What Does the HDFC ERGO Optima Secure Premium Chart Actually Say?

Three things stand out. The gap between Delhi and the rest of India is about 40% for a 35-year-old, and the jump from 45 to 50 is larger than the whole climb from 18 to 45. From 60 the six tiers collapse into two ^[1].

One oddity deserves a flag. Age 60 is cheaper than age 59 in several tables: at ₹10 lakh in Tier 1 the premium drops from ₹52,613 to ₹45,433 ^[1]. The prospectus never explains it. It may be connected to the claims-experience discount, which section 15 withdraws from every insured person at exactly that age, so that a lower base rate softens the loss of up to 21% off, but that is our reading of two separate pages and HDFC ERGO does not say so.

The second table holds the city fixed at Tier 6, the rest of India, and varies the cover.

Optima Select and Lite are the cheapest, and both limit room rent: Select to a single private room, Lite to 1% of the base cover a day ^[1]. Optima Secure, Super Secure and Secure + sit within a few hundred rupees of each other. Our judgement, from these numbers: if you are choosing among those three, decide on the benefits, not the price, because the city you live in moves the bill far more than the plan does.

4. What Secure, Plus, Protect and Restore mean in the document

These names carry the marketing, so it is worth reading how pages 11 to 13 actually define them.

• Secure Benefit adds a second layer of cover equal to 100% of the base sum insured (200% on Super Secure). It is used only after the base cover runs out, is available once each policy year, does not carry forward, and pays only for treatment in India ^[1].
• Plus Benefit adds 50% of the base cover at each renewal without a break, claims or no claims, until it reaches 100% ^[1].
• Protect Benefit pays the 68 non-medical items listed in Annexure B, such as gloves, masks and food charges, that the policy otherwise refuses. On Select and Lite it is optional, at a loading of 7.5% to 10% ^[1].
• Automatic Restore puts 100% of the base cover back after a claim uses it up, once a year on most plans and unlimited times on Select, Lite and Secure +. Restored money pays only later claims, never the one that triggered it ^[1].
• Infinite Benefit, on Secure + only (optional on Super Secure), adds 100% of the base cover every year with no ceiling ^[1].

Put together, HDFC ERGO's own illustration on page 3 says a ₹10 lakh Optima Secure policy pays at most ₹20 lakh on any single claim in year one, and ₹30 lakh across all claims that year ^[1].

5. What the quoted premium leaves out

The chart is a base rate. Several things change what you actually pay, and the prospectus spells most of them out.

• Discounts: A new buyer with no claims history gets 21% off in year one, 18% in year two and 10% after that ^[1]. Buying direct online is 5% off, and a 3-to-5-year policy paid upfront is 8% ^[1]. A voluntary deductible can cut the premium by half or more ^[1].
• Medical loading: Declared conditions can add up to 100% per condition and 150% in total ^[1].
• Add-ons and optional covers: Critical illness, hospital cash, the personal accident rider, Parenthood and the rest are priced in their own documents, not here ^[1].
• Tax: The figures exclude GST, which individual health policies no longer attract ^[1][2,3].

A pre-policy medical check-up may also be required, depending on age and cover; HDFC ERGO refunds it if you are accepted ^[1].

6. What it does not tell you

The prospectus says nothing about how often HDFC ERGO has raised these rates, or how many Optima Secure claims it pays in full. Nor does it give the add-on prices you would need for a complete quote. Its waiting periods, 36 months for pre-existing conditions and 24 for a listed set of procedures ^[1], are summarised, but the full exclusions and claim rules are in the Optima Secure policy wording, which carries the same UIN ^[5].

7. Where it fits

If you are pricing cover for a parent, start with what senior health insurance costs in India and what seniors actually pay once loadings and co-pays land, then read can your insurer raise a senior's premium by more than 10%, because IRDAI's limit on senior premium increases sits alongside the age bands in this chart and that page sets out how far the limit reaches. The regulator's rules on moratorium, portability and waiting periods are in the IRDAI health insurance master circular. Why health claims get rejected covers what happens after you buy. The official prospectus is at hdfcergo.com/download/prospectus.