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What is a health insurance policy?

A health insurance policy covers medical expenses for illnesses or injuries. A reliable health insurance plan protects you from sudden medical expenses. It reimburses your bills or pays the medical care provider directly on your behalf. A comprehensive medical insurance covers the cost of hospitalisation, daycare procedures, medical care at home (domiciliary hospitalisation), ambulance charges, amongst others.

A health insurance plan helps you stay covered against various diseases. Additionally, it helps you boost tax savings. Under section 80D of the Income Tax Act, 1961, you can claim tax benefits against your health insurance premium.

What are the benefits of a health insurance policy?

A comprehensive health insurance plan in India comes with many advantages.

1

Covers pre and post hospitalisation

One of the key benefits of a health insurance policy is that it covers your medical expenses incurred just before and after hospitalisation.

2

Covers pre-existing diseases

A health plan covers you for a pre-existing disease once you have completed the waiting period mentioned in the policy certificate.

3

Provides cashless treatment

At the time of hospitalisation, you don’t have to worry about arranging cash to pay your hospital bill. Your health insurance company will settle it directly with the hospital if it is in their network.

4

Lets you claim tax benefit

You can claim a tax benefit on health insurance premium under section 80D of the Income Tax Act, 1961.

5

Covers ambulance expenses

Comprehensive health insurance also pays for your ambulance expenses during a medical emergency.

6

Provides additional sum insured

Keeping healthy has its own benefits. You can enjoy additional sum insured for every claim-free year as per the policy certificate of your health plan.

What are the different types of ICICI Lombard health insurance policies?

We offer reliable health insurance plans that take complete care of your medical expenses.

ICICI Lombard Complete Health Insurance

ICICI Lombard’s Complete Health Insurance policy provides you with extensive coverage during a medical emergency. The medical policy gives you access to a wide range of cashless hospitals nationwide.

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Health Booster

Health Booster policy makes your health insurance more potent. It is a super top-up plan that acts as a backup in case your base plan gets exhausted. You can also purchase a Health Booster plan with ICICI Lombard without having a base plan.

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Arogya Sanjeevani Policy, ICICI Lombard

Arogya Sanjeevani Policy, ICICI Lombard is a health plan that takes care of your basic healthcare needs. It comes at an affordable premium with flexible sum insured options starting from ₹1 lakh.

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What are the top reasons to buy ICICI Lombard health insurance plans?

In-house claim settlement team that helps you 24x7. And, that’s just the beginning.

  • Complete Health Insurance
  • Health Booster
  • Arogya Sanjeevani Policy, ICICI Lombard
  • No limit on hospital room rent

    ICICI Lombard Complete Health Insurance policy has no sub-limits on hospital room rent. In case you opt for a private ward, we will bear its expenses.
  • Free health check-up every year

    ICICI Lombard Complete Health Insurance plan provides you with a complimentary health check-up coupon per policy year. If you have a floater policy for family, you get two free coupons every year for your medical check-ups.
  • No co-pay clause

    A co-pay is a fixed sum that you usually pay out-of-pocket for your medical services, and the insurance company takes care of the remaining amount. There is no co-payment clause under ICICI Lombard Complete Health Insurance. That means, you won’t have to worry about the medical expenses eating into your savings.
  • Wellness program

    You earn reward points for undertaking some wellness activities. These include joining a gym or a yoga centre, going for a medical check-up, participating in a health or fitness event organised by us, etc. You can redeem these points on your OPD bills for doctor’s consultation, medicine and drugs, diagnostic expenses, dental expenses, etc.
  • Domiciliary hospitalisation

    In case the insured has to undergo medical treatment at home either because no room is available in the hospital or the patient can't be moved to one, we cover that expense too.
  • Discount on premium

    You save up to 12.5% on our Health Booster policy by paying the premium for 3 years in one go.
  • Cumulative bonus

    You enjoy 10% additional sum insured on every claim-free year with our Health Booster policy. You can get up to 50% cumulative bonus with us.
  • Flexible sum insured

    You get to choose your sum insured from ₹1 lakh to ₹5 lakh depending upon your health needs.
  • Ambulance charges

    Your ambulance expenses will be covered up to ₹2000 per hospitalisation.

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How to pick a suitable health insurance plan from ICICI Lombard?

Go for the health insurance plan that suits your needs the best!

Sum insured

It is the maximum amount that you can claim in a policy year for hospitalisation. If you are looking for a policy with a lesser coverage (under ₹5 lakh sum insured), you may opt for Arogya Sanjeevani Policy, ICICI Lombard. But, if you need an extensive coverage (above ₹5 lakh sum insured), you should go for ICICI Lombard Complete Health Insurance, our comprehensive health insurance policy. In case you already have a group health insurance and need a super top-up plan, then you can buy our Health Booster policy.

