Healthy-U &

Golden years
Health Companion for your family
ICICI Bank- Health Insurance Bouquet
Healthy-U Golden Years- Health Plan

21-55 years 56-75 years

Age Band

•Target Audience: Account holders 55 years and

below •Target Audience: Account holders 56 years and
• Family: Self (mandatory), spouse, 2 Children, above
dependent parents and siblings(brothers/ • Family: Self and Spouse
sisters) • Tele u/w up to 65 years
• Built in Maternity and OPD benefits
ICICI Bank- Health Insurance Bouquet
Healthy-U Golden Years- Health Plan

21-55 years 56-75 years

Age Band

•Target Audience: Account holders 55 years and

below •Target Audience: Account holders 56 years and
• Family: Self (mandatory), spouse, 2 Children, above
dependent parents and siblings(brothers/ • Family: Self and Spouse
sisters) • Tele u/w up to 65 years
• Built in Maternity and OPD benefits
Changes in the Health-U base plan offering
We have reduced the waiting periods & added one more benefit with no premium change

Benefit / Waiting periods Before Now

Declared & accepted PED waiting
24 months Nil (30 day cooling period applies)
period
Standard listed diseases waiting
24 months 12 months
period (list in next slide)
COVID-19 cooling period** 30 days 15 days
Standard cooling period for all other
30 days 30 days
diseases including PED
Maternity waiting period 36 months 12 months

Home health care** Not covered Covered

Ambulance cover enhancement for
INR 3,000 INR 5,000
SI of 20 / 25 lacs
OPD waiting period 90 days 30 days

• Standard cooling period doesn’t apply to hospitalization required due to accidental injury
• **Covers and waiting period initiated due to COVID-19 pandemic (COVID-19 cooling period and Home
health care) shall be available for all our customers until 31st March 2021 only
Standard listed diseases
• Cataract
• Benign Prostatic Hypertrophy
• Myomectomy, Hysterectomy unless because of malignancy
• All types of Hernia, Hydrocele
• Fissures &/or Fistula in anus, hemorrhoids/piles
• Arthritis, gout, rheumatism and spinal disorders
• Joint replacements unless due to accident
• Sinusitis and related disorders
• Stones in the urinary and billiary systems
• Dilatation and curettage, Endometriosis
• All types of Skin and internal tumors/ cysts/ nodules/ polyps of any kind including breast lumps unless malignant
• Dialysis required for chronic renal failure
• Surgery on tonsils, adenoids and sinuses
• Gastric and Duodenal erosions & ulcers
• Deviated Nasal Septum
• Varicose Veins/ Varicose Ulcers
• All types of internal congenital anomalies/illness/defects
Covers under Home care

In this benefit, the following would be covered if prescribed by the treating medical practitioner and is
related to treatment,  

• Diagnostic tests undergone at home or at diagnostics centre 

• Medicines prescribed in writing 

• Consultation charges of the medical practitioner

• Nursing charges related to medical staff

• Medical procedures limited to parenteral administration of medicines

Conditions for availing Home care
In this benefit we will cover the medical expenses incurred by the Insured person on availing treatment at home provided that:  
a) The insured person has been advised non-emergency hospitalization by a Medical practitioner and the Insured person out
of his own will, opts to undergo treatment at home.
b)  The condition of the Insured Person is expected to improve in a reasonable and foreseeable period of time.  
c)  There is a continuous active line of treatment with monitoring of the health status by a medical practitioner for each day
through the duration of the home care treatment.
d)  Treatment that can be availed on Outpatient basis will not be qualified to be covered under this clause.
e)  Insured can avail the services as prescribed by the medical practitioner on cashless basis which would be arranged by the
Insurer through designated network provider.

If the insured intends to avail the services of non-network provider and claims for reimbursement, a prior approval from
the Insurer needs to be taken before availing such services. 
In case insured breach the conditions of approval or fails to take the prior written approval the insurer is not liable to settle
any claim under this section. 
Healthy-U Base plan: Key Features

Basic Proposition Claim Payment

• Sum Insured: 5 lacs, 7 Lacs,10 lacs,15 lacs, 20
• Co-pay: No co-pay
lacs and 25 lacs
• Room rent capping: Nil
• Entry age limits: 21 years to 55 years
• Sub-limit only on Cataract
• 24 hour hospitalization
• IL Take Care App: Bringing cashless OPD on
• Pre & Post Hospitalization: 30 / 60 days
your fingertips*
• Day care procedures

