Question 1

What is the minimum and maximum entry age for Medicare Plus by TATA AIG Health Insurance?

Accepted Answer

Medicare Plus allows entry from age 18 for adults and from 91 days for dependent children. There’s no strict upper age limit, though senior applicants may be reviewed under special underwriting rules.

Question 2

Till what age can my child stay covered under Medicare Plus?

Accepted Answer

Dependent children can remain covered under Medicare Plus until 25 years old, provided they are unmarried and financially dependent on the primary policyholder as per plan conditions.

Question 3

Are unmarried children eligible under Medicare Plus?

Accepted Answer

Yes, unmarried dependent children meeting the age and dependency criteria are eligible for coverage under Medicare Plus, helping protect your growing family.

Question 4

Can I add a new family member later under Medicare Plus?

Accepted Answer

Yes, you can add eligible family members like spouse, children or parents at renewal or qualifying life events, subject to underwriting approval and plan terms.

Question 5

Can my spouse and children be covered under a single sum insured in Medicare Plus?

Accepted Answer

Yes, Medicare Plus offers a family floater structure where your spouse and dependent children can share a common sum insured with you.

Question 6

Can I cover my parents under Medicare Plus?

Accepted Answer

Yes, parents and parents-in-law can be included under this plan, subject to age eligibility and underwriting acceptance by the insurer.

Question 7

Can family members be added mid-term under Medicare Plus?

Accepted Answer

Mid-term additions are generally permitted during qualifying events, though most member additions occur at renewal with insurer approval.

Question 8

What is the PED waiting period if I port to Medicare Plus?

Accepted Answer

If you port, the waiting period already served under your previous policy may be credited, reducing the remaining waiting time before conditions are covered.

Question 9

Can I port my existing health policy to Medicare Plus?

Accepted Answer

Yes, you can port your existing policy to Medicare Plus while keeping continuity benefits like waiting period credits, subject to underwriting acceptance.

Question 10

What is the PED waiting period after porting into Medicare Plus?

Accepted Answer

After porting, only the remaining waiting period needs to be served, accounting for the period already completed under the previous policy.

Question 11

What unique benefits does Medicare Plus offer?

Accepted Answer

Medicare Plus stands out with flexible sum insured tiers, optional OPD, family floater convenience, wellness benefits and strong core inpatient protection.

Question 12

Does Medicare Plus have disease-wise sub-limits?

Accepted Answer

The plan usually avoids strict disease-wise sub-limits on core hospitalisation benefits, offering broader claim flexibility unless specified otherwise.

Question 13

Are room rent or ICU charges capped in Medicare Plus?

Accepted Answer

Medicare Plus typically does not impose rigid room rent or ICU caps, allowing flexibility in selecting suitable hospital accommodation.

Question 14

Is co-payment compulsory or optional under Medicare Plus?

Accepted Answer

Co-payment may apply based on age or underwriting terms, and is clearly defined in the policy rather than automatically compulsory.

Question 15

Does Medicare Plus offer No-Claim Bonus (NCB)?

Accepted Answer

Yes, Medicare Plus offers a No-Claim Bonus that increases your sum insured for every claim-free year, enhancing long-term coverage value.

Question 16

Does Medicare Plus provide any loyalty bonus?

Accepted Answer

Loyalty rewards such as renewal incentives or wellness add-ons may be available, encouraging continuity and proactive health focus.

Question 17

Are preventive health check-ups included under Medicare Plus?

Accepted Answer

Yes, preventive health check-ups are included with all sum insured options to help monitor health and detect issues early.

Question 18

Is there a grace period for renewing Medicare Plus after expiry?

Accepted Answer

Yes, a grace period of around 30 days is provided after expiry, allowing renewal without losing continuity benefits, though coverage may temporarily pause.

Question 19

What are the available sum insured options under Medicare Plus?

Accepted Answer

Medicare Plus offers flexible sum insured amounts ranging from moderate to higher coverage, giving you options that match your healthcare needs and financial planning.

Question 20

Does Medicare Plus offer maternity and newborn benefits?

Accepted Answer

Yes, Medicare Plus provides maternity and newborn benefits after the applicable waiting period, assisting with delivery expenses and early baby care costs.

Question 21

Are pregnancy-related complications covered under Medicare Plus?

Accepted Answer

Yes, pregnancy-related complications are covered once the maternity waiting period is served and treatments meet the plan’s eligibility requirements.

Question 22

Are daycare procedures covered in Medicare Plus?

Accepted Answer

Yes, medically necessary daycare procedures that do not require overnight hospital stays are covered under the plan, making treatment more accessible.

Question 23

Are pre- and post-hospitalisation expenses covered under Medicare Plus?

Accepted Answer

Yes, pre-hospitalisation and post-hospitalisation costs are covered for specified days when tied to an eligible hospitalisation event under the plan.

Question 24

Does Medicare Plus include OPD coverage?

Accepted Answer

Yes, optional OPD coverage is available to help cover outpatient doctor visits, diagnostics and pharmacy expenses within defined annual limits.

Question 25

Are room rent or ICU charges capped under Medicare Plus?

Accepted Answer

Medicare Plus generally avoids harsh sub-limits on room rent or ICU charges, allowing flexibility to choose suitable hospital accommodation without unnecessary claim reductions.

Question 26

Is chemotherapy covered under Medicare Plus?

Accepted Answer

Yes, chemotherapy and cancer-related treatments are covered when medically necessary and subject to the policy’s terms and conditions.

Question 27

Are lifestyle diseases like diabetes covered from day 1 under Medicare Plus?

Accepted Answer

Lifestyle diseases are covered after the applicable waiting period, and once served, related hospitalisation expenses are eligible for claim reimbursement.

Question 28

Does Medicare Plus include mental health treatments or counselling?

