Is maternity covered in Optima Secure+?

No. Childbirth, caesarean section, miscarriage (unless caused by an accident) and infertility treatment are excluded from the base plan. You can add the Parenthood add-on for maternity, embryo storage and IVF cover, which has a 2-year waiting period.

What waiting periods apply?

There is a 30-day initial waiting period for illnesses (accidents are covered from day one), 24 months for specified illnesses and surgeries, and 36 months for pre-existing diseases. Waiting periods reduce by 1 year for each continuous policy year completed, and credit carries over when you port.

What is the entry age for Optima Secure+?

Adults can join from 18 years of age with no maximum entry age. Dependent children can join from 91 days up to 25 years. The policy is renewable for life.

Is there a room rent limit?

No. Room rent and ICU charges are covered at actuals. You can instead choose a single private room limit, subject to HDFC ERGO's discretion.

Which add-ons can I buy with Optima Secure+?

You can add my:health Critical Illness, Serious Illness Booster, Hospital Cash Benefit, Optima Wellbeing (OPD), ABCD Chronic Care, Parenthood, Limitless and the Individual Personal Accident Rider. Unlimited restore is already built into the plan, so you do not need an add-on for it.

HDFC ERGO Optima Secure+: Features, Infinite Benefit & Review

HDFC ERGO Optima Secure+: Features, Infinite Benefit & Review | Finzony India

Overview of Optima Secure+

Optima Secure+ is an indemnity health plan from HDFC ERGO's my:Optima Secure product family. Its headline feature is the Infinite Benefit: after every completed policy year, 100% of your base sum insured is added to your cover, irrespective of claims and with no limit on how much can accumulate. On top of that, the Secure Benefit doubles your base cover from day one at no extra premium, and the Automatic Restore Benefit refills your base sum insured every time you use it during the policy year. Base sum insured options are ₹10 lakh, ₹15 lakh, ₹20 lakh, ₹25 lakh, ₹50 lakh, ₹1 crore and ₹2 crore. Room rent is covered at actuals, the Protect Benefit covers listed non-medical expenses, and pre-hospitalisation is covered for 60 days and post-hospitalisation for 180 days. The policy can be taken for 1 to 5 years, as an individual or a family floater policy.

Coverage that never stops growing — 100% of your base sum insured is added every single year, with no upper cap, whether you claim or not. After 5+ years, effective cover can cross ₹1 crore on a ₹10L base.

Expert review

Optima Secure+ is built for people who want their cover to keep growing without waiting for a ceiling. A ₹10 lakh base cover becomes ₹20 lakh on day one through the Secure Benefit. After the first completed policy year, the Infinite Benefit adds another ₹10 lakh, and it adds another ₹10 lakh after each year that follows. HDFC ERGO states that there is no maximum limit on this accumulation. The older Optima Secure uses a Plus Benefit that stops at 100% of the base sum insured, and restores your cover only once a year unless you buy an add-on, so the difference is real. There are some conditions worth knowing. A single claim in a policy year cannot exceed the base sum insured plus the remaining Secure Benefit plus the remaining Infinite Benefit, so the unlimited restore helps with several claims in a year but cannot stretch one large claim. The Infinite Benefit is also not available in the first policy year, and it can be used only for claims under base coverage and the Protect Benefit. The usual limits for this category apply. Maternity and infertility are excluded from the base plan, with maternity, embryo storage and IVF available only through the optional Parenthood add-on. A 36-month waiting period applies to pre-existing diseases and 24 months to a list of specified illnesses and surgeries. Buyers who need outpatient cover can look at the Optima Wellbeing add-on.

Pros

Cover doubles from day one through the Secure Benefit, at no extra premium.
Infinite Benefit adds 100% of the base sum insured after every completed policy year, irrespective of claims, with no limit on accumulation.
Automatic restore of the base sum insured is built in and can trigger unlimited times in a policy year.
Room rent at actuals, and the Protect Benefit covers listed non-medical expenses.
Longer pre and post hospitalisation cover of 60 and 180 days.
Base sum insured from ₹10 lakh to ₹2 crore, no maximum entry age and lifelong renewal.

Insurer Profile

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.

Features of Optima Secure+

Secure Benefit (2X cover from day 1)

Your base sum insured is doubled the moment the policy starts, at no additional premium. A ₹10 lakh base cover becomes ₹20 lakh from day one.

A single claim in one policy year cannot exceed base sum insured + remaining Secure Benefit + remaining Infinite Benefit.

Infinite Benefit (+100% every year, no cap)

After each completed policy year, 100% of your base sum insured is added to your cover, irrespective of any claims. HDFC ERGO states there is no maximum limit on how much can accumulate. A ₹10 lakh base cover adds ₹10 lakh after year one, another ₹10 lakh after year two, and so on.

