ICICI Lombard Health AdvantEdge Plan

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      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.

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

      ICICI Lombard Health AdvantEdge Plan: Key Highlights

      Categories Specifications
      Sum Insured ₹3 lakh to ₹3 crore
      Policy Tenure 1 year, 2 years, 3 years
      Pre-Policy Medical Check-ups 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

      Benefits of ICICI Lombard Health AdvantEdge Plan

      Here are some of the reasons why buying an ICICI Lombard Health AdvantEdge plan is a good idea:

      1. 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.

      2. 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.

      3. 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.

      4. 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.

      5. 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.

      6. 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.

      7. 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.

      ICICI Lombard Health AdvantEdge Plan Eligibility Criteria

      Check out the eligibility criteria to buy an ICICI Lombard Health AdvantEdge plan:

      Parameters Eligibility Criteria
      Minimum Entry Age Adult - 18 years
      Child - 91 days
      Maximum Entry Age Adult - 65 years
      Child - 25 years
      Coverage Type Individual, Family Floater
      Renewability Lifetime

      Inclusions of ICICI Lombard Health AdvantEdge Plan

      The ICICI Lombard Health AdvantEdge plan comes with the following inclusions:

      • 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.
      • Day Care Procedures - It pays for day care procedures or treatments that require less than 24 hours of hospitalization.
      • Modern Treatments - It covers the cost of 12 modern treatments, such as robotic surgeries, oral chemotherapy, stem cell therapy, etc.
      • Pre-Hospitalization Medical Expenses - It pays for the medical expenses incurred up to 60 days before hospitalization.
      • Post-Hospitalization Medical Expenses - It covers the medical expenses incurred for up to 180 days after hospital discharge.
      • 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.
      • Bariatric Surgery Cover - It covers the cost of surgical procedures or treatments taken to control obesity.
      • Domestic Road Ambulance - It pays for the cost of availing road ambulance services to transport the insured to the nearest hospital.
      • Domestic Air Ambulance Cover - It covers the cost of availing air ambulance service to transport the insured to the nearest hospital.
      • Donor Expenses - It pays for the medical expenses incurred by the organ donor for the organ transplant surgery of the insured.
      • Domiciliary Hospitalization - It covers the cost of domiciliary hospitalization if the insured was admitted at home for at least 3 consecutive days.
      • Home Care Treatment - It pays for the medical treatments availed at home as per the advice of a medical practitioner.
      • Animal Bite (Vaccination) - It covers the cost of animal bite vaccinations taken on an OPD basis.
      • Convalescence Benefit - It pays a fixed amount in case the insured is admitted to a hospital for at least 10 consecutive days.
      • In-patient Hospitalization for Surrogate Mother - It covers the cost of in-patient hospitalization incurred by a surrogate mother.
      • 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.
      • Teleconsultation - It covers the cost of availing teleconsultation services from a qualified doctor through audio, video, chat, mobile application or web portal.

      Optional Covers:

      • 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.
      • Newborn Baby Cover - It pays for the in-patient treatment of the newborn baby until it turns 90 days old.
      • First-year Vaccinations of the Newborn Baby - It covers the vaccination expenses of the newborn baby until it turns 1 year old.
      • Critical Illness Cover - It pays a lump sum amount to the policyholder on the first diagnosis of any of the 20 listed critical illnesses.
      • Personal Accident Cover - It provides compensation in case an accident of the insured leads to accidental death or permanent partial/total disability.
      • Nursing at Home - It pays a daily allowance to the policyholder for up to 10 days if the medical services of a qualified nurse have been availed at home post-hospitalization.
      • 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.
      • 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.
      • Claim Protector - It pays for the non-payable expenses incurred by the insured during in-patient hospitalization or day care treatment.
      • 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.
      • Voluntary Co-Payment - It enables the policyholder to reduce the premium by opting for a voluntary co-payment on all claims.
      • Voluntary Deductible - It allows the policyholder to reduce the premium by opting for a voluntary deductible.
      • Worldwide Cover - It covers the cost of in-patient hospitalization and day care treatment availed outside India, including the USA and Canada.
      • Preventive Health Check-up (Reimbursement) - It reimburses the medical expenses incurred on preventive health check-ups during the policy year.
      • Room Rent Capping - It allows the policyholder to reduce the premium by opting for a capping on hospital room rent.

      Exclusions of ICICI Lombard Health AdvantEdge Plan

      The following medical expenses are excluded in an ICICI Lombard Health AdvantEdge plan:

      • OPD treatment
      • Treatment for alcohol or drug addiction
      • Sterility and infertility
      • Cosmetic or plastic surgery
      • Injuries due to participation in hazardous or adventure sports
      • Intentional self-injury
      • Sexually transmitted diseases

      ICICI Lombard Health AdvantEdge Plan Waiting Periods

      Take a look at the waiting periods applicable to the ICICI Lombard Health AdvantEdge plan:

      Category Waiting Period
      Pre-existing Disease Waiting Period 2 years
      Specified Disease/Procedure Waiting Period 2 years
      Initial Waiting Period 30 days
      Hypertension/Diabetes/Cardiac Conditions Waiting Period 90 days
      Bariatric Surgery Waiting Period 2 years
      Maternity Waiting Period 9 months, 2 years
      Worldwide Cover Waiting Period 2 years (For planned hospitalizations only)
      Critical Illness Waiting Period 90 days

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