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What is ICICI Lombard Health AdvantEdge policy?

No one plans to fall sick but most people will need medical care at some point in their life. Right from the first doctor’s visit, to the lab tests, and pharmacy bills, the mounting expenses pertaining to full treatment can be burdensome. To help you in your illness and wellness journey, ICICI Lombard's Health AdvantEdge is a holistic policy designed to cater to your healthcare needs at all stages.

This policy is one of the few healthcare products that offers all-round wellness and preventive care benefits. Some of the value-added services under the Wellness program include reward points for inculcating healthy habits. Under this cover, the policyholder can also avail services such as video/tele consultation, pharmacy and diagnostic services, online chat with doctors, second opinion, and more.

The policy also has benefits such as pre-existing disease cover flexibility, domestic and air ambulance and convalescence benefit. It provides an additional cover against 20 critical illnesses including cancer. These add-ons also include maternity insurance for both mother and the newborn baby for SI above 5 Lakhs.

Top reason to buy ICICI Lombard Health AdvantEdge policy

Restore benefit for sum insured Guaranteed cumulative Bonus
24x7 video/telephone consultation Convalescence benefit
Health rewards Pre-existing disease coverO
Domiciliary hospitalization Domestic Air Ambulance
Personal accident cover Maternity cover – optional add on
Bariatric surgery cover

Why should you buy a health insurance policy for yourself and your family?

Family health insurance is the need of the hour.

1

Medical costs are skyrocketing

They are high today and will be higher in the near future. A family floater health insurance is a smart way to safeguard your savings during a medical emergency.

2

Employer provided health policy is not enough

A health cover provided by your corporate firm or employer ceases to cover you once you switch the job. Furthermore, you cannot choose coverage or benefits as per your needs. Besides, the sum insured of corporate health plan may not be adequate to cover you and your dependants in case of a medical emergency. Hence, it is recommended to invest in one of the leading family health insurance plans in India that covers your family adequately.

3

Lifestyle diseases are on the rise

An unhealthy way of life and work stress have made even the younger generation prone to lifestyle diseases. Thus, the need to have a family health insurance is undisputable even if you are young. The onset of a chronic condition like diabetes may make it difficult for you to buy a comprehensive medical insurance. You may be required to undergo screening and medical check-up. Hence, it is recommended to invest in a family health insurance policy as early as possible. Not only is it affordable but also ensures optimum coverage when you need it most.

 
4

You can save some on family health insurance premium

By sharing your sum insured, you can smartly insure your entire family under one health plan. This will help in bringing down your health insurance premium significantly. You also do away with the hassle of managing multiple policies and their renewals.

5

You get tax benefit on health insurance premium

As per Section 80D of the Income Tax Act, you can avail tax benefit on the health insurance premium. Thus, a health policy not only saves you from breaking the bank during a medical emergency but also helps you to save in taxes.

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Why should you buy health policy online from ICICI Lombard?

It is a fuss-free way to secure yourself with one of the leading health insurance policies.

We know that your busy schedule may leave you with very little time to find a reliable health policy for family. So, digital can become your go-to solution for choosing one of the preferred health policies in India.

We have hence put together a super easy and customisable online experience. It can help you zero down on a health insurance policy for family from the comfort of your home. You can select and edit the number of family members you wish to cover under the family health plan. You can also have your pick from our smart set of add-on covers basis your healthcare needs. Additionally, our health assistance team is available to answer your health-related queries on our dedicated helpline 04066274205 between 9 AM to 6 PM from Monday to Saturday.

That’s not all. We let you claim digitally under your family medical insurance with us on our IL TakeCare mobile app. You also get to save 10% on your health insurance premium when you buy ICICI Lombard Health AdvantEdge Insurance policy for 2 years’ tenure.

What is covered in ICICI Lombard Health AdvantEdge policy?