Pre-conditions Additional Covers

• Maternity cover
• Pre-existing diseases: No PED specific waiting • OPD expenses
period • Air Ambulance
• Health scan : • Road Ambulance cover
• No Medicals for up to 55 years for all Sum • Alternate treatment
Insureds for non-PED cases • Donor Expense
• Domiciliary hospitalization
• Home health care
Healthy-U Base plan: Product Construct
Policy coverage
Annual Sum Insured 5 Lakh 7 Lakh 10 lakh 15Lakh 20Lakh 25Lakh 50Lakh
Inpatient hospitalization Covered up to SI
Day Care Treatment/ Procedures All Day Care Treatments & procedures covered up to SI
Pre / Post Hospitalization expenses 30 days /60 days
Domiciliary Hospitalization Covered up to SI
Donor expense Covered up to SI
Cover for Alternate methods of treatment In-patient hospitalization in Govt. recognized centers only covered up to SI
Road ambulance charges per emergency
Rs.1,500 Rs.1,500 Rs.3,000 Rs.3,000 Rs.5,000 Rs.5,000 Rs.5,000
hospitalization
Air ambulance Up to 10% of SI on a cumulative basis
OPD SI (Rs) Rs.6,000 Rs.7,000 Rs.12,000 Rs.15,000 Rs.20,000 Rs.25,000 Rs.25,000
Maternity SI Rs.25,000 Rs.25,000 Rs.50,000 Rs.50,000 Rs.75,000 Rs.100,000 Rs.100,000
Terms & Conditions
Eligibility 91 days to 55 years, child up to 20 years will be covered under floater plan only
Tenure 1 Year
Family definition Self (mandatory), spouse, 2 Children, dependent parents and siblings( brothers/ sisters)
Room rent restriction Nil
Sub-limit- Cataract (per eye) Rs.35,000 Rs.35,000 Rs.1 Lakh Rs.1 Lakh Rs.1 Lakh Rs.1 Lakh Rs.1 Lakh 9
Sales Pitch - Salaried Person
Illustration client profile 1 : Mr. Kumar

• 35 year old Salaried professional

• Stays with wife and two children
• Covered under Corporate Group Health Insurance Plan for Rs 2 Lac
• Monthly income Rs 80,000
• Monthly expenses include Home Loan EMI, Car EMI, children school fees, medicines, household expenses,
misc. expenses

Though comfortably placed financially, he must be made aware that any major hospitalization can hamper
his ability to meet all his expenses comfortably, as his existing health insurance from employer does not
cover his family adequately.

We may suggest him to opt for ‘Healthy U’, and evaluate its benefits

• He can opt for Sum Insured of Rs 10 Lac on floater basis for his family at premium of Rs 25,000 and
protect his savings in case of a major hospitalization.
• He also gets an OPD cover of Rs 12,000 which could be used by his entire family through an app and
cover expenses on pharmacy, doctor visits and diagnostics.
• Tax savings u/s 80D is Rs 7,500, so his effective cost of health cover would be only Rs 5,500.
Sales Pitch - Self employed
Illustration customer profile 2: Mr Rohit

• 40 years old businessman having chain of premium retail stores

• Married & having 2 Kids
• Has monthly earnings of Rs 3,00,000
• Though wealthy otherwise, he does not have any health insurance

A critical illness to him or any of his family members may not only entail major expenses but also cause business
disruption due to his unavailability.

Therefore, we can suggest him to opt for ‘Healthy U’ with high sum insured and see how does it benefit him

