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What is ICICI Lombard Health AdvantEdge policy?

ICICI Lombard’s Health AdvantEdge policy is a comprehensive health insurance plan offering all-around wellness and preventive care benefits. Apart from preventing out-of-pocket expenses during hospitalisation, this health insurance policy offers various other benefits, including health benefits, personal accident cover, 24/7 video/telephonic consultation, coverage against critical ailments, etc.

Designed to cater to your health care needs at all stages of life, this health insurance policy gives you complete peace of mind amid rising medical costs.

Top reasons to buy ICICI Lombard Health Insurance Plans for Family

When it comes to your family’s health, there is no compromise. ICICI Lombard’s Health Insurance Plans for family help you:

Cover all family members at a cost-effective price
Provide holistic coverage to your loved ones
Ensure funds are not paucity while receiving the best possible treatment
Mitigate rising costs of medical inflation
Meet other financial goals with ease

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

1

Medical costs are skyrocketing

Medical costs are rising at a fast clip. A medical emergency can dry your finances in no time. A family health insurance policy helps you easily meet the rising costs and ensure no family member remains uncovered.

2

Employer provided health insurance policy is not enough

Your employer-provided health insurance isn’t customisable to your requirements. The sum insured is low and may not be adequate to cover all family members. Also, it’s not in force once you leave the company.

3

Lifestyle diseases are on a rise

A sedentary lifestyle coupled with unhealthy habits have spiked lifestyle diseases, which can be mentally, physically and financially taxing. Buying a family health insurance plan early can protect your savings from taking a dip during treatment of such ailments.

 
4

You can save some on family health insurance premium

Buying an individual policy for each family member is expensive. A family health insurance plan ensures all members get duly covered. It helps save premiums and frees you from the hassle of managing multiple policies.

5

You get tax benefit on health insurance premium

The premium you pay for your family health insurance plan is eligible for tax exemption under section 80D of the Income Tax Act under the old tax regime. Thus, it helps lower your tax outgo as they say every penny saved is a penny earned.

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Why should you buy family health insurance online from ICICI Lombard?

Buying family health insurance online from ICICI Lombard spells multiple benefits. These include:

Ease and convenience: You can buy the plan in a jiffy at your convenience
No cumbersome paperwork: Provide basic documents to buy the policy without the need for extensive paperwork
Instant policy issuance: Get the policy documents in your email once you make payment to ensure swift coverage
Easy customisation: Customise the policy as per the requirements of your family members
Save on premiums: Get discounts on premiums during online purchases to bring down the cost of buying

What is Covered in ICICI Lombard Health Insurance for Family?

ICICI Lombard’s health insurance for a family offers holistic coverage. These include:

  • Inclusions
  • Exclusions
  • Hospitalisation

    The policy covers hospitalisation expenses incurred for more than 24 hours. These include doctor’s fees, room charges, medical bills, etc.
  • Pre and post hospitalisation

    The policy covers pre- and post-hospitalisation expenses for 60 days and 180 days, respectively, subject to the approval of the in-patient claim.
  • Day care treatments

    The policy covers some day care treatments that require hospitalisation for less than 24 hours, such as chemotherapy, dialysis, and radiotherapy.
  • AYUSH treatment

    The policy covers AYUSH treatment taken in a government hospital or any institute recognised by the government and accredited by the Quality Council of India or the National Accreditation Board on Health.
  • Wellness program

    Get rewarded for adopting a healthy lifestyle, and redeem those wellness points to reduce OPD bills, diagnostic expenses, the cost of medicines, etc.
  • Loyalty bonus

    Provides a 20% increase of the expiring or renewed Annual Sum Insured (whichever is lower) at the end of each policy year, as long as the policy is continuously renewed.
  • Domestic road ambulance

    Get coverage for availing an ambulance service offered by a hospital or an ambulance service provider in an emergency.
  • Claim protector

    Get coverage for items that are not payable as claims provided acceptance of in-patient hospitalisation claims.
  • Restore benefit

