• Tata AIG Mediprime Health Insurance Plan

    Health Insurance
    • Premiums as low as Rs12/day for coverage of Rs.4 Lakhs*
    • 10,000+ hospitals for cashless treatment
    • Claim up to Rs. 55,000 deduction under section 80D**

    Tata AIG is a general insurance service provider operating in the market. The company offers a range of health insurance products and ensures that policyholders are adequately covered against various illnesses and injuries. Mediprime is a comprehensive health insurance cover offered by Tata AIG. If you are looking for a family floater health insurance policy, this is one of the policies that must be certainly considered. This policy offers a range of benefits for policyholders and comes with an affordable price tag.

    Eligibility for Tata AIG Mediprime

    The following eligibility criteria must be met for potential policyholders to be enrolled in this cover:

    • Anyone between the age of 5 years and 65 years can be enrolled in this cover.
    • Dependent children less than 5 years of age can be covered from the 91st day after birth.
    • Once entered, this policy can be renewed for lifetime.
    • This policy can be taken for self, spouse, dependent children, and dependent parents.

    Features of Tata AIG Mediprime

    Some of the key features of Tata AIG Mediprime can be listed as follows:

    • This policy is available in multiple sum insured options ranging from Rs.2 lakh to Rs.10 lakh.
    • Premium amount for this policy starts from Rs.2,556 (excluding tax) for the lowest age group category.
    • Policyholders have the option of choosing between individual and family floater options.
    • The sum insured amount can be enhanced at the time of renewal.
    • Pre-existing conditions can be covered only after 48 months of continuous policy coverage.
    • Pre-insurance medical examination may be necessary at the time of signing up based on the entry age and sum insured chosen by the policyholder.
    • Pre-hospitalisation medical expenses can be reimbursed for up to 30 days. If the claim is initiated 5 days prior to hospitalisation, the number of days of coverage can be increased to 60 days.
    • Post-hospitalisation medical expenses are covered for up to 60 days. If the claim is initiated 5 days prior to hospitalisation, the number of days of coverage can be increased to 90 days.
    • A family discount of 10% is available if 3 or more members of the same family are enrolled in this cover.
    • This policy is available in 1 or 2-year policy terms. A 5% discount is available if the 2-year policy term is chosen.
    • Illnesses and diseases contracted with the first 30 days of commencement of coverage will not be covered. However, this waiting period does not apply for accidents.
    • There is a grace period of 30 days for policyholders to renew this cover after expiry.
    • The premium amount paid for this policy is eligible for tax benefit. Policyholders can claim income tax relief as per Section 80D of the Income Tax Act.
    • Portability option is available under this policy cover, and it can be transferred to any other insurers operating in the market.

    Benefits of Tata AIG Mediprime

    Some of the benefits offered by this medical insurance policy can be given in this table below:

    In-patient hospitalisation Actual expenses up to the sum insured limit including room rent, diagnostic tests, drugs, medications, etc.
    Day care treatment Coverage for up to 140 procedures that do not require 24-hour hospitalisation
    Domiciliary treatment Covered for up to the sum insured limit
    Alternative treatment Coverage for AYUSH (ayurveda, unani, siddha, and homeopathy)
    Emergency ambulance cover Up to Rs.2,500 per hospitalisation
    Dental treatment (arising out of accident) In-patient: up to the sum insured limit Outpatient: up to Rs.5,000 or Rs.7,500 (based on sum insured limit)
    Organ donor cover Covered for harvesting an organ from the donor
    Vaccination and inoculation (after post-bite treatment) In-patient: up to the sum insured limit Outpatient: up to Rs.5,000
    Cumulative bonus 10% per claim-free year (maximum of 50%)
    Health checkup Up to 1% of the sum insured (maximum of Rs.5,000)

    Exclusions of Tata AIG Mediprime

    Tata AIG is not liable for paying the following medical expenses:

    • Injuries or illnesses that can be attributed to war or warlike activities
    • Injuries or illnesses caused by nuclear weapons or materials
    • Any treatment expenses incurred for HIV, AIDS, or sexually transmitted diseases
    • Any kinds of mental or psychiatric disorders
    • Expenses that can be attributed to weight management treatments or obesity
    • Injuries or illnesses caused while intoxicated with alcohol or drugs
    • Any kinds of rehabilitation programs for drugs or alcohol
    • Injuries or illnesses caused while breaching the law with criminal intent
    • Any expenses related to pregnancy, maternity, or childbirth
    • Dental treatments and surgeries that are not caused by accidents
    • Medical accessories such as artificial limbs, crutches, or other devices
    • Expenses incurred for the diagnosis of a disease
    • Any items of personal comfort during a hospital stay
    • Any kinds of cosmetic surgeries or plastic surgeries

    Claim Procedure

    Any claims from Tata AIG can be made with the specified third-party administrator (TPA) who manages all claims. The TPA must be notified 48 hours prior to admission during a planned hospitalisation stay. In emergency situations, the notification can be made within 24 hours after hospital admission. For cashless treatment, the pre-authorisation form along with the required documents must be sent to the TPA as early as possible. Once the documents are submitted, the TPA will provide authorisation for cashless treatment.

    To get reimbursement after hospital stay, the insured must submit various documents such as medical bills, diagnostic reports, physician certificate, discharge summary, etc. to the TPA within 7 days after discharge from the hospital. Once the documents are submitted, the claim process will be initiated. If there is any reason for claim rejection, it will be communicated to the insured within 7 days. Following claim acceptance, the settlement amount will be provided to the insured in 30 days.

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