ICICI Pru Hospital Care II – this fixed benefit hospitalizations and surgical plan complements your existing coverage by offering payouts over and above any health insurance plan you have, thus availing best possible medical treatment, without having to trouble about the cost of the treatment or quality of care.
Eligibility –
| Min/Max age at entry | 1 year – 65 years(nearest birthday)
(90 days – 24 years for dependent children in case of family floater) |
| Coverage | Individual / Family floater ( self, spouse, First 3 dependent children) |
| Policy term | 10 years (Guaranteed insurability at renewal for life) |
| Premium payment frequency | Yearly, half yearly & monthly |
| Waiting period | 30 days |
| Annual Premium (Individuals) (Rs.) | ||||
| Age / Plan type | Plan A | Plan B | Plan C | Plan D |
| 25 years | 4,669 | 7,545 | 10,426 | 13,309 |
| 30 years | 4,756 | 7,724 | 10,700 | 13,678 |
| 35 years | 5,039 | 8,298 | 11,566 | 14,837 |
| 40 years | 5,508 | 9,244 | 12,999 | 16,753 |
| 45 years | 6,166 | 10,574 | 14,922 | 19,413 |
| 50 years | 7,670 | 13,062 | 18,480 | 23,906 |
| Annual Premium (Family floater: with spouse) (Rs.) | ||||
| Age / Plan type | Plan A | Plan B | Plan C | Plan D |
| 25 years | 6,912 | 11,729 | 16,557 | 21,388 |
| 30 years | 7,400 | 12,714 | 18,038 | 23,366 |
| 35 years | 8,213 | 14,363 | 20,524 | 26,688 |
| 40 years | 9,440 | 16,823 | 24,217 | 31,613 |
| 45 years | 10,719 | 19,388 | 28,059 | 36,733 |
| 50 years | 13,124 | 23,148 | 33,023 | 43,269 |
| Annual Premium (Family floater: with spouse & child) (Rs.) | ||||
| Age / Plan type | Plan A | Plan B | Plan C | Plan D |
| 25 years | 8,710 | 14,933 | 21,291 | 27,583 |
| 30 years | 9,198 | 15,978 | 22,772 | 29,561 |
| 35 years | 10,011 | 17,627 | 25,258 | 32,883 |
| 40 years | 11,238 | 20,087 | 28,951 | 37,808 |
| 45 years | 12,517 | 22,652 | 32,793 | 42,928 |
| 50 years | 14,922 | 26,142 | 37,937 | 49,464 |
The annual premium rates exclude service tax and education cess. The premiums are guaranteed for one year from the date of commencement of the policy. Thereafter the company reserves the right to revise the premium subject to prior approval from IRDA. The above premiums are only sample premiums for certain age groups.
Features & Benefits –
Following are the features in detail:
1. Daily hospitalization cash benefit (DHCB)
2. Intensive care unit benefit (ICUB)
3. Surgical benefit (SB)
4. Non surgical benefit
5. Recuperating benefit
6. Prolonged stay benefit
7. Health check-up
8. Optional additional daily hospitalisation benefit (ADHB)
1. Daily hospitalisation cash benefit (DHCB)
This benefit amount is payable in the event of hospitalisation from the 1st day of hospitalisation, for each day of hospitalisation, subject to a continuous stay for minimum of 24 hours.
2. Intensive care unit benefit (ICUB)
This benefit amount of 1 time the DHCB is payable per day for each day in the event of hospitalisation in an concentrated care unit and in any policy year is limited to a total of 15 times the DHCB under the plan.
The total DHCB and ICUB combined will be payable for a maximum of 90 days.
