Health AdvantEdge

Choose an annual sum insured on an individual or floater basis. It is the most the base policy pays in one policy year, and you can take a 1, 2 or 3-year term.

If earlier claims in a policy year leave the annual sum insured, with any bonus, too low, ICICI Lombard resets up to 100% of the annual sum insured for later claims. On covers of ₹10 lakh and above it can trigger unlimited times in a year.

At the end of each policy year ICICI Lombard credits 20% of the expiring or renewed annual sum insured, whichever is lower, as long as the policy is renewed continuously. It is credited whether or not you claimed in that year, and the total cannot go above 100% of the annual sum insured.

Inpatient treatment covers room rent, ICU charges, nursing, doctor fees, anaesthesia, blood, oxygen, operation theatre charges, medicines, consumables not on the excluded list, surgical appliances and prosthetic devices used during surgery, and investigations linked to the admission. Room cover is a single private room up to a ₹20 lakh sum insured, and any room above ₹20 lakh.

Day care procedures that need less than 24 hours in hospital are covered up to the sum insured, including chemotherapy, radiotherapy and dialysis. Twelve listed modern treatments are covered up to the sum insured: uterine artery embolisation and HIFU, monoclonal antibody immunotherapy, laser prostate vaporisation, stem cell therapy for bone marrow transplant, balloon sinuplasty, oral chemotherapy, robotic surgery, stereotactic radiosurgery, deep brain stimulation, intravitreal injections, bronchial thermoplasty and intra-operative neuro monitoring.

Relevant medical costs are covered for 60 days before admission and 180 days after discharge, once the inpatient, day care or AYUSH claim is accepted. Post-hospitalisation includes physiotherapy advised in writing.

Inpatient treatment under Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy is covered up to the sum insured when it is taken at an AYUSH hospital or AYUSH day care centre.

Treatment taken at home on a doctor's written advice is covered up to the sum insured if it continues for at least 3 consecutive days and you cannot be moved to a hospital, or no hospital room is available.

Treatment at home on a doctor's written advice is covered up to 5% of the sum insured, with a maximum of ₹1 lakh. It includes tests done at home, prescribed medicines, doctor consultations and nursing if advised.

The donor's hospitalisation costs for harvesting an organ donated to you are covered up to the sum insured, when your own inpatient claim is accepted.

Road ambulance to the nearest suitable hospital is covered at 1% of the sum insured up to ₹10,000 on reimbursement, and at actuals when a provider is used on a cashless basis. Domestic air ambulance is covered up to the sum insured.

If you are hospitalised for 10 continuous days or more for an admissible claim, ICICI Lombard pays a fixed ₹20,000, once in a policy year.

Weight-loss surgery is covered up to the sum insured for adults aged 18 or above with a BMI of 40 or more, or 35 or more together with obesity-related cardiomyopathy, coronary heart disease, severe sleep apnoea or uncontrolled type 2 diabetes, after less invasive methods have failed.

Each insured adult can take one cashless preventive check-up a policy year, up to 0.5% of the sum insured with a maximum of ₹10,000, at network providers through a pre-designed package.

Unlimited teleconsultations with qualified doctors, 24 hours a day, 365 days a year, by audio, video, chat or the ICICI Lombard app.

Outpatient vaccination after an animal bite is covered up to ₹10,000.

Inpatient treatment for complications of a surrogate mother appointed by the intending couple or woman is covered up to ₹5 lakh, and so are complications of an oocyte donor after retrieval, up to ₹5 lakh.

Once an inpatient or day care claim is accepted, items on IRDAI's non-payable list, such as gloves and masks, become payable. It is built into the base plan from a ₹15 lakh sum insured.

Planned treatment as well as emergency treatment abroad is covered on sum insured options of ₹25 lakh and above.

Adult insured persons, up to 2 on a floater, earn wellness points for onboarding on the app, a health risk assessment, medical records in the vault, teleconsultations, step targets, fitness challenges and health events. Each point is worth ₹0.25 and a person can earn up to 6,000 points.

A Health Assistance Team helps you find doctors and hospital beds, book second opinions, arrange cashless requests, order medicines and plan post-hospital care. ICICI Lombard also facilitates ground ambulance transport in listed cities and discounts on tests, medicines and homecare through the app.

You pay the premium for your city of residence without a zone-based co-payment on claims elsewhere. ICICI Lombard lists a 2.5% discount if all adult members have had the pneumococcal vaccine, up to 15% depending on the proposer's credit score, and 10% on the 2nd year and 15% on the 3rd year premium of a multi-year term.