TATA AIG Medicare Plus Plan

Brief Overview

A joint venture between Tata Group and American Insurance Group, Tata AIG was established in the year 2001, and this year it is celebrating 20 years of glorious service to the Indian insurance industry. Tata Group has been a prominent industrial conglomerate in India and the US-based American International Group is a leading financial services group. 

Tata AIG offers various health insurance plans that act like a companion that you can rely on. One such plan is Tata AIG Medicare Plus Plan, which is a top-up plan. This plan is an affordable plan that has been designed to supplement over and above your basic health insurance policy and enhance the coverage.

So, if you have an existing health insurance plan, and wish to increase the coverage up to INR 1 crore, then you can opt for Tata AIG Medicare Plus Plan for the incremental coverage at a nominal premium. In this plan, the coverage would be provided after the initial deductible amount which you choose according to your existing insurance coverage.

Let me explain with an example. If you have an existing health insurance plan of INR 5 lakhs, you can choose for Tata AIG Medicare Plus Plan for coverage up to INR 1 crore with a deductible of INR 5 lakhs. So, for the initial claim of INR 5 lakhs, you would have to claim from your erstwhile health insurance plan. The subsequent claim of more than INR 5 lakhs can be claimed from this plan.

Best Features of Tata AIG Medicare Plus Plan

• The plan offers a higher sum insured that goes up to INR 1 crore
• You can opt this plan for a tenure of 1/ 2/ 3 years
• There is an option to include Global Cover in your plan
• The plan offers a higher Cumulative Bonus
• You can cover up to 7 family members- Self, Spouse, up to 3 dependent children, up to 2 dependent parents
• There are a lot of options to choose deductible: INR 2 lakhs, INR 3 lakhs, INR 5 lakhs, INR 10 lakhs, INR 10 lakhs, INR 15 lakhs, INR 20 lakhs
• Discounts can be availed when you choose a longer tenure and also when you add more family members to your plan

Benefits of Tata AIG Medicare Plus Plan

Tata AIG Medicare Plus Plan comes with various features and benefits that have been tailor-made to suit your needs. 

1. In-Patient Hospitalisation Benefits
   The Medicare Plus Plan covers the hospitalisation expenses that arise due to any illness or injury during the policy tenure.
2. In-Patient Dental Treatments
   When you have to undergo dental treatment under anaesthesia, because of an accidental injury or illness, the expenses will be covered.
3. Pre and Post-Hospitalisation 
   Expenses on treatment are not limited to hospitalisation, with this plan you can cover pre-hospitalisation as well as post-hospitalisation expenses incurred up to 60 days and 90 days respectively.
4. Day-Care Procedures
   There are over 540 day-care procedures that are covered under this policy.
5. Organ Donation
   The medical and surgical expenses of the organ donor for harvesting the organ for the insured recipient will be covered.
6. Domiciliary Treatment
   For treatments that would have otherwise required hospitalisation, the plan would cover the medical expenses.
7. AYUSH Benefits
   Treatments taken from Ayurveda, Unani, Sidha and Homeopathy are also covered.
8. Second Opinion
   If you are diagnosed with the mentioned illnesses, you can seek a second opinion from another medical practitioner or network hospital.
9. Ambulance Charges
   Subject to INR 3,000 per hospitalisation, transportation of the insured member is covered, when the transport is to a hospital in an emergency or from one hospital to another.
10. Discounts on Premium

• 10% long-term discount on premium when you opt for a policy tenure of 3 years
• 5% long-term discount on premium when you opt for a policy tenure of 2 years

Family Floater Discounts

• 20% discount on premium when 2 members are added to the plan
• 28% discount on premium when 3 members are added to the plan
• 32% discount on premium when 4 members are added to the plan

1. Tax Benefit
   The premium paid will be eligible for a tax-exemption and thus allow you to save on taxes under section 80D up to INR 25,000.
2. Health Check-Ups
   All expenses pertaining to a Preventive Health Check-Up would be paid up to INR 10,000 or 1% of the sum insured of the previous year, whichever is less. However, this will be applicable only once in every 2 consecutive claim-free years.
3. Cumulative Bonus
   After every claim-free year, there would be a 50% increase in the cumulative bonus, up to a maximum of 100%. However, if a claim is made, the cumulative bonus would decrease by 50%.
4. Optional Global Cover
   With this cover, you can cover the medical expenses that are related to inpatient and day-care procedures, incurred outside the country, on the condition that the diagnosis was done in India only.
5. Lifelong Renewability
   You can opt for lifelong renewability for this plan if the premium is paid break-free.
6. Consumable Benefit
   With this cover, you can cover the cost of the specified consumables that are directly related to your medical or surgical treatment.
7. Aggregate Deductibles
   You will be able to receive all policy benefits when the aggregate of medical expenses in a policy year is more than the deductible specified in the schedule of the policy. If the policy is taken as a family floater policy then the deductible would be per policy per year. Whereas in case the policy is taken as an individual policy, the deductible would be per insured per year.

