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TATA AIG MediCare Premier Insurance

tata aig health insurance
Coverage available is Rs. 5,00,000, Rs. 10,00,000, Rs. 15,00,000, Rs. 20,00,000, Rs. 25,00,000 and Rs. 50,00,000.

Eligibility

  • Minimum entry age - 91 days and Maximum entry age - 65 years
  • Policy Tenure Options -1/2/3 Years
  • Covers upto 7 members (Self, Spouse, upto 3 dependent children and upto 2 dependent parents
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  • Key Features
  • Benefits
  • Waiting Period
  • Plan highlights
  • Exclusions
Global Cover Covers Medical Expenses related to Inpatient & Day Care Hospitalization of the Insured Person incurred outside India, provided that the diagnosis was made in India.

Bariatric Surgery Covers expenses incurred for Bariatric Surgery for treatment of Obesity and weight control.

Emergency Air Ambulance Covers expense for ambulance transportation by airplane or helicopter for emergency life threatening health conditions, which require immediate ambulance transportation to the hospital/medical centre.

Consumables benefit Covers expenses incurred, for consumables which are consumed during the period of hospitalization directly related to the insured person's medical or surgical treatment of illness/disease/injury.

Restore Benefits It automatically restores your sum insured to 100% for you and your family members.

Day Care Procedures Covers expenses for 540+ Day Care Treatment due to disease/illness/injury during the policy period taken at a hospital or a day care center.

Benefits of Medicare Premier (All Amounts in INR)

Benefits Tata AIG Medicare Premier
Maximum Sum Insured 5,00,000 / 10,00,000 / 15,00,000 / 20,00,000 / 25,00,000 / 50,00,000
Inpatient Treatment Covered upto max SI
Room Rent Charges No restrictions
Ambulance Charges (per policy period) upto ₹ 5,000 per hospitalisation
Air Ambulance (per policy period) upto 5,00,000
Pre Hospitalisation Expenses incurred upto 60 days
Post Hospitalisation Expenses incurred upto 90 days
Delivery Charges (Normal) 50,000 (60,000 for a girl child)
Deliver Charges (Caesarean) 50,000 (60,000 for a girl child)
Waiting Period for Delivery 48 months
Coverage for New Born Child 10,000
First Year Vaccination Charges 10,000 (15,000 for a girl child)
Outpatient (OPD) Dental Cover 10,000 after completing two years of continous coverage
Daily Cash - per day limit for shared accomodation / accompanying and insured child Upto 0.25% of Sum insured max ₹2,000each
Health Check Up 1% of Sum Insured every year upto ₹10,000
Restoration Benefit after exhaustation of Sum Insured (once during policy period) upto Sum Insured
Bariatric Surgery(per policy period) Covered
Accidental Death Fixed amount of 100% SI
Day Care Procedures 541 listed procedures covered
Domiciliary Treatment upto Sum Insured
E Opinion for Critical Illness Included
Ayush Benefit Covered Upto Sum Insured
Global Coverage for Treatment Covered upto max SI provided diagnosis was made in India
Second Opinion Included
Vaccination Charges (NIL waiting) Covered for ₹ 5,000 for Anti Rabies and Typhoid
Vaccination Charges (after waiting period of 2 years) Covered for ₹ 5,000 for HPV and Hepatitis B
Inpatient Dental Treatment Included
Hearing Aid 50% of Actual or 10,000 every third year
Prolonged Hospitalisation Benefit 1% of SI if continous hospitalisation is for more than 10 days
High End Diagnostics Upto 25,000 per policy year
Outpatient Treatment 5000 once for every two years
Compassionate Visit (Travel) Upto 20,000
Cumulative Bonus 10% of Sum Insured (for every claim free year) upto 100%
Consummables Benefit Included as per IRDA 2016 guidelines
Accidental Death Benefit 100% of Sum Insured
Additional Covers
Accidental Death Benefit NA
  • Policy coverage starts 30 days from the first inception of the policy (except accident).
  • Any listed illnesses/treatments will be covered after a waiting period of 24 months.
  • Any pre-existing condition will be covered after a waiting period of 36 months
In Patient Treatment Covers expenses for hospitalization due to disease/illness/Injury during the policy period that requires an Insured Person’s admission in a hospital as an inpatient. Medical expenses directly related to the hospitalization would be payable.

High End DiagnosticsCovers the insured person for the listed diagnostic tests on OPD basis if required as part of a treatment subject to Rs. 25,000 per policy year annually.

Accidental Death BenefitCovers 100% of sum insured in the event of death of insured person due to accident. This benefit is not applicable for dependent children covered in the policy.

Maternity CoverCovers maternity expenses – upto a maximum of Rs. 50,000/- (incase of birth of girl child cover would be for Rs. 60,000) per policy.No limit on number of delivery events.

First year VaccinationsCovers vaccination expenses for up to one year after the birth of the child subject to a limit of Rs.10,000/- (in case of girl child cover would be for Rs. 15,000) provided the child is covered with us.

Organ DonorCovers Medical and surgical Expenses of the organ donor for harvesting the organ where an Insured Person is the recipient.

Vaccination CoverCovers expenses related to Human Papilloma Virus (HPV) vaccine & Hepatitis B Vaccine after 2 years of continuous coverage and Anti-rabies vaccine & Typhoid vaccination without any waiting period.

Compassionate Travel Vaccination CoverCovers expenses upto Rs. 20,000 related to a round trip economy class air ticket, or first-class railway ticket, to allow the Immediate Family Member to be at insured person's bedside during his stay in the hospital.

OPD Dental TreatmentCovers expenses upto Rs. 10,000 related to root canal, filling, tooth extractions over and above sum insured. Does not impact cumulative bonus.

Other Features
  • Pre-Hospitalization expenses
  • Daily Cash for choosing shared accomodation
  • Second Opinion
  • OPD Treatment
  • Ambulance Cover
  • Health Checkup
  • Hearing Aid
  • Post-Hospitalization expenses
  • Daily Cash for accompanying an insured child
  • Domiciliary Treatment
  • New Born Baby Cover
  • Prolonged Hospitalization Benefit
  • AYUSH Benefit
  • In-patient Treatment-Dental
  • Cumulative Bonus
Medical Exclusions
  • Conditions related to or arising out of HIV or AIDS
  • Abuse of intoxicants or hallucinogenic substances such as intoxicating drugs and alcohol
  • Congenital External Diseases, defects or anomalies
Non-Medical Exclusions
  • War or any act of war, act of foreign enemy or war like operations
  • Intentional self-injury or attempted suicide while sane or insane
  • Any Insured Person attempting to commit a breach of law with criminal intent

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