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Tata AIG MediCare Health Insurance

316 reviews Rate This
Tata AIG Health Insurance
MediCare
Claim SettlementDedicated Team
Claim Settlement Ratio76.04%
COVID-19 CoverYes
Network Hospitals 3,000+
Policies Sold2,20,583
RenewabilityLifelong

About Tata AIG MediCare Health Insurance

A simplified and comprehensive health insurance plan, TATA AIG MediCare is designed considering the increasing cost of medical expenses these days. The policy covers persons in the age group of 5 years onwards (dependent children between 91 days and 5 years can be insured only when both parents are getting insured). The maximum entry age is 65 years.

Some of the benefits that the TATA AIG MediCare offers to its policyholders are - global cover, lifelong renewal, bariatric surgery cover and a strong network of more than 3,000 hospitals across India. Apart from this, the health insurance company offers various discounts on premiums depending on the term of the policy or on another basis.

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Key Inclusions and Exclusions of the Plan

What's Included

  • The medical and surgical expenses of the organ donor to harvest the organ
  • Daycare procedures due to a disease, illness or injury during the policy period
  • Post-hospitalisation 90 days immediately after the insured person is discharged
  • Pre-hospitalisation 60 days immediately before the insured person is hospitalized
  • In-patient treatment that is directly related to the hospitalisation would be payable

What's Not Included

  • Treatment of obesity and any weight control program
  • Treatment rendered by a medical practitioner, which is outside his discipline
  • General debility or exhaustion (“run-down condition”)
  • Psychiatric, mental disorders (including mental health treatments)
  • Pre-existing conditions are covered after a waiting period of 36 months

MediCare Plan Details

Features/PlanMedicareMedicare Premier
Restoration Benefit
Up to 100% of SI
Up to 100% of SI
No Claim Bonus
Up to 100% of SI
Up to 100% of SI
Room Rent
Single private/shared accomodation
No restriction
ICU Charges
Actual
Actual
Pre and Post Hospitalization
60 & 90 days
60 & 90 days
Day Care Procedure
541
541
Free Health Checkup
Up to 1% of SI for claim free year after 2 consecutive years
Up to 1% of SI after 2 consecutive years irrespective of claim made
Organ Donor
Available
Available
AYUSH
Available
Available
OPD Benefit
N/A
Up to Rs. 5000 per policy year
Domiciliary Hospitalization
Available
Available
Ambulance Cover
Up to Rs. 3000 per hospitalization
Up to Rs. 5000 per hospitalization
Second Opinion
Available for specified illness
Available for specified illness
Co-Pay
10% copay, if insured opts for higher room category than mentioned
N/A
Initial Waiting Period
30 days
30 days
Specific Illness Waiting Period
2 years
2 years
Waiting Period of PED
3 years
2 years
Special Feature
Inpatient dental treatment available, Global cover, Hearing aid, bariatric surgery also covered
Inpatient dental treatment, Global cover, Newborn vaccination, Hearing aid, Bariatric surgery also covered
Compassionate Travel
Up to Rs. 20,000 per policy year
Up to Rs. 20,000 per policy year
Accidental Death Benefit
Optional cover
Available
Anti-rabies Vaccination
Up to Rs. 5000
Up to Rs. 5000
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4975 Tata AIG Cashless Network Hospitals in India

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MediCare User Reviews

4.7
Rating based on
316 User reviews
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What users are saying
  • All
  • Medicare is the best plan

    Medicare health insurance plan is the best health insurance plan in the market which fulfils all my requirements and offers me all the benefits which I wanted under my plan. Some of them are-daycare procedures, pre and post hospitalisation expenses, in patient treatment that is directly related to the hospitalisation and many more   

    Read More

    N
    By Nitish Rajput
    On: Feb 27, 2020
  • liked it much!!

    This is a health insurance plan that you must not miss. I like it because it offers me many benefits. I have my whole family covered under it for benefits like pre and post hospitalisation expenses, daycare procedures, medical and surgical procedures and in patient expenses as well. It also gives me restoration benefit.   

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    G
    By Girish Choudhary
    On: Feb 27, 2020
  • Many benefits offered

    I am covered under TATA AIGs medicare plan since a year. I have recently renewed my policy frm Insurancedekho and it was such a simple process. My plan covers me for organ donor expenses, pre and post hospitalisation expenses, and day care procedures occuring due to disease, and so on.   