Not available in the first policy year. It can be used only for claims under base coverage and the Protect Benefit, and the amount paid from it in a policy year cannot exceed what had accumulated at the start of that year.

Automatic Restore Benefit (unlimited times)

Whenever a claim uses up part or all of your sum insured, up to 100% of the base sum insured is restored automatically, for any illness and for any insured person. It can trigger every time an admissible claim is paid during the policy year.

Restored amount can be used only for later claims in the same policy year, and unused restore cannot be carried to the next year.

Protect Benefit (non-medical expenses)

Covers the listed non-medical expenses charged in hospital bills, such as gloves, masks and other consumables, up to the sum insured. Without this cover, many plans deduct these items from claims.

Only items on the policy's list of non-medical expenses are covered.

Room rent at actuals

Room rent and ICU or ICCU charges are covered at actuals, so there is no per-day room-rent limit and no proportionate deduction on your bill.

A single private room limit can be chosen instead, subject to HDFC ERGO's discretion.

Pre and post hospitalisation: 60 and 180 days

Medical expenses incurred up to 60 days before admission and up to 180 days after discharge are covered, when related to an admissible hospitalisation.

Hospitalisation and day-care treatment

Covers in-patient treatment for illness and injury, including surgeon and anaesthetist fees, investigations, medicines, operation theatre charges, internally implanted prosthetics, and all day-care treatments, up to the sum insured.

Hospitalisation must be for at least 24 consecutive hours, except for day-care treatments.

Home healthcare

Treatment taken at home is covered when the treating doctor prescribes it and the treatment would normally need hospital admission.

Cashless basis only, in select cities, with pre-authorisation.

Domiciliary hospitalisation

Covers treatment at home when the insured cannot be moved to a hospital, or when no hospital room is available.

AYUSH treatment

In-patient treatment under Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy is covered in an AYUSH hospital.

Ambulance cover (road and air)

Road ambulance charges are covered up to the sum insured. Emergency air ambulance is covered up to ₹5 lakh.

Air ambulance needs a doctor's written advice and is available only when treatment is not available where you are.

Organ donor expenses

Covers the medical cost of the donor's hospitalisation for harvesting an organ when you are the recipient and your own claim is admissible.

Donor's pre and post hospitalisation, organ transport and preservation are not covered.

Daily cash for shared room

A fixed daily cash amount is paid for each completed 24 hours when you choose shared accommodation in a network hospital and the stay exceeds 48 hours.

₹800 per day, up to ₹4,800. Not paid for time spent in ICU.

E-Opinion for 51 critical illnesses

Get a second medical opinion for 51 listed major illnesses from network providers.

Available once per insured person in a policy year, in India, through network providers only.

Preventive health check-up

A preventive health check-up is provided after every completed policy year, irrespective of claims. You can choose the tests, up to a limit based on your base sum insured.

Individual policy, per insured: ₹2,000 (10 lakh), ₹4,000 (15 lakh), ₹5,000 (20, 25 and 50 lakh), ₹8,000 (1 and 2 crore). Floater policy, per policy: ₹5,000, ₹8,000, ₹10,000 and ₹15,000 for the same tiers. Not available with a ₹5 lakh aggregate deductible.

Lifelong renewal

The policy can be renewed for life. Renewal cannot be denied because you made a claim in an earlier year, except on grounds of fraud or misrepresentation.

No geography-based co-payment, no claim-based loading

You are treated in any city in India without a co-payment based on where you bought the policy, and your renewal premium is not loaded just because you claimed.

1 to 5 year tenure, individual or floater

Choose a 1, 2 or 3-year policy, or 4 or 5 years subject to underwriting. Premium can be paid monthly, quarterly, half-yearly or yearly. A floater policy can include up to 4 adults and 6 children on a common sum insured. An individual policy can include up to 6 adults and 6 children, each with their own sum insured.

A long-term discount of 6% (2 years) or 8% (3 years and above) applies when the premium is paid upfront as a single premium.

Add-ons of Optima Secure+

my:health Critical Illness

Pays a lump sum on diagnosis of a listed critical illness, separate from your hospitalisation cover.

Sum insured from ₹1 lakh up to ₹5 crore, in multiples of ₹1 lakh.

Serious Illness Booster

A critical illness add-on that works on an indemnity basis with double the sum insured, reimbursing actual medical expenses for listed critical illnesses.

my:health Hospital Cash Benefit

Exclusions in Optima Secure+

Conditions or treatments that the policy clearly says it will not cover.

