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Reviewed by Finzony Finance TeamLast updated:
Tata AIG MediCare is an indemnity health plan for individuals and families, with sum insured options of ₹3 lakh, ₹4 lakh, ₹5 lakh, ₹7.5 lakh, ₹10 lakh, ₹15 lakh and ₹20 lakh. One policy can cover up to 7 family members (self, spouse, 3 dependent children, 2 parents and 2 parents-in-law) on an individual or family floater basis. Adults can join from 18 to 65 years and children from 91 days to 25 years, the policy term can be 1, 2 or 3 years, and there is no maximum cover-ceasing age. The base cover pays in-patient treatment, day care, organ donor expenses, domiciliary treatment, AYUSH treatment and consumables up to the sum insured, with 60 days of pre-hospitalisation and 90 days of post-hospitalisation expenses. It also covers bariatric surgery, global cover for treatment abroad when the diagnosis was made in India, a once-a-year restore of the base sum insured, and smaller benefits such as vaccination, a hearing aid, a second opinion, compassionate travel and 8 teleconsultations. You can choose a 50% Cumulative Bonus for every claim-free year, up to 100%, or a 1% renewal discount instead. MediCare is an inpatient plan. Pre-existing diseases wait 36 months, 35 listed conditions and procedures wait 24 months, and maternity is excluded, with no OPD benefit listed. If you take a room category higher than your policy schedule allows, you bear 10% of the admissible claim. Cover stops at ₹20 lakh, so buyers who want a higher limit should compare MediCare Premier.
₹3L–₹20L cover with a 50% Cumulative Bonus up to 100%, sum insured restore, consumables benefit and global cover for treatment diagnosed in India.
Finzony sees MediCare as a plain, value-for-money inpatient plan. Its strongest points are the 50% Cumulative Bonus for each claim-free year, a restore of the base sum insured, consumables covered up to the sum insured, and global cover for planned treatment abroad. The prospectus says benefits carry no sub-limit unless stated, and no extra loading is applied at renewal for your own claims. A floater discount of up to 32% helps families. Read the limits before you buy. The bonus is an either-or choice with the 1% renewal discount, and after a claim it drops by 50% the next year. Restore works once a year, and a related illness can use it only after 45 days from the earlier discharge. Sub-limits apply to the ambulance (₹3,000 per hospitalisation), vaccination, hearing aid and a few smaller benefits. Cover tops out at ₹20 lakh, which many families will outgrow within a few years of medical inflation. Cover starts late on important conditions: pre-existing diseases wait 36 months and 35 listed conditions and procedures, from cataract and hernia to joint replacement, wait 24 months. There is no maternity or OPD benefit. If you want a higher sum insured, compare MediCare Premier, which goes up to ₹3 crore.
Tata AIG Health Insurance
Key Insights
Founded
2001
Tata AIG Health Insurance was established 25 years ago and has built strong credibility over time, backed by its long-standing presence in the market.
Claims Experience
94.3% CSR, calculated as a 3-year average
Tata AIG Health Insurance settles 94.3% of all claims it receives.
Network Hospitals
10,000+
Tata AIG Health Insurance has a network of 10,000+ hospitals, ensuring wide accessibility and convenience for policyholders.
Pays medical expenses directly related to a hospital admission caused by disease, illness or injury during the policy period, up to the sum insured. The plan is indemnity based, with a range of benefits and no sub-limit unless the policy states one.
If you take a room category higher than the one in your policy schedule, you bear 10% of the admissible claim.
Pays medical expenses for 60 days before admission and 90 days after discharge.
Pays listed day care treatments taken at a hospital or day care centre, up to the sum insured.
The list of covered day care procedures is on Tata AIG's website.
For every claim-free policy year, the sum insured goes up by 50% of the base sum insured of the expiring policy, up to a maximum of 100%.
You pick this or a 1% renewal discount, not both. After a claim, the bonus reduces by 50% in the following year.
If the sum insured including the bonus is completely used up in the policy period, an amount equal to the base sum insured is restored once in that period.
It can be used for a related illness only after 45 days from the discharge of the earlier claim, and it is not carried forward to later renewals.
If an accident is the sole and direct cause of an insured person's death within 365 days, Tata AIG pays a fixed 100% of the base sum insured.
Optional, for an extra premium. This premium does not qualify for the Section 80D deduction.
Choose a shared room as your room category and get a 6% discount on the premium.
If you then take a higher room category than your schedule allows, a 10% co-payment applies.
A 30-day wait applies to any illness except accidents, and it does not apply if you have more than 12 months of continuous cover. 35 listed conditions and procedures wait 24 months, even if you contracted them after the policy started or declared them. Pre-existing diseases wait 36 months, and are covered after that only if declared at the time of application and accepted. If a condition falls under both lists, the longer wait applies. HPV and Hepatitis B vaccinations are covered only after 2 years of continuous cover. Waits are reduced to the extent of prior cover if you port or migrate without a break, and they start again for any increase in sum insured. The grace period is 30 days, and 15 days for monthly instalments.
Initial waiting period
Expenses for any illness in the first 30 days of the policy are excluded, except for accidents. This does not apply if you have more than 12 months of continuous cover.