    Read More

    N
    By Nasir S
    On: Feb 17, 2020
  • Good network hospitals

    Not only this plan is good, but also the insurance company. The number of network hospitals they have is huge. Which means that you will not have to compromise as far as quality treatment is concerned. I got treated in a good hospital near by my place and it was easy to reach in emergency  

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    S
    By Sonara Meet
    On: Feb 17, 2020
  • Good deal...

    This plan offers me for not only the basic coverage features, like pre and post hospitalisation expenses, but also major other expenses which i wanted in my policy like daycare procedures, in-patient expenses, organ donor cover etc. I am covered under this plan since a few months now and planning to renew it too.   

    Read More

    J
    By Janvi Shorey
    On: Feb 04, 2020
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Add-ons to Enhance Benefits

  • Accidental Death Benefit

    TATA AIG offers Accidental Death Benefit as an rider under the MediCare plan. Under this benefit, when you suffer from an accident during the policy period and the accident causes death within 365 days from the date of the accident, then the insurer will pay a fixed amount of 100% of the base Sum Insured.

    You can avail this feature by paying an additional premium. 

Tata AIG MediCare Expert Review

  • Expert Review

    TATA AIG MediCare is a comprehensive health insurance plan which offers a range of coverage benefits to policyholders. The plan covers basic and advanced coverage benefits some of which promise an all-inclusive coverage to the insured. The premiums are affordable and there are good discounts too which help in making the premiums more pocket-friendly. The plan is, therefore, a comprehensive plan which is not hard on your pockets.

    The entry age ranges from 91 days for dependent children and the maximum entry age is 65 years. The policy can be taken on an individual basis or a family floater basis. The family floater variant would cover the policyholder, spouse, dependent children and dependent parents. Coverage term is available for up to three years. The sum insured is also available in multiple levels which start at Rs. 3 Lakh and goes up to Rs. 20 Lakh.

  • Major Attractions

    Coverage is available for ambulance charges incurred in taking the insured to the hospital, inpatient treatments, pre and post hospitalisation costs, day care procedures and organ donor treatments. The other major coverage benefits include the following –

    • The policy covers treatments which are taken internationally too if the insured is diagnosed in India but travels to an international country to get treated
    • Coverage is allowed for bariatric surgery for correction of weight if such a surgery is prescribed by a certified medical practitioner
    • Dental treatments taken on an inpatient basis are also covered under the plan
    • If the sum insured is exhausted in a policy year due to previous claims, it is completely restored within the same year for any future claims
    • Free medical health check-ups are allowed once in a block of two consecutive policy years up to 1% of the chosen sum insured
    • If the insured suffers from a prescribed critical illness, free medical second opinion is allowed under the plan
    • Vaccination cover is available
    • Cost of hearing aid and consumable are also covered up to a specified limit
    • A daily cash benefit is allowed if the insured chooses shared accommodation or accompanies a minor child
    • Coverage for compassionate travel is allowed for family members if the insured is hospitalised in another city for more than 5 days
    • The policy can be enhanced by choosing an optional Accidental Death benefit rider which pays the sum insured in case of accidental death
    • 50% of the sum insured is increased free of cost after a claim-free policy year 

  • What’s More?

    The policy offers the following additional benefits –

    • Renewals can be done lifelong
    • There is a tax benefit on the premium paid for the plan under Section 80D
    • 5% discount is allowed if the policyholder buys two-year coverage. The discount increases to 10% in case of choosing a term of 3 years
    • 10% premium discount is allowed if a shared room is selected in case of hospitalisation
    • 20% premium discount is allowed on family floater policies if two members are added, 28% if 3 members are added and 32% if more than three members are added to the cover

  • Conclusion

    The plan is, therefore, quite a comprehensive plan which provides some of the best coverage benefits. The sum insured levels are flexible and suitable for all and the premiums are also affordable.

    If you are looking to buy the policy you can choose InsuranceDekho website and buy the policy online. Buying online is more convenient and the website helps you understand and fulfill your coverage needs with its expert help.

