Overview
The ICICI Lombard iHealth Plus plan is a comprehensive health insurance policy designed to offer enhanced protection with sum insured options ranging from ₹2 lakh to ₹10 lakh. It includes maternity benefits (with a 3-year waiting period) [maximum up to: Normal Delivery of ` 25,000/ Caesarian delivery of ` 50,000/ Pre-Post Natal ` 2,000 each depending on the SI opted for], outpatient consultation coverage up to a specified limit, cumulative bonuses [10% increase up to 50%] for claim-free years and no co-payment clause. The plan allows policyholders to choose any room type without restrictions and offers full restoration of the sum insured [once in a policy year for unrelated illness] after a claim, making it suitable for those seeking extensive and flexible health coverage.
Experts Review
Written by Nikhil Nair
Senior Writer
The ICICI Lombard iHealth Plus plan is a premium upgrade over the base iHealth plan, offering several valuable enhancements. Its key USPs include maternity coverage after a 3-year waiting period and outpatient consultation reimbursement, which are not available in the base plan. The absence of co-payment and room rent restrictions provides greater financial predictability and comfort during hospitalization. Additionally, the plan offers full restoration of the sum insured once a year [for unrelated illness], which is beneficial for policyholders.
However, the iHealth Plus plan is significantly more expensive—typically 20-30% higher in premium than the base iHealth plan—reflecting its broader coverage and added benefits. It also excludes domiciliary hospitalization, which may be a drawback for some. Disease-wise sub-limits are also present on conditions like Cataract, Hernia, Hysterectomy, etc.
Pros
Feature set is satisfactory.
Great pick if you're looking for something affordable.
Insurer has a solid track record with great claim and service metrics.
Cons
No coverage if you are forced to hospitalize at home, which is a notable gap.
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
Good
Bad
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
Your insurance cover won’t be fully available in case you are treated for Cataracts and a few other diseases. Meaning the insurance company has a cap on the total amount they’ll pay out if you are treated for these specific illnesses.
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 you wait for 3 years.
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 - 30 days before you are hospitalized and 60 days after discharge. This includes the cost of medication by the way.
Add-ons
Hospital Cash
Hospital cash benefit paid out if hospitalization is at least 3 days, with a maximum payout of ₹1000 for up to 10 days.
Critical Illness
Paid out as a lump sum of 100% of sum insured for listed Critical illnesses.
Convalescence Benefit
Lump sum payout of a fixed amount in case the hospitalisation exceeds more than 10 continuous days. This benefit is available once per insured member per policy year.
Permanent Exclusions
Conditions or treatments that the policy clearly says it will not cover.
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.
Services for terminally ill individuals addressing non-medical needs are 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.
Cataract
Benign Prostatic Hypertrophy
Gynecological conditions:
Myomectomy and Hysterectomy (unless because of malignancy)
Dilatation and Curettage
Waiting Period
30 days Initial waiting period
2 years Specific illness waiting period
3 years Pre-existing disease waiting period
Ditto's Take
◦ Standard ◦
After a close look at the waiting periods, it’s safe to say they are fairly standard.
What's missing in the policy
No coverage if you are forced to hospitalize at home.
Customer Reviews
A
Amit
Hopefully, the extra cost means better service.
P
Priya
Seems like it has good coverage, being the 'Plus' version.
R
Rahul
Expecting better benefits with this plan.
P
Pooja
Not sure if the extra cost is fully justified by the benefits.
A
Aisha
It is quite expensive compared to other options.
D
Deepika
The name suggests enhanced features, which is good.
Still confused?
Talk to our expert
advisor for
instant clarity
Frequently Asked Questions
Does iHealth Plus 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 3-year waiting period for any pre-existing disease you may have while buying the policy.
- Maternity and Newborn Waiting Period: There’s a 3-year waiting period before you can make claims related to pregnancy and childbirth.
Does iHealth Plus have room rent restrictions?
Does iHealth Plus offer a restoration benefit?
TALK TO OUR ADVISORS
Get real help from advisors who listen, guide and go the extra mile for you.