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my:health Medisure Super Top Up is a super top-up health plan from HDFC ERGO. It is built to sit on top of an existing health policy: you choose an aggregate deductible and a sum insured, and the plan starts paying once your hospital claims in a policy year add up to more than the deductible. The deductible can be met by you or by your existing health policy, and it can be crossed in one claim or across several claims in the same policy year. Once it is crossed, in-patient hospitalisation, day care procedures and pre and post hospitalisation expenses are covered up to the sum insured with no sub-limits.
Not a replacement for a base health plan — it starts paying only after your claims in a policy year cross the aggregate deductible you choose (₹2 lakh to ₹5 lakh), paid by you or your existing insurer. No sub-limits on in-patient costs once the deductible is crossed.
A super top-up is useful when your base cover feels too small but a bigger base policy would cost too much. Because the plan ignores the first slice of your yearly hospital bills, the premium stays low for the amount of cover you get. The deductible adds up across all claims in the policy year, so several smaller claims count towards it, which is the main advantage over a regular top-up that looks at each claim on its own. The trade-offs are plain. Nothing is paid until your claims for the year exceed the deductible, so it works best when the deductible matches your base policy's sum insured. The plan does not cover ambulance charges, domiciliary hospitalisation or outpatient treatment, and a 10% co-payment applies on every claim once an insured person is above 80 years. Waiting periods follow the standard IRDAI structure: 30 days for illness, 24 months for listed conditions and 36 months for pre-existing diseases, reduced for continuous prior cover under portability.
HDFC ERGO Health Insurance
Key Insights
Founded
2002
HDFC ERGO Health Insurance was established 24 years ago and has built strong credibility over time, backed by its long-standing presence in the market.
Claims Experience
97.9% CSR, calculated as a 3-year average
HDFC ERGO Health Insurance settles 97.9% of all claims it receives, demonstrating strong credibility.
Network Hospitals
12,000–14,000
HDFC ERGO Health Insurance has a network of 12,000–14,000 hospitals, ensuring wide accessibility and convenience for policyholders.
You choose an aggregate deductible, which is the total hospital expense for the policy year that you or your existing health policy must bear first. The plan pays only after your claims for the year add up to more than the deductible, and it pays the amount above it up to the sum insured. For example, with a ₹8 lakh sum insured and a ₹2 lakh deductible, three claims that total ₹10 lakh in a year leave ₹8 lakh payable by HDFC ERGO.
Any expenses above the sum insured you choose are not paid by the plan. The deductible starts again in every policy year.
The brochure pairs each deductible with set sum insured options (in ₹ lakh): deductible 2 with sum insured 3 or 8; deductible 3 with 7 or 12; deductible 4 with 6, 11 or 16; deductible 5 with 5, 10, 15 or 20.
The sum insured is in addition to the deductible. Check the live quote page for the combinations currently on sale.
Covers medical expenses for hospitalisation due to illness or accidental injury: room rent, ICU or therapeutic unit, medical practitioner, anaesthetist and nurse fees, blood, oxygen and anaesthesia.
There are no sub-limits under this cover, so payment is up to the sum insured once the deductible is crossed.
Treatments or procedures that need less than 24 hours of hospitalisation under general or local anaesthesia are covered. There is no fixed list, so new procedures that qualify as day care are also covered.
Diagnostic procedures and treatment taken in an outpatient department are not covered.
Medical expenses are covered for up to 30 days before admission and 60 days after discharge.
The expenses must be for the same condition as the hospitalisation, and the in-patient claim must be admissible.
Pays the sum insured as a lump sum on diagnosis of any of the 51 listed major illnesses and procedures. Sum insured options range from ₹1 lakh to ₹5 crore.
Optional add-on at extra premium.
Pays a fixed amount for each day of medically necessary hospitalisation due to illness or injury. Daily amount options are ₹500, ₹1,000, ₹1,500, ₹2,000, ₹2,500, ₹3,000, ₹5,000, ₹7,500 and ₹10,000.