3. Surgical benefit (SB)
A fixed lump-sum amount is payable in the event of undergoing any of the more than 1000 covered surgical procedures and is paid irrespective of whether the DHCB is payable or not. In any policy year, the surgical benefit is limited to 300 times the DHCB.
| Grade of surgery | Examples of surgeries covered under the grade |
| I | Tennis Elbow Release, Haemorrhoids Surgery |
| II | Lithotripsy for Kidney Stone, Cataract Surgery, Tonsils Removal |
| III | Lumps Excision, Gall Stone (Cholecystectomy) |
| IV | Hernia Repair, Uterus Prolapse |
| V | Arthroscopy, Knee reconstruction |
| VI | Coronary Angioplasty, Valvular Open Heart Surgery |
| VII | Coronary Artery Bypass Graft, Total Hip Joint Replacement |
4. Non surgical benefit (NSB)
This benefit amount is payable in the event of hospitalisation without any surgery. An extra benefit of 100(%) per cent of DHCB is payable for every day spent in the hospital up to a maximum limit of 4 times DHCB, subject to the DHCB being payable at the time of hospitalisation.
5. Recuperating benefit
A post-hospitalisation benefit amount of 3 times the DHCB is payable to help you with recuperating expenses like follow-up tests, medicines and consultations. Benefit amount payable for 7 or more days of continuous hospitalisation for the same injury or disease, subject to the DHCB being payable at the time of hospitalisation. This benefit is payable only if the life insured is discharged from the hospital.
6. Prolonged stay benefit
A long stay in the hospital can drain your savings and may even lead to loss of income. This benefit tries to lower the impact of prolonged captivity in the hospital. An additional 100% of DHCB is payable per day of continuous hospitalisation after the first 30 days up to a maximum of 60 days for the same injury or disease, subject to the DHCB being payable at the time of hospitalisation.
7. Health check-up
Health check-up will be available for all insured family members under the plan, once every two years after completion of the first policy year. This benefit is provided on reimbursement basis to a maximum of Rs 4,000 per policy irrespective of plan type.
8. Optional additional daily hospitalisation benefit (ADHB):
You have an option to increase the DHCB and ICUB payout by an additional 100% by taking up this option. This however does not change the payout limits for other benefits in the plan. The benefit under he ADHB option is subject to the total annual limit under the insurance plan.
Benefit amounts at-a-glance
| Benefit | Plan A(Rs.) | Plan B (Rs.) | Plan C (Rs.) | Plan D (Rs.) |
| DHCB (per day) | 1,000 | 2,000 | 3,000 | 4,000 |
| ICUB (per day) | 1,000 | 2,000 | 3,000 | 4,000 |
| Surgical benefit | ||||
| Grade 1 | 10,000 | 20,000 | 30,000 | 40,000 |
| Grade 2 | 20,000 | 40,000 | 60,000 | 80,000 |
| Grade 3 | 30,000 | 60,000 | 90,000 | 1,20,000 |
| Grade 4 | 40,000 | 80,000 | 1,20,000 | 1,60,000 |
| Grade 5 | 75,000 | 1,50,000 | 2,25,000 | 3,00,000 |
| Grade 6 | 1,00,000 | 2,00,000 | 3,00,000 | 4,00,000 |
| Grade 7 | 1,50,000 | 3,00,000 | 4,50,000 | 6,00,000 |
| Non-surgical benefit (per day) | 1,000 | 2,000 | 3,000 | 4,000 |
| Recuperating benefit | 3,000 | 6,000 | 9,000 | 12,000 |
| Prolonged stay benefit (per day) | 1,000 | 2,000 | 3,000 | 4,000 |
| Health check-up | Up to Rs. 4,000 | Up to Rs. 4,000 | Up to Rs. 4,000 | Up to Rs. 4,000 |
| Benefit limits | Plan A(Rs.) | Plan B (Rs.) | Plan C (Rs.) | Plan D (Rs.) |
| Annual limit | 4,00,000 | 8,00,000 | 12,00,000 | 16,00,000 |
| Lifetime limit | 20,00,000 | 40,00,000 | 60,00,000 | 80,00,000 |
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Tags: Health Insurance, ICICI Pru Hospital Care II, ICICI Pru Life Insurance