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Last updated on: September 19, 2025
The HDFC Ergo Optima Restore Plan and ICICI Lombard Max Protect Premium Plan are popular health insurance options in India, each with distinct advantages. Optima Restore stands out for its innovative ‘restore’ benefit, automatically replenishing the sum insured if exhausted, and features no-claim bonus and lifelong renewability. It covers in-patient treatment, pre/post-hospitalization, and offers family floater options. Meanwhile, ICICI Lombard’s Max Protect Premium Plan offers a higher sum insured (up to ₹3 crores), global cover, wellness benefits, and unlimited restoration as key highlights. Additionally, it provides a broader range of add-ons and comprehensive features such as OPD coverage and annual health check-ups. While both plans provide robust health coverage, HDFC Ergo is suitable for those seeking affordable premiums and essential cover with restoration, whereas ICICI Lombard is better for higher coverage needs, add-on flexibility, and more comprehensive protection. Comparing inclusions, exclusions, and premiums is essential when choosing between the two.
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The search of the right health insurance plan will be the major concern of the great part of Indian families in 2025. The HDFC Ergo Optima Restore Plan and the ICICI Lombard Max Protect Premium Plan are the two biggest alternatives that most individuals are dealing with. They are both very popular, offer an array of health benefits and cover in the case of medical emergencies. But which one is the best fit to your needs?
In this article, the comparative performance of these two plans with the latest features, comparison data, pros, cons, and the professional opinion can be seen to make an informed choice this year.
HDFC Ergo optima restore plan is a popular health insurance that is currently being opted by individuals and families throughout India. The primary distinction of this plan is its so-called Restore benefit that essentially implies that your sum insured is automatically replaced with its initial value in case it is consumed throughout the same policy year.
Prospero Knowledge: Did you notice that a significant percentage of the customers in metro cities have now shifted their preference to restore benefit plans, rather than using the traditional floater plans, to get a better security, particularly after the COVID period?
ICICI Lombard Max Protect Premium Plan shall offer full health cover to the policyholder in the year 2025. It has been placed as a high coverage plan and has many wellness benefits, yearly checkups and is not as limited in the room rent or treatment expenses. ICICI will target the requirements of higher sum insured seekers and top up / super top up medical expense requires.
People Also Ask: Do senior citizens purchase the Max Protect Premium policy? Yes, this health policy has a lifetime entry age but co payment may after the age of 60 years.
We will take a glance at some of the critical parameters and compare them to determine the position of the two plans at the year 2025.
| Characteristic | HDFC Ergo Optima Restore Plan | ICICI Lombard Max Protect Premium |
|---|---|---|
| Sum Insured Range | [?]5 lakh to [?]50 lakh | [?]5 lakh to [?]1 crore |
| Restore/Reset Benefit | One time in a year | Unlimited in a year. |
| Network Hospitals | 12000 plus | 7000 plus |
| Domiciliary/Home Care | On demand (as add on) | Standard included. |
| OPD/Maternity | Optional add on | Optional add on |
| Pre and Post Hospitalization | 60 days/180 days | 60 days/180 days |
| Room rent limit | No sub limit (after 2024) | No sub limit. |
| Free Medical Check-up | Once in policy year | Once in policy year |
| Entry Age | 91 days onwards | 91 days onwards |
| Critical Illness Add on | Available | Available |
Expert’s Insight: Did you know? The majority of young city couples are choosing the unlimited reset plans to cope with the increasing expenses of numerous hospitalizations annually.
Premium belongs to the list of the best things to consider before purchasing health insurance. The premium largely hinges on age, number of individuals covered, amount insured chosen as well as its add-ons (such as OPD or maternity).
Sum insured = [?]10 lakh/year in a case of a family of four (2 adults 2 kids, age 35 33 8 5):
In case of single individual of age 30 years, [?]10 lakh cover:
Premiums are suggestive because the real rates can change depending on the profile of health and term of the policy.