  • Inclusions
  • Exclusions
  • Hospitalisation

    Medical expenses incurred during hospitalization for more than 24 hours, including room charges, doctor/surgeon’s fee, medicine bills, etc.
  • Pre and post hospitalization

    Medical expenses incurred 60 days prior and 180 days post (provided we have accepted the in-patient claim).
  • Day care treatments

    The expenses for advanced, technological medical surgeries and procedures requiring less than 24 hours of hospitalization (including dialysis, radiotherapy and chemotherapy).
  • AYUSH treatment

    Expenses for in-patient treatment under Ayurveda, Unani, Siddha and Homeopathy (AYUSH) treatment only when it has been undergone in a government hospital or any institute recognized by the government and/or accredited by the Quality Council of India/National Accreditation Board on Health.
  • Wellness program

    Redemption of wellness points earned due to healthy behavior through various wellness and fitness activities. You can redeem the wellness points on OPD bills for doctor’s consultation, medicine and drugs, diagnostic expenses, dental expenses, etc.
  • Guaranteed cumulative bonus

    At renewal of the policy, 20% (up to a maximum of 100%) extra sum insured awarded to you over your base sum insured for every claim-free year. In the event of a claim, there won’t be any bonus upon renewal of the policy but the bonus accrued prior to this would remain intact.
  • Surface ambulance

    Reimbursement of up to 1% of the sum insured, subject to a maximum of ₹.10,000, for each hospitalization, and for reasonable expenses incurred on availing an ambulance service offered by a hospital or ambulance service provider in an emergency condition.
  • Claim protector

    Coverage for items that are not otherwise payable by us under your claim. You can avail yourself of this if your in-patient hospitalization claim has been accepted.
  • Restore benefit

    Facility to restore your balance sum insured up to 100% of the base sum insured once in a policy year in case the sum insured, including accrued additional sum insured (if any), is insufficient as a result of previous claims in that policy year.
  • Cashless hospitalization

    Cashless hospitalization facility at any of our network providers or hospitals.
  • Pre-existing diseases

    Pre-existing diseases declared at the time of proposal and accepted by us will be covered immediately after 2 years waiting period.
  • Pre-policy medical check-up

    No medical tests will be required for health cover below the age of 45 years and sum insured up to ₹10 lakh.
  • Health check-up

    This benefit covers an annual health checkup, reimbursing up to 0.5% of the sum insured (with a maximum limit of Rs. 10,000). For sum insured amounts exceeding 10 lakhs, reimbursement can be availed through both cashless and reimbursement modes
  • Domiciliary hospitalization

    This should either be because of the unavailability of beds at a hospital or the inability to move the insured to a hospital. This will also cover expenses on Qualified Nurses engaged on recommendation of attending medical Practitioner
  • Domestic Air ambulance

    Air ambulance expenses to transfer you to the nearest hospital for emergency care. Available up to sum insured.
  • Organ Donor

    Reimbursement of medical expenses for organ donor up to sum insured. This benefit is provided only if the hospitalization claim for organ donation surgery is accepted.
  • Emergency services

    Road ambulance expenses for emergency care, telephonic or virtual consultations with a medical practitioner for routine health issues. You can receive the consultation via audio, video, online portal, chat or mobile app. This service is available 24 hours a day, 365 days a year.
  • Copay

    No copayment is needed unless you opt for 10% or 20% copay
  • Lifelong renewability

    Provision to renew the health policy every year without any restriction on age.
  • Floater benefit

    Floater cover to get family (self, spouse, dependant parents, dependant children, brothers and sisters) covered for the same sum insured under a single policy by paying one premium amount. Any individual above 91 days of age and up to 5 years can be covered under the family insurance plan provided 1 adult is also covered under the same policy.
  • Free look period

    You can cancel the policy by giving written notice within 15 days of receiving the policy.
  • Convalescence benefit