Specified diseases and procedures
The 35 listed conditions and procedures, such as cataract, hernia, joint replacement, gallstones and tonsillectomy, wait 24 months of continuous cover, except accidents.
Pre-existing diseases
Declared and accepted pre-existing diseases are covered after 36 months of continuous cover. If a listed condition is also pre-existing, the longer wait applies.
Conditions or treatments that the policy clearly says it will not cover.
These listed conditions and procedures are excluded for the first 24 months of continuous cover, even if they begin after the policy starts and even if you declared them. The wait does not apply to accidents. If one of them is also a pre-existing disease, the longer wait applies.
Insurer
Tata AIG Health Insurance plans and claim process
MediCare is an indemnity health insurance plan from Tata AIG for individuals and families. It pays hospital expenses up to the sum insured, adds a 50% Cumulative Bonus for every claim-free year, restores the sum insured once in a policy year, and renews for life.
₹3 lakh, ₹4 lakh, ₹5 lakh, ₹7.5 lakh, ₹10 lakh, ₹15 lakh and ₹20 lakh. If you need a higher cover, compare MediCare Premier.
For every claim-free policy year, your sum insured goes up by 50% of the base sum insured, up to a maximum of 100%. After a claim, the bonus reduces by 50% in the following year. You can pick a 1% renewal discount for every claim-free year instead, but not both.
Disclaimer: Premium amounts are indicative and may vary based on age, health, and plan selected. Claim settlement ratios are from IRDAI Annual Reports. Finzony is not an insurance broker or agent. Verify all details on the official Tata AIG Health Insurance website before purchasing.
Contact Details
1800 266 7780
Headquarters: Peninsula Business Park, Tower A, 15th Floor, G.K. Marg, Lower Parel, Mumbai – 400013, Maharashtra, India
The aforementioned ratios have been averaged over three years (FY24-FY26)
Pay monthly, quarterly, half-yearly or in a limited number of instalments instead of one annual premium.
A loading applies, from 0.5% to 13% depending on the instalment option and policy term. All later instalments fall due if you claim.
HPV and Hepatitis B vaccines
These two vaccines are covered only after 2 years of continuous cover. Anti-rabies and typhoid vaccines have no wait.
Restore for a related illness
A restored amount can be used for a related illness only 45 days after the discharge of the earlier claim.
Higher sum insured
If you raise your sum insured, the waits and exclusions start again only for the added amount.
If your sum insured and bonus are completely used up in a policy period, an amount equal to the base sum insured is restored once in that period. It can be used for a related illness only 45 days after the discharge of the earlier claim, and it does not carry forward to later renewals.
Yes. The consumables listed in the policy's optional items list are covered up to the sum insured when they are used during a hospitalisation directly related to your treatment. The list is on Tata AIG's website.
Yes, as global cover up to the sum insured, but only if the diagnosis was made in India and you travel abroad for treatment. It is paid on reimbursement and only for in-patient and day care treatment.
Any illness waits 30 days, except accidents. 35 listed conditions and procedures, such as cataract, hernia and joint replacement, wait 24 months. Pre-existing diseases wait 36 months. The waits are reduced to the extent of prior continuous cover if you port or migrate.
Yes, after 36 months of continuous cover, if you declared them when you applied and Tata AIG accepted them. Tata AIG may also apply a risk loading after medical underwriting.
No. Maternity and childbirth expenses are excluded, except ectopic pregnancy, and no OPD benefit is listed. The only outpatient items are teleconsultations, a preventive health check-up, listed vaccines and a hearing aid.
There is no daily rupee cap in the prospectus, but if you take a room category higher than the one in your policy schedule, you bear 10% of the admissible claim. Check your schedule for your eligible category. Choosing a shared room gives a 6% premium discount.
Medical expenses for 60 days before admission and 90 days after discharge are covered, along with the in-patient treatment.
Adults from 18 to 65 years can buy it, and dependent children can be covered from 91 days to 25 years. A policy covers up to 7 members: self, spouse, 3 children, 2 parents and 2 parents-in-law. There is no maximum cover-ceasing age.
A family floater discount of 22% for 2 members and up to 32% for 3 or more, 5% for a 2 year term and 7.5% for a 3 year term if you pay a single premium, 10% for Tata Group employees, and 6% for choosing the shared room category.
It is 20% at the start of the policy. At renewal it depends on how many of the last 3 policy years had a claim: 0% for 3 claim years, 5% for 2, 10% for 1 and 20% if there were none.
For cashless treatment, ask for authorisation at least 48 hours before planned hospitalisation, or within 24 hours of an emergency. For reimbursement, inform Tata AIG within 7 days of completing treatment and send the documents within 15 days. Tata AIG must settle or reject within 15 days of the last document. Call 1800 266 7780.
Yes. Renewal cannot be denied because you made a claim, and no loading is applied for your own claims. After 5 continuous years of cover, no claim can be contested except for established fraud.
Yes. You get 8 teleconsultations with a general physician and an ambulance booking facility through Tata AIG's app. A cashless preventive health check-up worth up to 1% of the previous year's sum insured, with a maximum of ₹10,000, is available after every two continuous claim-free policy years.