Tata AIG MediSenior Plan

Tata AIG General Insurance Company is one of the leading insurance companies in the country today. A joint venture between Tata Group and American International Group (AIG) the company has introduced various products and services in the insurance industry. Their easy to understand policies, quick claims and efficient customer care has helped them in becoming one of India’s most reliable health insurance companies.

Tata AIG also offers multiple health insurance policies which are popular among all economic backgrounds and age groups. One such policy is the Tata AIG MediSenior Plan. Tata AIG MediSenior Plan is a health insurance plan for the senior citizens, i.e., for people who are between 60 - 80 years of age. It is a great option for the seniors as with growing age there is a higher risk of health complications penetrating into your daily life. 

The plan covers your in-patient treatments when you are in shared accommodation for over 24 hours. Also, when you incur expenses for availing medical treatment at home, that otherwise, you had to be hospitalised for, the treatment would be covered. The cost of an ambulance for your medical transportation to and from the hospital would also be taken care of. 

Let us explain this with an example, Mohit Verma, a bank employee, retired in February last year. After three months he was hospitalised for gallbladder surgery. But because he had no health insurance, he had to take out a big chunk from his hard-earned savings. He realised the importance of investing in a health insurance plan and bought Tata AIG MediSenior Plan for himself and his wife. After a few months, his wife met with a car accident and was in the hospital for three days. Thankfully this time the company paid for treatment. Mrs Verma got excellent healthcare without burning in a hole in their pocket. 

Best Features of Tata AIG MediSenior Plan

1. Health insurance plan exclusively for senior citizens that offer benefits specifically suited to their needs
2. The cover can be extended to your spouse
3. Sum insured per person is INR 2 lakhs/ 3 lakhs and 5 lakhs
4. The policy term can be 1 year/ 2 years as per your convenience
5. The policy does not have a maximum cover ceasing age
6. There is a lifetime renewability option with the policy
7. The policy can be purchased on a family floater or an individual basis, keep in mind that family includes only you and your spouse
8. Avail No Claim Discount for every claim-free year

Benefits of Tata AIG MediSenior Plan

1. In-Patient Benefits
   When you get admitted to a hospital for treatment related to an illness or an injury for more than 24 hours, the expenses will be covered under the MediSenior plan.
2. Pre and Post-Hospitalisation 
   Under this plan, you can cover the medical costs of the treatments taken 30 days prior and 60 days after the hospitalisation, provided they are all under the same treatment. 
3. Ambulance Charges
   Ambulance costs up to INR 2,000 are covered under this policy when the insured is transported to a hospital in case of an emergency.
4. Domiciliary Treatment 
   Sometimes medical expenses are incurred for availing doctor-prescribed treatment at home, which otherwise required hospitalisation. These treatments are covered under Medi Senior. 
5. Day Care Procedures
   Some medical procedures do not require an admission over 24 hours, such procedures are called day-care procedures. MediSenior Plan covers 140 day-care procedures.
6. Organ Donor
   The expenses that are incurred on harvesting the organ from the donor for the transplantation will be covered under this plan. 
7. Network of Hospitals
   In the network hospitals that cover the MediSenior plan, you would be able to get cashless treatment. 
8. No Claim Discount
   You can avail a 2.5% discount on the premium amount at the time of renewal of the policy, for every claim-free year. 
9. Co-Payment
   A co-payment clause is applicable on the following basis:
   • 15% for Shared Accommodation or any lower accommodation type
   • 30% for Single occupancy or any higher accommodation type
   • 15% for all Day Care Procedures

Plan Details of Tata AIG MediSenior Plan

What is not Covered in Tata AIG MediSenior Plan?

Just like all other insurance plans, Tata AIG MediSenior Plan also comes with a set of exclusions. Given below is a list of the most common exclusions. When you make a claim under the following circumstances, it would not be covered. Hospitalisation arising because of participating in:

1. An illegal or criminal activity
2. War, civil war or warlike operations
3. Armed force operations
4. Intentional injury to self or a suicide attempt
5. Hazardous adventure sports

The following situations are also excluded from cover:

1. Obesity and weight control procedures
2. Maternity and other child-birth related complications
3. Sleep Apnoea
4. Sterility and infertility
5. Dental treatments
6. Refractive Error

If you are looking for a detailed list, it is recommended that you refer to the policy document.