    A lumpsum of ₹.20,000, payable only once in a policy year. The insured should be hospitalized for over 10 days to avail this benefit. For policy more than 1 year, you are eligible to receive lump sum every policy year
  • Critical Illness cover

    Coverage for 20 critical illnesses on a lumpsum basis with a 30-day survival clause. The lumpsum amount will be equal to the sum insured, or up to ₹.50 lacs, whichever is lower.
  • Bariatric surgery cover

    Coverage applicable to insured person aged 18 years or older after a waiting period of 3 years, capped at 50% of sum insured. The surgery needs to be recommended by the doctor for BMI greater than or equal to 40. If the surgery meets the requirements as per the Policy wording, the same can be covered, if the insured person attains prior approval from the company.
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  • Any illness contracted within 30 days from the start date of your policy, except those incurred due to an accident. This clause does not apply to the subsequent renewals.

  • For the first 2 years, some diseases like cataract, hernia, stone in the urinary system and others will not be covered.

  • Any illness or disease or injury or a pre-existing disease before the start of the policy. However, these pre-existing diseases start to get covered if the policy is renewed with us for two consecutive yea₹.

  • Permanent exclusions

  • War, civil war or breach of law.

  • Naturopathy treatment, acupressure, acupuncture, magnetic and other such therapies.

  • Treatment taken outside the country.

  • Any expenses arising out of domiciliary treatment.

    Exclusions valid for the first 2 years

    Treatment of the following diseases/illness/ailments


  • Cataract #

  • Benign prostatic hypertrophy

  • Myomectomy, hysterectomy unless because of malignancy

  • All types of hernia and hydrocele

  • Joint replacement, unless due to accident

  • Sinusitis and related disorders

  • Stone in the urinary and biliary systems

  • Dilatation and curettage, endometriosis

  • All types of skin and all internal tumors/cysts/nodules/polyps of any kind, including breast lumps, unless malignant

  • Dialysis required for chronic renal failure

  • Surgery on tonsils, adenoids and sinuses

  • Gastric and duodenal erosions and ulcers

  • Deviated nasal septum

  • Varicose veins/varicose ulcers

  • All types of internal congenital anomalies/ illness/ defects

If you renew the policy with us for 2 consecutive years, we will cover the above diseases or illness or ailments from the third year.
This list contains major inclusions & exclusions. For the full list, please read our policy document.

ICICI Lombard Health AdvantEdge Insurance policy add-on benefits

Customise your health insurance policy for your family with our ready-made set of add-ons*.

Why should you buy health policy online

Maternity Benefit

This benefit covers medical expenses related to childbirth and/or pregnancy termination, reimbursing up to 10% of the Annual Sum Insured with a maximum limit of INR 1 Lakh under the Maternity Sum Insured. It is applicable for insured females aged 18 to 45 and is limited to three instances

Sum Insured Protector

Claim Protector

For policies with a Sum Insured less than 15 lakhs (optional), this coverage extends to include all items listed by the IRDAI as non-payable. These non-payable items become payable in the event of a claim. For policies with a Sum Insured of 15 lakhs or more (inbuilt), this coverage is automatically included. In the event of a claim, it ensures that all items listed by the IRDAI as non-payable become payable.

Sum Insured Protector

Co-payment Option to choose 10% or 20% co-pay

Co-pay or co-payment is defined as a contribution made by the policyholder towards the cost of medical treatment, they claim under their health policy. Copayment is a good choice if you are young and less prone to falling sick or contracting diseases. With this benefit, you can choose a 10% or 20% co-payment in your health insurance claim.
There are two copay in policy one is optional cover named as “Co-payment” and second is Zonal copay if you are taking treatment in other zone than the policy purchase zone

 
Sum Insured Protector

Teleconsultations

Unlimited teleconsultations, available 24x7 with health care professionals for routine & emergency health concerns
We will arrange consultations and recommendations for emergency or everyday health issues by a qualified healthcare professional via phone, video call or other virtual means.

