Health Insurance 251 views June 8, 2021

Tata AIG Medicare Protect Plan

If you want to secure your finances in medical emergencies, Tata AIG Medicare Protect Plan could be the right choice for you. This policy is best suited for those individuals looking for a plan that covers basic medical expenses. Before going any further, let’s check out its key features mentioned below.

  1. In-patient treatment coverage
  2. Pre and post-hospitalization expenses coverage
  3. Day Care Procedures
  4. Organ Donor Cover
  5. Domiciliary Treatment
  6. Restore Benefits
  7. AYUSH Benefit
  8. Ambulance Cover
  9. Compassionate Travel
  10. Accidental Death Benefit
  11. Cumulative Bonus
  12. A 15-day free look period
  13. Tax Benefits under Section 80D of the Income Tax Act, 1961

Read through this page to understand all these benefits in detail so that you can decide whether this policy would be suitable for you or not. Let’s start!

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Features and Benefits of the Tata AIG Medicare Protect Plan in Detail

We are discussing the key features and benefits of the Tata AIG Medicare Protect Plan in a detailed manner below. Please check!

In-patient Treatment Coverage

If an insured person needs hospitalization due to a disease/ illness/ injury during the policy period, the policy from Tata AIG will cover expenses incurred on such treatment in a hospital. However, it will only cover the medical expenses directly related to hospitalization. The coverage amount will be up to the sum insured.

Pre and Post-hospitalization Expenses Coverage

The policy will cover the expenses incurred 30 days before admission to the hospital and 90 days after the date of discharge from the hospital. These expenses will include pre and post-hospitalization consultations, investigations and required medicines.

Day Care Procedures

Policyholders will also get coverage against expenses for 540+ listed day care procedures due to a disease/ treatment/ injury during the policy period (taken at a hospital or day care center). Under this coverage benefit, treatment normally taken on an outpatient basis will not be included.

Organ Donor Cover

If a policyholder needs to undergo an organ transplant surgery, the policy will cover the organ donor’s medical and surgical expenses for harvesting the organ. To get this benefit, the insurer must have accepted an in-patient hospitalization claim for the insured member.

Domiciliary Treatment

Tata AIG Medicare Protect Plan will cover expenses incurred on domiciliary hospitalization (treatment taken at home) of the insured person for more than 3 days of treatment. Also, such treatment should be for the management of an illness and not for internal feelings or end-of-life care.

Restore Benefits

On choosing the policy tenure of more than one year, the policy will automatically restore the basic sum insured upon exhaustion of the same (plus accumulated No Claim Bonus) during a policy year. Policyholders can get this benefit once in a policy year. In the case of a family floater policy, the reinstatement of the sum insured will be available for all insured members on a floater basis.

Ambulance Cover

Policyholders will also get cover for the expenses incurred on their transportation from one hospital to another (for admission) via a registered ambulance. The coverage amount can go up to INR 1,000 per hospitalization.

Compassionate Travel

If you are hospitalized for more than three days in a place where no adult member of your immediate family is present, the policy will cover the expenses related to the round-trip economy class air ticket or first-class railway ticket for your family member’s travel. However, such expenses must be incurred within India and can be up to INR 20,000 during a policy year.

Tata AIG will also ask for Proof of Travel (Boarding pass or Railway Ticket, or any other document) for the claim. Also, this benefit has a separate limit and will not affect your cumulative bonus.

Cumulative Bonus

If you haven’t claimed in a policy year, you will get a 10% cumulative bonus on the sum insured for the next policy year. It is called the No Claim Bonus facility and can go up to 100% of the basic sum insured. However, there should not be any break on the renewal of your policy.

Accidental Death Benefit

If an insured person suffers an accident during a policy year and dies within 365 days from the date of the accident, Tata AIG Medicare Protect will give a fixed benefit amount of 100% of the sum insured. Do remember this benefit is not applicable for dependent children covered in the policy.

What is Not Covered Under Tata AIG Medicare Protect Plan?

Have a look at the major exclusions of the Medicare Protect Plan mentioned below.

  1. Hospitalization solely for enteral feedings (infusion formulae via a tube into the upper gastrointestinal tract) and other nutritional and electrolyte supplements
  2. Experimental and Unproven treatments, Rotational Field Quantum Magnetic Resonance (RFQMR), External Counterpulsation (ECP), etc.
  3. Dental treatment or surgery of any kind (unless as a result of Accidental Bodily Injury to natural teeth and also requiring hospitalization)
  4. Pregnancy, voluntary termination of pregnancy, maternity or birth (including cesarean section) except in the case of ectopic pregnancy about – Inpatient Hospitalization only and miscarriage due to accident
  5. Provision or fitting of hearing aids, spectacles or contact lenses (including optometric therapy)
  6. Crutches or any other external appliance and/or device used for diagnosis and treatment
  7. Medically unnecessary treatment (drugs or treatments not supported by a prescription)
  8. Expenses on alopecia, baldness, wigs, or toupees, medical supplies including elastic stockings, diabetic test strips, etc.

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