    Restore your sum insured up to 100% of the base sum insured to ensure you never run out of cover.
  • Cashless hospitalisation

    Enjoy the benefit of cashless hospitalisation at network and non-network hospitals.
  • Pre-existing diseases

    Get coverage for declared and approved pre-existing diseases at the time of proposal after a waiting period of 2 years.
  • Pre-policy medical check-up

    No medical check-up is required for health coverage below 45 years and a sum insured of up to Rs 10 lakhs.
  • Domiciliary hospitalisation

    Get coverage for domiciliary hospitalisation due to the non-availability of a bed at the hospital or the inability to move to a hospital. Expenses for qualified nurses engaged on the recommendation of the attending medical practitioner are also covered.
  • Domestic air ambulance

    Get covered for air ambulance charges to transfer you to the nearest hospital for emergency care up to the sum insured.
  • Organ donor

    Get reimbursement for organ donor expenses up to sum insured, provided hospitalisation claim for organ donor surgery is accepted.
  • Emergency services

    Get covered for road ambulance expenses for emergency care, virtual or telephonic consultation with a medical practitioner for routine health issues.
  • Co-pay

    No need for copayment on medical bills unless opted for.
  • Lifelong renewability

    Get covered at every stage of life with the provision to renew the policy every year without age restriction.
  • Floater benefit

    Get all family members covered under a single plan by paying only one premium. You can cover self, spouse, dependent children, brothers and sisters.
  • Free-look period

    You can cancel your policy anytime within the free-look period by giving a written notice within 30 days of receiving the policy document.
  • Convalescence benefit

    Get a convalescence benefit, a lump sum of Rs 20,000, once in a policy year. However, you need to be hospitalised for over 10 days to get this benefit.
  • Critical illness cover

    The policy offers coverage for 20 critical ailments with a 30-day survival clause. The cover will be equal to the sum insured or up to Rs 50 lakhs, whichever is lower.
  • Bariatric surgery cover

    Get coverage for bariatric surgery recommended by a doctor for a BMI greater than or equal to 40. After a waiting period of 3 years, coverage is applicable for a person aged 18 or more, capped at 50% of the sum insured.
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    Permanent exclusions

    Permanent exclusions under the policy for which you will not receive coverage include:

  • 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 for the following diseases and ailments are excluded from coverage during the first two years:


  • 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

Go through the policy documents and wording for a complete list of exclusions.

Policy documents: Downloads

ICICI Lombard Health AdvantEdge Insurance policy add-on benefits

You can choose from various add-ons to customise the plan per your family’s needs. Some add-ons you can opt for are as follows:

Why should you buy health policy online

Maternity benefit

Helps cover medical expenses related to childbirth and/or pregnancy termination, reimbursing up to 10% of the annual sum insured with a maximum limit of Rs 1 lakh under maternity sum insured. Applicable for insured females aged 18 and 45 and for three instances.

Sum Insured Protector

Claim protector

With this add-on, you can make claims for all items listed as non-payable by the Insurance Regulatory and Development Authority of India (IRDAI) on policies whose sum insured is less than Rs 15 lakhs.

Sum Insured Protector

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

This add-on allows you to choose a 10% or 20% co-payment in your health insurance claim. Co-payment refers to a certain portion of the payment you opt for from your pocket.

 
Sum Insured Protector

Teleconsultations

This add-on gives you access to unlimited teleconsultations with healthcare professionals 24 hours a day, 7 days a week, via phone, video calls, or any other virtual means, for routine or emergency teleconsultations.

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

Mediclaims are health insurance plans that offer a financial cushion during hospitalisation due to illness or accident. They only cover hospitalisation costs while you've to bear other medical expenses. Mediclaims don't allow you to add any add-ons.

Health insurance plans, on the other hand, offer more comprehensive coverage. With them, you can claim reimbursement for medical costs not only during hospitalisation but also before and after admission and discharge up to a specific number of days, depending on the policy's terms and conditions. Many health insurance plans also cover expenses incurred on OPD treatments, diagnostic tests, medicines and alternative therapies.

