Loading...
Loading...
Reviewed by Finzony Finance TeamLast updated:
Tata AIG MediCare Premier is the top plan in Tata AIG's MediCare range. You can choose a sum insured of ₹5, 10, 15, 20, 25 or 50 lakh, or ₹75 lakh, ₹1 crore, ₹2 crore or ₹3 crore, on an individual or family floater basis, for a term of 1, 2 or 3 years. The plan sets no room rent limit and no co-payment, and most of its extras are built into the base premium rather than sold as add-ons. The base cover pays for in-patient hospitalisation, day care, domiciliary treatment, AYUSH treatment, organ donor expenses, modern treatments such as robotic surgery, bariatric surgery for eligible cases, and consumables. Pre-hospitalisation is covered for 60 days, and post-hospitalisation for 90 days up to ₹50 lakh and 200 days from ₹75 lakh. A Restore Benefit refills your base sum insured once in a policy year, and the Cumulative Bonus adds 50% of your sum insured for each claim-free year, up to 100%. It also includes global cover for planned treatment abroad when the illness is diagnosed in India, emergency air ambulance, maternity, OPD and OPD dental, high-end diagnostics, an annual health check-up, vaccination, a hearing aid benefit, accidental death cover and wellness services. From ₹75 lakh, you also get home care treatment and more generous limits. Global cover is not available if the policyholder or any insured person is an NRI, OCI or foreign national. Renewal is for life, with no exit age.
High sum insured (up to ₹3Cr) with global cover for planned treatment abroad when diagnosed in India — note: this global benefit is not available to NRIs/OCIs per policy terms.
Finzony reads MediCare Premier as a plan for buyers who want a large sum insured and almost everything included in one premium. Its biggest advantage is the waiting periods: pre-existing diseases and the listed conditions and procedures wait only 24 months, shorter than the 36 months many plans use for pre-existing diseases. It also has no room rent limit, no co-payment and no disease-wise sub-limits, a 50% Cumulative Bonus that can reach 100%, a Restore Benefit that also works for the same illness after 45 days, and consumables built in. Global cover for planned treatment abroad, emergency air ambulance, OPD, maternity and accidental death are all in the base plan. The trade-offs are clear. Global cover is switched off entirely if the policyholder or anyone insured is an NRI, OCI or foreign national, and a resident Indian who opts out cannot opt back in. Maternity waits 3 years and pays ₹50,000 up to ₹50 lakh cover. OPD, ambulance and health check-up benefits have small caps. Restore does not trigger on the first claim in a policy year and cannot be used for global cover. Post-hospitalisation is 90 days until ₹50 lakh, and home care, higher air ambulance limits and the longer post-hospitalisation period start only at ₹75 lakh. The Cumulative Bonus halves after a claim year. If you want a lower premium, compare it with MediCare and MediCare Select. If you hold, or may hold, NRI or OCI status, global cover is not available, so weigh the plan on its other benefits.
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.
Choose ₹5, 10, 15, 20, 25 or 50 lakh, or ₹75 lakh, ₹1 crore, ₹2 crore or ₹3 crore, on an individual or family floater basis, for 1, 2 or 3 years.
Several limits, such as ambulance, check-up, OPD and post-hospitalisation days, change by sum insured band, and many get bigger from ₹75 lakh.
The plan sets no room rent capping, no co-payment and no disease-wise sub-limits. Medical expenses directly related to the hospitalisation are payable.
Benefit caps still apply to maternity, OPD, ambulance and diagnostics.
Pays expenses for hospitalisation due to a disease, illness or injury that needs admission as an in-patient.
Pays consultations, investigations and medicines for 60 days before admission and for 90 days after discharge up to ₹50 lakh cover, or 200 days from ₹75 lakh. From ₹75 lakh, up to 15 physiotherapy sessions at home are also arranged.
Payable when a hospitalisation, day care, domiciliary or home care claim is accepted.
Covers day care treatment at a hospital or day care centre, up to the sum insured.
Treatment normally taken as an outpatient is not included.
Optional maternity-related coverage is available subject to the applicable benefit terms and waiting period.
Optional benefit
Provides coverage for eligible planned treatment abroad when the insured is diagnosed in India, subject to policy conditions.
Subject to policy terms
A 30-day wait applies to any illness except accidents, and it is waived if you have more than 12 months of continuous cover. The 42 listed conditions and procedures wait 24 months, and pre-existing diseases wait 24 months. OPD, OPD dental and some vaccines wait 24 months, and maternity waits 3 years. Waits are reduced to the extent of prior cover if you port or migrate, and they start again for any increase in sum insured.
Initial waiting period
Expenses for any illness in the first 30 days of the first policy are excluded, except for accidents. This is waived if you have more than 12 months of continuous cover.
Specified diseases and procedures
42 listed conditions and procedures, such as cataract, hernia, joint replacement, gallstones and kidney stones, wait 24 months, unless an accident caused them.
Pre-existing diseases
Declared and accepted pre-existing diseases are covered after 24 months. If a listed disease is also pre-existing, the longer wait applies.
OPD, OPD dental and some vaccines
Conditions or treatments that the policy clearly says it will not cover.
These 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 claims arising from an accident. If one of them is also a pre-existing disease, the longer wait applies, which here is also 24 months.