Renewal Process of Tata AIG MediSenior Plan

When you buy a health insurance plan, it is imperative that you get the renewal done on time. A delay will bring a break in the policy, making you lose out on your No Claim Discount and also leaving you without medical coverage. If unfortunately, you get hurt or sick during this uncovered period, you will have to bear all the expenses on your own. 

So, if you wish to enjoy the policy benefits always ensure that you do not miss the date of renewal. However, if somehow you have missed the policy renewal date, there is still a 30-day grace period that is offered by the company. Pay the premium during this time and save your policy from being terminated. 

To renew your policy, you can:

1. Visit the website and renew the policy online by making the payment via an electronic medium.
2. Go to a TATA AIG branch office and fill in the renewal form. Make the payment and your policy would be renewed.

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

• Your request to renew the policy must reach the company before the expiry date
• Any claims that are made during the grace period won’t be accepted
• If you want to enhance the Sum Insured, it can be done at the time of policy renewal

Tata AIG MediSenior Plan - Claim Process

In case you need to make a claim, you need to keep a few things in mind. If you follow all instructions and guidelines carefully, the claim will be processed quickly and easily. 

Under Tata AIG MediSenior Plan, the claims are settled through the company or the appointed TPA. In the case of planned hospitalisation, you have to inform the company/TPA 48 hours prior to the admission. However, in case of emergency hospitalisation, you can notify the hospitalisation within 24 hours of admission. Senior citizens can call directly on a dedicated helpline number: 040-23552899. Depending on the hospital that you get admitted in, your claim would be settled.  

• Cashless Claim 
  Only when you get admitted at a network hospital, you would be able to avail the cashless facility. At the hospital Helpdesk or with the TPA executives, you need to submit the claim form along with the relevant medical documents. After the submission, the paperwork will be verified. Once the approval is given, the treatment will begin. The final bill will be settled by the company. Bear in mind that all the uncovered expenses will be paid by you.

If you want to locate a network hospital, click https://www.tataaig.com/health-insurance and enter the Pincode of the area you wish to seek treatment in.

• Reimbursement Claim 
  Though you would not be able to avail the cashless facility, after your treatment, you can request for reimbursement. However, make sure you inform the TPA/the company well in time, as explained above. When making the claim, you would have to submit the Claim form along with all the treatment-related documents and the KYC documents. Once all the documents are verified and approved by the company, your claim will be settled within a few days.
• Required Documents
  • Company Claim Form-filled and signed
  • Copy of policy documents
  • All treatment-related bills including diagnostic bills, pharmacy bills and consultation bills
  • All medical and diagnostic reports including discharge summary, investigation reports etc
  • Diagnosis report by the doctor
  • Medical prescriptions
  • Your KYC Documents
  • Bank Account Details and Cancelled Cheque in case of Reimbursement Claim

Tata AIG Network Hospitals

When you invest in a health insurance policy by Tata AIG, such as the MediSenior Plan, you get the advantage of cashless treatments in over 3,200 hospitals all over the country. Tata AIG has a collaboration with the most prominent hospitals in the country where you can get the best of treatments without the worry of a big bill. The company requires you to submit very little and very simple paperwork, after which the procedures are carried out by the company/TPA executives. You can sit back and concentrate on getting better. 

Review of Tata AIG MediSenior Plan

When you reach the golden years of your life, you do not want everyday worries and complications bothering you. However, you never know when an unpredictable medical urgency may arise. At such a time digging into your life’s savings would be the only option you have, if you do not have a health insurance plan. Tata AIG MediSenior is a great option if you or someone you know is a senior citizen. Most health insurance plans come with the maximum entry age till 55 or 60 years, in such a scenario investing in MediSenior is a great option. The plan covers your in-patient expenses along with domiciliary treatment. The policy term can also be selected on your convenience. A comprehensive health insurance policy, Tata AIG MediSenior is an option worth considering. 

TATA AIG Customer Care Details