ICICI Lombard Health AdvantEdge Plan

In 2025, healthcare is not only about paying hospital bills. It is about care and prevention, early diagnosis, new therapies and the proper care at the most crucial time possible. This is just what the ICICI Lombard Health AdvantEdge Plan offers. It is not only a health insurance plan. It is an all-out lifestyle protection program established to cater to individuals who desire optimum welfare and wellness of themselves and their families. It is a wellness-focused yet modern and worldwide-covering product that reinvents what full health protection is.

What is ICICI Lombard Health AdvantEdge Plan?

The Apex Plus Plan is covered under the benefit of Health AdvantEdge premium plans of ICICI Lombard. It has extensive cover of five lakh to three crore and covered with features such as hospitalisation, wellness benefits, coverage of modern treatments, teleconsultation, maternity, newborn care, loyalty bonuses and even cover of global hospitalisation in case of high sum insured.
It is designed to meet the needs of working professionals, families with increasing needs, and to the global citizens seeking an Indian coverage with a worldwide flexibility.

Benefits and features

• Insurance cover of up to 3 crores
• Sum insured exceeding twenty lakh: there is no capping of room rent
• No-cash treatment in all localities of India
• Global cover of plans having sum insured of twenty five lakh and more
• AYUSH inpatient treatment
• Expenses are up to five lakh in terms of surrogate mother and oocyte donor
• Up to one lakh of home care treatment
• Preventive health check-up to a ten thousand yearly
• The facility to reset benefit an unlimited number of times in a year
• Convalescence benefit—-twenty thousand
• Unlimited teleconsultation using mobile application
• Pay coverage of domestic air ambulance and transportation by road ambulance
• Loyalty bonus (20 per cent per year with no claim, to 100 per cent)
  Pro Tip: Choose this plan if you want a whole plan that provides complete protection with no co-pay hassle.

Coverage Summary (Based on Brochure)

Wellness and Preventive Care Benefits

The program comprises a comprehensive wellness program which promotes healthy lifestyle and incentives good behavior. You can accumulate wellness points by being healthy, consuming services with the IL TakeCare app and engaging in preventive care services. They can be spent on medicines, diagnostics, or a visit to a doctor.
Also included:

• Mobile app with no restrictions to teleconsultation
• Up to ten-thousand worth annual health check-ups
• Medical equipment and supplements discounts, labs tests
• Helpline on how to utilize the help of ambulances

Loyalty Bonus and Reset

This is a plan that is characterized with a rich reset benefit. Once you have used your sum insured, when claiming, the sum insured is replaced again to use in future unrelated claims on the same year. It is a no limitation or annual reset feature available on any plan except five lakh and seven point five lakh plan where reset is possible once in a year.
When you go without a claim, Loyalty Bonus will add twenty percent to your sum insured, by the end of the bonus period, it can add one hundred percent. There is no reduction of your bonus unlike some of the policies even in case you make a claim.

Inclusions

• Hospitalization of any sickness or injury
• AYUSH and higher treatment measures
• Complications of surrogate and oocyte donors
• Home treatment and domiciliary care
• Costs of organ donor
• Air and road ambulance
• Day cares surgeries
• Preventive check-up annual check-up
• Home convalesence and nursing
• Teleconsultation without limits
• Maternity, child birth, vaccination and serious illness cover where chosen
• Qualifying sum insured coverage throughout the world, including hospitalisation
• Integration of wellness services and app
• Personal accident and claim protector (voluntary)
• Tax benefit through the Income Tax Act of 1961 Section 80D

Optional Benefits

You get to customize your plan by going with add-ons:

• Maternity allowance of maximum lakh
• New born baby exceeds the maternity cover twofold
• Newborn immunization to ten thousand
• An event coverage up to fifty lakh
• Cover of personal accidents up to fifty lakh
• Domestic nursing, up to two thousand a day
• Compassionate visit takes into consideration up to twenty thousand
  Sum insured protector
• Claim protector add-on (built-in at 15 lakh and above sum insured)

Case Study Sneha (34 years), marketing manager, Mumbai, acquired maternity and newborn cover to her Apex Plus Plan. By the time her second child was born in 2024 the cost of hospitalization had come up to over one lakh, and not only was it covered under the plan, the baby was given the required vaccinations.

Exclusions

There are a couple of exclusions just like any other plan:

• Initial thirty days treatment excluding accidents
• Critical ill treatment under first ninety days
• Pre-existing and specific conditions have 2-years waiting period
• Cataract, piles, hernia, sinusitis and joint replacements are not covered in the initial 2 years
• No coverage of dental, cosmetic and fertility treatments
• Cost relating to malicious self-harm or drug abuse
• Over-the-counter medication products
• Out-of-region treatment when not included in a global plan

Waiting Periods

• Waiting period: thirty days
• Specific condition waiting period: two years
• Waittig period - pre-existing disease: two years
• Waiting period on maternity: two years
• Waiting time on critical illness: ninety days
• Critical illness claims have no survival period
• Diabetes and hypertension and heart issues: ninety days except when pre-existing is already declared

How to Cancel the Policy?

ICICI Lombard provides a standard procedure if you wish to terminate your plan:

• A fifteen-day free-look period with a complete refund
• You can cancel by calling customer service or sending an email with your policy details
• .Refunds are normally processed within seven to ten working days. -
• If a claim is made, the refund will be adjusted appropriately.
• Refunds are then processed based on the unused policy duration.
  Note: To maintain continuity benefits, always review portability options prior to cancelling.

How to buy ICICI Lombard ICICI Lombard and Apex Plus Through Fincover?

1. Go to the Fincover website and choose Health Insurance.
2. To choose ICICI Lombard and Apex Plus, use filters.
3. Type in your information, the amount insured, and any necessary optional coverages.
4. Examine coverage scope, add-ons, and premiums.
5. Choose your plan and make a secure online payment.
6. Receive your e-policy by email right away.
7. Use the app to monitor claims, wellness points, and renewals.

Real Example

Using Fincover, Ramesh from Bengaluru purchased the plan for his family of four. He selected a twenty-lakh sum that was paid for with EMIs and covered by maternity and critical illness add-ons. From quote to policy confirmation, the digital process only took fifteen minutes.

FAQ on What Is the ICICI Lombard Health AdvantEdge Plan

Is worldwide coverage offered by this plan?
Yes, after a two-year waiting period, plans with a sum insured of at least 25 lakh are eligible for worldwide coverage.

How often can I use the reset benefit, and what is it?
For unrelated illnesses, reset enables full sum insured restoration. With the exception of the five and seven point five lakh sum insured options, which are only permitted once a year, it can be used an unlimited number of times for all plans.

Are maternity and newborn costs covered by this plan?
Yes, but only if you choose to add the maternity option. It includes first-year vaccinations, hospitalization of the newborn, and delivery

How does the system of wellness points operate?
Using the IL TakeCare app and maintaining your health earns you points. These can be exchanged for medications, diagnostic tests, and doctor visits.

Are there any sublimits or copayments?
Unless you choose it as an optional discount, there is no need for a copayment. There are no restrictions on certain diseases or room rent.