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ICICI Lombard Health AdvantEdge Policy

The majority of people require medical attention at some point in time. The growing costs associated with medical treatment, starting with the doctor’s appointment to the lab tests and pharmaceutical expenditures, can be onerous. 

ICICI Lombard’s Health AdvantEdge is a comprehensive plan made to meet your healthcare needs at every stage of your disease or illness. The plan comes in three options, namely Prime Plus, Royal Plus, and Apex Plus. Additionally, the policy offers advantages, including flexible pre-existing illness coverage, domestic and international ambulance, and convalescence benefit.

Eligibility Criteria

Minimum Entry Age18 Years
Maximum Entry Age65 Years
Product Code4193
UIN NumberICIHLIP22206V022122
Policy TenureEvery policy has a calendar year from the date of purchase as its period.
Sum Insured Options

Prime Plus: 3/4 Lakhs

Royal Plus: 5/7.5/10/15/20/25/30/40/50 Lakhs

Apex Plus: 75/100/150/200/300 Lakhs

What’s Covered Under ICICI Lombard Health AdvantEdge Plan?

Let’s check out what is covered under the plan!

CategoryPrime PlusRoyal PlusApex Plus
In-Patient HospitalizationCovered
Daycare ProceduresCovered
AYUSH TreatmentCovered
Organ Donor ExpensesCovered
Animal Bite (Vaccination)Covered
Surface AmbulanceCovered
Home Care TreatmentCovered
Critical Illness CoverCovered
Domestic Air AmbulanceUp To Sum Insured
Personal AccidentCovered
Domiciliary HospitalizationCovered
Health Check-UpCovered
Pre-Existing Disease CoverCovered
MaternityNot CoveredCoveredCovered
Newborn Baby & VaccinationNot CoveredCoveredCovered
OPDNot CoveredCoveredCovered
Bariatric SurgeryNot CoveredCoveredCovered
Worldwide CoverNot CoveredCovered For SI Above 10 LakhsCovered For SI Above 25 Lakhs

Why Should You Get Hold Of ICICI Lombard Health AdvantEdge?

The plan provides a multitude of benefits to the policyholder. Some of them are discussed below:

  • Restore Benefit: If your total amount insured, including accrued additional sum insured (if any), is insufficient due to prior claims in a given policy year, the option to restore your balance sum insured up to 100% of the base sum insured is available under the plan.
  • Guaranteed Cumulative Bonus: For each year without a claim, you will receive an additional sum insured of 20% (up to a maximum of 100%) at the time of policy renewal. When the policy is renewed in the case of a claim, the bonus that has already accumulated would still be in effect.
  • Wellness Programs: The plan allows redemption of wellness points gained through various wellness and fitness activities owing to healthy conduct. The wellness points can be used to pay for medical consultations, prescription medications, diagnostic costs, dental costs, and other OPD fees.
  • Value Added Services: The plan also offers a wide range of value-added services to the policyholder, including health rewards, medical condition management, doctor appointment, medical second opinion, doctor on call, pharmacy and diagnostics, 24 X 7 e-consultations, online chats, and telephonic consultations.
  • Sum Insured & Claim Protector: The plan provides coverage for products that would not otherwise be covered by your claim with the company. If your claim for an in-patient hospitalization has been approved, you may use the claim protector feature of the plan. Moreover, if you happen to make claims that are up to Rs. 50,000 in the prior policy year, it will have no impact on the additional money insured that you have accrued over the years.
  • Convalescence Benefits: A lump sum payment of Rs. 20,000 will be payable only once each policy year. To be eligible for this benefit, the insured must be hospitalized for more than 10 days.
  • No Medical Test Up To 45 Years: For health coverage for those under the age of 45 and amounts covered up to Rs. 10 lakhs, no medical exams will be necessary.
  • Lifelong Renewability: The plan also has the option to renew the health insurance plan every year without any age restrictions.
  • Critical Illness Cover: It provides lump-sum coverage for 20 critical illnesses that include a 30-day survivor clause. The insured money or up to Rs. 50 lacs will be the lump sum payment, whichever is lower.

Preclusions Under ICICI Lombard Health AdvantEdge Plan

The following points are not included under the policy:

  • Any disease, excluding those brought on by an accident, that develops within 30 days of the policy’s commencement date. For the succeeding renewals, this clause is not applicable.
  • Some illnesses, such as cataracts, hernias, urinary tract stones, and others, won’t be covered for the first two years.
  • Any ailment, disease, injury, or pre-existing condition that existed before the policy’s inception. However, if the policy is renewed with us for two consecutive years, these pre-existing conditions begin to be covered.
  • Wars
  • Breach of law
  • Treatment taken outside the geographical locations of the country
  • Expenses arising out of domiciliary treatment
  • Acupuncture, naturopathy, acupressure, magnetic, and other related treatments or therapies.
  • The treatments of the following will be excluded for the first two years:
    • Cataract treatment
    • Hernia and hydrocele
    • Benign prostatic hypertrophy
    • Joint replacement, unless because of an accident
    • Sinusitis and related disorders
    • Urinary stones
    • Stones in biliary systems
    • Myomectomy and hysterectomy, unless because of malignancy
    • Dilatation and curettage
    • Endometriosis
    • Dialysis required for chronic renal failure
    • Internal congenital anomalies
    • Tonsils, adenoids, and sinuses
    • Gastric and duodenal erosions and ulcers
    • Deviated nasal septum
    • Varicose veins/varicose ulcers
    • All types of skin and all internal tumors/cysts/nodules/polyps of any kind, including breast lumps, unless malignant

Frequently Asked Questions

Yes. Hospitalization associated with COVID-19 is covered under the plan.

The company provides a 15-day trial period. You can write a notification to the insurer about your decision to terminate the insurance during this free look period. The insurance company will then reimburse the premium amount. 

Yes. When you buy this policy for yourself, your spouse, or your children, you may be able to deduct up to Rs. 25,000 from your premium, thanks to Income Tax benefits under Section 80D. You may deduct up to Rs. 50,000 in taxes for dependent parents who are over 60 years old.

This plan has a zero copay. 10% and 20% are both options that you can have under the plan.

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