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Health Insurance Plans

Health Insurance Plans

A health insurance plan is your most effective guard against rising medical costs. It covers hospitalisation costs and pre-and-post hospitalisation expenses per the policy’s terms and conditions. Buying comprehensive health insurance not only saves out-of-pocket expenses but also ensures other crucial commitments don’t take a hit. It also helps you save taxes under section 80D of the Income Tax Act, 1961, under the old tax regime.

Anywhere Cashless Hospitalisation with ICICI Lombard Health Policy

With our health insurance plans, you can experience the convenience of cashless hospitalisation wherever you are. You don't have to worry about arranging money upfront during a medical emergency.

Simply visit any hospital, network or non-network to avail yourself of cashless hospitalisation. We will settle the bill on your behalf and send it directly to the hospital. Our cashless facility allows you to focus on what truly matters—your health and ensures you receive quality care on time. Be it a planned hospitalisation or an emergency, our cashless feature has you covered.

Anywhere Cashless Hospitalisation with ICICI Lombard Health Insurance Policy

What are the benefits of buying a health insurance policy?

A health insurance plan offers these benefits:

1

Financial protection during medical emergencies

Health insurance aid in covering the costs of medical treatments, hospital stays, and surgeries. Without it, these expenses can significantly burn a hole in your pocket. Health insurance lets you focus on getting better without worrying about high medical expenses.

2

Coverage for pre and post-hospitalisation expenses

Several health insurance plans help cover pre- and post-hospitalisation expenses up to a certain number of days. This offers an extra layer of financial protection and prevents a dip in savings.

3

Preventive care and regular check-ups

Many health insurance plans offer preventive care coverage, including regular health check-ups and screenings. These can aid in detecting potential health issues early, thus ensuring timely treatment and potentially better health outcomes.

4

Tax benefits

Under Section 80D of the Income Tax Act, you can claim tax deductions on the premiums paid for health insurance policies. This lowers your tax outgo.

5

Peace of mind

Health insurance offers peace of mind, knowing that you are financially protected in case of a medical emergency. This can bring down stress and help you focus on your well-being and family.

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

ICICI Lombard offers various health insurance plans, such as:

Elevate Includes BeFit Rider

The Elevate policy is characterised by flexibility in sum insured, a range of add-on covers, reward points for healthy habits, maternity benefit cover, coverage for donor expenses, and personal accident cover, among other features.

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MaxProtect Includes BeFit Rider

Offering a sum insured of up to ₹1 crore, MaxProtect's extensive coverage ensures you remain adequately cushioned in the event of a medical contingency. It also offers worldwide coverage and unlimited sum insured reset benefits.

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Health Booster Includes BeFit Rider

A super top-up health insurance plan, Health Booster covers you when your basic insurance plan falls short. Cost-effective, it offers flexible deductible options and attractive discounts on two—and three-year policies.

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Health AdvantEdge Includes BeFit Rider

Offering all-around wellness and preventive care benefits, Health AdvantEdge offers pre-existing disease coverage flexibility, additional coverage for 20 critical illnesses, a loyalty bonus, health rewards, and more.

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Arogya Sanjeevani Policy BeFit Rider - Coming soon

Offering basic coverage at affordable premiums, the Arogya Sanjeevani Policy helps you secure basic health care needs. It enables you to cover your family members and provides coverage for pre and post-hospitalisation, daycare procedures, emergency ambulance, etc.

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Health Insurance Befit Cover

What is Befit Cover?

The Befit cover offers you access to OPD services, including doctor, consultation, pharmacy, diagnostics services, etc., on a cashless basis. It also covers minor procedures that don't require hospitalisation. The Befit cover offers you 360-degree support as per your needs.

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

Our health insurance plans bring these benefits to the table:

A range of network hospitals

We offer a vast network of hospitals, ensuring that you have easy access to top-notch healthcare services whenever needed. We have 10,800+ health care providers for hassle-free service.

Unlimited reset benefit

Several of our plans offer unlimited reset benefit(s). This ensures you never run out of cover if you get hospitalised more than once during the policy tenure.

Reward points for wellness activities

Our plans reward you for undertaking wellness activities. You get reward points which you can use to get discounts on plans or bring down expenses incurred on medicines, doctor’s consultation, diagnostic tests, etc.