• A Sum Insured of Rs 25 Lac on floater basis for his family at a premium of Rs. 42,600. This would enable him
to meet all medical expenses, without disturbing his savings
• What’s more, even OPD expenses of Rs 25,000 are covered under his plan which he could easily claim through
IL take care app and cover all his annual expenses on medicines, doctor visits, diagnosis etc.
• Since he could claim premium deduction of upto Rs 25,000 u/s 80D, his tax saving would be Rs 7,500.
• Therefore with OPD benefits of Rs 25,000 and Tax savings of Rs 7,500 his effective cost for a Rs 25 Lac health
cover would be only Rs 10,100
Healthy-U Base plan: Pricing
SI: 5 Lac SI: 7 Lacs
Age Band  21-25  26-35  36-45  45-50 51-55 Age Band  21-25  26-35  36-45  45-50 51-55
1A 7,250 9,250 11,000 14,800 20,400 1A 8,500 9,800 11,800 16,200 21,800
2A 12,500 14,100 15,000 22,300 31,200 2A 13,000 15,800 16,700 24,500 33,200
2A+1C 15,000 16,500 17,200 24,300 32,700 2A+1C 15,500 18,500 19,200 26,700 35,000
2A+2C 18,000 19,500 20,200 27,500 36,000 2A+2C 19,000 21,900 22,600 30,300 35,600
1A+1C 8,700 10,500 11,800 15,700 21,000 1A+1C 10,200 11,700 13,200 17,500 22,900
1A+2C 11,300 12,900 14,200 18,100 22,500 1A+2C 13,000 14,500 15,900 20,200 24,400

SI:10 Lac SI: 15 Lacs

Age Band  21-25  26-35  36-45  45-50 51-55 Age Band  21-25  26-35  36-45  45-50 51-55
1A 10,700 12,500 14,500 19,100 25,400 1A 12,300 15,200 17,900 21,600 28,400
2A 17,500 18,600 19,300 27,800 37,800 2A 20,200 24,300 25,500 31,200 41,900
2A+1C 20,600 21,500 21,900 30,200 39,600 2A+1C 23,900 27,700 28,800 34,300 44,400
2A+2C 24,200 25,000 25,500 34,000 43,400 2A+2C 28,300 32,100 33,200 39,000 49,000
1A+1C 12,400 14,100 15,700 20,300 26,000 1A+1C 15,500 17,600 19,600 23,500 29,000
1A+2C 15,500 17,100 18,500 23,200 28,000 1A+2C 19,200 21,300 23,100 27,100 32,300

Age completed on policy start date Premium is inclusive of GST

Adults: 21 years & above
Kids: 20 years & below
Healthy-U Base plan: Pricing
SI: 20 Lac SI: 25 Lacs
Age Band  21-25  26-35  36-45  45-50 51-55 Age Band  21-25  26-35  36-45  45-50 51-55
1A 14,600 17,700 20,500 24,400 31,800 1A 16,800 20,000 22,900 27,000 34,700
2A 25,000 29,000 29,700 34,600 46,000 2A 29,600 33,200 34,100 37,700 49,700
2A+1C 28,900 32,600 33,000 37,900 48,600 2A+1C 33,700 37,000 37,600 41,000 52,300
2A+2C 34,100 37,800 38,200 43,500 54,200 2A+2C 38,700 42,000 42,600 46,400 57,700
1A+1C 17,900 20,200 22,300 26,400 33,300 1A+1C 20,200 22,600 24,800 29,000 36,300
1A+2C 21,800 24,000 25,900 30,200 35,800 1A+2C 24,300 26,500 28,500 32,900 38,900

SI: 50 Lacs
Age Band  21-25  26-35  36-45  45-50 51-55
1A 17,700 21,300 24,600 29,200 38,600 Age completed on policy start date
2A 30,000 35,300 34,100 41,100 55,300 Adults: 21 years & above
2A+1C 34,500 39,400 37,900 44,800 58,200 Kids: 20 years & below
2A+2C 39,700 44,700 43,100 50,400 63,800
1A+1C 21,500 24,100 26,600 31,400 39,100
1A+2C 26,000 28,500 30,800 35,700 43,000
Premium is inclusive of GST
Healthy-U Base plan: Renewal pricing
Premiums are inclusive of GST
SI 5 lacs SI 15 lacs
Age 56-60 61-65 66-70 71-75 76-80 >80 Age 56-60 61-65 66-70 71-75 76-80 >80
1A 27,200 35,100 43,100 47,800 54,600 83,800 1A 37,000 56,300 68,600 81,300 92,600 142,500
2A 42,200 54,600 77,800 86,400 99,000 153,000 2A 55,500 86,500 121,600 145,200 166,100 258,400
2A+1C 43,000 55,000 81,800 90,400 103,000 157,100 2A+1C 57,200 86,200 127,400 151,000 171,900 264,200
2A+2C 46,200 58,000 85,800 94,400 107,000 161,100 2A+2C 61,900 90,900 133,100 156,700 177,600 269,900
1A+1C 25,800 32,100 44,100 48,400 54,700 81,800 1A+1C 38,500 58,200 69,700 81,500 91,900 138,100
1A+2C 27,600 33,500 48,200 52,500 58,000 85,800 1A+2C 41,800 60,700 75,400 87,200 97,700 143,800

