs, crutches, etc., are excluded. 

Apart from the HDFC ERGO health insurance not covered diseases list, certain illnesses and ailments are only covered once the waiting period ends. The waiting period applies to diseases under two heads: pre-existing diseases and specified diseases/procedures.  

1. Pre-Existing Diseases: A pre-existing disease is an illness a policyholder already suffers from before buying the health insurance policy. Under the HDFC ERGO health plan, the waiting period for pre-existing diseases is 48 months. 
2. Specified Diseases/Procedures: The waiting period for expenses related to specified diseases/treatments under the HDFC ERGO plan is 24 months. If any specified disease/procedure falls under a pre-existing disease, the longer of the two waiting periods will apply. 

The following table includes some specified diseases/procedures subject to a waiting period under the HDFC ERGO health policy.

To know more about the exclusions and waiting period under the HDFC health insurance policy, you can download HDFC ERGO’s prospectus from the HDFC ERGO website. 

HDFC ERGO caters to the need of every individual by offering health insurance plans that cover major illnesses and diseases. HDFC ERGO’s critical illness plan can protect you against several critical illnesses.

The following is the HDFC ERGO health insurance covered diseases list to help you understand what you will be covered for if you invest in this policy:

1. Mental health illnesses
2. COVID-19
3. Diabetes
4. Cancer
5. Heart attack
6. Kidney failure
7. Alzheimer’s disease
8. Parkinson’s disease
9. Multiple sclerosis
10. Stroke
11. Major organ transplantation
12. Coronary artery bypass surgery
13. Aorta graft surgery
14. Heart valve replacement
15. Paralysis
16. Primary pulmonary arterial hypertension
17. End-stage liver disease
18. Benign brain tumour

HDFC ERGO health insurance policy offers several benefits to its customers. The vast HDFC ERGO critical illness list helps policyholders avail of treatment benefits for major diseases without worrying about the expenses. The benefits of HDFC ERGO health insurance include the following:

1. Cashless treatment across 13000+ network hospitals
2. A dedicated in-house claim settlement team
3. Cashless claim approval in just 20 minutes
4. Sum insured upto two crores
5. Lifelong renewability
6. Free health check-up within 60 days after renewal
7. Additional benefits such as wellness programs to keep you healthy
8. Covers expenses upto 60 days of pre-hospitalisation and 180 days post-discharge
9. Tax benefits upto Rs 1 lakh

While buying a health insurance plan, it is crucial to check the diseases covered under it to select the policy that best suits your needs. So if you are looking to buy HDFC ERGO health insurance, make sure to know about the diseases covered under the policy. However, it is equally important to check the HDFC ERGO health insurance not covered diseases list to avoid any surprises during medical billing. 

Buy the right health policy as per your needs and requirements TODAY and protect yourself and your family from emergencies in the future! To learn more about HDFC ERGO health plans, you can contact an expert at HexaHealth. Our team will gladly guide you through the inclusions, exclusions, benefits, and policy buying process.