ICICI Lombard Health AdvantEdge Plan

Plan Highlights

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      About ICICI Lombard Health AdvantEdge Plan

      ICICI Lombard Health AdvantEdge is a comprehensive plan that offers uninterrupted medical coverage by restoring the sum insured unlimited times in a policy year. It comes with no hospital room rent limit for a sum insured of ₹5 lakh & above and provides preventive health check-up benefits. The plan also offers in-patient hospitalization coverage for surrogate mothers and oocyte donors.

      Moreover, this ICICI Lombard health insurance plan provides optional coverage for maternity expenses, consumables, critical illnesses, overseas medical expenses and inflation.

      Eligibility
      Adult minimum entry age
      18 years
      Adult maximum entry age
      65 years
      Renewability
      Lifelong
      Child minimum entry age
      91 days
      Child maximum entry age
      25 years
      Get more details ›
      Cholamandalam Health Insurance
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      ICICI Lombard Health AdvantEdge Plan: Key Highlights

      Categories Specifications
      Sum Insured ₹3 lakh to 3 crore
      Pre-policy Medical Check-up No required for people below 45 years with a sum insured of ₹10 lakh
      Pre-existing Diseases Waiting Period 2 years
      Discount Up to 15% tenure discount
      Up to 15% zone-based discount
      2.5% pneumococcal disease vaccination discount
      Check premium ›

      Health AdvantEdge Features

      What we love
      Get coverage for doctor consultation fees, pharmacy cover, medical tests, physiotherapy, and more without hospitalisation with BeFit rider
      Organ Donor Related ExpensesKnow more ›
      Waiting PeriodKnow more ›
      Home Care TreatmentKnow more ›
      Coverage
      Room rent limit
      Single private ac room
      Restoration of cover
      Rs 10 lakh unlimited times a year; for related and unrelated illness
      Renewal Bonus
      Rs 2 lakh per year and up to Rs 10 lakh irrespective of claim
      Co-pay
      100% paid by the insurer
      Pre-hospitalization coverage
      60 days
      Post-hospitalization coverage
      180 days
      Day care treatment
      All day-care treatments are covered up to the sum insured, provided that the duration of treatment in a hospital or daycare does not exceed 24 hours
      Hospitalization at home
      Up to Rs 10 lakh
      Ambulance charges
      Up to Rs 10,000 (Actuals on network hospital)
      Cashless hospitals
      10922 cashless hospitals in India
      Check in your city
      Value Added Services
      Mid year member addition
      Child age should be 91 days at the time of addition in the policy after issuance. Addition of spouse is not allowed
      Free health checkup
      Up to Rs. 5,000; Available in Cashless and Reimbursement (Applicable for insured members who are of 18 years or above)
      E-consultation
      Unlimited tele-consultations
      Discount on Renewal
      Reedem wellness points to avail services such as out-patient consultations, purchase of pharmaceutical drugs/medicines, undergoing diagnostic tests, purchase of health supplements etc. through ICICI mobile application.
      Daily cash allowance
      Up to Rs 20,000 per policy year on continuous hospitalization for 10 days or more
      Out patient consultation benefits
      Available as an optional cover
      Waiting periods
      Existing Illness cover
      2 years
      Initial Waiting Period
      30 days; except claims arising due to an accident, provided the same are covered. This is standard in the industry across all insurance policies
      Specific Illness cover
      24 months; for slow growing diseases like knee replacement, hernia, cataract etc. See full list of diseases mentioned in policy wordings
      Additional Features
      Alternate medicine (AYUSH)
      Up to Rs 10 lakh
      Worldwide coverage
      Not available in this plan
      Consumables Coverage
      Available as an optional cover
      Domestic evacuation
      Air Ambulance cover up to Rs 10 lakh
      Cover for organ donor
      Up to Rs 10 lakh
      Animal bite vaccination
      Up to Rs 10,000
      Maternity Benefit(s)
      Maternity cover
      Available as an optional cover
      Download policy documents
      We have summed up the plan for you but if you are still curious read all the fine prints here
      Prospectus
      Policy Wordings
      Brochure
      Network list
      Disclaimer: The plan features detailed are for a ₹10 Lakh cover. Not all features may be applicable to your specific profile.
      Buy now ›

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        Key Benefits of ICICI Lombard Health AdvantEdge Plan