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What is the difference between mediclaim insurance and health insurance policy?

In India, ‘mediclaim’ and ‘health insurance’ are often used interchangeably. Just as people normally confuse ‘guarantee’ with ‘warranty’, they tend to assume mediclaim policy to be the same as health insurance. But this is not true.

That’s why, before you decide to secure your health with mediclaim insurance, it is important to understand what it brings to the table. This will help you map the right coverage against your health needs.

Advantages of mediclaim insurance

  • Hospitalisation coverage
  • Accident cover
  • Pre-specified disease cover
  • Lower premium
  • ·
  • Tax benefit

Disadvantages of mediclaim insurance

  • No add-ons
  • No flexibility
  • No customisation
  • Maximum coverage only up to ₹5 lakh

It is natural to find mediclaim policy lucrative over health insurance due to lower premium and tax benefit. But how wise is it to secure your health by only looking at these two advantages? What about the medical expenses that you would incur before and after hospitalisation? If you go for a mediclaim insurance policy, you lose out on many such benefits that our health insurance policy can provide apart from the sum insured that can go as high as ₹50 lakh. You also don’t enjoy the flexibility to customise your health coverage with add-ons in a mediclaim insurance policy.

Mediclaim vs Health insurance

The table below gives you the overall picture of what you would generally get in a mediclaim policy against a health one.

Key Benefits Mediclaim insurance policy Health insurance policy
Hospitalisation
Day care procedures
Tax benefit
Personal accident
Pre hospitalisation
Post hospitalisation
AYUSH treatment
Pre-existing diseases
Additional sum insured
Reset benefit
Wellness program
Free health check-up
Emergency ambulance
Donor expenses
Unlimited reset benefit
Domiciliary hospitalisation
Air ambulance cover
Additional sum insured protector
Emergency services
Hospital daily cash
Convalescence benefit
Maternity cover
OPD benefit
Nursing at home
Compassionate visit
Critical illness cover
Donor expenses add-on
Claim protector
Sum insured protector
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Health Insurance Plans for Family

A family health insurance plan, as the term implies, covers both you and your family members in the event of a medical emergency. Family health insurance has a single premium; you do not have to pay separately for each covered family member. One of the key features of a family health plan is that you can easily add your spouse, children, and dependant parents in a single health insurance policy and pay premium for a floater family health insurance.

Benefits of buying health insurance plans for the family

Covers entire family

Covers entire family

Under family health insurance plans, you can cover your spouse, children, dependant parents as well as your dependant in-laws.

Affordable Premiums

Affordable premiums

Family health insurance premiums are lower and affordable than individual health plans for each family member as you don't have to pay a separate premium for each family member.

High Coverage

High coverage

Under family health insurance, if the covered member falls ill, they can use the entire sum insured.

Flexibility to add members

Flexibility to add members

Under family floater health insurance, you can easily add more dependant members to your existing family insurance plans subject to underwriting guidelines.

Tax benefits

Tax benefits

Under Section 80D of the Income Tax Act, 1961, you can claim a tax deduction on the premium paid towards health insurance policy for self, spouse, dependant children and parents.

Save tax with family insurance plans

Save tax with family insurance plans

  • Claim tax deduction against family health insurance premium

    Under section 80D of the Income Tax Act, 1961, if you are younger than 60 years, you can claim up to ₹25,000 tax deduction by opting for a family health insurance policy.

  • Health insurance policy for parents

    Premiums paid for parents' health policy are subject to additional tax deductions. Under section 80D of the Income Tax Act, 1961, you can get a deduction of up to ₹50,000 per year, given that the parents age is 60 years or above.

Things to remember while buying a health insurance plan for the family

Coverage under family insurance plans

Coverage under family insurance plans

When choosing the best health insurance for family, check for the basic health coverage that it offe₹. Check for value-added services, waiting periods for certain diseases and coverage for pre-existing medical conditions, among other things.

