Tata AIG MediPrime Plan Overview
Tata AIG Medicare is a basic and comprehensive medical insurance plan. The plan is created to help you deal with medical emergencies and exorbitant hospitalization costs in an effective manner. For its highest claim paying ability, Tata AIG General Insurance Company has been credited with iAAA rating by ICRA. It has earned the trust of its customers and continues to lead the market for with its seamless health insurance services.
Coverage’s of Tata AIG MediPrime Plan
- In-Patient Hospitalization Charges: It includes ICU, room rent, nursing, consumables, and medicines drugs without any sub-limits.
- Expenses Incurred During Pre and Post Hospitalization: Treatment charges up to 30 days before hospitalization and to a maximum of 60 days after hospitalization. It is extendible to 60 days before hospitalization and 90 days after discharge, but you need to furnish the required documents 5 days prior to the hospitalization.
- Domiciliary Treatment: It compensates for medical expenses incurred while availing medical treatment at home as advised by the doctor based on your medical condition.
- DayCare Procedures: It covers expenses incurred on 140 different daycare procedures do not require 24 hours of hospitalization
- Organ Donor Expenses: Compensation is provided for medical expenses on organ transplantation while harvesting the organ from the donor
- Accidental Dental Treatment: This plan recompenses medical expenses incurred on dental treatment only in case of an accident. The maximum liability of the insurer shall be limited to the specific coverage amount.
- Ayush Benefit Cover: It pays off expenses incurred In-patient Ayurveda treatment, including Sidha, Unani, or Homeopathy treatment and the limit is up to Rs. 20,000 for a policy ranging from Rs. 2lacs to Rs. 4 lacs and up to Rs. 25,000 for a plan ranging between Rs. 5 lacs and Rs. 10 lacs during a policy term.
- Vaccination Charges: The plan also covers vaccination charges for inpatient treatment and the limit is 100% of the sum insured. And in case of outpatient treatment, the limit is Rs. 5,000 once in a year.
Benefits of Tata AIG MediPrime Plan
Claim Settlement: All the health claims are settled in a hassle-free and quick manner. It enables you to focus on the treatment and recover timely to be able to manage the expenses and submit all the required documents.
Lifelong Renewability: The plan comes with a lifelong renewability option if the premium is paid timely. The premium amount will be based on the coverage opted and the age of the insurer. The premium at the time of renewal will be based on your revised age band. This is without any extra loading clause based on your individual claim.
Optional 2-year Plan: you can opt for a long-term plan for 2 years and avail the coverage benefits at an economical premium amount.
Network Hospitals: The insurance company ensures the best and timely treatment in some of the best hospitals in your city. You can avail cashless treatment in more than 3000 network hospitals across the country. You will need to carry the original identity proof, photo ID, and your health card to avail cashless hospitalization in the network hospital.
Tax Saving Benefits: if you have purchased a policy for self, children, and spouse then you can avail tax exemption benefits for the premium paid and the limit is up to Rs.25, 000. If you buy Tata AIG health insurance coverage for your elderly parents above 60 years of age then you can avail extra tax deduction benefits up to Rs. 50,000. These benefits are covered under section 80D of the Income Tax Act 1961. Tax benefits are subject to changes in tax laws.
Exclusions of Tata AIG MediPrime Plan
The insurer shall reject your claim under the following conditions:
- The cost of treatment beyond the scope of coverage and the sum insured limit
- Expenses incurred on dental treatment apart from an accident. Even in accidental cases, the maximum liability limit is up to specific amount as mentioned in the in the policy wording.
- Treatment for sexually transmitted diseases, venereal diseases, AIDS and HIV are not reimbursed
- Intentionally Injuries of self-inflicted Injuries and ailments
- Hospitalization required due to war conditions, pregnancy-related complications, congenital anomalies, drug abuse, alcohol, and addiction or intoxication, etc. Please refer to policy wordings for the detailed list of benefits and exclusions
- Plastic surgeries and cosmetic surgeries unless specified in the treatment ( subjected to terms and conditions)
- Experimental and unproven medical treatments
- Cost of fitting of hearing aids, contact lenses, diabetic test strips and spectacles
- Cost of crutches and artificial limbs is also not compensated
- Non-medical expenses are not reimbursed under this plan
- Expenses incurred on donor screening
- Miscarriage and Infertility related treatments are not covered under this plan
How to File Online Claim for the Tata AIG MediPrime Plan
The claim can be easily filed online by filling the online form. The form is easily available on their official website.
The information required include details of the insurance history including date of commencement of the insurance, policy number, sum insured, hospitalization in the last 4 years, previously covered by other health insurance provider etc.
Details of the hospitalized insured member includes name, gender, occupation, address, details of hospitalization, date of admission, date of discharge, nature of the injury and the likewise.
Details of the claim such as pre-hospitalization expenses, post-hospitalization expenses, ambulance charges, claim for domiciliary hospitalization, hospital daily cash, and critical illness benefit, surgical cash, convalescence, pre/post hospitalization
Documents Required at the Time of Claim
- Claim form duly signed
- Hospital Bill Payment Receipt
- Pharmacy Bill
- Hospital Discharge Summary
- Operation Theatre Notes
- Doctor’s Prescription
- Investigation Reports
- Copy of the Claim Intimation
Written By: PolicyBazaar - Updated: 09 January 2020