        No Room Rent Limit
        No Room Rent Limit
        The ICICI Lombard General Insurance Company does not levy any limit on hospital room rent if the sum insured of the health insurance policy is ₹5 lakh or above.
        Reset Benefit
        Reset Benefit
        With this benefit, policyholders can restore the sum insured of their ICICI Lombard health policy by 100% unlimited times in a policy year if the original coverage amount was fully or partially or exhausted after the first claim.
        Preventive Health Check-ups
        Preventive Health Check-ups
        People can utilize cashless preventive health check-up benefits at a network provider of the insurer with this ICICI Lombard medical insurance plan.
        Wellness Program
        Wellness Program
        The ICICI Lombard Health AdvantEdge plan promotes healthy living by providing access to wellness programs, ambulance assistance, health assistance and discounts on services & products by accumulating wellness points.
        Guaranteed Cumulative Bonus
        Guaranteed Cumulative Bonus
        Policyholders can earn a cumulative bonus of 20% for up to 100% if no claims were raised in the previous policy year.
        Discount on Premium
        Discount on Premium
        The ICICI Lombard General Insurance Company provides a premium discount of 2.5% in case the policyholder has taken the conjugate pneumococcal vaccine to prevent pneumococcal disease.
        Tax Benefits
        Tax Benefits
        Under Section 80D of the Income Tax Act, tax benefits can be earned on the premium paid to buy the ICICI Lombard Health AdvantEdge policy.
        View more benefits
        Get covered today ›

        ICICI Lombard Health AdvantEdge Plan Inclusions, Exclusions & Optional Cover

        Inclusion of ICICI Lombard Health AdvantEdge Plan may differ from one plan to another. Some of the inclusions that are common under all the policies are given below:

        1. In-patient Treatment
          It covers the cost of in-patient hospitalization of at least 24 hours, including hospital room rent charges and doctor’s fees.
        2. Day Care Procedures
          It pays for day care procedures or treatments that require less than 24 hours of hospitalization.
        3. Modern Treatments
          It covers the cost of 12 modern treatments, such as robotic surgeries, oral chemotherapy, stem cell therapy, etc.
        4. Pre-Hospitalization Medical Expenses
          It pays for the medical expenses incurred up to 60 days before hospitalization.
        5. Post-Hospitalization Medical Expenses
          It covers the medical expenses incurred for up to 180 days after hospital discharge.
        6. In-patient AYUSH Hospitalization
          It pays for in-patient treatments availed at an Ayurveda, Unani, Homeopathy, Siddha, Yoga and Naturopathy hospital or day care centre.
        7. Bariatric Surgery Cover
          It covers the cost of surgical procedures or treatments taken to control obesity.
        8. Domestic Road Ambulance
          It pays for the cost of availing road ambulance services to transport the insured to the nearest hospital.
        9. Domestic Air Ambulance Cover
          It covers the cost of availing air ambulance service to transport the insured to the nearest hospital.
        10. Donor Expenses
          It pays for the medical expenses incurred by the organ donor for the organ transplant surgery of the insured.
        11. Domiciliary Hospitalization
          It covers the cost of domiciliary hospitalization if the insured was admitted at home for at least 3 consecutive days.
        12. Home Care Treatment
          It pays for the medical treatments availed at home as per the advice of a medical practitioner.
        13. Animal Bite (Vaccination)
          It covers the cost of animal bite vaccinations taken on an OPD basis.
        14. Convalescence Benefit
          It pays a fixed amount in case the insured is admitted to a hospital for at least 10 consecutive days.
        15. In-patient Hospitalization for Surrogate Mother
          It covers the cost of in-patient hospitalization incurred by a surrogate mother.
        16. In-patient Hospitalization for Oocyte Donor
          It pays for the in-patient hospitalization expenses incurred by an oocyte donor for complications arising out of oocyte retrieval.
        17. Teleconsultation
          It covers the cost of availing teleconsultation services from a qualified doctor through audio, video, chat, mobile application or web portal.
        View more Inclusions

        Exclusion of ICICI Lombard Health AdvantEdge Plan may differ from one plan to another. Some of the inclusions that are common under all the policies are given below:

        1. OPD treatment
        2. Treatment for alcohol or drug addiction
        3. Sterility and infertility
        4. Cosmetic or plastic surgery
        5. Injuries due to participation in hazardous or adventure sports
        6. Intentional self-injury
        7. Sexually transmitted diseases
        View more Exclusions

        Optional Cover of ICICI Lombard Health AdvantEdge Plan may differ from one plan to another. Some of the inclusions that are common under all the policies are given below:

        1. Maternity Benefit
          It covers the medical expenses incurred due to pregnancy, including delivery of the baby, pre-natal expenses, post-natal expenses and medically recommended lawful termination of pregnancy.
        2. Newborn Baby Cover
          It pays for the in-patient treatment of the newborn baby until it turns 90 days old.
        3. First-year Vaccinations of the Newborn Baby
          It covers the vaccination expenses of the newborn baby until it turns 1 year old.
        4. Critical Illness Cover
          It pays a lump sum amount to the policyholder on the first diagnosis of any of the 20 listed critical illnesses.
        5. Personal Accident Cover
          It provides compensation in case an accident of the insured leads to accidental death or permanent partial/total disability.
        6. Nursing at Home
          It ensures that policyholders above 60 years do not have to pay any co-payment while raising a claim.
        7. Compassionate Visit
          It reimburses the cost of a two-way aeroplane or train ticket of an immediate family member if the insured is admitted to a hospital for more than 5 days.
        8. BeFit
          It allows the insured to avail benefits like physical consultations, pharmacy cover, e-counselling, physiotherapy sessions and diet & nutrition e-counselling on a cashless basis.
        9. Claim Protector
          It pays for the non-payable expenses incurred by the insured during in-patient hospitalization or day care treatment.
        10. Sum Insured Protector
          It enhances the sum insured of the policy on a cumulative basis on each renewal based on the previous year’s inflation rate.
        11. Voluntary Co-Payment
          It enables the policyholder to reduce the premium by opting for a voluntary co-payment on all claims.
        12. Voluntary Deductible
          It allows the policyholder to reduce the premium by opting for a voluntary deductible.
        13. Worldwide Cover
          It covers the cost of in-patient hospitalization and day care treatment availed outside India, including the USA and Canada.
        14. Preventive Health Check-up (Reimbursement)
          It reimburses the medical expenses incurred on preventive health check-ups during the policy year.
        15. Room Rent Capping
          It allows the policyholder to reduce the premium by opting for a capping on hospital room rent.
        View more Optional Covers
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        Policybazaar Exclusive Benefits
        • On ground claims support##(In 120+ cities)
        • Relationship manager For every customer
        • 24*7 claims assistance In 30 mins. guaranteed*
        • Instant policy issuance No medical tests~
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        ₹1000 Cr worth of claims assisted in 2022-2023
        How we helped our customers

        Policybazaar Claim Process

        Step 1
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        In case of emergency we are just a call away.

        • Inform your Dedicated Relationship Manager
        • Or, Call us on the 24x7 toll-free helpline 1800-258-5881
        Step 2
        Step 2

        Take care of your family, we will do the rest.

        Our claim specialists will reach your location & complete the formalties from filing the claim to documentation to coordinating with insurer, TPA & hospital.

        Available in New Delhi and 114+ cities

        View cities list ›

        If you are not a Policybazaar customer you can view ICICI Lombard claim process here 👇
        ICICI Lombard
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        ICICI Lombard Health AdvantEdge Plan: FAQs

        Disclaimer: The list mentioned is according to the alphabetical order of the insurance companies. Policybazaar does not endorse, rate or recommend any particular insurer or insurance product offered by any insurer. For complete list of insurers in India refer to the Insurance Regulatory and Development Authority of India website www.irdai.gov.in
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        ICICI Lombard claim process

        ICICI Lombard offers two types of claim settlements – cashless and reimbursement. Follow the steps to raise a claim:

        1
        Step 1: Find network hospital
        • Find the nearest network hospital of ICICI Lombard
        • Get admitted to the hospital
        2
        Step 2: Inform ICICI Lombard
        • Notify the insurance company about the hospitalization
        • In case of pre-planned hospitalization, intimate the insurer before hospital admission.
        3
        Step 3: Get Pre-authorization
        • Fill up the pre-authorization form and submit it to the hospital staff
        • The pre-authorization form will be sent to ICICI Lombard for approval.
        • Once approved, obtain medical treatment.
        4
        Step 4: Hospital Discharge
        • At the time of discharge, sign all the medical documents.
        • Pay for the items/services not covered under the ICICI Lombard policy
        5
        Step 5: Claim settlement
        • The network hospital will send the hospital bill to ICICI Lombard.
        • After review, the insurance company will pay the bill amount directly to the network hospital.
        1
        Step 1: Get Hospitalized
        Get admitted to a non-network hospital of the insurance provider
        2
        Step 2: Intimate the Insurance Company
        • Inform the insurance company about the hospitalization
        • In case of planned hospitalization, notify the insurer before hospital admission.
        • Receive medical treatment
        3
        Step 3: Hospital Discharge
        • At the time of discharge, pay the entire hospital bill in full.
        • Collect all the medical documents, bills and payment receipts
        4
        Step 4: Submit Documents
        Send all the required documents to the insurance company
        5
        Step 5: Settlement of Claim
        The insurance company will review the documents and pay the claim amount.
        Policybazaar 30 mins Claim Support