Additional sum insured

It is the bonus amount that is added to your sum insured for every claim-free year. While you can earn up to 10% additional sum insured with ICICI Lombard Complete Health Insurance and Health Booster policy, you can earn up to 5% with Arogya Sanjeevani Policy, ICICI Lombard. The maximum cumulative bonus that can be earned across our health insurance plans is 50%.

Add-ons

You can purchase our add-ons at an additional premium. If you wish to customise your health plan with our add-ons that cover maternity, donor and OPD expenses, then you can consider ICICI Lombard Complete Health Insurance policy. We also let you customise our Health Booster policy with add-ons like critical illness cover, personal accident cover, hospital daily cash, etc.

Compare ICICI Lombard health insurance plans

See which plan works for you!

Features & benefits ICICI Lombard Complete Health Insurance Health Booster Policy Arogya Sanjeevani Policy, ICICI Lombard
Hospitalisation Up to sum insured, no sublimit. (except on Cataract) Up to sum insured, no sublimit. Sub-limits on room rent, ICU charges, cataract treatment & modern treatments.
Pre hospitalisation expenses 30 days before hospitalisation. 60 days before hospitalisation. 30 days before hospitalisation.
Post hospitalisation expenses 60 days after hospitalisation. 90 days after hospitalisation. 60 days after hospitalisation.
Room rent Up to sum insured, no daily capping. Up to sum insured, no daily capping. 2% of the sum insured subject to a maximum of ₹5000 per day.
AYUSH treatment
Medical expenses for Ayurveda, Unani, Siddha and Homeopathy
Up to sum insured, no sublimit. Up to sum insured, no sublimit. Up to sum insured, no sublimit.
Day care treatments Covers 150 day care procedures. Covers 150 day care procedures. Covers all day care procedures.
Pre-existing diseases Coverage begins after 2 years waiting period for sum insured of ₹3 lakh and above. Coverage begins after 2 years waiting period. Coverage begins after 4 years waiting period.
Standard time bound exclusions like cataract, stone in the urinary and biliary system, sinusitis, endometriosis, etc. Coverage begins after 2 years waiting period for sum insured of ₹3 lakh and above. Coverage begins after 2 years waiting period. Coverage begins after 4 years waiting period.
Reset benefit 100% sum insured will be restored once in a year. 100% sum insured will be restored once in a year.
Health check-up Free once in a year for individual policy and twice a year for floater policy. Free once in a year for individual policy and twice a year for floater policy.
Additional sum insured provided on renewal for every claim-free year 10% of your sum insured. Up to 50% cumulative bonus. 10% of your sum insured. Up to 50% cumulative bonus. 5% of your sum insured. Up to 50% cumulative bonus.
Cataract treatment limit ₹20,000 per eye for policy with up to ₹5 lakh sum insured. ₹1 lakh per eye for policies above ₹7 lakh sum insured. Up to sum insured, no sublimit. Up to 25% of the sum insured or ₹40,000, whichever is lower.
Emergency ambulance Up to ₹1500 per hospitalisation. Up to 1% of sum insured, maximum up to ₹5000. Up to ₹2000 per hospitalisation.
Domiciliary hospitalisation Up to sum insured, no sub limit.
Donor expenses Available as an add-on cover. Up to sum insured, no sub limit.
Wellness program second medical opinion, dietician & nutrition counselling, medical evacuation, etc.
Co-pay 20% co-pay on claims made after 60 years of age if your age at the time of policy purchase is >45 years. 5% on every claim.
Add-ons Can be bought only on payment of additional premium. Can be bought only on payment of additional premium.
Maternity cover Coverage will begin after 3 years waiting period.
Outpatient treatment cover & wellness and preventive healthcare reimbursement Up to ₹20,000 per policy.
Critical illness cover Lump sum benefit -100% of sum insured for up to ₹10 lakh sum insured. 50% of sum insured for ₹15 lakh sum insured and above. ₹5,00,000 (Silver plan) & ₹10,00,000 (Gold plan).
Hospital daily cash ₹1,000 or ₹2000 or ₹3000 per day for maximum 10 days with minimum 3 days hospitalisation. ₹1,000 per day (Silver plan) & ₹3,000 (Gold plan) for maximum 30 days with minimum 3 days hospitalisation.
Convalescence benefit ₹10,000 per member for 10 or more consecutive days of hospitalisation. ₹10,000 (Silver plan) & ₹20,000 (Gold plan) per member for 10 or more consecutive days of hospitalisation.
Personal accident cover
Accidental death or permanent total disablement
Lump sum benefit -100% of sum insured for up to ₹10 lakh sum insured. 50% of sum insured for up to ₹15 lakh sum insured and above. Up to ₹10 lakh (Silver plan) & ₹15 lakh (Gold plan).
Temporary total disablement Up to ₹50,000 (Silver plan) & ₹1 lakh (Gold plan).
Repatriation of remains Up to ₹50,000 (Silver plan) & ₹1 lakh (Gold plan).