Cashless hospitalisation

Cashless hospitalisation

Check the list of network hospitals available with the insurer. Make sure the list includes the name of a hospital that is close to your residence and is well-known.

Flexibility in sum-insured

Flexibility in sum-insured

Healthcare and medical treatment costs are steadily rising. Make sure the family medical insurance plan you choose allows you to increase the sum insured amount in the future.

Maximum renewal age

Maximum renewal age

This aspect is important if you are approaching retirement or if your parents are above the age of 60. Consider the family health insurance that offers the option to renew lifelong.

Claim settlement process

Claim settlement process

Family health insurance plans come with an option of cashless claims and reimbursement claims. Make sure there are no hidden clauses in the claim settlement process and that the documentation procedures are easy and convenient.

How to buy a family health insurance plan under ICICI Lombard Health AdvantEdge policy?

Get quote

Get quote

To get a quote for a family insurance plan, share your basic details like number of family members, their age and your contact details here.

Pick plan

Pick plan

Choose the plan that is best suited for your needs and budget.

Pay

Pay

Pay your family health insurance premium and get started on your journey.

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Frequently asked questions on Health AdvantEdge policy for family

  • General
  • Cover
  • Premiums
  • Claims
  • Policy

What is a family floater insurance plan under ICICI Lombard Health AdvantEdge policy?

Family floater insurance is a single health insurance policy that covers one or more members of your family. They can be your legally wedded spouse, dependant parents and parents-in-law, and dependant children aged 3 months to 25 years. It doesn't cover children above 18 years of age who are financially independent.

What is ICICI Lombard Health AdvantEdge product?

This product covers basic healthcare benefits like hospitalisation, daycare, domiciliary hospitalisation, pre & post-hospitalisation expenses, emergency ambulance services and more. This plan also includes value-added services such as a Wellness Program, routine full-body health checkups & more. You can also opt for the maternity benefit add-on that covers maternity expenses of up to 10% of base SI subject to a maximum of 10L and includes the newborn's health expenses right from birth. Teleconsultation add-on allows you to avail unlimited teleconsultations, available 24x7 with health care professionals for routine & emergency health concerns. 

How does a family floater plan under ICICI Lombard Health AdvantEdge work?

The total sum insured in a family floater plan is available for each policy member. So, if the total sum insured is ₹10 lakhs, and member one claims ₹3 lakhs, ₹7 lakhs will be the available sum insured amount for the remaining members in the plan for that given policy year. 

What is the age limit for taking this policy?

The minimum age limit for taking this policy is 18 years, and the maximum is 65 years.

How can I switch my current insurance to ICICI Lombard?

If you wish to switch your existing health insurance to any ICICI Lombard plan, please provide your application, including a duly filled portability form and your previous policy documents. Kindly share these at least 45 days before the renewal date of your existing health policy.

What is the difference between base coverage and add-ons?

The base coverage is in-built into the policy. The add-ons are optional; you can add them to the policy by paying a small additional premium to enhance the coverage based on your individual needs and & budgets.

How much premium qualifies for tax benefits?

With Income Tax benefits under Sec 80D, you can claim tax deductions up to a maximum of ₹25,000 when you purchase a policy for yourself, or spouse, or your children. For dependant parents above 60, you can claim a tax deduction up to a maximum of ₹50,000.

Are all the major corporate hospitals on the network?

There are 7000+ network hospitals where you can avail of cashless facilities. You can claim reimbursement if your treating hospital is not a network hospital.

Is overseas treatment for an illness covered?

Any form of treatment taken outside India will not be covered. However, if you opt for worldwide coverage, it is included.

Will ICICI Lombard Health AdvantEdge Insurance pay for maternity expenses?

With the Apex plan in Health AdvantEdge product, you can avail of the maternity benefits add-on that includes coverage for newborns from birth. 

Will ICICI Lombard Health AdvantEdge Insurance cover hospitalization expenses for COVID-19?