Coverage for domiciliary hospitalisation

Many of our plans offer coverage for domiciliary hospitalisation should the need arise. Domiciliary hospitalisation means treatment at home because a hospital room is not available or for any other reason.

Hassle-free claim settlement

We offer hassle-free claim settlement with our in-house team, which is available 24/7. You can contact our team anytime with your claims or queries, and our team will address everything promptly.

Health Insurance Claims

Easy health insurance claims

We settle your health insurance claims in a jiffy. All you need to do is:

  • 1

    Inform us about your claims through any of our channels

  • 2

    Provide us with the required documents for verification

  • 3

    Upon successful verification, we settle the claim amount directly to your bank account

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

Keep in mind these things while choosing a suitable health insurance plan:

Evaluate the coverage needed

Evaluate the coverage you need and choose a plan accordingly. If you need basic coverage with not a high, very high sum insured, you can opt for Arogya Sanjeevani Policy. You can go for either MaxProtect or Health AdvantEdge if you need high coverage.

Requirement for add-ons

Add-ons help you strengthen your coverage further. See if you want add-ons added to your base policy and customise it according to your needs. Several of our plans, like Health AdvantEdge and Health Booster, allow you to add add-ons.

Policy inclusions and exclusions

Go through policy inclusions and exclusions carefully and pick up the plan that you are most comfortable with. Most importantly, choose a plan that best aligns with your health needs.

Compare ICICI Lombard health insurance plans

The table below will help you compare our health insurance plans on several parameters:

Parameters Elevate MaxProtect Health
Booster
Health
AdvantEdge
Arogya
Sanjeevani
Hospitalisation
Pre Hospitalisation
Post Hospitalisation
AYUSH Treatment
Day Care Treatment
Home Health Care
Emergency Ambulance
Donor Expenses
Reset Benefit
Maternity Cover -

What is the need for a health insurance plan?

  • Health insurance helps in protecting your savings in case of a medical emergency.

  • Health insurance covers the cost of treatment for illness due to medical conditions, including lifestyle diseases such as diabetes, hypertension and obesity.

  • Employer provided health insurance may not provide adequate coverage. You’ll still need to buy health insurance plans to supplement them.

  • When you buy health insurance, you can avail tax benefit under section 80D.

What are Fixed Benefit Health Insurance Plans?

  • As the name suggests, a fixed benefit health insurance plan offers a fixed amount for hospitalisation, irrespective of the expenses incurred. You can use the pay-out received to settle medical bills and manage recovery expenses, among others. These plans generally offer a lump sum payment upon which the policy gets terminated.

What is covered by ICICI Lombard Health insurance policy?

While the specifics may differ across plans, our plans cover:

Hospitalisation expenses

Pre-and-post hospitalisation costs

Ayush treatment

Day care and home care treatments

Donor expenses

Costs for emergency ambulance

For the complete list of inclusions and exclusions, please read the policy wording here.

Key factors to consider before buying health insurance plans

Key factors to consider before buying health insurance plans

Consider these vital factors before buying health insurance plans:

  • Choose a plan covering various medical expenses

  • Opt for a sum insured aligning with your healthcare needs

  • Ensure the insurer has a wide network of hospitals for cashless treatment

  • Be aware of the waiting period for pre-existing conditions and specific treatments

  • Understand any co-payment or deductible clauses where you share a portion of the medical expenses

  • Check the insurer's claim settlement ratio, which indicates the percentage of claims settled

  • Carefully read the policy's exclusions to know what is not covered

  • Compare premiums across plans, but don't compromise on coverage

Does your health insurance policy cover coronavirus treatment?

  • Yes, your existing health insurance policy will cover the costs of coronavirus treatment. Depending on the policy’s terms and conditions, it can also cover pre- and post-hospitalisation expenses.

Why compare health insurance plans online?

Online comparison of health insurance plans helps you:

  • View different plans side by side and evaluate their premiums, benefits and coverage

  • Identify features that might be important for you

  • Make a more informed decision and choose a policy that balances coverage and cost

How to buy health insurance online?