Optional add-on at extra premium.
Conditions or treatments that the policy clearly says it will not cover.
The conditions and procedures below are covered only after 24 months of continuous coverage with HDFC ERGO. The waiting period does not apply to claims that arise from an accident. If any of them is also a pre-existing disease, the longer waiting period applies. The waiting period starts afresh on any increase in sum insured, and continuous prior cover reduces it under portability norms.
Insurer
HDFC ERGO Health Insurance plans and claim process
A super top-up is a health plan that works alongside your existing policy and starts paying once your total hospital expenses in a policy year cross the deductible. my:health Medisure Super Top Up adds up all claims in the policy year against the deductible, so several smaller claims count together. A regular top-up looks at each claim on its own, so it only pays when a single claim is above the deductible.
The aggregate deductible is the amount you or your existing health policy pays towards your hospital expenses in a policy year before this plan pays. HDFC ERGO's illustration uses a ₹8 lakh sum insured with a ₹2 lakh deductible: three claims totalling ₹10 lakh leave ₹8 lakh payable by the plan after the first ₹2 lakh. The plan does not pay anything above the sum insured you chose.
Disclaimer: Premium amounts are indicative and may vary based on age, health, and plan selected. Claim settlement ratios are from IRDAI Annual Reports. Finzony is not an insurance broker or agent. Verify all details on the official HDFC ERGO Health Insurance website before purchasing.
Contact Details
1800-2700-700
Headquarters: 6th Floor, Leela Business Park, Andheri-Kurla Road, Andheri (East), Mumbai – 400 059, Maharashtra, India
The aforementioned ratios have been averaged over three years (FY24-FY26)
The brochure shows deductibles of ₹2, 3, 4 and 5 lakh, each paired with set sum insured options between ₹3 lakh and ₹20 lakh. For example, a ₹5 lakh deductible pairs with ₹5, 10, 15 or 20 lakh and a ₹2 lakh deductible pairs with ₹3 or 8 lakh. HDFC ERGO's product page FAQ mentions a ₹4 lakh minimum and ₹5 lakh maximum deductible, so check the live quote page for the combinations on sale now.
Adults can join from 18 to 65 years and dependent children from 91 days to 23 years. You can cover your spouse and two dependent children, and parents and parents-in-law can be added in the same policy on an individual sum insured basis or in a separate floater policy. On an individual sum insured basis you can also cover grandparents, siblings, grandchildren, a daughter-in-law, a son-in-law, nephews and nieces in a single policy.
There is a 30-day waiting period for any illness from the first policy start, which does not apply to accidents. Listed conditions and procedures such as cataract, hernia and joint replacement have a 24-month waiting period, and pre-existing diseases have a 36-month waiting period. Continuous prior cover with another insurer reduces the waiting periods under IRDAI portability norms.
No pre-policy medical tests are needed up to 55 years if you have not declared any pre-existing disease. Above 55, or if you declare a condition, you need to take specified tests and the proposal goes through medical underwriting. On acceptance of the proposal, HDFC ERGO reimburses 50% of the cost of the pre-acceptance tests. A loading of up to 100% of the basic premium can apply.
Among others, ambulance charges, domiciliary hospitalisation, outpatient treatment, maternity and infertility treatment, cosmetic surgery and non-medical expenses are not covered. Claims that fall within the aggregate deductible are also not paid by the plan. For an insured person above 80 years, a 10% co-payment applies on every claim.
A 2-year policy earns a 5% discount and a 3-year policy earns 10% when the premium is paid in advance as a single premium. Covering more than 2 family members on an individual sum insured basis earns a 10% family discount. Two add-ons are offered: my:health Critical Illness, which pays a lump sum on diagnosis of 51 listed illnesses, and my:health Hospital Cash Benefit, which pays a daily amount during hospitalisation.