Pre-existing diseases and their direct complications until 36 months of continuous cover are completed.
Listed specified illnesses and surgeries during the first 24 months, unless caused by an accident.
Illness within the first 30 days of the first policy (accidents are covered). This does not apply if you have had more than 12 months of continuous cover.
Hospital admission primarily for diagnosis and evaluation.
Rest cure, rehabilitation, respite and custodial care.
Obesity or weight-control surgery that does not meet the clinical conditions in the policy.
Change-of-gender treatments.
Cosmetic or plastic surgery, unless needed after an accident, burns or cancer, or certified as medically necessary.
Treatment arising from professional participation in hazardous or adventure sports.
Breach of law: treatment arising from committing or attempting a criminal offence.
Treatment at hospitals or providers excluded by HDFC ERGO.
Treatment for alcoholism, drug or substance abuse and any addictive condition.
Treatment at health hydros, nature cure clinics, spas or similar establishments.
Dietary supplements and substances available without prescription.
Correction of eyesight for refractive error below 7.5 dioptres.
Unproven or experimental treatments.
Sterility and infertility, including contraception, sterilisation, IVF, surrogacy and reversal of sterilisation.
Maternity: childbirth and caesarean section, miscarriage (unless caused by an accident) and medical termination of pregnancy. Ectopic pregnancy is not excluded.
War, nuclear, chemical or biological attack, intentional self-injury or suicide, and participation in naval, military or air force operations.
Non-medical expenses that are not on the Protect Benefit list.
Treatment on an outpatient basis, hearing aids, spectacles and contact lenses, vaccinations, and treatment for hair loss.
Congenital external diseases, stem cell harvesting, artificial limbs and external devices (other than those used during surgery).

Disclaimer: For illustration purposes only - exact terms are in the policy wording.

Specific illness

A 24-month waiting period applies to the illnesses and surgeries below, unless the claim arises from an accident. If an illness is also a pre-existing disease, the longer waiting period applies. The list follows the specified disease and procedure list in HDFC ERGO's prospectus for this product.

Cataract and other disorders of the lens and retina
Hernia
Calculus diseases of the urogenital system, such as kidney stones and bladder stones
Diseases of the gall bladder including cholecystitis, and cholecystectomy
Fissure, fistula, haemorrhoids, pilonidal sinus, and perianal and perineal abscesses
Benign prostatic hyperplasia and surgery on the prostate
Hydrocele, rectocele and varicocele
Joint replacement surgeries, osteoarthritis and osteoporosis
Surgery for prolapsed intervertebral disc
Non-infective arthritis, gout and rheumatism
Ligament, tendon and meniscal tear
Fibroids (fibromyoma) and myomectomy
Polycystic ovarian disease and endometriosis
Hysterectomy, prolapsed uterus and dilatation and curettage (D&C)
Benign tumours, cysts, nodules and polyps including breast lumps, and skin tumours
Sinusitis, rhinitis, tonsillitis, and ENT surgeries such as tonsillectomy, adenoidectomy, tympanoplasty, mastoidectomy, nasal septum correction, nasal polypectomy and nasal concha resection
Pancreatitis, all forms of cirrhosis, and ulcer and erosion of the stomach and duodenum
Gastro-oesophageal reflux disorder (GERD)
Varicose veins and varicose ulcers surgery
Rectal prolapse
Surgery of the genito-urinary system, unless needed because of malignancy
Retinal detachment and glaucoma

What's missing in Optima Secure+

Maternity, delivery and newborn cover in the base plan.
Infertility, IVF and assisted reproduction in the base plan.
Outpatient (OPD) consultations and treatment that do not need admission. This needs the Optima Wellbeing add-on.
Treatment outside India is not listed in the plan's schedule of key benefits.
Base sum insured options below ₹10 lakh. The plan starts at ₹10 lakh.

Insurer

HDFC ERGO Health Insurance plans and claim process

Frequently asked questions

What is the Infinite Benefit in Optima Secure+?

After each completed policy year, HDFC ERGO adds 100% of your base sum insured to your cover, irrespective of claims. There is no maximum limit on how much can accumulate. It is not available in the first policy year and can be used only for base coverage and Protect Benefit claims.

How does the cover grow in Optima Secure+?

Take a ₹10 lakh base cover. The Secure Benefit makes it ₹20 lakh on day one. After the first completed policy year the Infinite Benefit adds ₹10 lakh, making ₹30 lakh, and after the second year it adds another ₹10 lakh, making ₹40 lakh. A single claim in a year cannot exceed base cover plus the remaining Secure and Infinite Benefits.

Is restore unlimited in Optima Secure+?

Yes. The Automatic Restore Benefit restores up to 100% of the base sum insured each time it is used in a policy year, for any illness and any insured person. The restored amount is available for later claims in the same year, not for enlarging a single claim.

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.

Optima Secure+