Insurer
Tata AIG Health Insurance plans and claim process
MediCare Premier is the top plan in Tata AIG's MediCare range. It offers a sum insured from ₹5 lakh to ₹3 crore, no room rent limit and no co-payment, and includes OPD, maternity, air ambulance, consumables and global cover for planned treatment in the base plan.
You can choose ₹5, 10, 15, 20, 25 or 50 lakh, or ₹75 lakh, ₹1 crore, ₹2 crore or ₹3 crore, on an individual or family floater basis. Several limits and benefits get larger from ₹75 lakh.
Your premium depends on your age, sum insured, zone and policy term. As an illustration in the policy wording, a 40-year-old on a ₹5 lakh individual plan for one year pays ₹15,702 before tax. Get a quote for your own age and city.
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)
Covers eligible non-medical consumable items used during admissible hospitalisation according to the selected benefit.
Optional benefit
Provides eligible outpatient consultation and treatment benefits where selected under the policy.
Optional benefit
Provides eligible outpatient dental treatment benefits subject to the selected cover and applicable waiting period.
Optional benefit
Wellness-related benefits may be available according to the selected variant and policy conditions.
Subject to selected cover
You choose either the Cumulative Bonus or a discount on your renewal premium for claim-free years.
Pick one at the start, and it is shown in your policy schedule.
A resident Indian can give up global cover for planned hospitalisation and the visa fee cover in return for a 2% premium discount.
Cannot be taken up again after opting out, and it applies to the policyholder and every insured person.
A voluntary program for insured adults. After an online health risk assessment, you earn points for each healthy day, and spend them on OPD, pharmacy, check-ups, health supplements and non-payable items.
Points are earned for the first 300 days of each policy year, and they are valid for one year if the policy is renewed within the grace period.
OPD consultation and pharmacy, OPD dental, and the HPV, hepatitis and other listed vaccines are available only after 2 years of continuous cover.
Maternity
Maternity expenses are covered after 3 years of continuous cover, so buy it well before you plan a delivery.
Anti-rabies and typhoid vaccines
These two vaccines are covered from the start, without any waiting period.
Higher sum insured
If you raise your sum insured, the waits start again only for the added amount. Waits are reduced to the extent of prior cover if you port or migrate without a break.
No. The plan sets no room rent capping, no co-payment and no disease-wise sub-limits. Some extras, such as maternity, OPD and ambulance, have their own caps.
At each renewal after a claim-free year, Tata AIG adds 50% of your sum insured, up to 100%. If you claim, the bonus reduces by 50% of the sum insured in the next policy year. You can choose a renewal premium discount instead of the bonus.
If your sum insured and bonus are not enough to pay a claim, your base sum insured is restored once in a policy year. It does not trigger on the first claim in the year, and for the same illness the new admission must come at least 45 days after discharge. Unused restore does not carry forward.
Global Cover pays in-patient and day care treatment abroad, up to your sum insured, when the illness is diagnosed in India and you travel abroad for treatment. It is not available if the policyholder or any insured person is a foreign national, an NRI or an OCI. A resident Indian can opt out for a 2% discount and cannot opt back in.
Any illness waits 30 days, except accidents, and this is waived with more than 12 months of continuous cover. Pre-existing diseases and the 42 specified diseases and procedures wait 24 months. OPD and OPD dental wait 2 years, and maternity waits 3 years.
Yes. Maternity pays up to ₹50,000 (₹60,000 for a girl child) up to ₹50 lakh cover, and ₹1 lakh (₹1.2 lakh) from ₹75 lakh, after a 3-year wait. Delivery complications and first-year vaccinations are covered on separate small limits. Pre and post natal care and voluntary termination are not covered.
Yes, after 2 years of continuous cover. OPD consultations and pharmacy are paid up to ₹5,000 a year up to ₹50 lakh and up to ₹20,000 at ₹3 crore. OPD dental, such as root canal, extraction and filling, is paid up to ₹10,000 to ₹25,000 a year.
From ₹75 lakh you get 200-day post-hospitalisation, home care treatment for dialysis, chemotherapy and pandemic care, up to 15 physiotherapy sessions at home, air ambulance up to the full sum insured at network providers, visa fee cover for global treatment, higher maternity and OPD limits, and more vaccines.
Pre-hospitalisation is covered for 60 days. Post-hospitalisation is covered for 90 days up to ₹50 lakh and 200 days from ₹75 lakh to ₹3 crore, for the same condition and when the hospital claim is accepted.
Adults can join from 18 to 65 years and children from 91 days to 25 years. There is no exit age, and renewal is for life. You can cover yourself, your spouse, dependent children, and parents or parents-in-law on a floater or individual basis.
A family floater gets a discount that rises with the number of members and children, and a 2-year or 3-year policy paid with a single premium gets 5% or 7.5%. Opting out of global cover gives 2%.
It is a voluntary program for insured adults. After an online health risk assessment, you earn points for every day you record 10,000 steps or burn 500 calories, and you can spend them on OPD, pharmacy, health check-ups, supplements and non-payable items.
For cashless treatment, intimate Tata AIG within 24 hours of an emergency admission or at least 48 hours before a planned one, and use a network hospital. Tata AIG must settle or reject a claim within 15 days of the last document, or 45 days if it needs an investigation. Call 1800 266 7780, or 1800 22 9966 if you are a senior citizen.
Yes. Renewal cannot be refused because you claimed, and there is no loading for your own claims. After 5 continuous years, no claim can be contested except for established fraud. A new policy has a 30-day free look period, and you can cancel with 7 days' notice.