What is the Health Advantage Apex Plus 2.0 Policy?

ICICI Lombard’s Health Advantage Apex Plus 2.0 policy offers a wide range of features to enhance the healthcare experience. It includes cashless hospitalization, extensive coverage for pre and post-hospitalization expenses, and additional benefits such as health check-ups and telemedicine. This policy caters to various healthcare needs while emphasizing preventive care.

Health Advantage Apex Plus 2.0 Policy Specifications

Specification	Details
Policy Name	Health Advantage Apex Plus 2.0
Insurer	ICICI Lombard
Policy UIN	ICIHLIP23075V032223
Sum Insured	Up to 3 crore rupees (Base + GCB)
Claim Settlement	Cashless and reimbursement options are provided for the convenience of policyholders
Hospitalization Coverage	Covers medical expenses for disease, illness or injury
Ambulance Charges	No cash is needed for an ambulance to the hospital or diagnostic centre
Health Check-up	Health check-ups are covered for insured individuals aged 18+ on a cashless basis
Convalescence Benefit	Fixed hospitalization allowance for 10+ days within the specified limits
Wellness and Value-Added Services	Earn health rewards through wellness programmes
Eligibility	Coverage is available for individuals 18 years and older, with the added benefit of family floater options
Renewal Benefits	Increased sum insured for claim-free years to avail no claim bonus
Exclusions	Prior medical conditions and failure to disclose important information
Waiting Period	Waiting period for specific conditions as outlined in the policy document

Coverage Benefits of the Health Advantage Apex Plus 2.0 Policy

ICICI Health Advantage Apex Plus 2.0 policy provides extensive coverage for different healthcare requirements, offering financial security for medical costs.

Coverage Benefits	Details
In-Patient Hospitalization	Insurance covers hospitalization for illness or injury, with cashless facilities at network hospitals
Pre-Existing Illness Coverage	Pre-existing conditions are covered after a 36-month waiting period
Ambulance Charges	Coverage for both domestic and international ambulance transportation to hospitals
Restore Benefit	Sum insured automatically restored up to 100% if exhausted by claims in a policy year
Guaranteed Cumulative Bonus	Increased sum insured by 20% per claim-free year, up to 100% maximum
Wellness Programs	Exchange wellness points for medical services and expenses
Value-Added Services	Health rewards, condition management, appointments, teleconsultations and second opinions
Convalescence Benefits	20,000 rupees payment for hospitalization for over 10 days once every year
No Medical Test Up To 45 Years	No medical tests for individuals under 45 years for a coverage of up to 10 lakh rupees
Lifelong Renewability	The policy can be renewed annually with no age limits
Critical Illness Cover	Insurance for critical illnesses, offering financial assistance when diagnosed
Health Check-up	Yearly health check-ups covered as per plan
Domiciliary Hospitalization	Home treatment covered with limitations
Tax Benefits	Premiums are tax deductible under Section 80D of the Income Tax Act of 1961

What’s Covered and Not Covered in Health Advantage Apex Plus 2.0 Policy

Health Advantage Apex Plus 2.0 Policy Inclusions

Wide range of hospitalization coverage with no room rent limit for preferred room category
Covers road and air ambulance expenses, ensuring timely transportation to medical facilities
No waiting period for accident hospitalization
Covers health check-ups for eligible insured individuals on a cashless basis
A fixed allowance for hospitalization over 10 consecutive days
Cashless treatment at network hospitals for easy access to healthcare
The insurer must settle claims or communicate non-admissibility within specified timeframes, improving customer service efficiency
The plan includes wellness benefits, preventive care and reward points for a healthy lifestyle

Health Advantage Apex Plus 2.0 Policy Waiting Periods

36-month waiting period for pre-existing diseases
Some illnesses have a waiting period of up to 24 months (high-risk illnesses with high medical costs)
30-day initial waiting period before making claims, except for accidents
Maternity benefits have a 24-month waiting period and newborns are covered after a waiting period from birth
Daycare procedures are covered with waiting periods for some
A grace period of 30 days for premium payment allows coverage to continue, but no claims can be made if the premium is not paid