SI 7 lacs SI 20 lacs
Age 56-60 61-65 66-70 71-75 76-80 >80 Age 56-60 61-65 66-70 71-75 76-80 >80
1A 29,000 37,300 45,700 50,600 57,800 88,900 1A 40,800 61,100 74,000 87,400 99,400 152,200
2A 44,800 57,900 82,100 91,200 10,500 162,000 2A 60,500 92,500 130,000 154,900 176,900 274,700
2A+1C 45,800 58,200 86,600 95,700 109,000 166,500 2A+1C 62,200 93,000 136,000 160,900 183,000 280,700
2A+2C 49,500 61,800 91,100 100,100 113,400 171,000 2A+2C 67,800 98,300 142,900 167,800 189,800 287,600
1A+1C 30,300 38,800 47,000 51,500 58,200 86,900 1A+1C 42,600 63,300 75,100 87,600 98,600 147,500
1A+2C 32,600 40,900 51,500 56,000 62,600 91,400 1A+2C 46,000 66,300 81,200 93,600 104,600 153,500

SI 10 lacs SI 25 lacs
Age 56-60 61-65 66-70 71-75 76-80 >80 Age 56-60 61-65 66-70 71-75 76-80 >80
1A 33,200 42,000 51,100 56,400 64,100 97,600 1A 44,100 65,100 78,500 92,400 104,800 159,700
2A 50,400 64,200 90,400 100,200 114,500 177,100 2A 64,600 98,000 136,500 162,300 185,200 286,900
2A+1C 51,400 64,600 95,100 105,000 119,200 181,800 2A+1C 66,400 98,500 142,800 168,600 191,400 293,100
2A+2C 55,200 68,300 99,800 109,600 123,900 186,500 2A+2C 71,800 103,300 149,400 175,200 198,100 299,700
1A+1C 31,700 38,700 52,300 57,200 65,400 95,700 1A+1C 45,900 67,300 79,600 92,500 103,900 154,800
1A+2C 33,800 40,400 57,100 62,000 69,100 100,400 1A+2C 49,400 70,100 85,800 98,700 110,200 161,000
Changes in the Healthy-U Top-up offering
We have reduced the waiting periods & added one more benefit with no premium change

Benefit / Waiting periods Healthy plan Before Healthy plan Now

Declared & accepted PED waiting
24 months Nil (30 day cooling period applies)
period
Standard listed diseases waiting
24 months 12 months
period
COVID-19 cooling period** 30 days 15 days
Standard cooling period for all other
30 days 30 days
diseases including PED
Home health care ** Not covered Covered

• Standard cooling period doesn’t apply to hospitalization required due to accidental injury
• **Covers and waiting period initiated due to COVID-19 pandemic (COVID-19 cooling period and Home health
care) shall be available for all our customers until 31st March 2021 only
Healthy-U Top up plan : Key Features

Basic Proposition Claim Payment

• • Co-pay: No co-pay
Sum Insured: 10 lacs,15 lacs, 20 lacs, 25 lacs
• Room rent capping: Nil
& 50 lacs
• • Sub-limit only on Cataract
Entry age limits: 21 years to 55 years
• • Deductible 3 lac, 4lac, 5 lac
24 hour hospitalization
• Pre & Post Hospitalization: 30 / 60 days
• Day care procedures

