Eligibility Criteria of Elevate Plan

The ICICI Lombard Elevate Plan is available for individuals and families, making it suitable for people looking for flexible and comprehensive health insurance coverage. Entry age generally starts from adulthood, and dependent children can also be included under a family floater policy. This eligibility structure makes the plan accessible for young professionals as well as families seeking long-term health insurance protection.

Basic Feature of ICICI Lombard Elevate Plan

This plan is designed to offer comprehensive health coverage along with flexibility so policyholders can choose protection according to their medical needs and budget. It generally focuses on providing financial support during medical emergencies while also including benefits that support long-term healthcare security. Here are the basic features of the ICICI Lombard Elevate Plan:

1. In-patient hospitalization - It covers hospital expenses up to the annual sum insured, including room charges for a single private AC room. This ensures that during a medical emergency, you and your family can focus on recovery instead of worrying about rising hospital bills.
2. Day care procedures - The policy also takes care of day care procedures and treatments that do not require a 24-hour hospital stay. Many modern medical procedures can now be completed within a few hours, and these expenses are covered up to the sum insured. 
3. Pre and post hospitalization expenses – Covering medical costs incurred before admission up to 90 days and after discharge up to 180 days, helping you manage consultations, diagnostic tests, and follow-up treatments smoothly.
4. Organ donor expenses - This includes hospitalization costs related to organ harvesting, offering financial support during critical procedures. 
5. Domiciliary hospitalization – In it treatment is taken at home on a doctor’s advice for at least three consecutive days, ensuring care even when hospital admission is not possible.
6. AYUSH hospitalization – It’s covering treatments under Ayurveda, Yoga, Unani, Siddha, and Homeopathy up to the sum insured, whether on a reimbursement or cashless basis. 
7. Road ambulance - Charges are covered for emergency transportation to the nearest hospital, providing timely medical access when it matters the most.
8. Coverage for surrogacy and oocyte donor expenses – This benefit helps manage inpatient treatment costs for a surrogate mother or egg donor, up to a defined limit. This makes the journey toward parenthood more financially secure and less stressful.
9. Bariatric surgery - Covering hospitalization expenses related to obesity treatment if medically required. 
10. Reset benefit - One of the most valuable features is the reset benefit where up to 100% of the annual sum insured can be restored for future claims. This reset can be available multiple times for unrelated illnesses or injuries, ensuring that your coverage does not get exhausted after a single major claim. 
11. Loyalty bonus – Loyalty bonus may increase your coverage over time by adding a cumulative bonus for every claim-free year, up to a specified limit of the base sum insured.
12. Technological advancements & modern treatments - This ensures that you are protected not just for today’s treatments, but also for advanced medical procedures that may become necessary in the future.

Optional Riders of ICICI Lombard Elevate Plan

A flexible health insurance plan should adapt to your unique needs, and that’s where personalization with add-ons becomes truly valuable. With a range of optional covers, policyholders can customize their coverage based on lifestyle, age, medical history, and future healthcare expectations. These add-ons enhance the base policy and provide wider financial protection against unexpected medical situations.

1. Worldwide coverage – It ensures access to advanced global healthcare facilities. This benefit safeguards you against planned or emergency hospitalization outside India, subject to specified terms and waiting periods. 
2. Two Hour hospitalization – Many treatments and procedures now require shorter hospital stays, and this add-on ensures that even brief admissions, including room rent, ICU charges, and doctor’s fees, are covered as per policy conditions.
3. Chronic disease management program - It focuses on conditions such as hypertension, diabetes, high cholesterol, obesity, and certain cardiac issues. With organized care and cashless treatment access.
4. Infinite Care – It allows a one-time unlimited claim amount for a selected medical condition, offering an added layer of protection during critical health events.
5. Compassionate visit benefit – It cover travel expenses for an immediate family member if hospitalization extends beyond a specified number of days, ensuring emotional support during recovery.
6. Power Booster - This feature rewards policyholders with a significant loyalty bonus on eligible claims. This ensures that your coverage grows stronger the longer you stay insured, providing extended security for future medical needs.
7. Jumpstart Benefit - If you have health concerns such as asthma, diabetes, hypertension, high cholesterol, obesity, or certain heart-related conditions, coverage may begin earlier than traditional waiting periods, subject to policy terms. Comprehensive protection.
8. Claim Protector Benefit - Non-payable items such as gloves, syringes, masks, and other essential consumables are covered up to the sum insured. 
9. Inflation Protector – This feature helps your policy stay relevant over time by increasing the sum insured at renewal based on the previous year’s inflation rate, ensuring that rising healthcare costs do not reduce your financial safety net.
10. Maternity Benefit - It covers pregnancy related medical expenses up to a specified limit after a defined waiting period. Complementing this is the Newborn Baby Cover, which takes care of hospitalization expenses for a newborn baby during the initial days of life, offering reassurance to growing families.
11. Air ambulance - The Domestic Air Ambulance Cover helps manage emergency air transfer expenses to the nearest hospital.
12. Dependent Accommodation Benefit - It cover the stay expenses of an accompanying family member during prolonged hospitalization, ensuring emotional and logistical support.
13. Nursing at Home - The policy reimburses the cost of qualified nursing care at your residence for a defined period after discharge. 
14. Durable Medical Equipment Cover – It reimburses expenses for renting or purchasing medically necessary equipment prescribed by your doctor after hospitalization for the same condition.
15. Preventive health check up – It is equally important, which is why the plan may include a health check-up benefit every policy year. This allows insured members to undergo routine medical tests up to a specified limit on a cashless basis. 
16. Room modifier option – It allowing to upgrade or downgrade hospital room category as per their preference. 
17. Voluntary co-payment option – It enables insured members to share a fixed percentage of claim expenses, which may help reduce the premium cost.

Waiting period of ICICI Lombard Elevate Plan

The waiting period in the ICICI Lombard Elevate Plan means a certain amount of time after purchasing the policy during which some medical conditions or benefits cannot be claimed. This period is designed to ensure that the policy is used for genuine and future medical needs rather than immediate claims:

1. Initial waiting period - 30 days initial waiting period for most illnesses.
2. Pre-existing diseases – PED have a waiting period of up to 36 months. 
3. Specific illnesses - Benefits such as maternity, bariatric surgery, or global coverage options may have a waiting period of around 24 months.
4. Critical illness coverage – It has a waiting period of 90 days
5. Bariatric Surgery - Bariatric surgery benefits generally come with a waiting period of around 24 months.
6. Worldwide cover benefit - It usually comes with a waiting period of about 24 months, after which policyholders can access eligible medical treatment coverage outside India.

Once these waiting periods are completed, the policyholder can access the respective benefits under the plan according to the policy terms and conditions.

Exclusions of ICICI Lombard Elevate Plan

Like most health insurance policies, the ICICI Lombard Elevate Plan also has certain exclusions, which means some situations or treatments are not covered under the policy. Understanding these exclusions helps policyholders know what expenses may not be payable under a claim.

Generally, the plan does not cover treatments related to self-inflicted injuries, substance abuse, or cosmetic procedures done purely for appearance unless they are medically necessary. Expenses arising from participation in hazardous activities, illegal acts, or non-medical treatments are also typically not included under the policy coverage.

In addition, treatments that are not medically necessary, experimental procedures, or conditions specifically listed in the policy exclusion list may not be eligible for reimbursement. It is always important to review the policy document carefully so that you clearly understand the situations where the insurance company may not approve a claim.