Plan Details of Tata AIG Medicare Plus Plan

• Waiting Period
  The waiting period includes:
  1. The coverage of the policy starts 30 days after the first inception. However, accidental injuries do not have a waiting period.
  2. The listed illness or treatments are covered after a waiting period of 24 months.
  3. Pre-existing conditions are covered after 36 months.
• Free Look Period
  With the purchase of the Tata AIG Medicare Plus Plan, the company allows you a free-look period of 15 days. During this time you can review the terms and conditions of the policy, and you have the option to return the policy. The premium paid by you will be refunded after deducting the stamp duty charges and the proportionate risk premium. If any pre-policy medical tests were done by the insurance company, the cost will be deducted too.

What is not Covered in Tata AIG Medicare Plus Plan?

Despite a wide coverage, there are certain situations that are not covered in Tata AIG Medicare Plus Plan. These exclusions are:

1. Medical
   • Alcoholic pancreatitis
   • Investigations and evaluations
   • Congenital External Defects and Diseases
   • Correction of eye-sight due to the refractive error that is less than 7.5 dioptres
2. Non-Medical 
   • Treatment rendered by a doctor that is outside his discipline
   • Self-inflicted injuries
   • Injuries caused because of involvement in criminal/ illegal activities

Renewal Process of Tata AIG Medicare Plus Plan

Tata AIG ensures that all its policies have a very easy renewal process. To renew your MediCare Plus Plan, you need to visit the company website and log in using your mobile number or email id. You will be able to see your policy details. You can renew your policy by making the required payment via credit/ debit card, net banking or UPI transfers.

At the time of renewal keep the following things in mind:

• Tata AIG is under no obligation to send you a notice for renewal
• Your renewal request must reach the company before the policy expires
• After the expiry date, a 30-day grace period will be given for you to renew the policy, after this period your policy will expire
• Claims made during the grace period are not accepted
• No loadings will be applied based on the claim history

Tata AIG Medicare Plus Plan - Claim Process

The first thing to do when making a claim is notifying the company about the same. In case of a planned hospitalisation, you need to raise the claim 48 hours before the admission in the hospital, whereas, in case of an emergency, the claim can be raised within 24 hours of the admission. The intimation can be in a number of the following ways. You can:  

• Write an email to general.claims@tata-aig.com
• Visit the company website and register the claim online or click https://www.tataaig.com/service/claim-register
• Call the customer care 1800 266 7780
• SMS “CLAIMS'' to 5616181
• Write to - Tata AIG General Insurance Company Ltd. Health Claims Department A-501, 5th Floor, Building No. 4, Infinity Park, Gen. A. K. Vaidya Marg, Dindoshi, Malad (E), Mumbai, India - 400 097
• In case you are a senior citizen who wants to raise a claim, you can call on 1800 22 9966
• Tata AIG Cashless Claims
  To avail the cashless health treatment, you would be required to be hospitalised at a Tata AIG network hospital. At the time of admission, you would need to submit the claim form along with the relevant treatment-documents with the hospital Helpdesk. After verifying the paperwork, if everything is found in order by the company, approval for your treatment will be given. The final bill will be settled by the company. You must remember that you have to pay for the uncovered expenses.

To locate a network hospital, click https://www.tataaig.com/health-insurance.

• Tata AIG Reimbursement Claims
  You would not be able to avail the cashless treatment facility at a non-network hospital, however, you can get the expenses reimbursed. Make sure that the hospital fulfils all the Company laid criteria. After your treatment, you would be required to pay the hospitalisation bills upfront and then raise a claim. Keep in mind that the claim will have to be raised 48 hours before a planned hospitalisation and within 24 hours of the admission in case of emergency hospitalisation. 
  For reimbursement, you would then be required to submit the claim form and all the treatment-related documents, listed below. These documents must then be submitted with the company for processing. The reimbursement amount will be transferred to your bank account after thorough verification of all your documents.
• Required Documents
  The necessary documents for processing a claim are: 
  • Filled and signed Company Claim Form
  • Copy of policy document
  • Treatment-related bills such as pharmacy bills,  diagnostic bills and consultation bills
  • Medical and diagnostic reports such as investigation reports
  • Discharge summary
  • Medical prescriptions

Tata AIG Policy Network Hospitals

Tata AIG has a collaboration with over 3,200 leading hospitals that are spread across the length and breadth of the country. In a network hospital, the company settles the bills directly and you only end up paying for the uncovered expenses. Such a facility acts as a blessing because as when you are already stressed because of your or your loved one’s hospitalisation, running around arranging money will only cause more anxiety and hassle. In such a time, a network hospital lets you focus on the treatment without the worry of finances. 

Review of Tata AIG Medicare Plus Plan

Tata Group comes with a legacy of trust, their customers feel safe and protected under the health insurance plans. With Tata AIG Medicare Plus Plan, you can have the assurance that in the time of need, you would not have to make any compromises on your and your family members’ health. 

 If you have been looking for a way to enhance your current health insurance policy, Tata AIG Medicare Plus Plan will be the perfect choice for you.

TATA AIG Customer Care Details