Pre-conditions Additional Covers

• Air Ambulance
• Pre-existing diseases: No PED specific waiting
• Road Ambulance cover
period
• Alternate treatment
• Health scan :
• Donor Expense
• No Medicals for up to 55 years for all
• Domiciliary hospitalization
Sum Insured for non-PED cases
• Home health care
Healthy–U Top up plan : product construct
Annual Sum Insured
In Patient hospitalization
Day care treatment
Pre/ Post hospitalization
Domiciliary Expenses
Home Care exp.
Donor Expense
Alternate Treatment
Road Ambulance Cover
Air ambulance
Maternity
OPD
Eligibility
Family definition
Sub-limits
Rs. 3 lacs , 4 lacs & 5 lacs deductible will apply on aggregate basis for all hospitalization expenses during
Mandatory Deductible amount
Cooling period
Specific exclusions
Policy Coverage
10 lacs 15 lacs 20 lacs 25 lacs 50 lacs
Covered up to Sum Insured
All Day-care Surgeries & Procedures
Covers medical expenses incurred 30 days prior to hospitalization and 60 days post discharge
Covered up to Sum Insured
Covered up to Sum Insured
Covered up to Sum Insured
In-patient hospitalization in Govt. recognized centers only Covered up to Sum Insured
Rs.3,000/- per event of emergency hospitalization
Up to 10% of SI on a cumulative basis
NA
NA
Terms & Conditions
91 days to 55 years, child up to 20 years will be covered under floater plan only
Self (mandatory), spouse, dependent siblings & parents and up to 2 kids
Rs. 1 lac per year on Cataract
policy year for respective plans
Waiting periods
30 days for all diseases including PED except hospitalization due to accident
Standard list of diseases & procedures will be covered after 12 months of continuous coverage 17
Top-up plan: pricing for 3 lacs deductible Premiums are inclusive of GST
SI 10 lacs with Deductible 3 lacs SI 15 lacs with Deductible 3 lacs
Age  21- 25 26-35 36-45 46-50 51-55 Age  21- 25 26-35 36-45 46-50 51-55
1A 3,000 3,200 4,400 7,400 11,000 1A 3,700 4,000 5,400 8,000 12,000
2A 4,500 4,800 6,500 11,900 17,700 2A 5,600 6,000 8,100 12,800 19,100
2A+1C 6,400 6,600 8,200 13,400 18,800 2A+1C 7,800 8,200 10,200 14,800 20,800
2A+2C 8,500 8,800 10,400 15,700 21,100 2A+2C 10,500 10,800 12,800 17,600 23,600
1A+1C 4,500 4,700 5,500 8,400 11,300 1A+1C 5,600 5,800 6,900 9,400 12,600
1A+2C 6,400 6,500 7,300 10,100 12,800 1A+2C 7,800 8,000 9,000 11,600 14,600
SI 20 lacs with Deductible 3 lacs SI 25 lacs with Deductible 3 lacs
Age  21- 25 26-35 36-45 46-50 51-55 Age  21- 25 26-35 36-45 46-50 51-55
1A 3,900 4,200 5,700 8,400 12,600 1A 4,000 4,300 5,900 8,700 13,100
2A 5,900 6,300 8,500 13,500 20,200 2A 6,100 6,500 8,800 14,000 21,000
2A+1C 8,200 8,600 10,700 15,600 21,900 2A+1C 8,500 8,900 11,000 16,100 22,700
2A+2C 10,900 11,300 13,400 18,500 24,800 2A+2C 11,300 11,700 13,900 19,100 25,700
1A+1C 5,900 6,100 7,200 9,900 13,200 1A+1C 6,100 6,300 7,400 10,200 13,700
1A+2C 8,200 8,400 9,400 12,200 15,300 1A+2C 8,500 8,700 9,800 12,600 15,900
SI 50 lacs with Deductible 3 lacs
Age  21- 25 26-35 36-45 46-50 51-55
1A 4,500 4,800 6,500 9,800 14,700
Age completed on policy start date
2A 6,700 7,200 9,800 15,600 23,600
Adults: 21 years & above
2A+1C 9,400 9,800 12,300 18,000 25,500
Kids: 20 years & below
2A+2C 12,500 13,000 15,400 21,400 28,800
1A+1C 6,700 6,900 8,300 11,400 15,400
1A+2C 9,400 9,600 10,800 14,000 17,800
