Bharti AXA General Insurance is now part of ICICI Lombard General Insurance.

Bharti AXA General Insurance is now part of ICICI Lombard General Insurance.

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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 plan 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 includes maternity insurance for both mother and the newborn baby.

Top reason to buy ICICI Lombard Health AdvantEdge policy

Restore benefit for sum insured No-claim bonus
24x7 video/telephone consultation Hospital daily cash*
Pharmacy and lab tests cover Health rewards
Pre-existing disease cover Domiciliary hospitalization
Domestic Air Ambulance Personal accident
Maternity cover New born baby and vaccine cover
Bariatric surgery cover OPD cover: Medical and Dental

Why do you need to purchase Health AdvantEdge policy?

Many people often suffer through curable illnesses due to a lack of financial resources. Some meet the spurting expenses by losing their savings and possessions; especially when they don’t have a critical illness insurance.. With rising healthcare costs and the sudden onset of diseases, health insurance has become a necessity even for the fittest individuals.

From the youngest to oldest member of our society, everyone deserves access to good quality medical resources. Health insurance is the financial backup that helps millions of Indians every day from going bankrupt during medical emergencies.

4 reasons to buy health insurance

  • Changing lifestyle

    Modern lifestyle has made us prone to multiple health disorders. Pollution, low food quality, bad eating habits, hectic work schedules, and extensive commutes affect people in every age group.
  • Income tax benefit

    Premium amount for health insurance up to ₹75,000, is eligible for tax deductions under section 80D of the Indian Income Tax Act,1961.
  • Coverage of pre and post hospitalization expenses

    Covering a person at all stages of their healthcare needs ensures that you or your loved one gets the right treatment without worrying about the bills.
  • Additional benefits

    The plan offers a plethora of add-on benefits like maternity cover, personal accident cover, air ambulance, and value-added services like 24x7 online and telephonic consultations, wellness programs, and much more.

Who needs Health AdvantEdge plan?

Healthcare needs of both an individual and a family are important, regardless of age and fitness status. It’s always a good idea to be ready for a rainy day! With the right insurance plan, you ensure your financial security without compromising on the healthcare needs of yourself or your loved ones.

No matter your current life stage, investing in health insurance is especially important if you are -

1 Young entrepreneur or a salaried person

2 Recently married

3 People with children

4 People with aging parents

5 People on the verge of retirement

Is your family protected?

Family floater health insurance plans cover the entire family on a single premium. You can cover your spouse, children, dependent parents. The premium amount is affordable and is better than buying individual plans for each member. The sum insured is for all the members in the policy regardless of their age. This one-time investment means that you can avail excellent health care facilities when your family needs it the most. A medical emergency within the family is already tough, and to not be able to afford it without insurance is tougher.

What’s covered?

Plan Prime Plus, Royal Plus, Apex Plus
Sum Insured 3/4 Lacs 5/7.5/10/15/20/25/30/40/50 Lacs In-75/100/150/200/300 Lacs
Hospitalization
In-patient treatment
Doctor's fees
Diagnostic tests
Medicines, drugs, and consumables
Nursing charges
IV fluids, blood transfusions, injections, administration charges
Operation theatre charges
Prosthetics & Other devices or equipment if implanted internally during a Surgical Operation
ICU Charges
Hospital accomodation
Basic
Pre & post hospitalization
AYUSH treatment
Day care Procedure
Organ donor expenses
Surface ambulance
Animal bite (vaccination)
Restore benefit
Guaranteed cumulative bonus
Wellness & valued added services
0% copay
Sum insured protector & Claim protector
Other
Home care treatment
Domestic air ambulance
Critical illness cover
Personal accident
Domiciliary hospitalization
Health checkup
Convalescence benefits
Pre-existing disease cover
Optional
Maternity covered plan
New born baby and vaccination covered plan
OPD covered plan
Bariatric surgery covered plan
World-wide cover For sum insured above 10 lacs in Royal Plus and above 25 lacs in Apex Plus
Expand

Value-added services of Health AdvantEdge plan

24x7 e-Consultation, telephonic
consultation, online chat

Health
rewards

Medical condition
management

Pharmacy and
diagnostics

Doctor
appointment

Medical second
opinion

Doctor on
call

What’s included and what’s not?

