Overview
Health AdvantEdge by ICICI Lombard is a well-balanced, modern health plan offering coverage from ₹5lakh to ₹3 crore. It covers hospitalisation, day care, AYUSH, organ donor costs, and even bariatric surgery. You can personalise it with add-ons like maternity, newborn care, air ambulance, and OPD for medical and dental needs. The plan includes wellness rewards, teleconsultations, free health check-ups, digital health tools, global hospitalisation as in-built features. Claims are easy to manage, and your sum insured can grow through cumulative bonuses and restoration. It’s a flexible, future-ready option for families or individuals looking for solid, scalable coverage.
Experts Review
Written by Nikhil Nair
Senior Writer
Health AdvantEdge by ICICI Lombard is a solid, future-ready health plan that works well for individuals, parents, or families. The base plan covers hospitalisation, day care procedures, AYUSH treatments, organ donor expenses, and pre and post-hospitalisation bills. It also includes free annual check-ups, ambulance charges, and a restore benefit that recharges your sum insured if it's used up during the policy year.
One of the biggest strengths is its flexibility. You can add maternity, newborn, and child vaccination cover if you're starting a family, or choose global treatment and air ambulance support if you travel frequently. The OPD add-on helps you claim routine medical and dental bills, and extras like hospital cash, personal accident cover, and critical illness payouts let you tailor the plan to your life stage and risk appetite.
Room rent terms are transparent: single private room for sum insured up to ₹20 lakhs, no capping if sum insured goes beyond that amount. Depending on your chosen sum insured, you get fixed This clarity at the outset helps avoid claim-time surprises. The wellness ecosystem is also well thought out. You earn rewards for healthy habits, which can be used for premium discounts, and get access to doctor-on-call, online consults, and wellness coaching as standard services.
On the flip side, there are 2-year waiting periods for maternity and pre-existing conditions, which is quite good. But there are no rider/add-on options to reduce it further. Nursing at home, and non-medical charges are excluded unless added through riders.
Pros
Offers a wide range of features.
Premiums are relatively well priced.
Insurer has a solid track record with great claim and service metrics.
Cons
Maternity benefits not offered, which is a notable gap. Need to opt add-on for maternity cover.
Doctor consultations are not covered, which could be a drawback for some. Need to opt add-on for doctor consultations.
ICICI Lombard
Key Insights
Founded
2001
ICICI Lombard was established 24 years ago and has built strong credibility over time, backed by its long-standing presence in the market.
Claims Experience
85% claims settled in 30 Days
ICICI Lombard settles only 85% of claims it receives, which is relatively low and may raise concerns about reliability during claim payouts.
Network Hospitals
10,200+
ICICI Lombard maintains a moderate network of 10,200 hospitals, offering reasonable coverage across key locations.
Complaints
11 complaints per 10,000 claims registered
ICICI Lombard experiences a moderate number of complaints, indicating room for improvement in addressing customer concerns.
Features
All
Great
Co-payment
The insurer will bear the entire cost of treatment (up to the sum insured). You won’t have to pay a single penny. Meaning this policy has no co-payment.
Room Rent
Shared room, single room, deluxe room or any room that’s available. The insurer won’t nitpick on your choice of room since the policy has no restrictions on room rent.
Disease sub-limit
No funny business here. If your insurer hasn’t explicitly stated they won’t cover a certain illness, you can claim the full amount up to the sum insured, irrespective of the disease you’re dealing with. Meaning this policy doesn't impose the dreaded disease wise sub-limits.
Pre existing diseases waiting
If you’re already dealing with diabetes, cardiovascular problems or any such illnesses, the insurer will cover all costs arising out of these pre-existing problems after just 2 years. It’s probably the best deal you can get to be honest.
Pre/Post hospitalization
No worries if the doctor had to run a host of diagnostic tests before or after hospitalizing you. The insurer has your back. They will cover this amount in full for a pretty reasonable duration - 60 days before you are hospitalized and 180 days after discharge. This includes the cost of medication by the way.
Add-ons
Sum Insured Protector
Recommended
Cover increases in line with inflation.
Claim Protector
Recommended
Covers list of 68 non-medical items as per list I
Critical Illness
Recommended
Paid out as a lump sum of 100% of sum insured for 20 listed Critical illnesses up to a limit of Rs. 50 lakhs for insured aged 18 to 50 years at the time of policy purchase.
Annual Health Checkup
Annual health check-up for specified tests, with a maximum limit up to the sum insured on a cashless or reimbursement basis.
OPD
Get unlimited e-consultations from General Physicians.
Maternity Benefits
Maternity expenses covered up to 10% of sum insured with limit of ₹1,00,000 after a waiting period of 9 months(if the plan is taken for 3 years in a single shot).
Personal Accident Cover
Paid out as a lump sum of 100% of sum insured for Accidental Death up to a limit of ₹5000000, applicable only for the proposer.
BeFit cover
Get coverage for outpatient and e-consultations i.e. doctor visits upto defined limits as per amount chosen.
Maternity
With this add-on, you get added coverage for maternity expenses i.e. childbirth . However, the coverage is limited to 10% of the base sum insured maximum up to ₹1 Lakh with Maternity Waiting Period of 9 months (if the plan is taken for 3 years in a single shot).
Permanent Exclusions
Conditions or treatments that the policy clearly says it will not cover.
STDs except HIV
Expenses related to any admission primarily for diagnostics and evaluation purposes are excluded.
Diagnostic expenses not related or incidental to current diagnosis and treatment are excluded.
Expenses for admission primarily for bed rest and not for treatment are excluded.
Custodial care at home or in a facility for help with daily activities is excluded.
Disclaimer: For illustration purposes only - exact terms are in the policy wording.
Specific Illness
The following illnesses are not covered under the policy for 2 years.
Gastric and Duodenal Ulcers
Benign Prostatic Hypertrophy
Sinus-related conditions:
All types of sinuses
Dysfunctional Uterine Bleeding
Waiting Period
30 days Initial waiting period
2 years Specific illness waiting period
2 years Pre-existing disease waiting period
Ditto's Take
◦ Excellent ◦
After a close look at the waiting periods, we can say that the waiting periods on this policy are excellent. Especially the PED waiting period which is better than usual.
What's missing in the policy
Maternity benefits not offered. Need to opt add-on for maternity cover.
Doctor consultations are not covered. Need to opt add-on for doctor consultations.
Customer Reviews
V
Vivaan Mishra
Teleconsultations are super convenient, especially for minor issues. Saves a hospital visit!
Y
Yash Iyer
Worldwide cover for higher sum insured is a great option for those who travel or seek treatment abroad.
Z
Zara Menon
Claim protector add-on that makes non-payable items payable is a very smart feature.
A
Anila Chandra
Vaccine discount requires all adult members to be vaccinated in past year, bit specific.
A
Amara Das
Room rent capping is based on sum insured. Lower SI plans have limits.
A
Aditi Jain
Good mix of essential and modern benefits. Seems like a well-rounded plan.
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Frequently Asked Questions
Does Health AdvantEdge have waiting periods?
- 30-Day Waiting Period: Hospitalizations won’t be covered for the first 30 days of the policy unless it’s an accident.
- Specific Illness Waiting Period: There’s a 2-year waiting period for a list of diseases which is a mandate before you can start claiming.
- Pre-Existing Disease Waiting Period: There's a 2-year waiting period for any pre-existing disease you may have while buying the policy.
Does Health AdvantEdge have room rent restrictions?
Does Health AdvantEdge offer a restoration benefit?
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