TATA AIG MediCare Plus (Super Top Up) Plan: Everything You Need to Know
Published On Jun 10, 2022 12:00 PM By InsuranceDekho
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Tata AIG Medicare is an upgraded, robust health insurance plan, built keeping in mind the one factor: no compromise when it comes to your health. Choosing the right mix of features and coverage levels is essential to get everything you would need at the time of a medical emergency. From cumulative bonus to 100% restoration benefits on Sum Insured, we have thought of it all, to make it the ideal health cover.
One can buy the TATA AIG Medicare Plus plan and choose between the Individual or Family Floater option with a Sum Insured from 3 lakh up to Rs 1 crore. The plan offers coverage for the following:
- In-patient benefits- Any hospitalization expenses incurred during the policy period are covered.
- Pre-hospitalization- Pre- hospitalization expenses will be covered up to 60 days before the hospital admission date.
- Post-hospitalization- Any medical expenses incurred post hospitalization will be covered up to 90 days.
- Daycare Procedure- Expenses for daycare treatment up to 540 plus days are covered in the policy year.
- Organ Donor- Organ donor's medical and surgical expenses are covered.
- Domiciliary Treatment- In the case of domiciliary hospitalization for any treatment that requires admission to the hospital will be covered along with pre and post-hospitalization expenses.
- In-patient Dental Treatment- Expenses towards a dental treatment needed due to an accident or illness will be covered.
- AYUSH benefit - Treatment expenses incurred under Ayurveda, Unani, Sidha, or Homeopathy are covered, provided they are conducted in a government recognized hospital or center.
- Ambulance Cover- Ambulance expenses up to Rs 3,000 per hospitalization for transportation from and to the hospital are covered.
- Second Opinion- A second opinion can be availed of from the medical network providers in case a critical illness or disease is diagnosed.
- Health Checkup- Once in every two-consecutive claim-free policy year, expenses incurred for a health check-up up to Rs 10,000 are covered.
Inclusions of the Policy
Apart from the basic coverage, the TATA AIG Medicare Plus policy also includes the following benefits.
- Global Cover (optional cover)- If opted for a Global Cover, the insured person's hospitalization, including daycare and inpatient expenses, will be covered outside India as well.
- Consumables Benefit- Expenses related to medical or surgical treatment during hospitalization are covered.
- Cumulative Bonus- Cumulative bonus is rewarded for every claim-free year from 50% to a maximum of 100%. The accumulated bonus will be reduced by 50% in the next year if a claim is made during the policy year.
- Aggregate Deductible- The insurer will only pay any claims made if the aggregate of expenses exceeds the deductible mentioned in the policy schedule. For family floater plans, the deductible will be per person per year.
Exclusions of the Policy
The following medical and non-medical expenses are excluded from TATA AIG Medicare Plus policy:
- Alcoholic pancreatitis is not covered.
- Medical tests or diagnostic tests are taken only for the purpose of evaluation are not covered.
- Congenital External disease is not covered.
- Treatment expenses for correction of eyesight due to the refractive error below 7.5 diopter are not covered.
- Treatment taken from a medical professional which is not in his discipline is not covered.
- Medical expenses incurred due to intentional self-injury is not covered.
- Any treatment expenses incurred due to breach of law.
Features and Benefits of the TATA AIG Medicare Plus Policy
The main features and benefits of TATA AIG Medicare Plus Health Insurance are mentioned below:
- The policy can be availed for 3 years.
- Option to choose Global Cover for medical expenses incurred outside India
- This offers a comprehensive coverage up to Rs 1 cr.
- No pre-policy check-up is required.
- Consumables benefit is provided.
- A cumulative bonus of up to 100 % can be availed.
- Deductible options are available.
- The policyholder can avail family savings up to 10% for a 3-year policy and 5% for opting for a 2-year policy.
One can cancel the policy within a free look period of 15 days, and the refund will be provided unless any medical claim is paid by the insurer. Beyond 15 days, the premium will be deducted proportionately
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