TATA AIG MediSenior Insurance

 
1. Coverage amount
2. Age of senior member of the family
  OR age   
Policy Duration
3. Start Date
4. End Date
*Optional

  • Available for 61 years and above
  • Buy policy for 2 years to get 7.5% discount
  • Lifelong renewal provided
  • Eligible for a tax deduction benefit upto Rs 20,000
 

  • Plan life
    • Life long renewal

  • Eligibility Criteria
    • Individuals aged 61 years and above are eligible

  • Policy options
    • Individual
    • Family discount of 5% is available when self and spouse are insured under TATA AIG MediSenior plan
    • Choice of paying the premium for 1 year or 2 years
    • Discount of 7.5% is available if the premium is paid 2 years in advance

  • Sum Insured options
    • 2 lakhs, 3 lakhs, 5 lakhs

  • Pre-policy check
    • Mandatory and must be done in a diagnostic center in the network
    • Reimbursement of 50% of the expenses incurred if the proposal is accepted
    • Medical reports are valid for 90 days from the pre-policy check-up date

  • Claims Free Discount
    • Offers 5% non-cumulative discount on the premium to be paid for renewing if there are no claims in the previous years.

  • Waiting period
    • 30 days from the 1st inception of the policy (except medical expenses due to accident)
    • 24 months for specific illness and treatments
    • 48 months for pre-existing conditions

  • Portability
    • Policy holder who desires to shift to this plan may do so by applying at least 45 days before the renewal date of the existing plan.
    • The accrued benefits and time bound exclusions can also be transferred

  • In-patient Treatment: Room rent, ICU, nursing, medicines drugs and consumables
  • Pre Hospitalization: Expenses incurred up to 30 days prior to hospitalization
  • Post Hospitalization: Expenses incurred up to 60 days immediately after discharge from hospital
  • Domiciliary Treatment: Expenses incurred while getting treated at home on an advice from the attending medical practitioner which could not be transferred to hospital or due to unavailability of hospital bed
  • Emergency Ambulance: Maximum up to Rs.2,000/- per hospitalization used for ambulance service for transporting the insured to the nearest hospital offering necessary services
  • Day Care Procedures: Medical expenses incurred for any of the 140 day care procedures requiring not more than 24 hours of hospitalization
  • Organ Donor: Inpatient medical expenses incurred on the insured and the organ donor during a organ transplant surgery
  • Tax Benefit: Income Tax Benefit under section 80D

Co-payment for Accommodation Type
  • Shared Accommodation or any lower accommodation type: Insured has to pay 15% of the admissible claim amount
  • Single Occupancy or any higher accommodation type: Insured has to pay 30% of the admissible claim amount
Co-payment for Day Care Procedures
  • Insured has to pay 15% of the admissible claim amount for expenses incurred from day care procedures
Co-payment for Specific illness/surgeries
For expenses incurred from treatment of the following illnesses and Surgeries, the insured has to pay 30% of the admissible claim amount.
  1. Cataract(each eye)
  2. Hysterectomy
  3. Cholecystectomy
  4. Transurethral resection of the prostate (TURP) / Benign prostate surgery
  5. Surgery of Hernia
  6. Angiography (CT Angiogram excluded)
  7. Arthroscopy
  8. PID - Discectomy
  9. Mastectomy
  10. Joint replacement
  11. PTCA (Angioplasty)
  12. Hydrocele
  13. Major organ Transplant
  14. Coronary Artery Bypass Graft (CABG)
Note: If a claim is accepted for any of the above mentioned surgery then no additional co-payment will be applicable on the accommodation for the same claim. No 2 different co-payment will be applicable for a single claim.
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