Top-up plan: pricing for 4 lacs deductible Premiums are inclusive of GST
SI 10 lacs with Deductible 4 lacs SI 15 lacs with Deductible 4 lacs
Age  21- 25 26-35 36-45 46-50 51-55 Age  21- 25 26-35 36-45 46-50 51-55
1A 2,700 2,900 3,900 6,700 9,900 1A 3,400 3,600 4,800 7,300 10,800
2A 4,100 4,300 5,800 10,800 15,900 2A 5,000 5,400 7,200 11,600 17,200
2A+1C 5,700 6,000 7,300 12,100 16,900 2A+1C 7,000 7,400 9,100 13,400 18,700
2A+2C 7,600 7,900 9,200 14,200 19,000 2A+2C 9,400 9,700 11,400 15,900 21,,200
1A+1C 4,100 4,200 4,900 7,600 10,100 1A+1C 5,000 5,200 6,100 8,500 11,300
1A+2C 5,700 5,800 6,500 9,100 11,500 1A+2C 7,000 7,200 8,000 10,500 13,100
SI 20 lacs with Deductible 4 lacs SI 25 lacs with Deductible 4 lacs
Age  21- 25 26-35 36-45 46-50 51-55 Age  21- 25 26-35 36-45 46-50 51-55
1A 3,500 3,800 5,000 7,700 11,400 1A 3,600 3,900 5,200 7,900 11,800
2A 5,300 5,600 7,500 12,200 18,200 2A 5,400 5,800 7,800 12,700 18,900
2A+1C 7,400 7,700 9,500 14,100 19,700 2A+1C 7,600 8,000 9,800 14,600 20,400
2A+2C 9,800 10,200 12,000 16,700 22,300 2A+2C 10,100 10,500 12,400 17,300 23,100
1A+1C 5,300 5,400 6,400 8,900 11,900 1A+1C 5,400 5,600 6,600 9,200 12,300
1A+2C 7,400 7,500 8,400 11,000 13,800 1A+2C 7,600 7,800 8,700 11,400 14,300
SI 50 lacs with Deductible 4 lacs
Age  21- 25 26-35 36-45 46-50 51-55
1A 4,000 4,300 5,800 8,900 13,300
Age completed on policy start date
2A 6,000 6,500 8,700 14,200 21,200
2A+1C 8,400 8,800 10,900 16,300 22,900
Adults: 21 years & above
2A+2C 11,200 11,600 13,700 19,300 25,900 Kids: 20 years & below
1A+1C 6,000 6,200 7,400 10,300 13,800
1A+2C 8,400 8,600 9,700 12,700 16,000
Top-up plan: pricing for 5 lacs deductible Premiums are inclusive of GST
SI 10 lacs with Deductible 5 lacs SI 15 lacs with Deductible 5 lacs
Age  21- 25 26-35 36-45 46-50 51-55 Age  21- 25 26-35 36-45 46-50 51-55
1A 2,500 2,700 3,600 5,600 7,900 1A 3,100 3,300 4,400 6,800 9,600
2A 3,800 4,000 5,400 9,000 12,600 2A 4,700 4,900 6,600 10,800 15,300
2A+1C 5,300 5,500 6,800 10,100 13,600 2A+1C 6,600 6,800 8,400 12,500 16,700
2A+2C 7,100 7,300 8,500 11,800 15,300 2A+2C 8,800 9,000 10,600 14,800 19,000
1A+1C 3,800 3,900 4,600 6,300 8,100 1A+1C 4,700 4,800 5,700 7,900 10,200
1A+2C 5,300 5,400 6,100 7,600 9,300 1A+2C 6,600 6,700 7,500 9,800 11,900
SI 20 lacs with Deductible 5 lacs SI 25 lacs with Deductible 5 lacs
Age  21- 25 26-35 36-45 46-50 51-55 Age  21- 25 26-35 36-45 46-50 51-55
1A 3,300 3,400 4,600 7,100 10,100 1A 3,400 3,600 4,800 7,400 10,500
2A 4,900 5,200 7,000 11,400 16,200 2A 5,100 5,300 7,200 11,800 16,800
2A+1C 6,900 7,100 8,800 13,100 17,600 2A+1C 7,100 7,300 9,100 13,600 18,200
2A+2C 9,200 9,400 11,100 15,600 20,100 2A+2C 9,500 9,700 11,400 16,100 20,800
1A+1C 4,900 5,000 5,900 8,300 10,700 1A+1C 5,100 5,200 6,100 8,600 11,100
1A+2C 6,900 7,000 7,800 10,200 12,500 1A+2C 7,100 7,200 8,100 10,600 12,900
SI 50 lacs with Deductible 5 lacs
Age  21- 25 26-35 36-45 46-50 51-55
1A 3,700 3,900 5,400 8,300 11,800
2A 5,600 5,900 8,000 13,200 18,900 Age completed on policy start date
2A+1C 7,900 8,100 10,100 15,200 20,500 Adults: 21 years & above
2A+2C 10,500 10,800 12,700 18,000 23,300 Kids: 20 years & below
1A+1C 5,600 5,800 6,800 9,600 12,400
1A+2C 7,900 8,000 9,000 11,800 14,400
ICICI Bank- Health Insurance Bouquet
Healthy-U Golden Years- Health Plan