Mediclaim vs Health Insurance

The table highlights major differences between a mediclaim and a health insurance plan in various aspects:

Aspect Mediclaim Health Insurance
Coverage offered

Coverage is limited only to hospitalisation expenses and nothing beyond that.

Offers coverage beyond hospitalisation, including pre- and post-hospitalisation expenses, OPD costs, ambulance expenditures, and other medical expenses, among others. Some health insurance plans also offer compensation for lost income.

Sum Insured

The maximum sum insured in a mediclaim policy is generally Rs 5 lakh.

The sum insured offered by health insurance plans is much higher. Today, you can get a health insurance plan providing coverage of up to Rs 1 crore. A higher sum insured widens your financial cushion significantly.

Customisation

Flexibility for customisation is less in mediclaim. In other words, tailoring it as per your needs is difficult.

Health insurance plans offer more flexibility in terms of customisation. You can tailor it as per your needs in terms of the sum insured and add-on covers.

Health Insurance Policy

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Making claims on our family health insurance plans is as easy as clicking a photo. Just:

  • 1

    Intimate us about your claim

  • 2

    We’ll verify your claim once received

  • 3

    Settle the claim after successful verification

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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

A family health insurance plan offers several benefits. Some of them are:

Covers entire family

Covers entire family

You can cover all members of your family through a family health insurance plan. You can cover your spouse, children, parents and even dependent in-laws.

Affordable Premiums

Affordable premiums

A family health insurance plan is more affordable than buying individual plans for every family plan. You just need to pay a single premium to cover all members.

High Coverage

High coverage

A family health insurance offers high coverage to your family members ensuring funds are not a paucity while receiving the best treatment.

Flexibility to add members

Flexibility to add family members

A family health insurance plan allows you to add family members as and when needed as per the policy’s terms and conditions.

Tax benefits

Tax benefits

Premiums paid towards family health insurance plans qualify for tax exemption under section 80D of the Income Tax Act, under the old tax regime.

Save tax with family insurance plans

Save tax with family health insurance plans

As said, you can lower your tax outgo with family health insurance plans. Here’s how:

  • Claim tax deduction against family health insurance premium

    The premium paid for family health insurance towards self, spouse and dependent children (all under 60) is eligible for deduction under section 80D, maximum up to Rs 25,000.

  • Health insurance policy for parents

    If you pay premiums for health insurance for your parents, they, too, are eligible for a tax deduction. If your parents are senior citizens, you can claim a maximum deduction of Rs 50,000 under section 80D.

Things to remember while buying a health insurance for family

Buying health insurance for a family shouldn’t be a rushed decision. Some vital considerations are:

Coverage under family insurance plans

Coverage under family insurance plans

Go through the coverage offered under family plans. Closely evaluate the waiting period, inclusions, exclusions and other add-ons, among others.

Cashless hospitalisation

Cashless hospitalisation

While recent amendments in health insurance make you eligible for cashless hospitalisation across non-network hospitals, it’s a good idea to check the insurer’s network hospitals.

Flexibility in sum-insured

Flexibility in sum insured

With rising medical costs, it’s prudent to avail a health insurance policy that allows you to be flexible and increase the sum insured with time.

Maximum renewal age

Maximum renewal age

Go for a family health insurance plan that offers lifelong renewability. This ensures you remain covered at every life stage.

Claim settlement process

Claim settlement process

Understand the claim settlement process and make sure it’s a smooth one. Also, check the insurer’s claim settlement ratio and opt for an insurer with a high ratio.

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

Buying it is simple and easy. All you need to do is:

Get quote

Get quote

Get a quote by providing basic details like number of family members, their age and contact details.

Pick plan

Pick plan

Choose a plan that best suits your needs.

Pay

Pay

Pay the premium to buy your plan and get coverage.

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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 entry age of the insured is 6 years, however the proposer (Parents/Legal guardian/s) should be at least 18 years of age and the Maximum age 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 calculate the premium for this product?

Please refer the rate chart for checking premium for this policy

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 ICIHLIP25043V052425

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