  • 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 30 days prior and 60 days post hospitalization in base plans, and 60 days prior and 90 days post hospitalization in PLUS plans (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 claim 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.
  • 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.
  • Additional sum insured protector

    No effect on the additional sum insured that you have earned over the years if you happen to make claims that are up to ₹50,000 in the previous policy year.
  • 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. In specific cases, it could be increased to 3-4 years or reduced to 1 year. In case of SI reset exclusion shall apply afresh to extend of SI
  • 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.
  • Emergency ambulance

    Available annually, starts from 1st year, up to 0.5% of sum insured, to a max of ₹10,000.
  • 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
  • Air ambulance cover

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

    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.
  • Lifelong renewability

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

    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.
  • Additional sum insured protector

    Floater cover to get family (self, spouse, dependent parents, dependent children, brothers and sisters) covered for the same sum insured under a single policy by paying one premium amount. Any individual above 3 months of age and up to 60 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 Rs.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. 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.
Read more
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.
  • 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 years.

  • 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.
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Frequently asked questions

  • 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 will cover one or more members of your family. They can be your legally wedded spouse, dependent parents and parents-in-law, and dependent children in the age group of 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 hospitalization, day care, domiciliary hospitalization, critical illness cover, and more. It also has value-added services. With a plan of sum insured Rs.5 lakh or above, the policy also provides maternity insurance and newborn baby insurance.

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 member in the policy. So, if the total sum insured is ₹10 lakh, and member 1 makes a claim of ₹3 lakh, ₹7 lakh will be the available sum insured amount for the remaining members in the plan.

What is the age limit for taking this policy?

The minimum age 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 insurance to any ICICI Lombard plan, please provide your application and a duly filled portability form along with your previous policy documents. Kindly share these at least 45 days before the renewal date of your existing policy.

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

The base coverage is in-built in the policy. The add-ons are optional; you can add them to the policy by paying a small additional premium to enhance the coverage.

How much premium qualifies for tax benefits?

With Income Tax benefits under Sec 80D, you can claim tax deduction up to a maximum of ₹25,000 when you purchase policy for self, or spouse, or children. For dependent parents aged 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 6700+ network hospitals where you can avail cashless facilities. If your treating hospital is not a network hospital, you can claim reimbursement.

Is overseas treatment for an illness covered?

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

Will ICICI Lombard Health AdvantEdge Insurance pay for maternity expenses?

With Royal or Apex plan in Health AdvantEdge product, you can avail maternity benefit and newborn coverage.

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

Yes. Covid-19 related hospitalization 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 assesse, spouse, dependent children and parents (whether dependent or not):
Scenario Medical Insurance paid for self, spouse and dependent children (in ₹) Medical Insurance paid for parents (whether dependent or not) (in ₹) Total deduction under section 80D (in ₹
All are under the age of 60 years 25,000 25,000 50,000
Assessee and family are under the age of 60 years 25,000 50,000 75,000
Parents are above the age of 60 years 25,000 50,000 75,000
Assessee and parents have attained or are above the age of 60 years 50,000 50,000 1,00,000

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 intimate my claim for ICICI Lombard Health AdvantEdge Insurance after hospitalization?

During hospitalization, you need to intimate us. Post hospitalization, you can claim reimbursement
of the expense. To intimate or claim, you can choose any of the following ways:

Whom do I call at the time of emergency hospitalization?

You can contact us on our toll-free number 1800 2666 or SMS "HEALTHCLAIM" to 575758 to receive a call back. To avail cashless service, use the health card at any network hospital.
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 offers 0% copay. You can choose to opt for 10% and 20%.

What do I do if my claim is rejected?

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

What are the sum insured options provided under ICICI Lombard Health AdvantEdge Insurance?

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

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

How can I add my family members to the existing policy?

You can add family members to your existing health insurance policy for the family at the time of renewal. You can initiate this process by visiting the ICICI Lombard website. However, keep in mind that except for a newborn, you cannot add dependants in the middle of your insurance plan.

What is the tenure for ICICI Lombard Health AdvantEdge policy?

Each policy period is 1 calendar year from the date of purchase.

Do I need to undergo 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 your age is 45 years or above. Your medical examination will be done at our designated diagnostic centers. We will return the cost incurred for the test in case your proposal for Arogya Sanjeevani Policy, ICICI Lombard, 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. 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 ICIHLIP22206V022122

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