21-55 years 56-75 years

Age Band

•Target Audience: Account holders 55 years and

below •Target Audience: Account holders 56 years and
• Family: Self (mandatory), spouse, 2 Children, above
dependent parents and siblings (brothers/
sisters) • Family: Self (mandatory) and Spouse
• Built in Maternity and OPD benefits • Tele u/w up to 65 years
•Base & Top up plans
Changes in the Golden Years health plan offering
We have reduced the waiting periods & added one more benefit with no premium change

Benefit / Waiting periods Healthy plan Before Healthy plan Now

Declared & accepted PED waiting
24 months Nil (30 day cooling period applies)
period
Standard listed diseases waiting
24 months 12 months
period
COVID-19 cooling period** 30 days 15 days
Standard cooling period for all other
30 days 30 days
diseases including PED
Home health care** Not covered Covered

• Standard cooling period doesn’t apply to hospitalization required due to accidental injury
• **Covers and waiting period initiated due to COVID-19 pandemic (COVID-19 cooling period and Home health
care) shall be available for all our customers until 31st March 2021 only
Golden Years Health Plan: Key Features

Basic Proposition Claim Payment

• Sum Insured: 5 lacs & 10 lac • Co-pay: 20%

• Entry age limits: 56-75 years • Room rent capping: Nil
• 24 hour hospitalization • Sub-limit (only) on
• Pre & Post Hospitalization: 30 / 60 days • Cataract
•
• Day care procedures Total Knee Replacement

Pre-conditions Additional Covers

• Pre-existing diseases: No PED specific
• Air Ambulance
waiting period
• Road Ambulance cover
• Health scan :
• Alternate treatment
• Tele underwriting up to 65 years for
• Donor Expense
non-PED cases
• Domiciliary hospitalization
• Medicals for 66 to 75 years & PED
• Home Care benefit for COVID-19
cases
Golden Years Health plan: Product Construct
Policy coverage
Annual Sum Insured 5 Lacs 10 Lacs
Inpatient Treatment Covered up to SI
Day Care Treatment All Day Care Treatments & procedures covered up to SI
Pre / Post Hospitalization 30 days /60 days
Domiciliary Covered up to SI
Donor expense Covered up to SI
Home Care exp. for COVID-19
Alternate Treatment In-patient hospitalization in Govt. recognized centers only covered up to SI
Road ambulance charges (per
Rs. 1,500 Rs. 3,000
hospitalization)
Air ambulance Up to 10% of SI on a cumulative basis
OPD SI Not available
Maternity SI Not available
Terms and Conditions
Eligibility for entry 56- 75 years
Family definition Self (mandatory) and Spouse only
Sub-limit- Cataract(per eye) Rs. 35,000 Rs. 1,00,000
Sub Limit- Knee Replacement 20% of SI
Co-Pay 20% of claim
24
Golden Years Health Insurance : Pricing

5 lacs Age Group 1 Adult 2 Adults

56-60 21,800 39,300

61-65 28,300 51,000
66-70 43,100 77,500
71-75 54,900 98,800

Age Group 1 Adult 2 Adults

10 lacs
56-60 31,300 56,300
61-65 41,900 75,400
66-70 65,550 1,17,900
71-75 77,300 1,39,100

Age completed on policy start date

Adults: 21 years & above
Kids: 20 years & below
**premium is including GST 25
IL TakeCare: OPD Reimbursement Process

Customer can upload these

Customer visits hospital for Customer has medical bills viz.
bills along with prescription
treatment Pharmacy and diagnostics.
on IL Takecare app

Claimed benefit per SI limit Post submission, OPD bills Customer can submit
transferred to the insured as uploaded are processed request for OPD processing

26
Sales Illustration: IL TakeCare Registration Process

• 35 year old salaried professional

• Stays with wife and two children

Aditya Singhvi Profile Registration Add Policy

Aditya is covered under OBOP health insurance plan for Sum Insured Aditya registers on After signing in, add
the app with the policy with
of Rs. 20 Lacs. Aditya has got a OPD cover of Rs 20,000 on floater
• Mobile number • Master Policy
basis. • DOB number
• OTP is sent • UHID/ Card
Aditya registers himself on the IL Take Care app • MPIN is generated number/ Alternate
(to be used for Policy number
login every time) • DOB

Registration Process

27
Sales Illustration: IL TakeCare App Claims Process

• Aditya one day has running cold

and mild fever and he is reminded
of IL TakeCare App benefits.