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Frequently asked questions (FAQs) related to health insurance plans in india

  • General
  • COVID-19 cover

What do you mean by a pre-existing disease?

Any condition, ailment or injury or related condition(s), for which you have had signs or symptoms, and/or were diagnosed, and/or received medical advice/treatment, within 48 months prior to the first policy with the insurance company is called a pre-existing disease.

What do you mean by waiting period?

The duration after which you can make a claim is called a waiting period. Our waiting periods for ICICI Lombard Complete Health Insurance and Health Booster policy are as below:

  • No waiting period for accidental hospitalisation.
  • 30 days for all claims other than accidental hospitalisation.
  • 2 years for pre-existing diseases. These diseases should be declared at the time of proposal and accepted by us for policy with sum insured of ₹3 lakh and above.
  • 2 years for standard list of diseases and procedures.

What does annual sum insured mean?

Annual (basic) sum insured is the maximum amount that an insurance company will pay you in the event of a claim in a policy year.

If I increase my sum insured at the time of renewal, does a waiting period apply?

Yes, a waiting period will apply only to the added sum insured.

My employer provides me with a health insurance. Do I still need one?

Numerous employers offer group or individual health plans. However, these are not customised as per your needs and may have certain restrictions and limitations. Also, the coverage is dependent on the continuation of the job. Once you quit, you cannot avail the health plan benefits. Therefore, it is important to insure yourself with a comprehensive cover that lets you customise as per your needs. For example, for a family of 4 members, a sum insured of ₹2 lakh-₹3 lakh provided by your employer may be inadequate.

From what age can I include my children in the plan?

You can include your children aged between 90 days to 20 years in your policy. Newborns can be included after 90 days of birth. However, your daughter or son cannot be shown as a ‘dependent’ if they file a joint tax return.

Will my existing health insurance policy cover hospitalisation expenses for COVID-19?

Yes, hospitalisation expenses on account of COVID-19 will be covered under the health insurance policy as per the policy terms and conditions.

How can I intimate my claim after hospitalisation?

You can intimate the health insurance claim online on IL Health Care or using our mobile app, IL Take Care. Upload the scanned copies or photographs of all claim related documents on the app. Then, furnish or courier hard copies of all required claim documents to the below mentioned address:

ICICI Lombard Healthcare,

ICICI Bank Towers,

Plot No. 12, Financial district,

Nanakramguda, Gachibowli,

Hyderabad- 500032

Are any waiting periods applicable to claims under COVID-19?

In case of hospitalisation for COVID-19, the hospitalisation expenses incurred will be covered if the illness is contracted after 15 days of starting a fresh policy. The 15 days condition will not apply if you have renewed your health policy without a break or have ported it to ICICI Lombard.

Will I be allowed to enhance my sum insured?

Sum insured enhancement will be allowed based on medical assessment in accordance with the underwriting guidelines. However, such sum insured enhancement will be done only at the time of renewal.

Are the expenses on medicines and diagnostic tests incurred during medically advised home isolation due to COVID-19 covered?

In case you choose to get treated at home for COVID-19, we will cover the same under the home healthcare facilitated by us through our empaneled service providers.

Will the policy cover expenses due to quarantine?

In case the quarantine is in a hospital on the advice of a medical practitioner, then the medical expenses incurred will be covered in accordance with the policy terms and conditions. However, expenses incurred on account of self-quarantine or quarantine at home will not be covered.

Will the policy cover hospitalisation in a country other than India?

No. The geographical scope of the policy is limited to India.

Will my travel history abroad affect the admissibility of claim under the policy?

So long as the hospitalisation is in India, the travel history will not affect the admissibility of claim under the policy.

Are the consultations with a medical practitioner and diagnostic tests in relation to COVID-19 covered under my health insurance policy?

In case your policy has an outpatient treatment cover, then consultations with a medical practitioner and diagnostic tests as advised by a medical practitioner will be covered up to the sum insured. A claim under outpatient treatment cover can be made in accordance with the claims procedure mentioned in the policy wordings.

Further, in case there is hospitalisation on account of COVID-19 and the same has been accepted under the policy, then all expenses related to COVID-19 incurred due to consultations with a medical practitioner and diagnostic tests as advised by a medical practitioner in the 30 day period, prior to the date of admission and 60 day period after the date of discharge will be covered as per the policy terms and conditions.

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