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TATA AIG MediCare Protect Insurance

tata aig health insurance
Coverage available is Rs. 2,00,000, Rs. 3,00,000, Rs. 4,00,000, Rs. 5,00,000.

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
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 Centre.

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

Cumulative bonus 10% increase in cumulative bonus for every claim free year, upto a maximum of 100%. In the case a claim is made during the policy year, the cumulative bonus would reduce by 10% in the following year. Consumables Benefit Covers expenses incurred for consumables which are consumed during the period of hospitalization directly related insured person's medical or surgical treatment of illness/disease/injury.

Benefits of Medicare Plans ((All Amounts in ₹ INR)

Benefits Tata AIG Medicare Protect
Maximum Sum Insured 200,000 / 300,000 / 400,000 / 500,000
Inpatient Treatment Covered upto max SI
Room Rent Charges Room Rent covered for Shared accomodation
Ambulance Charges (per policy period) upto ₹ 1,000 per hospitalisation
Air Ambulance (per policy period) -
Pre Hospitalisation Expenses incurred upto 30 days
Post Hospitalisation Expenses incurred upto 60 days
Delivery Charges (Normal) -
Deliver Charges (Caesarean) -
Waiting Period for Delivery -
Coverage for New Born Child -
First Year Vaccination Charges -
Outpatient (OPD) Dental Cover -
Daily Cash - per day limit for shared accomodation / accompanying and insured child -
Health Check Up 1% of Sum Insured subject to 3 claims free years upto ₹10,000
Restoration Benefit after exhaustation of Sum Insured (once during policy period) upto Sum Insured
Bariatric Surgery(per policy period) -
Accidental Death -
Day Care Procedures 541 listed procedures covered
Organ Donor upto Sum Insured
Domiciliary Treatment upto Sum Insured
E Opinion for Critical Illness -
Ayush Benefit Covered Upto Sum Insured
Global Coverage for Treatment -
Second Opinion -
Vaccination Charges (NIL waiting) -
Vaccination Charges (after waiting period of 2 years) -
Inpatient Dental Treatment -
Hearing Aid -
Prolonged Hospitalisation Benefit -
High End Diagnostics -
Outpatient Treatment -
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 -
Additional Covers
Accidental Death Benefit Coverage upto 100% of Sum Insured only for Primary Insured
  • 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 48 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.

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

Ambulance Cover Covers expenses, upto Rs 1,000 per hospitalization, on transportation of Insured Person in an ambulance to a Hospital for admission in case of an Emergency or from one hospital to another for better treatment.

Domiciliary Treatment Covers for expenses related to Domiciliary Hospitalization of the insured person if the treatment exceeds beyond three days. The treatment must be for management of an illness and not for enteral feedings or end of life care.

Compassionate Travel Covers 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.

Optional Accidental Death Cover Covers 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.

Other Features
  • Pre-Hospitalization expenses
  • Post-Hospitalization expenses
  • AYUSH Benefit
  • Health Checkup
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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