Tata AIG MediCare Brochure

  • 189.85 KB
  • PDF Document
  • Mar 22, 2019
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Claim Process at Tata AIG Health Insurance

  • Network Hospital
  • Non-Network Hospital
  • 1

    Claim Assistance

    For any assistance or query, call InsuranceDekho at the toll-free number 755 1196 989.
  • 2

    Claim Intimation

    Emergency hospitalisation needs intimation within 24 hours and for planned hospitalisation intimate within 48 hours prior to admission.
  • 3

    Claim Processing

    Fill in the pre-authorisation form and hand it over to hospital's insurance/TPA desk to initiate claim request.
  • 4

    Claim Settlement

    Once your request is approved, claim is settled. If not approved, claim for reimbursement after discharge.
  • 1

    Claim Assistance

    For any assistance or query, call InsuranceDekho at the toll-free number 755 1196 989.
  • 2

    Claim Intimation

    Emergency hospitalisation needs intimation within 24 hours and for planned hospitalisation intimate within 48 hours prior to admission.
  • 3

    Claim Processing

    Submit claim form with original documents such as doctor’s reports, hospital bills, diagnostic tests, etc.
  • 4

    Claim Settlement

    Once your request for reimbursement of expenses is approved, the claim will be settled.

FAQs on MediCare Health Insurance Plan

  • What all does TATA AIG’s Medicare plan cover?

    TATA AIG’s Medicare plan covers the following: 1)In-patient treatment 2)Pre-hospitalisation 3)Post-hospitalisation 4)Daycare procedures 5)Organ donor 6)Domiciliary treatment 7)Global cover 8)Bariatric surgery cover 9)In-patient dental treatment 10)Restore benefit 11)AYUSH benefit 12)Ambulance cover 13)Health checkup 14)Second opinion 15)Vaccination cover 16)Hearing aid 17)Daily cash for choosing shared accommodation 18)Daily cash for accompanying an insured child 19)Compassionate travel 20)Consumables benefit

  • What are the options for sum insured in Tata AIG MediCare Health Insurance?

    You can choose to get a cover for sum insured of Rs. 3 Lakh, Rs. 4 Lakh, Rs. 5 Lakh, Rs. 7.5 Lakh, Rs. 10 Lakh, Rs. 15 Lakh, and Rs. 20 Lakh.

  • What is the minimum age required for entry to TATA AIG MediCare plan?

    TATA AIG MediCare plan covers persons in the age group 5 years onwards (dependent children between 91 days and 5 years can be insured only when both parents are insured).

  • What is the maximum entry age for the TATA AIG MediCare plan?

    The maximum entry age for TATA AIG MediCare plan is 65 years.

  • Is TATA AIG MediCare plan for an individual or family?

    This policy can be issued to an individual and/or family.

  • Are day care procedures included in TATA AIG’s MediCare plan?

    Yes, TATA AIG covers expenses for listed Day Care Treatment due to disease/illness/Injury during the policy period taken at a hospital or a Day Care Centre. The list of such day care procedures covered is available on the company’s official website. 

  • When can I avail bariatric surgery cover under TATA AIG MediCare plan?

    The policy covers reasonable and customary expenses for bariatric surgery if the insured fulfills: i) Surgery to be conducted upon the advice of the Doctor ii) The member has to be 18 years of age or older iii)BMI greater than or equal to 40 iv)BMI greater than or equal to 35 in conjunction with any of the following severe comorbidities following the failure of less invasive methods of weight loss: a) Obesity-related cardiomyopathy, b) Severe sleep apnea, c) Uncontrolled Type 2 diabetes, or d) Coronary heart disease

  • How many people are covered under one Individual Plan?

    Maximum 7 members of a family are covered in one Individual Plan (self, spouse, 3 dependent children, and 2 dependent parents).

  • How many people are covered in one Family Floater Policy?

    Maximum 7 members are covered in one Family Floater Policy (self, spouse, 3 dependent children (up to the age of 25 years) and 2 dependent parents. In case of family floater, where the age of the dependent child is crossing 25 years, the child can be covered under a separate policy with an eligible continuity benefit.

  • What all is covered under consumables benefit in the TATA AIG MediCare plan?

    TATA AIG will pay for expenses incurred, for consumables which are listed in ‘Items for which optional cover may be offered by insurers’ under ‘Guidelines on Standardization in Health Insurance, 2016’, which are consumed during the period of hospitalisation directly related to the insured’s medical or surgical treatment of illness/disease/injury.

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