ICICI Lombard Health Care medical plan

What you need to know

ICICI Lombard Health Care administers the medical insurance policy, which is 100% company paid. This means you pay nothing for medical insurance for you or your dependants. You and your dependants are automatically enrolled in this policy.

Plan at a glance Extensive coverage Exclusions Claims process

Plan at a glance

Benefit	Coverage
Sum Insured	Base cover of INR 5,00,000 per family per year In case of a medical emergency, additional support of up to INR 7,50,000 per family per year can be requested via Corporate Buffer.
Voluntary Top-Up Cover	Employees have flexibility to purchase an annual top-up cover ranging from INR 2,50,000 to INR 20,00,000 by electing to pay an additional premium. The top-up cover would provide supplementary support, which would be in addition to the annual base cover of INR 5,00,000 and the corporate buffer of INR 7,50,000, an overall annual cover of INR 12,50,000 (5L + 7.5L) provided by PayPal to all employees, per family.
Pre- and Post-hospitalisation	Up to 30 and 60 days respectively
Intensive care unit with nursing staff (charges)	On actuals
Room rent (including charges for nursing staff)	Single, private, air-conditioned, with a cap of INR 12,000 per day on the room rent
Home nursing (with doctor's prescription)	Domiciliary hospitalisation benefit including nursing care at home up to INR 50,000 per family
Maternity care	INR 1,00,000 for normal delivery and INR 1,25,000 for a C-section for first 3 deliveries. Additional benefit of INR 25,000 in case of multiple births. Includes pre- and post-natal expenses. Same cover applies for surrogacy.
Newborn day one	Newborn child is covered from day one and can be added to your policy within 30 days of birth date
OPD treatment	Employees, their spouse, and children are covered up to INR 30,000 with the following limits: INR 6,000 consultation, INR 9,000 diagnostics, and INR 15,000 dental, vision, mobility aids and physiotherapy. Cost of spectacles/contact lenses is covered under vision sub-limit.
Ambulance service	Intensity ambulance service up to INR 10,000 and air ambulance up to INR 1,00,000 per person, up to three events per policy period
IVF/infertility treatment	Covered up to INR 2,00,000 on OPD/IPD basis
Flu vaccination	Up to INR 3,000 per family
AYUSH	INR 75,000 per family payable on a reimbursement basis
Copayment for parents or parents-in-law	15% co-pay capped at INR 50,000, for parent/in-law claims only.
Same sex partner	Employees can enrol a same-sex partner under the medical insurance plan
Gender reassignment surgery	Covered up to the base sum insured, i.e., INR 5,00,000

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