Yes. Covid-19 related hospitalisation is covered in the policy.

What are the different modes of payment on icicilombard.com?

You can choose between any of these payment options to pay your premium online:
  • Credit Card – Make secure premium payment with your VISA, Master, AMEX, RuPay or Diners Club card.
  • Net banking - Transfer the premium amount online through ICICI Bank or any of the other 50+ banks.
  • Debit Card – Just enter your bank's debit card details to pay your insurance premium directly.
  • UPI and e-wallets - Pay through UPI apps such as Google Pay, BHIM UPI & PhonePe, or an online wallet.
  • EMI - Use the credit/debit card EMI facility to pay your premium in instalments

How much premium qualifies for tax benefits?

Under section 80D of the Income Tax Act, you can avail of tax benefits for premiums paid towards your health insurance policy. The following table explains total tax deduction for only assess, spouse, dependant children and parents (whether dependant or not):

Will my premium be the same when I renew my policy?

Your premium depends on your age and the benefit amount/coverage period you have opted for in your policy. If you move to a higher age band at the time of renewal, the premium will change as per the new age band. If you upgrade your product to a higher sum insured at the time of renewal, add covers or make changes to the coverage period, your premium will change.

How can I raise my ICICI Lombard Health AdvantEdge insurance claim post-hospitalisation?

In case of planned hospitalisation, pick a hospital within our network to avail of cashless claims, so you won't have to pay the hospital bills out of your pocket. You can claim reimbursement for hospitalisation expenses in an emergency where you must pick a non-network hospital for immediate care. To raise a reimbursement claim, contact us by using any of the following ways:

Who do I call at the time of emergency hospitalisation?

You can contact us on our toll-free number, 1800 2666 or SMS "HEALTHCLAIM" to 575758 for a callback. Use the health card at any network hospital to avail of our cashless service. Contact us within 24 hours of hospitalisation for cashless emergency hospitalisation.
For cashless emergency hospitalization, we need to be contacted within 24 hours of hospitalization.

Do I have to pay any amount while claiming ICICI Lombard Health AdvantEdge Insurance?

This plan has a 0% copay clause. You can opt for 10% or 20% based on your needs & budget.

What do I do if my claim is rejected?

A claim can be rejected for several reasons, such as an incomplete waiting period, incorrect information provided, delay in making a claim & others. If your claim is denied, you can ask the reason for such rejection. If you're not convinced, you can contest the decision.

How many plans does ICICI Lombard Health AdvantEdge have? 

Health AdvantEdge has 3 plans:
  • Prime: 3/4 Lacs
  • Royal: 5/7.5/10/15/20/25/30/40/50 Lacs
  • Apex: 75/100/150/200/300 Lacs

I wish to add my spouse to an individual health insurance policy. Is it possible?

You can change your policy to a family floater health insurance policy at renewal and easily add your spouse.

What is the tenure for ICICI Lombard Health AdvantEdge policy?

Each policy period is one calendar year from the date of purchase.

Do I need a pre-medical check-up while buying ICICI Lombard Health AdvantEdge policy?

No, you don't have to go for a pre-policy medical check-up if your age is below 45 years. However, a pre-policy medical check-up is compulsory if you are 45 years or above. Your medical examination will be done at our designated diagnostic centre. We will return the cost incurred for the test if your proposal for Health AdvantEdge is accepted.

What happens if I don't renew my policy on time?

We provide a grace period of 30 days from the expiry of the policy. Beyond this period, you lose your renewal benefits, including continuity benefits required to cover pre-existing diseases. You will have to apply for a fresh policy post the grace period.

Can I cancel my ICICI Lombard Health AdvantEdge policy?

We provide a 15-day free look period. You may cancel this policy in the free look period by giving us written notice, and then we shall refund the premium.
Product Product Code UIN no.
Health AdvantEdge 4193 ICIHLIP24182V042324
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