With the global spread of the COVID19 pandemic, health has become the primary focus everywhere. There is huge pressure on the health infrastructure and the cost of treatments through hospitalization has increased. Unless individuals have adequate health insurance, the financial position will be severely impacted.

We have examined a few health insurance policies and found Optima Restore is a good one. This was earlier known as Apollo Optima Restore but after the merger of Apollo health Insurance Co with HDFC Ergo, the policy has been named HDFC Ergo Health Optima Restore Insurance Policy.

 Hospitalization expenses for COVID19 are covered under this plan subject to all terms and conditions of the policy.

Features

This policy can be taken for self, spouse, dependent children and dependent parents. The plan can be taken for an Individual or as a Family Floater. In a Family Floater policy, a maximum of 2 adults and a maximum of 5 children can be included in a single policy. You can opt for 1 Adult and 3 children also. The plan offers lifelong renewability. There is no claim-based loading. 

There are 2 Unique Benefits in this plan:

Restore Benefit: The uniqueness of this plan is that the Sum Insured is instantly restored after partial or complete utilization of your existing policy.

Let’s take an example –If you have a base Sum Insured of 5 lakhs, and you claim Rs 1 lakh in the beginning of the year, it will restore the base sum insured of 5 lakhs to your remaining balance, i,e. you will now have Rs 9 lakhs which can be used for subsequent claims in the remaining policy year for all claims under in patient benefit.

However, single claim in a policy year cannot exceed the sum of basic sum insured and multiplier benefit ( if any)

Multiplier Benefit: Another Unique Benefit of this plan is that for a claim free year, there is a 50% increase in the Basic Sum Assured as No claim Bonus and if the consecutive year is also Claim Free then the total No claim Bonus increases by 100% .So the Sum Assured becomes twice  the Basic Sum Assured.

This plan covers:

• In-patient Treatment
• Pre-Hospitalization Coverage up to 60 Days
• Post-Hospitalization Coverage up to 180 Days
• Day Care Procedures for 140 listed day care procedures
• Domiciliary Treatment
• Emergency Ambulance up to Rs.2,000 per Hospitalization
• Organ Donor

Additional Features:

• Cashless Hospitalization
• No caps/limits on doctor/surgery fees, operation theatre, room rent, and intensive care unit
• Quick turnaround time with 90% of pre-authorization is done within 2 hours of intimation or hospitalization
• Policy term options of 1 or 2 years with a 7.5% Discount on 2-year policy terms
• Tax benefit on premiums paid under Section 80D of the Income Tax Act, 1961
• Freelook period of 15 days from the receipt of policy documents
• There is No claim-based loading in this plan
• Easy upgrade: This health plan also comes with an easy upgrade option on policy renewal

 Exclusions;

• Any treatment within the first 30 days of cover except accidental injury.
• Any Pre-existing diseases/conditions will be covered after a waiting period of 3 years.
• 2 years exclusion for specific diseases like cataract, hernia, hysterectomy, joint replacement etc.
• Expenses arising from HIV or AIDS and related diseases.
• Abuse of intoxicant or a hallucinogenic substance like drugs and alcohol.
• Pregnancy, dental treatment, external aids, and appliances.
• Hospitalization due to war or an act of war or due to the nuclear, chemical or biological weapon and radiation of any kind.
• Non-allopathic treatment, congenital external diseases, mental disorder, cosmetic surgery or
• weight control treatments.

Pricing (Premium in Rs excluding GST)