About TATA AIG MediCare Plus

TATA AIG Health Insurance Company offers an ideal top-up plan called MediCare Plus that is specifically designed as an affordable and pocket-friendly option. MediCare Plus comes with various benefits and features to suit all your medical requirements, ensuring healthy and secure well-being for you and your family. This plan provides comprehensive coverage and compensates the policyholder in case the sum insured gets exhausted.

Key Features of TATA AIG MediCare Plus

Tata AIG provides the best service and products to its customers. It offers various plans, but what plans to choose is a big question here. MediCare Plus is an affordable plan that suits all your medical requirements on a go. But, one should always be aware of the terms and conditions of the availed policy, so let's understand the key features and benefits that might help you to lead a financially secure life,

• The policy can be availed for a longer tenure of up to 3 years.
• It offers you an option of Global cover that covers the expenses incurred for medical treatments outside India.
• Get the higher sum insured options i.e., up to Rs1 Crore.
• You can avail of a high cumulative bonus of up to 100%
• In this plan, a policyholder is not required to have a pre-policy check-up.
• It also provides consumable benefits
• Deductible options are also available of Rs 2 lakh, Rs. 3 lakh, Rs. 5 lakh, Rs. 10 lakh, Rs. 15 lakh & Rs. 20 lakh.
• This plan offers you the tax benefits on the paid premium under 80(D) of the Income Tax Act.
• You are eligible for the free look period under individual health insurance policies, but it is not applicable on renewals or at the time of migrating or porting the policy. A 15 days of free look period is allowed for the insured from the date of receipt of the policy documents to review the terms and conditions of the policy.

Eligibility

**Last Updated on 05-05-2021

Coverages under TATA AIG MediCare Plus

TATA AIG MediCare Plus helps you to benefit in multiple ways. Let's have a look at the below section to understand the coverage option available under this plan;

1. Inpatient Hospitalization

   Medicare Plus plan covers the expenses incurred on the hospitalization due to injury/illness during the policy tenure. This requires the policyholder to be admitted to the hospital for inpatient treatment.

2. Pre-Hospitalization

   Medical expenses incurred up to 60 days before the date of admission to the hospital.

3. Post-Hospitalization

   Medical expenses incurred up to 90 days after the date of discharge from the hospital.

4. Daycare Treatments

   Offers coverage for the listed daycare treatments i.e., about 540+ in the policy's brochure caused due to certain illness/disease/injury during the policy tenure taken at a Daycare center or a hospital.

5. Domiciliary Treatment

   MediCare plus policy provides you the coverage of medical expenses for availing the treatment at home which might require hospitalization in later stages. In case of domiciliary hospitalization, this plan also covers pre and post-hospitalization expenses.

6. Organ Donor

   Covers medical expenses on harvesting the organ for the process of organ transplantation.

7. AYUSH

   The medical expenses incurred on inpatient treatments taken under Ayurveda, Unani, Sidha, or Homeopathy are also covered under this plan.

8. Cover for Ambulance

   Covered expenses incurred during the transportation of policyholder to the hospital in a registered ambulance in case of an emergency hospitalization or transferring the insured from one hospital to the other. The medical facilities and treatments are subject to Rs3000 per hospitalization under this plan.

9. Inpatient Dental Treatments

   The expenses on dental treatments caused due to an accident/injury are also covered.

10. Consumable Benefit

    Get coverage for the expenses incurred for certain consumables specified in the policy which are consumed during the hospitalization tenure.

11. Preventive Health Check-up

    Expenses for preventive health checkups are covered up to 1% of the previous year's policy that is subject to a maximum of Rs. 10,000 per policy once in a time of every two consecutive claim-free years.

12. Cumulative Bonus

    Get an increase of 50% in cumulative bonus for every claim year. This is subjected up to a maximum of 100%. During the policy year when a claim is made, the cumulative bonus reduces up to 50% in the following year.

13. Global Cover

    MediCare Policy provides you an option of Global cover in which the medical expenses associated with inpatient and daycare treatments of the policyholder are covered. This applies to the expenses incurred outside India but the diagnosis was made in India.