        Our Claim specialists in below cities will reach your hospital or home in 30 minutes to support your health insurance claim

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        *We will respond in the first instance within 30 minutes of the customers contacting us. 30-minute claim support service is for the purpose of giving reasonable assistance to the policyholder in pursuance of the claim. Settlement of claim (including cashless claim) is the responsibility of the insurer as per policy terms and conditions. The 30- minute claim support is subject to our operations not being impacted by a system failure or force majeure event or for reasons beyond our control. For further details, 24x7 Claims Support Helpline can be reached out at 1800-258-5881.

        *Product information is authentic and solely based on the information received from the Insurer. Policybazaar is acting only as a facilitator and claims settlement shall be at the sole discretion of the Insurer. Policybazaar does not provide any medical or surgical advice or diagnosis and is not responsible for your interactions / treatment by a medical practitioner/hospital. Please consult a registered medical practitioner for any medical or surgical advice. The Information that you obtain or receive from Policybazaar, and its employees, or otherwise on the Website is for informational purposes only. As per the Insurance guidelines, you are allowed to cancel the policy with-in 30 days from the date of Issuance of policy.This option is available incase of policies with a term of one year or more.

        *All the health insurance plans cover hospitalization expenses including COVID-19 treatment cover up to the specified limits. You can also buy specific COVID-19 health insurance policies such as Corona Kavach Policy and Corona Rakshak policy.

        **All savings and online discounts are provided by insurers as per IRDAI approved insurance plans. #Tax Benefits are subject to changes in tax laws. GST Exemptions depend on fulfilment of qualification criteria and submission of relevant documents.

        *₹1748/month is the starting price for a 1 crore health insurance for an 18-year-old male, with no pre-existing diseases. Discount on renewal premium is subject to the number of wellness points earned in the health insurance policy. For more details about the plans, please read the sale brochure carefully to get upto 100% discount on renewal premium.

        *₹400/month is the starting price for ₹ 5 lakh Health insurance for a 30 year old male & 29 years old female, living in Delhi with no pre-existing diseases

        *₹541/month is the starting price for ₹ 10 lakh Health insurance for a 30 year old male & 29 years old female, living in Delhi with no pre-existing diseases

        *₹762/month is the starting price for ₹ 1 Crore Health insurance for a 30 year old male & 29 years old female, living in Delhi with no pre-existing diseases

        *₹243/month(₹ 8/day) is the starting price for a 5 lakh health insurance for a 20-year-old male, non-smoker, living in Bengaluru with no pre-existing diseases

        *₹2020/month is the starting price for ₹ 1 Cr Health insurance for a 50 year old male & 50 years old female, living in Bangalore with no pre-existing diseases rounded off to nearest 10.

        *₹390/month (₹13 per day) is starting price for 1 cr. Health insurance for 25 years old male, with pre-existing diseases, residing from tier 1 city rounded off to the nearest 10.

        *No medical tests are required unless requested by the insurer’s underwriter. In-case of pre-existing diseases relevant medical proof would be required as per the terms and condition of the policy opted.

        *The values taken for effective cost calculation are indicative values and may change as per the selected plan.

        *Coverage upto double the amount of Sum Insured is available on certain covers for a minimum plan of Rs. 5 Lakh on the first claim only to an individual of upto 45 years of age with no pre-existing diseases. The benefit is available with or without extra cost depending on the plan chosen.

        *Coverage of pre-existing diseases is provided by insurer as per their underwriting policy.

        *The scope of coverage may vary from plan to plan.

        ~Source: Google Review Rating available on:- http://bit.ly/3J20bXZ

        ##On ground claim assistance is available in 114 cities

        Tax Benefits are subject to changes in tax laws. GST Exemption depends on fulfilment of qualification criteria and submission of relevant documents as required by the insurers. For more details on risk factors, terms and conditions, please read the sales brochure and applicable rules and regulation carefully before concluding a sale.

        STANDARD TERMS AND CONDITIONS APPLY. For more details on risk factors, terms and conditions, please read the sales brochure carefully before concluding a sale.

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