Aditya Singhvi Policy details Meet a doctor Pharmacy and

Diagnostics
He selects “meet a doctor” and appointment is fixed Policy details will be This provides OPD
with an empanelled doctor. The doctor basis Aditya’s visible to the customer services viz. This provides option
diagnosis prescribes him medicines. along with facilities • Fixing to avail pharmacy
• Hospital N/W appointment and diagnostic
• Hello doctor with doc services on cashless
Aditya visits the network pharmacy and gets basis at network
• Claims • Pharmacy
medicines on cashless basis for Rs 5 K. centers
• Meet a doctor • Diagnostic
• Health Assistance
Remaining, Rs 15,000 can be utlised by him or his • Blog
family members on similar basis • Know your health
• Queries

Claims Process

28
Wellness Programs
WellnessPLUS Program : Product Proposition

Program
• Comprehensive Wellness and Health insurance program for customers
residing in top 7 cities between 56-75 years of age

Chennai Mumbai

Kolkata Hyderabad

Bangalore Pune

Delhi
WellnessPLUS - Key Features
Basic Proposition Claim Payment

• Entry age limits: 56-75 years

• Co-pay: No co-pay
• Hospital Daily Cash :₹ 7,000/ day for 30
• Deductible: No deductible
days
• ICU Daily Cash: ₹ 14,000/ day for 30 days
• Day Care: ₹ 7,000/ day for 5 events

Pre-conditions Wellness Benefits

• Pre-existing diseases: All pre-existing • Comprehensive health check-up

diseases covered from day 1 • Cashless OPD
• 24 X 7 Tele-consultation
• Health scan : No medical check-up under • Emergency Ambulance
the policy • Cashless medical doctor consultation
WellnessPLUS Program : Product Construct

Features Offering Frequency

Hospital Daily Cash
Wellness
Tele consultations
Emergency ambulance
GP / Specialist / Hospital OPD
Cashless medical consultation at empanelled networks
visit
• INR 7,000 per day on hospitalization or ICU • Up to 30 days /year
• INR 7,000 per event of day care procedure • Up to 5 procedures /year
Health check-up package Once a year
Per year count Unlimited
Unlimited utilization @ 39
ALS/BLS Ambulance services
cities across India
4

Available on cashless mode through IL TakeCare App up 3 ( Limit for reimbursement

Diagnostics/Pharmacy
to Rs 5,000 based claims)
Premium (inclusive of GST) INR 25,555

BLS: Basic Life Support

ALS: Advanced Life Support 32
Wellness plans: offerings chart

Entry age limit: 56-75 years

Feature WellnessPLUS Wellness

Daily Cash on hospitalization

₹ 7,000 ₹ 5,000
up to 30 days

Hospitalisation benefits Daily Payout on ICU

₹ 7,000 ₹ 5,000
Hospitalization
Cover for day care procedures
₹ 7,000 ₹ 5,000
(up to 5 events)
New Doctor’s Visits Cover 4 in a year Not available

Consultation benefits Cashless OPD Claims Available with IL Take Care App -

24x7 Tele-consultations Unlimited 15 consultations in a year

OPD Cover OPD Expenses ₹ 5,000 Not available
Health Check-up Health Check-up Once a year Once a year
Emergency Assistance Emergency Assistance Unlimited usage in a year
Unlimited usage in a year
including Ambulance including Ambulance
Premium inclusive of GST ₹ 25,555 ₹ 16,666
Does ICICI Lombard have health insurance for all?

Aditya Piya Paresh Ronald Sanjay

• Salaried • 60 years old • Salaried • 51 years old
• Businessman
professional • Retired professional • Diabetic since 40
• 35 years old
• 28 years old • Does not have • 24 years old • Convinced that will
• Has wife and 2 kids
• Covered under health plan • Healthy, does not not get any kind of
Employer Health • Worries for himself & think about health health insurance
Plan for Rs 5 Lac wife regarding health insurance
expenses • Has elderly parents

Golden Years Golden Years

Healthy-U Golden Years
Healthy-U (Health plan) (Wellness Plan)
(Top Up Plan) (Health Insurance)
(Gift for parents) (Gift for parents)
Thank you