Eligibility Criteria of TATA AIG MediCare Plus Plan

TATA AIG MediCare plus Top-Up Plan is available to individuals who meet the minimum entry age criteria as defined in the policy, with coverage options for both individuals and families. The plan also offers long-term renewability, subject to policy terms and underwriting guidelines. Now let see the eligibility criteria for Medicare plus health insurance plan:

Features of Tata Aig Medicare Plus

A comprehensive health insurance plan is designed to protect you from the financial burden of medical emergencies by covering a wide range of healthcare expenses.

1. In patient hospitalization coverage - It pays for medical treatment costs if you are admitted to a hospital due to illness, injury, or disease during the policy period. This includes expenses directly related to your hospital stay.
2. Pre-hospitalization & post hospitalization expenses - Medical costs incurred up to 60 days before hospital admission and up to 90 days after discharge are covered, ensuring you are financially supported even before and after your treatment. 
3. Day care procedure - For treatments that do not require 24-hour admission, the policy offers coverage for day care procedures performed at a hospital. 
4. Domiciliary Treatment - It covers medical expenses when treatment is taken at home due to medical necessity, along with related pre and post hospitalization costs.
5. Organ Donor Expenses - If an insured person is the recipient of an organ transplant, the plan covers the medical expenses of the organ donor, including costs related to harvesting the organ. This can significantly reduce the financial stress associated with major surgeries.
6. Ambulance charges - Its covering transportation to the hospital during an emergency or when shifting to a better medical facility, up to the specified limit. 
7. Second medical opinion - You can avail of a second medical opinion from network providers if diagnosed with a listed illness, helping you make informed treatment decisions.

To encourage preventive healthcare, the plan offers annual health check-up benefits for insured members. Regular health screenings help detect potential health issues early and promote long-term well-being.

A key highlight is the Cumulative Bonus feature, where your sum insured increases by 50% for every claim-free year, up to a maximum of 100%. This means your coverage grows over time without a proportionate increase in premium. Even if you make a claim, the bonus is reduced gradually, and there is also an option to protect your accumulated bonus.

The plan also covers consumables expenses such as specific medical items used during hospitalization that are directly related to treatment. Moreover, it provides global coverage for planned hospitalization and day care treatments outside India, provided the diagnosis was made in India. Special benefits like in-patient dental treatment (if hospitalization is required due to accident or injury) and AYUSH treatment coverage for alternative therapies such as Ayurveda, Yoga, Unani, Siddha, and Homeopathy are also included, covering in-patient and related expenses.Overall, this health insurance policy is built to offer complete protection from emergency hospitalization and advanced treatments to preventive care and global medical support giving you financial security and peace of mind when you need it most.

Exclusions of Tata Aig Medicare Plus

1. Under medical exclusions, the policy does not cover alcoholic pancreatitis
2. investigation and evaluation done without active treatment, and congenital external diseases, defects, or anomalies. 
3. It also excludes expenses related to correction of eyesight due to refractive error if the power is less than 7.5 dioptres.
4. Under non-medical exclusions, treatment taken from a medical practitioner outside their area of specialization is not covered. 
5. Any claim arising due to intentional self-injury or attempted suicide, whether the person is sane or insane, is excluded. 

Additionally, situations where the insured person attempts to break the law with criminal intent are not covered under the policy. For a complete understanding, it is important to refer to the detailed policy wording.

Waiting Period of Tata Aig Medicare Plus

1. The policy has an initial waiting period of 30 days from the date of first inception, except in case of accidents, which are covered from day one.
2. Specific listed illnesses or treatments are covered only after a waiting period of 24 months.
3. Pre-existing diseases are covered after a waiting period of 36 months from the policy start date, subject to policy terms and conditions.