IVF Clause in ICICI Lombard - Health Shield 360 Policy - Is It Covered?

Starting a family or already undergoing IVF? It helps to know exactly what applies. This is a precise breakdown of maternity and IVF coverage under ICICI Lombard - Health Shield 360 Policy - waiting periods, exclusions, and the costs involved.

Know Your Policy

What You Need to Know About Maternity or IVF coverage?

Here are the questions people most often ask about IVF coverage, summarised:

Is maternity covered under ICICI Lombard - Health Shield 360 Policy?
Does ICICI Lombard - Health Shield 360 Policy cover IVF treatments?
Is there a maternity health insurance plan with no waiting period at all?
Do co-payment clauses apply to maternity or IVF claims?
What exactly is included: labour, delivery, IVF cycles, and complications?
Which exclusions apply, such as pre-existing conditions or outpatient care?
Are complications like C-sections or IVF-related surgeries covered?
Is newborn vaccination covered under your maternity insurance policy?
Does your child get coverage from day 1 or only after 90 days of birth?
Can a pregnant woman buy a maternity insurance policy based on her trimester?
Must both spouses be covered under the same health plan for pregnancy-related claims to be approved?
Can maternity benefits be added to an existing policy by paying a small extra premium annually?

How to check if IVF is covered in your ICICI Lombard - Health Shield 360 Policy

Insurance brochures rarely state plainly whether maternity or IVF is fully covered, and the fine print is easy to misread. Here is a precise way to read your ICICI Lombard - Health Shield 360 Policy:

Search for terms such as: “Maternity Benefit”, “Family Planning”, “Assisted Reproductive Treatments”, “Fertility Expenses”, “Pregnancy Complications”
Check the waiting periods: maternity and IVF often carry 9-48 month waits, even when covered.
Identify the exclusions: IVF costs, outpatient treatments, and pre-existing pregnancy are frequently not covered.
Confirm whether newborn coverage begins only after 90 days, which is common.
Review sub-limits and co-pay clauses: delivery may be capped (e.g., ₹50,000) or require 10-20% co-pay.
Note that some plans require both spouses to be on the same policy to access maternity benefits.
Account for trimester: if already pregnant, maternity add-ons may be denied based on the current trimester.
Some health plans for pregnancy allow add-on maternity coverage by paying a small extra premium. Check whether ICICI Lombard - Health Shield 360 Policy offers that option.

IVF costs and financial Impact

IVF Can Be Expensive - Here's What You Need to Know

Maternity and IVF treatment carry significant out-of-pocket costs, and the largest ones tend to come from:

IVF costs: ₹40,000 - ₹2,00,000 per cycle
Maternity hospitalization: ₹30,000 - ₹50,000 for delivery
C-sections or complications: ₹60,000 - ₹1,50,000
ICU costs for maternity complications: ₹18,000–₹30,000 per day

Know how your policy's limitations could affect these costs, and plan ahead.

What Happens When You Try to Claim for IVF?

Understanding IVF is Great - But Don't Stop There

Here are real-life examples of the issues expectant parents and IVF patients run into:

Case 1: My maternity claim was not paid because my husband and I had both not served the complete waiting period.
Case 2: IVF was covered under my policy, but only 50% of the costs were reimbursed. The other 50% was limited due to a sub-limit.
Case 3: My policy covered the delivery but not the IVF treatment leading up to it. I didn't realise IVF wasn't covered under the standard maternity benefit.
Case 4: My newborn's vaccinations weren't reimbursed because they were classified as outpatient care.
Case 5: My wife was already 6 months pregnant, and no insurer was willing to issue a maternity insurance policy due to the trimester.

Knowing what ICICI Lombard - Health Shield 360 Policy covers - and what it doesn't - is essential to keep this from happening to you.