TATA AIG Medicare

TATA AIG Medicare plan offers several benefits such as lifelong renewal, restore benefits, global cover, and a strong tie-up with 6200+ network hospitals across India. Let's understand this plan in more detail for better understanding,

Key Features and Benefits of TATA AIG Medicare

Let's look at few important key features that could help you make an informed decision, here's a quick lay down:

1. Global Cover

   TATA AIG Medicare covers the medical expenses related to daycare and inpatient treatments/hospitalization of the policyholder incurred outside India but the diagnosis was performed in India only.

2. Restore Benefit

   The sum insured amount automatically gets restored to 100% to you and your family.

3. Cumulative Bonus

   For every claim-free year, a 50% increase is applicable in cumulative bonuses up to a maximum of 100%. If the claim is made during the policy year, then the cumulative bonus decreases by 50% in the next year.

4. COVID Coverage

   This plan also provides coverage against COVID.

5. Network Hospitals

   Empanelled with 6200+ network hospitals that provide cashless hospitalization. In the cashless facility, you are not required to pay a single penny to the hospital for the treatment of an illness/disease.

Benefits of TATA AIG MediCare Plan

TATA AIG provides individual and family floater plans. Let's discuss some of the benefits of Tata AIG health insurance for your smooth and quick understanding,

1. No Room Rent

   There are no such limits on room rent that includes the coverage of boarding, nursing expenses, fees of a medical practitioner, and medicines.

2. Bariatric Surgery

   Get coverage for the expenses incurred on Bariatric Surgery treatment related to weight and obesity control.

3. In-Patient Treatment

   This plan provides coverage for hospitalization caused to injury/disease/illness during the policy tenure. This requires the admission of a policyholder to the hospital as an inpatient. Some of the medical expenses which are directly related to the hospitalization would also be payable such as the room rent, charges of ICU, Operation theatre expenses, nursing and boarding charges, and anaesthesia.

4. Day Care Treatments

   Offers coverage for 540+ daycare treatments listed in the policy's documents caused due to any disease/illness/injury during the policy tenure taken at a daycare centre or at a hospital.

5. Consumable Benefits

   Covers the expenses incurred on certain listed consumables which are consumed during the process of hospitalization.

6. Coverage For Vaccination

   It covers the expenses incurred on the HPV vaccination i.e., Human Papilloma Virus and Hepatitis B Vaccine. This is offered after 2 years of continuous coverage under this plan. The anti-rabies and typhoid vaccination are also covered without any waiting period.

7. Organ Donor Coverage

   Medical and surgical expenses are covered for harvesting the organ.

8. Vaccination For First-Year

   This plan covers the expenses on vaccination for up to 1 year after the child's birth subject to a limit of Rs. 10,000/-. In the case of a girl child, the cover would be Rs. 15,000/-.

9. Tax Benefits

   The plan offers tax saving benefits on the paid premiums under section (80D) of the Income Tax Act.

10. Pre Hospitalization

    Medical expenses incurred before the date of admission and after the date of discharge from the hospital.

11. Hospital Daily Cash Benefit

    If in case the policyholder is hospitalized (in-network hospital) in shared room/accommodation, then coverage limit would be 0.25% of base sum insured and maximum Rs. 2000 per day would be payable to the insured by the insurer.

12. Second Opinion

    Get the second opinion from the medical practitioner or your network provider if the policyholder has been diagnosed with the diseases/.illnesses mentioned in the policy's documents.

13. Ambulance Cover

    Covers the expenses for using the service of an ambulance during an emergency for transporting the policyholder to the hospital.

Types of TATA AIG MediCare Categories

TATA AIG Medicare health insurance plan is majorly classified into three categories: TATA AIG MediCare, TATA AIG MediCare Protect, and TATA AIG Medicare Premier.

1. TATA AIG MediCare

   By availing of this policy, you can get various additional benefits such as bariatric surgery, global cover, restore benefit, and many more. It offers wide coverage options with different sums insured ranging from 3 lakhs-20 lakhs.

2. TATA AIG Medicare Premier

   This is a comprehensive policy that provides protection to you and your family. This plan also offers some extra benefits such as OPD dental treatments, air ambulance, and many more. It offers a number of sum insured options ranging from 5 lakhs-50 lakhs.

3. TATA AIG MediCare Protect

   This is the plan for those who are looking for pre and post-hospitalization expenses.

Coverage Details of TATA AIG MediCare

**Last Updated on August, 2021

Sample Premium Rates of TATA AIG MediCare Plan

This table illustrates the premium payable by individuals at different ages that are: 30 years, 40 years, 50 years & 60 years for a sum insured of Rs. 5 lakh. Here we are comparing the premium amount of three variants of the Medicare Plan. Let's understand the plan with the help of a graph,

Premium Rates of MediCare Plan

Claim Process of TATA AIG Medicare Plan

The company provides a simple claim process to assist the policyholder during medical emergencies. It has divided the process into two forms- Cashless and Reimbursement. Let's discuss both types of claims in detail.

Cashless

Under this form of claim settlement, the insured has the freedom to take the needful treatment at any network hospital. For smooth cashless claim service, follow the below-mentioned steps,

• In case of treatment, get admitted to one of the network hospitals empanelled with Tata AIG. You can check the list of network hospitals on the company's website.
• Validate your identity with the network hospital, after which the hospital will submit the pre-authorization request form to the company.
• Then the company will review your request and confirm the network hospital by email and a copy of the same will also be shared with you.
• The company will settle the claim with the hospital after the completion of all the formalities.

Note- In the case of emergency hospitalization, you need to inform the insurer within 24 hours. In case of planned hospitalization, you need to inform the insurer at least 5 days in advance.

Reimbursement Claims

Here you need to pay all the treatment bills to the hospital.

• Later, you can file for reimbursement under TATA AIG health insurance. To do that, the insured must collect all bills, and prescriptions related to the treatment and submit the same along with the claim form to the insurance company or TPA.
• The insurer will analyze your claim and might ask for additional documents (if required).
• If it gets approved, the company will transfer the amount directly into your account and in case of rejection, you will receive the reason for the same.