To buy health insurance online:

  • 1

    Explore the health insurance policies here

  • 2

    Choose the plan that best fits your needs

  • 3

    Fill up personal information like your name, age, contact details and medical history, among others

  • 4

    Pay the said premium through the payment section

  • 5

    Upon payment, you will receive the policy soft copy on your email

Difference between mediclaim and health insurance

The table captures the differences between mediclaim and health insurance on several parameters:

Aspect Mediclaim Health Insurance
Coverage offered Coverage is limited only to hospitalisation expenses and nothing beyond. 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.
Add-on Covers Non-availability of add-on covers limits the scope of a mediclaim policy. Add-on covers enhance the scope of coverage and have their individual sum insured on top of the coverage provided by the base policy. Health insurance plans offer various add-ons that you can opt for. Some of these include critical illness, personal accident, maternity cover, etc. Opting for these add-ons further enhances coverage. However, you need to pay some additional premiums to add them to your base policy.
Sum Insured The maximum sum insured in a mediclaim policy is generally ₹ 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 ₹ 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 are more flexible in terms of customisation. You can tailor it as per your needs in terms of the sum insured and add-on covers.
Why to choose ICICI Lombard's Health Insurance Policy?

Why choose ICICI Lombard Health
Insurance Plans?

Choosing ICICI Lombard’s Health Insurance plans offers you the following benefits:

  • Choose from a range of plans as per your requirements

  • Adequate sum insured to take care of your medical expenses

  • Wide range of coverage

  • Multiple add-ons to choose from

  • Easy customisation

  • Hassle-free buying

  • Quick claim settlement

How to save tax with a health insurance policy?

Premiums paid towards health insurance qualify for tax exemption under section 80(D) of the Income Tax Act under the old tax regime:

Premiums Paid For Maximum Tax Exemption
Self and family (all below 60 years) ₹ 25,000
Self and family + parents (all below 60 years) ₹ 50,000
Self and family (below 60 years) + parents above 60 years ₹ 75,000
Self and family + parents (all above 60 years) ₹ 1 lakh

You can claim tax exemption while filing your income tax returns.

Which health insurance plan is ideal for you?

Here’s a short guide that will help you choose the right health insurance plan:

  • Individual health insurance plan if you want coverage for yourself

  • Family floater health insurance plan if you want coverage for the entire family

  • Critical illness insurance plan if you seek to cover yourself against critical ailments like cancer, kidney failure

  • Top-up health insurance plan if you want to enhance your existing health coverage at a cost-effective price point

Why buy health insurance online?

Buying health insurance online allows you to:

  • Compare multiple policies and purchase the one that meets your requirements at your comfort

  • Buy the policy instantly with minimal paperwork

  • Get discounts as there are no intermediaries

  • Compare different policies and their features

Why buy health insurance plan at an early age?

Buying health insurance at an early age gives you the benefits of:

  • Lower premiums:

    Health insurance premiums are generally lower when you are young and healthy. This helps you save money.

  • Easy management of waiting periods:

    Buying early helps you complete waiting periods for specific illnesses before you might need them.

  • Comprehensive coverage:

    When you are younger and without pre-existing health conditions, you can secure comprehensive coverage with fewer exclusions.

What are optional add-ons in health insurance?

Optional add-ons give you extra benefits up and above your base policy. While they command an additional premium, they can be quite handy. Some common optional add-ons are:

Critical illness cover

Critical illness cover, which offers a lump sum payout if diagnosed with any critical ailment as mentioned in the policy.

Hospital cash cover

Hospital cash cover, which provides a fixed daily allowance for each day of hospitalisation

Donor expense cover

Room rent waiver cover, which removes capping on room rent

Convalescence benefit cover

OPD cover, which covers OPD expenses like doctor consultation, diagnostic tests, etc

Eligibility Criteria for Health Insurance Policy

What is the health insurance eligibility criteria?

Health insurance eligibility criteria spell out the eligibility you must meet for health insurance coverage. They generally cover:

  • Age, where insurers set the minimum and maximum age limit

  • Pre-existing medical conditions where certain ailments can lead to higher premiums

  • Maximum size of a family for family floater plans

  • The requirement for undergoing medical tests or not

Every policy has its eligibility criteria, and therefore, it’s crucial to check them before applying.

How to calculate health insurance premiums?

You can take help of health insurance premium calculator to calculate your health insurance premiums. Most calculators will ask for these details while calculating premiums:

  • Your age

    The lower the age, the lower the premiums.

