Tata AIG Medicare Plan

The Tata AIG Medicare is packed with amazing benefits and is cost-friendly with affordable premium rates. It offers you medical insurance across the globe and comes with 100% auto restore sum insured facility. You can choose from a wide range of sum insured ranging from Rs. 3 lakh – Rs. 20 lakh.

It covers expenses for bariatric surgery and 540+ day-care treatments. This plan is the most ideal health insurance plan to cover the medical expenses of you and your loved ones.

 

Key Features and Benefits


The key features covered under Tata AIG Medicare Plan are as follows:

  • In-patient hospitalisation expenses

    Tata AIG Medicare Plan covers expenses for hospitalization due to disease/illness/injury during the policy period that requires insured person’s admission in a hospital as an inpatient. Medical expenses directly related to the hospitalization would be payable.

  • Consumables benefit

    The policy covers expenses incurred for consumables which are consumed during the period of hospitalization and are directly related to the insured person’s medical or surgical treatment of illness/disease/injury.

  • Day care treatments

    The policy covers 540+ day-care procedures that need hospitalization less than 24-hours. All the costs incurred in such treatments are covered under the Tata AIG Medicare Plan.
    Note: To know the list of day care procedures, you can visit the insurer’s website (www.tataaig.com).

  • Vaccination cover

    We will cover expenses related to the cost of the following vaccines:
    i. Without any waiting period:
    a. Anti-rabies vaccine following an animal bite
    b. Typhoid vaccination
    ii. After 2 years of continuous membership with the insurer’s:
    a. Human Papilloma Virus (HPV) vaccine

  • Compassionate travel

    The plan covers expenses for up to Rs. 20,000 covering both air and railway travel tickets. The coverage is provided in the event of insured person’s hospitalisation for more than five consecutive days, while no adult member of immediate family is present.

  • Optional accidental cover

    The policy provides 100% of the sum insured in the event of the policyholder’s demise due to an accident.

  • Domiciliary cover

    You can get claims on domiciliary covers if the condition of the insured person is not suitable enough to go to the hospital or in case of non-availability of hospital beds.

  • Organ donor expenses

    The medical and surgical expenses of the organ donor for harvesting the organ, in case the insured person is the recipient.

  • AYUSH treatment cover

    Medical expenses incurred for in-patient treatment taken at the AYUSH hospital.

Policy Details

Tata AIG Medicare Plan
Policy Type Individual/ Family
Entry Age Minimum Entry Age: 91 days
Maximum Entry Age: 65 years
Tenure One, two and three years
Sum Insured Rs. 3 lakh – Rs. 20 lakh
Starting Premium Rs. 3953
Policy Renewal Lifetime Renewable
No of member covered: 7 Members (Self, spouse, up to 3 dependent children and up to two dependent parents)

Premium chart for accidental death benefit rider:

Age/sum insured 3 Lakh 4 Lakh 5 Lakh 7.5 Lakh 10 Lakh 15 Lakh 20 Lakh
All ages 167 223 279 418 558 836 1,115

Plans Available

Health Insurance helps you to be stress-free while dealing with medical contingencies due to sickness and accidental injuries. The plans are available starting from Rs. 3953, with maximum coverage of Rs. 25 lakh.

How to Purchase the Policy

  • To apply for the product, click on 'Apply Now' and fill in the necessary details
  • Make the fee payment online using your preferred mode of payment
  • Fill in your name and mobile number
  • Complete the process by clicking 'Buy Now', you can also request a call back

List of Documents Required for purchasing the policy

The following mandatory documents will be needed to purchase the policy:

 
  • Photograph of the Applicant
  • Age proof such as birth certificate, Voter’s ID, PAN card, passport etc.
  • Identity proof such as passport, Aadhaar card, PAN card, Voter’s ID, etc.
  • Income Proof such as Form 16, salary slips, employment certificate etc.
  • Address proof such as telephone bill, electricity bill, passport, bank statement, Voter’s ID, etc.
  • Medical Test that the insurer requires you to undergo

How to Process the Claims

Cashless Claims

With the Tata AIG Medicare Plan, you can avail the benefit of cashless treatment with our 6700+ network hospitals by following the following process:

  • Get admitted to any one of the insurer’s network hospitals.
  • Use your Tata AIG Medicare Plan card or share your policy number with the concerned team at a hospital along with your Passport/PAN card/ Voter’s ID as identification proof.
  • Now, the network hospital will verify your identity for validation and submit the pre-authorization request to the insurer
  • After validation, the insurer will review and provide their confirmation to the network hospital by fax and email. The insurer ensures you are also notified of the same through text message and email. The insurer will respond to your request within 30 minutes of filing of the claim request.
  • The only activity left to do now is the final settlement of your claim (as per policy terms & conditions) with the hospital after completion of all the necessary formalities

Reimbursement claim:

  • If you get hospitalized, notify the insurer within 48 hours of admission in our network or non-network hospital. After getting admitted pay the amount directly to the hospital you are in.
  • After you are discharged from the hospital, make sure you have all the relevant documents, invoices, medical reports and discharge certificate with you. The insurer would need the originals of all the mentioned documents to process your reimbursement.
  • Send all the documents to the insurer with filled and signed claim form and/or KYC form if the claim amount is > 1 Lakh. Send your valid ID proof and age proof as well.
  • After receiving your documents, the insurer will review your claim request and accordingly will give our approval, raise a query or reject the same (as per policy terms & conditions)
  • Finally, the insurer will settle the claim (as per policy terms & conditions) and reimburse the approved amount.

Documents Required for Reimbursing Claims

Collect below mentioned relevant document in original from the hospital and submit them to us within 15 days of discharge from the hospital

 
  • Original investigation reports
  • Final hospital discharge summary FIR or post-mortem report if happened
  • Pharmacy bills along with the prescription
  • Cancelled cheque or NEFT details for payment
  • Original bills, receipts, and discharge report
  • Indoor case papers and duly filled claim form
  • Original hospital bills and a valid photo ID proof Treating doctor's report
  • Original consultation notes Nature of operation performed and surgeon's bill and receipt
  • Test reports along with attending doctor’s or surgeon’s report.

Major Policy exclusions

  1. Ailment wise capping and ambulance charges
  2. Ailments requiring treatment due to use or abuse of any substance, drug or alcohol and treatment for de-addiction.
  3. Breach of law with Criminal Intent, intentional self-injury.
  4. Cosmetic, aesthetic and re-shaping treatments & surgeries.
  5. Dental treatments and cosmetic surgeries
  6. Waiting Period:
  7. 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.
  8. Refer the policy document to know more exclusions in detail

Claim/Assistance Contact Details

BFL Helpline Number: –  08698010101

Tata AIG Helpline Number: – 1800-266-7780/1800 229966 (For Senior Citizens)

E-mail –  wecare@bajajfinserv.in

Mailing address: Ground Floor, Bajaj Finserv Corporate Office, Off Pune-Ahmednagar Road, Viman Nagar, Pune – 411014.

 

*For claim related issues please refer your policy document or certificate of insurance (COI).

Disclaimer

Bajaj Finance Limited (‘BFL’) is a registered corporate agent of third party insurance products of Bajaj Allianz Life Insurance Company Limited, HDFC Life Insurance Company Limited, Future Generali Life Insurance Company Limited, Bajaj Allianz General Insurance Company Limited, Tata AIG General Insurance Company Limited, Oriental Insurance Company Limited, Max Bupa Health Insurance Company Limited, Aditya Birla Health Insurance Company Limited and Manipal Cigna Health Insurance Company Limited under the IRDAI composite registration number CA0101.

Please note that BFL does not underwrite the risk or act as an insurer. Your purchase of an insurance product is purely on a voluntary basis after your exercise of independent due diligence on the suitability, viability of any insurance product. Any decision to purchase an insurance product is solely at your own risk and responsibility and BFL shall not be liable for any loss or damage that any person may suffer, whether directly or indirectly. This product provides insurance coverage under the product name Tata AIG Medicare with UIN: TATHLIP18004V011819. Please refer to the insurer's website for Policy Wordings. For more details on risk factors, terms and conditions and exclusions please read the product sales brochure carefully before concluding a sale.

Tax benefits applicable if any will be as per the prevailing tax laws. Tax laws are subject to change. BFL does NOT provide Tax/Investment advisory services. Please consult your advisors before proceeding to purchase an insurance product.