People Also Ask: Which is a cheaper plan among young single adults? The HDFC Ergo plan is usually less expensive in case of solo coverage, whereas premiums of family coverage reduces the difference.
It is essential to know the positive and negative aspects before a decision is made.
Cons
Cons
Both HDFC Ergo and ICICI Lombard are the best claim support insurance companies. The average settlement time of HDFC Ergo of claims is approximately 13 days whereas ICICI Lombard has 10 days in 2025. Both digital claims submitters are robust but HDFC claims to have more cashless networks whereas ICICI is lauded to have proactive claims tracking.
Professionals Perceptions: The surveys conducted on the industry in 2025 indicate that the support of the claim and the cashless experience may be considered a priority when customers renew their policy as opposed to the price.
Both health policies can either allow you to purchase critical illness riders, accident protection, and maternity benefits. HDFC Ergo can be said to have good add-on structuring where you can choose and select according to your budget. Add-ons at ICICI Lombard are more detailed, but they may cause an increase in the total premium at a slightly accelerated rate. In the case of new married couples or those intending to have children, both provide maternity benefit add-on following a standard waiting period.
Other questions to ask: Is it possible to buy add ons following the issue of the policy? Add ons are normally selected at the time of purchase or renewal; add ons added mid-term may require underwriting or additional company acceptance.
It is one of the aspects that can have a serious effect on users. In both plans, in-existing diseases are insurable upon 3 consecutive years of a policy. Minimum waiting of general illnesses is 30 days (except accidents). The waiting period may be as high as 2-4 years in the case of maternity and certain diseases hence it is advisable to cover early.
Did you know? The policy purchasers in metros now in large numbers are taking top up health plans earlier to overcome the wait durations until they have a family.
People Also Ask: Can such plans be ported by other health insurers? Yes, both admit the ported existing sums under regulatory rules on insurers who are approved by the IRDA.
Q1. What plan includes more number of hospitals on cashless facility?
A: HDFC Ergo Optima Restore has a larger network, which has more than 12000 hospitals as opposed to 7000 in ICICI Lombard Max Protect Premium.
Q2. Which is a better policy when the needs of unlimited the hospitalization in a single year?
A: ICICI Lombard Max Protect Premium has unlimited reset benefit which is superior when it comes to having more than one expensive treatment under one policy year.
Q3. Is it possible that I receive tax benefits in both plans?
A: Indeed, you can claim tax benefits on health insurance in section 80D of the Income Tax Act on both policies, up to the lawful per annum limit.
Q4. Are pre-existing diseases covered on the first day?
A: No, both plans come with a minimum of 3 year waiting period on pre-existing illnesses.
Q5. What would happen in case my claim sum insured runs out in the middle of the year?
A: HDFC Ergo will reimburse the sum insured once in a year, unless it is re-imburse in ICICI Lombard unlimited according to the policy terms.
Q6. What is the best plan of newly-wed couples who want to have a family?
A: Both plans have maternity add-on, complete with waiting periods; check budget and add-on requirements prior to buying.
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Written by Prem Anand, a content writer with over 10+ years of experience in the Banking, Financial Services, and Insurance sectors.
Prem Anand is a seasoned content writer with over 10+ years of experience in the Banking, Financial Services, and Insurance sectors. He has a strong command of industry-specific language and compliance regulations. He specializes in writing insightful blog posts, detailed articles, and content that educates and engages the Indian audience.
The content is prepared by thoroughly researching multiple trustworthy sources such as official websites, financial portals, customer reviews, policy documents and IRDAI guidelines. The goal is to bring accurate and reader-friendly insights.
This content is created to help readers make informed decisions. It aims to simplify complex insurance and finance topics so that you can understand your options clearly and take the right steps with confidence. Every article is written keeping transparency, clarity, and trust in mind.
Based on Google's Helpful Content System, this article emphasizes user value, transparency, and accuracy. It incorporates principles of E-E-A-T (Experience, Expertise, Authoritativeness, Trustworthiness).
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