  • Type of coverage

    The premium amount will depend on whether you want to buy an individual plan, a critical illness plan or a family floater plan.

  • Sum insured

    The higher the sum insured, the higher the premium.

  • Add-on riders

    Premiums increase if you opt for add-on riders.


You can also refer the rate chart for other products by clicking on the following link and give commands for Health Insurance Products - Rate Chart

What are the factors that affect health insurance premiums?

Factors affecting health insurance premiums are:

  • Age

    The higher the age, the higher the premium.

  • Lifestyle habits

    Smoking, drinking, and any such habit will increase the premium.

  • Location

    Premiums can vary depending on healthcare costs incurred in your area of residence.

  • Medical history

    Pre-existing conditions can increase the premium amount.

What is the procedure for health insurance claims?

For making health insurance claims:

  • 1

    Contact ICICI Lombard to inform about your claim

  • 2

    Fill up the claims settlement form and provide all the necessary documents like hospital bills, reports, doctor’s prescriptions, etc

  • 3

    Post successful verification, the insurer will settle the claim amount

Documents required for health insurance claim reimbursement

Documents required for health insurance claim reimbursement

The required documents are:

  • A duly filled claims form

  • Doctor’s prescription that mentions hospitalisation, diagnostic tests and medicines

  • Invoice of pharmacy bills

  • Policy documents

Check with your insurer if any additional documents are needed.

How to renew health insurance online?

To renew health insurance online:

  • 1

    Visit your insurer’s website and check for a specific renewal page

  • 2

    Enter your policy number and mobile number

  • 3

    Follow the appearing instructions to renew in a few clicks

 

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Frequently asked questions on health insurance

  • 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 36 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 Health AdvantEdge 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.

Which health insurance policy is ideal?

If you have a family, you should choose a family floater health insurance over an individual health plan. It not only protects your entire family but also helps you save a lot on premiums.

What is the advantage of health insurance?

Health insurance plans provide cover for unexpected medical expenses. It covers an array of costs incurred on daycare procedures, hospitalisation, ambulance and domiciliary hospitalisation. Apart from this, you can also get tax benefits on your health insurance policy.

Can a person have more than one health insurance policy?

Yes, you can buy multiple health insurance policies to cover your medical costs. If one insurer rejects your claim, there is still a chance that others may accept as per its terms and conditions.

What is the right age to buy a health insurance policy?

It is recommended that you obtain a health insurance policy as soon as possible. Purchasing insurance at a young age allows you to earn an additional sum insured for every claim-free year under your policy. And as you get older, you will be able to accumulate higher and better coverage.

What to do if I am admitted to a non-network hospital?

If you get admitted to a non-network hospital, you have to pay for the medical treatment costs out of your pocket. Post-discharge, you can submit all the relevant documents such as medical bills and ambulance receipts for the reimbursement claim. Post verification, the claim amount will be transferred to your bank account.

Will my existing health insurance policy cover hospitalisation expenses on account of COVID-19?

Yes, hospitalisation expenses on account of COVID-19 will be covered under the policy in accordance with the policy terms and conditions.

How can I intimate my claim after hospitalisation?

You can intimate a claim by calling us on 1800 2666 (toll-free) or using our mobile app, IL Take Care. Scanned copies or photographs of all claim related documents can be uploaded in the app.

Further, the Insured is required to furnish/courier hard copies of all requisite claim documents at his/ her own expense 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 your policy has an outpatient treatment cover, then waiting periods are not applicable. A claim under outpatient treatment cover can be made in accordance with the claims procedure mentioned in the policy wordings.

In case of hospitalisation on account of COVID-19, the hospitalisation expenses incurred will be covered provided the illness is contracted after completion of 15 days in case of a fresh policy. In case of a policy that has been renewed continuously without a break or in case of policies that have been ported in to ICICI Lombard, the 15 day condition will not be applicable.

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 paid under the policy, then all expenses related to COVID-19 incurred on account of consultations with a medical practitioner and diagnostic tests as advised by a medical practitioner in the 30 day period prior to date of admission and 60 day period after date of discharge will be covered in accordance with the policy terms and conditions.

Why should I port to ICICI Lombard health insurance?

  • High health claim settlement record
  • Option of Anywhere Cashless hospitalisation

How can I port?

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