Accepted Answer

Yes, inpatient mental health treatments are covered as per regulatory guidelines and policy definitions, ensuring support when it matters most.

Question 29

Does Medicare Plus cover AYUSH/alternative treatments?

Accepted Answer

Yes, inpatient AYUSH treatments such as Ayurveda, Homeopathy and Unani are included when received at recognised treatment centres in line with policy terms.

Question 30

Are diagnostic tests and pathology covered under Medicare Plus?

Accepted Answer

Yes, diagnostic tests and pathology expenses are covered if they are connected to a covered hospitalisation or related pre/post-hospital care.

Question 31

Is ambulance service covered under Medicare Plus?

Accepted Answer

Yes, ambulance charges are covered up to specified limits per hospitalization when medically necessary and linked to an eligible claim.

Question 32

Is organ donor surgery covered under Medicare Plus?

Accepted Answer

Yes, expenses related to living organ donor surgery are covered when medically necessary and part of an admissible transplant hospitalisation claim.

Question 33

Are congenital conditions covered for children under Medicare Plus?

Accepted Answer

Congenital external conditions are covered, while internal congenital conditions become eligible after the specified waiting period under plan terms.

Question 34

Does Medicare Plus cover vaccinations?

Accepted Answer

Routine vaccinations are generally excluded, though certain preventive vaccines may be covered under wellness or maternity benefit sub-limits if included.

Question 35

Does Medicare Plus provide international coverage?

Accepted Answer

Medicare Plus primarily offers coverage within India. International treatment coverage is typically not included unless specified through optional riders.

Question 36

Are occupational hazards or accident injuries covered under Medicare Plus?

Accepted Answer

Yes, hospitalisation due to accidental injuries including occupational hazards is covered subject to policy admissibility conditions.

Question 37

Are cosmetic or plastic surgeries covered under Medicare Plus?

Accepted Answer

Cosmetic surgeries are covered only when medically necessary due to accident, illness or congenital conditions, and not for elective aesthetic reasons.

Question 38

Does Medicare Plus include chronic disease management support?

Accepted Answer

Yes, the plan includes structured support for chronic conditions once waiting periods are served, helping you manage ongoing health care needs.

Question 39

Are wellness, fitness, or reward-based benefits included in Medicare Plus?

Accepted Answer

Yes, preventive health check-ups and wellness incentives are included to encourage early detection and healthier lifestyle choices.

Question 40

Does Medicare Plus provide any death benefit?

Accepted Answer

No, Medicare Plus does not include a separate death benefit; it focuses primarily on covering medical and hospitalisation costs.

Question 41

What are PEDs, and when are they covered under Medicare Plus?

Accepted Answer

Pre-existing diseases are conditions present before buying the policy. They are covered only after completion of the waiting period specified in plan terms.

Question 42

Is day-1 PED coverage available under Medicare Plus?

Accepted Answer

No, day-one coverage for pre-existing diseases is not available. These conditions are eligible only after the waiting period is fully served.

Question 43

What is the waiting period for PEDs under Medicare Plus?

Accepted Answer

The waiting period for pre-existing diseases is generally around 36 months from policy start before related claims become eligible for settlement.

Question 44

Does TATA AIG offer top-up or super top-up options with Medicare Plus?

Accepted Answer

Yes, TATA AIG offers top-up and super top-up plans that can be paired with Medicare Plus to enhance overall protection limits.

Question 45

Does Medicare Plus offer cashless hospitalisation?

Accepted Answer

Yes, cashless hospitalisation is available at a wide network of empanelled hospitals, subject to pre-authorisation and policy conditions for eligible treatments.

Question 46

How long does TATA AIG take to approve cashless claims?

Accepted Answer

Cashless pre-authorisation requests are typically processed promptly once the hospital submits all required medical documentation on your behalf.

Question 47

What documents are required to file a claim under Medicare Plus?

Accepted Answer

Required documents include the completed claim form, discharge summary, hospital bills, prescriptions, investigation reports and identity proof as required by the insurer.

Question 48

Is pre-authorisation mandatory under Medicare Plus?

Accepted Answer

Yes, pre-authorisation is mandatory for planned admissions to avail cashless benefits, while emergency admissions must be informed within specified timelines.

Question 49

How many claims can I make in one policy year under Medicare Plus?

Accepted Answer

There is no fixed limit on the number of claims in a policy year, as long as the total claimed amount remains within the available sum insured.

Question 50

Is the hospital network list available for Medicare Plus?

Accepted Answer

Yes, a network hospital list is provided for cashless treatment; you can also seek reimbursement for non-network treatment subject to policy terms.

Question 51

What is the claim settlement ratio of TATA AIG for Medicare Plus?

Accepted Answer

TATA AIG maintains a strong claim settlement ratio, reflecting reliable processing, prompt decisions and consistent customer service across its health plans.

Tata AIG Medicare Plus

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Expert Review: TATA AIG Medicare Plus

Final Verdict

What Is Medicare Plus?

Medicare Plus

Insurer Rating

9.07

Insurance Rating

6.5

Additional Benefits (Informational Only — Not part of score)

Real People. Real Relief

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Akash Kumar

TATA AIG Medicare Plus Inclusions and Exclusions

Disease-wise sublimits

Co-payment

Initial Waiting Period

Restoration Benefit

Waiting Period

Cumulative Bonus

Coverage Options

Claim Settlement Ratio

Maternity Cover

Pre-Hospitalisation

Post-Hospitalisation

Deductible Option

Cashless Healthcare Providers

Daycare Treatment

AYUSH Treatment

Room Rent

ICU Charges

Annual Health Checkup

Outpatient Department Cover (OPD Expense)

Consumable Cover

Specific Waiting Period

PED Waiting Period

Modern Treatment

Exclusions

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