14. Second Opinion

    This plan provides a second opinion from your doctor or medical practitioner in case the insured is diagnosed with the listed illnesses during the policy term.

Additional Benefits

1. Renewability

   Get the lifetime renewability option for your policy provided when the premium is paid without any break.

2. Network Hospitals

   TATA AIG provides cashless facilities at 6200+ hospitals across India.

3. Deductible

   All the claims that come under this policy shall only be payable when the aggregate of covered medical expenses (in terms of hospitalization) is more than the deductible that is mentioned in the policy documents/brochures.

4. Tele-Medical Examination

   Pre policy health check-up table

   Age / Sum Insured	Up to 50 lakhs	More than 50 lakhs
   Up to 65 years	No PPC	Tele MER
   46-65 years	Tele MER	Tele MER

   **Last Updated on 05-05-2021

   **PPC - Pre- Policy Check-Up

   **Tele- MER - Tele Medical Examination

Plan Details

**Last Updated on 05-05-2021

Sample Rates of Premium

This graph illustrates the premium amount payable at different ages for policy tenure 1 year and sum insured Rs. 5 lakhs with the deductible amount of Rs.2 lakhs.

Premium rates for MediCare Plus Individual Plan at different ages

In this graph, the premium to be paid at 30 years is Rs. 3821 and at 40 years, it increased to Rs.4222. The premium amount is increasing with age because of certain factors such as medical conditions, smoking habits, lifestyle, pre-existing illnesses, etc.

What, if you want to cover your family members under a single plan. Then you can opt for a family floater plan offered by MediCare Plus. This graph shows the premium amount payable by a family (assuming the age to be self: 30 years, Spouse: 28 years, Son- 10 years, Daughter-5 years) at the different sum insured options with a deductible amount of Rs. 2 lakhs. Let's understand this with the help of a graph.

Premium rates for MediCare Plus Family Plan at different sum insured

Both plans, individual and family floater are ideal plans for you and your family but if you have little kids at your home, then having a family floater plan is better. The family plan provides good coverage for a lower cost than the number of individual plans in a family. If in case one of your family members has a chronic medical history or an adverse health condition, then go for individual health cover because that will help you in the long run. At last, the selection of the plans depends on your requirements and medical needs. Go through the policy carefully and choose your plans wisely.

Discount Offering under MediCare Plus

**Last Updated on 05-05-2021

Exclusions of TATA AIG MediCare Plan

• Alcoholic/drug/substance abuse
• Congenital anomalies, defects, or diseases are not covered.
• Does not cover Alcoholic pancreatitis
• Medical expenses related to the treatment of eyesight correction because of the refractive error i.e., less than 7.5 dioptres.
• Self-inflicted injuries
• Attempted suicide
• Any policyholder attempting to commit a breach of law with criminal intent.
• Treatment is done by a doctor or medical practitioner which is outside his expertise is not covered.

For detailed information about the exclusions, please refer to policy brochures/documents.

Waiting Periods

• Initial waiting periods for 30 days from the beginning of the policy (this is not applicable for accidents).
• After a waiting period of 24 months, certain listed diseases/illnesses will be covered under this plan.
• Any pre-existing illnesses will be covered after a waiting period of 36 months.

How to buy this TATA AIG MediCare Plan?

• Visit the official website of TATA AIG Insurance company and choose 'Health' by clicking on 'All Products'.
• Select the category for whom you want to buy the plan and click 'Get Plan'.
• Fill in the required details like your contact number, dob, and click on the 'See Plan'.
• Check the plans as per your needs, tap the 'Buy' button, and make the payment.
• Your policy document will be mailed to you at your registered email address.

Claim Process of MediCare Plus

For cashless claims:

• Call on our toll-free number 1800 266 7780/ 1800 229 966 (for senior citizens) in case of any assistance at the time of hospitalization or you can reach out at healthclaimsupport@tataaig.com
• If you want to check the list of network hospitals, refer to the company's website or PolicyX.com network hospital page.

For Reimbursement

• 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.