TATA AIG Mediplus Health Plan

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Introduction/Overview

This is a top-up health insurance plan that enhances your current health insurance with a higher total coverage at an affordable premium. There is no family floater option available with it but the company allows a maximum cover of upto 7 dependent family members under the same policy on an individual cover basis.

 

Key Features

  • Guaranteed insurance cover at renewals.
  • In – patient hospitalization including room rent ,ICU, nursing, medicines drugs & consumables covered
  • Policy covers medical expenses for 140 different day care treatments which do not require 24 hours hospitalization.
  • Cashless claim settlement across 3000+ network hospitals in India
  • Lifelong renewal provided premium is paid without any break.
  • Income tax benefit on the premium paid as per Section 80D of the Income Tax Act.
  • No family floater option available with it but the company allows a maximum cover of upto 7 dependent family members under the same policy on an individual cover basis.
  • Free Look Period of 15 days from the date of receipt of the Policy document to review the terms and conditions of this Policy
  • A deductible is the amount paid for medical services before TATA AIGs MediPlus Health Insurance begins to pay.

Benefits

  • In-patient Treatment – Medical Expenses for Hospitalization above 24 hrs.
  • Pre-Hospitalization - Medical Expenses incurred in 60 days before the admission in the Hospital.
  • Post-Hospitalization - Medical Expenses incurred in 90 days after the discharge from Hospital.
  • Day-Care procedures – Medical Expenses for enlisted 140 Day care procedures
  • Organ Donor- Medical Expenses on harvesting the organ from the donor for organ transplantation.
  • Emergency Ambulance– Actual expenses incurred or Rs. 2,000 whichever is lower per Hospitalization for utilizing ambulance service for transporting Insured Person to Hospital in case of an Emergency.
  • Domiciliary Treatment - The Medical Expenses incurred by an Insured Person for availing medical treatment at his home which would otherwise have required Hospitalization.

Details About Premium

Annual premium in Rupees

 

 

*The above rates may change. Please check the policy wordings for more details.

Policy Details

Coverage type: Individual

Grace period: 30 days for renewing the Policy. However, coverage would not be available for the period for which no premium has been received.

Free Look Period :15 days from the date of receipt of the Policy document to review the terms and conditions of this Policy.

Policy termination: 3 months prior to the expiry of the policy

 

Exclusions

  • Pre existing diseases will not be covered for the first 4 policy years given there has been continuous renewal from the policy start date
  • Treatment done in the first 30 days from the commencement of the policy, unless the treatment is done as a result of accident or emergency. This is referred to as a waiting period.
  • Any illness or disease contracted due to intake of alcohol/drugs or other addictive substances will not be covered.
  • The waiting period in case of specific conditions is 24 months Any pre-existing condition will be covered after a waiting period of 48 months
  • Treatment which starts during waiting period, except accident related / war / intentional self injury or attempted suicide / abuse of drugs and alcohol and nicotine addiction / treatment of obesity / sleep apnoea / maternity / psychiatric or mental disorders / congenital diseases / conditions related to or arising out of HIV/AIDS / etc.

Documents Required

A proposer has to fill up an ‘Application form/ proposal form’ with accurate medical history along with the address proof. Medical examination may be required in some cases, based on the sum insured and the age of the person.

Eligibility

Entry age for the policyholder, spouse and parents is 18 years to 65 years with lifetime renewal option.