Tata AIG Medicare Select

Overview

Tata AIG Medicare Select is a new launch from Tata AIG General Insurance Company Ltd. It is an all-inclusive health insurance plan providing robust coverage for hospitalisation expenses. Multiple optional benefits provide room for customisation as per need. You can opt for unlimited cover once in the policy lifetime. It also allows combined access to multi-year sum insured anytime if you choose a tenure of 2 or 3 years.

You can also add consumables cover and maternity care coverage.

Hospitalisation expenses covered up to sum insured

Medicare Select is a comprehensive plan that covers all hospitalisation expenses up to the sum insured with no copayment or disease-specific limit.

Room rent limit

The base variant covers up to a single private room. If you choose a higher category room during hospitalisation, a proportionate deduction on all associated medical expenses applies. However, ICU charges are covered at actuals.

All daycare treatments covered

Many treatments or surgeries done under anaesthesia require less than 24 hour hospitalisation due to advancements in modern science. Think of cataract surgery or kidney stone removal surgery. These are called daycare treatments, and the plan covers all such treatments fully.

Coverage for pre and post-hospitalisation expenses

The insurer also covers all hospitalisation-related expenses up to 90 days before admission and 90 days post-discharge. These include doctor consultations, diagnostic tests, and medication, among others.

Covers organ donor expenses

Organ transplant surgeries are expensive. Moreover, the donor also requires surgery to harvest the organ. But you don’t have to worry anymore. The insurer covers the cost of harvesting an organ from a donor in case you are the organ recipient.

Covers the cost of treatment even if you are forced to be hospitalised at home

Are you forced to be hospitalised at home? Think of a situation when hospital beds are unavailable or the patient’s medical condition does not allow him to be moved to a nearby hospital. This is called domiciliary hospitalisation. The plan still covers the expenses related to hospitalisation if done under the supervision of a medical practitioner and exceeds 3 consecutive days.

Covers alternative treatments

Do you want to consider an alternative treatment for your ailment such as Ayurveda or Homoeopathy? The plan covers the hospitalisation expenses of such alternative treatments.

Ambulance charges covered

You also get coverage for road ambulance charges within a radius of 50 km.

Unlimited restorations available

With the Restore Infinity Plus feature, you do not have to worry about coverage for the next claim if you have already made a claim. Your insurer restores your sum insured multiple times during a policy year if your base cover is fully or partially exhausted. This feature comes in handy if you need to make multiple claims during any policy year.

Get daily cash benefit if you choose shared accommodation

You get a daily cash benefit for each day of hospitalisation if you choose to stay in a shared accommodation. This benefit has a separate limit over and above the sum insured.

No-claim bonus for claim-free years

You have the option to choose between a 50% no-claim bonus or a 1% discount on renewal premium for every claim-free year. The bonus is capped at 100% of the base sum insured. If you opt for a bonus, your no-claim bonus reduces by 50% of the sum insured in case you make a claim.

Add-ons

Consumables Benefit – For non-medical items

With this add-on, you get coverage for the non-medical items that are usually excluded from a health insurance plan. It includes items such as gloves, masks, and syringes, among others, used in treatment.

Maternity Care

This add-on covers maternity expenses related to childbirth after a waiting period of 2 years. Moreover, delivery complications of the newborn, if any, and first-year vaccinations are also included. The coverage is limited to 10% of the base sum insured, subject to a maximum of Rs. 1 Lakh per policy year. You can also reduce the maternity waiting period to 1 year with the payment of an additional premium.

Infinite Advantage – Unlimited coverage once in policy lifetime

With this add-on, you get unlimited coverage for any one claim during the policy lifetime, irrespective of the base cover. This add-on is only available at policy purchase.

Early Access

This add-on gives you access to the combined sum insured at any time if you buy a multi-year policy. If you purchase a 3-year policy with Rs. 10 Lakh base sum insured along with the Early Access add-on, Rs. 30 Lakh cover will be available to you over the period of 3 policy years.

Upgrade Room Category

The base plan covers up to a single private room. If you want something fancier, you can upgrade to any room with this add-on.

Supercharge Bonus

With this add-on, get a guaranteed cumulative bonus equal to 100% of the base sum insured every year, irrespective of claims, up to a maximum of 500%.

Advanced Cover

This add-on reduces the waiting period for 4 pre-existing diseases from 36 months to a mere 30 days, providing early access to treatment. The diseases are diabetes, hypertension, hyperlipidemia and asthma. This is a good add-on for those living with these illnesses.

Annual Health Check-up

With this add-on, get preventive annual health check-ups every year for all insured persons. Health check-ups can be availed on a cashless basis via pre-booking through the insurer’s mobile app.

OPD Care

This add-on provides coverage for OPD consultation, including dental and vision, and teleconsultations for seamless outpatient care.

Mental Wellbeing

With this add-on, you get access to mental health screening once in a policy year at any of the emplanelled service providers. Your insurer also covers the cost of consultations/ therapy sessions with psychologists, dietitians and other healthcare professionals to maintain your mental wellbeing.

Premium Savers

Aggregate Deductible

Opt for a small annual aggregate deductible in case you want to buy the policy at better rates. However, choose this with caution as policy benefits get triggered only after you pay the deductible amount upfront while making a claim.

Modify Room Category

If you find the plan expensive, opt for shared accommodation at policy purchase to reduce your premium.

Policy Conditions

About the Insurer

Tata AIG General Insurance is a joint venture between Tata Group and American International Group. The company was founded in 2001. It offers an extensive range of insurance policies including fire, marine, cargo, home, motor, health and travel insurance among other commercial and consumer lines of insurers policies.

Performance Highlights (FY24)

Turnover – Rs. 15,423 Crore

Claim Settlement Ratio – 96.67%

Incurred Claim Ratio – 71%

Volume of Claim Complaints – 12.11 / 10,000 claims

Network Hospitals – 12,000+