Question 1

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

Accepted Answer

Medicare Premier accepts adults from age 18 and dependent children from 91 days. There is no strict upper entry age, but older applicants may require additional health disclosures and underwriting approval.

Question 2

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

Accepted Answer

Children can remain covered until age 25 under Medicare Premier, provided they are unmarried and financially dependent, giving extended family health protection through crucial adulthood years.

Question 3

Are unmarried children eligible under Medicare Premier?

Accepted Answer

Yes, unmarried dependent children are eligible for coverage under Medicare Premier when they meet the age criteria and dependency conditions in the policy wording.

Question 4

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

Accepted Answer

Yes, eligible family members can be added at policy renewal or during qualifying life events, subject to underwriting acceptance and plan terms.

Question 5

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

Accepted Answer

Yes, Medicare Premier offers a family floater option so you, your spouse and children share the same sum insured, making management easier for families.

Question 6

Can I cover my parents under Medicare Premier?

Accepted Answer

Yes, parents and parents-in-law can be covered under this plan, subject to age eligibility and underwriting criteria at the time of inclusion.

Question 7

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

Accepted Answer

Mid-term additions are generally allowed only on qualifying life events and with underwriting approval; most additions happen at policy renewal.

Question 8

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

Accepted Answer

If you port, the waiting period already served under your previous policy may reduce the remaining waiting period under Medicare Premier.

Question 9

Can I port my existing health policy to Medicare Premier?

Accepted Answer

Yes, portability is allowed under regulatory rules, letting you retain continuity benefits such as waiting period credits subject to underwriting.

Question 10

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

Accepted Answer

After porting, only the remaining waiting period needs to be served, considering the portion that was already completed under the previous policy.

Question 11

What unique benefits does Medicare Premier offer?

Accepted Answer

Medicare Premier stands out with high coverage limits, flexible sum insured options, optional OPD benefits, wellness incentives and family floater convenience for comprehensive care.

Question 12

Does Medicare Premier have disease-wise sub-limits?

Accepted Answer

The plan generally avoids rigid disease-wise sub-limits, offering broader claim flexibility unless specific caps are mentioned in policy wording.

Question 13

Are room rent or ICU charges capped in Medicare Premier?

Accepted Answer

Medicare Premier typically does not impose harsh caps on room rent or ICU categories, allowing reasonable choices without proportionate claim deductions.

Question 14

Is co-payment compulsory or optional under Medicare Premier?

Accepted Answer

Co-payment may apply based on age or underwriting terms but is clearly defined in the policy and not universally forced on all members.

Question 15

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

Accepted Answer

Yes, you earn a No-Claim Bonus which increases your sum insured for every claim-free year, boosting coverage value without proportionate premium hikes.

Question 16

Does Medicare Premier provide any loyalty bonus?

Accepted Answer

Loyalty rewards such as renewal incentives and wellness rewards may be provided to encourage consistent policy retention and health engagement.

Question 17

Are preventive health check-ups included under Medicare Premier?

Accepted Answer

Yes, annual preventive health check-ups are included across sum insured options to support early detection and proactive health monitoring.

Question 18

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

Accepted Answer

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

Question 19

What are the available sum insured options under Medicare Premier?

Accepted Answer

Medicare Premier offers a range of sum insured options from basic to higher levels, letting you choose protection based on healthcare expectations and financial comfort.

Question 20

Does Medicare Premier offer maternity and newborn benefits?

Accepted Answer

Yes, Medicare Premier includes maternity and newborn coverage after the applicable waiting period, helping manage delivery costs and newborn healthcare.

Question 21

Are pregnancy-related complications covered under Medicare Premier?

Accepted Answer

Yes, pregnancy-related complications are covered once the maternity waiting period is served and treatment meets eligibility criteria defined in the policy.

Question 22

Are daycare procedures covered in Medicare Premier?

Accepted Answer

Yes, medically necessary daycare procedures that don’t require overnight hospitalisation are included, helping cover modern treatments and shorter hospital stays.

Question 23

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

Accepted Answer

Both pre-hospitalisation and post-hospitalisation expenses are covered for defined days when tied to a covered hospitalisation event, reducing out-of-pocket spending.

Question 24

Does Medicare Premier 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 Premier?

Accepted Answer

Medicare Premier generally avoids tight sub-limits on room rent or ICU charges, giving flexibility without reducing claim values unnecessarily.

Question 26

Is chemotherapy covered under Medicare Premier?

Accepted Answer

Yes, chemotherapy and cancer-related treatments are covered when medically necessary and admissible under the plan’s hospitalisation benefits.

Question 27

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

Accepted Answer

Lifestyle diseases are covered after the applicable waiting period, after which related hospitalisation costs are eligible for claim.

Question 28

Does Medicare Premier include mental health treatments or counselling?

Accepted Answer

Yes, hospitalisation related to mental health conditions is covered in line with regulatory guidelines and the plan’s definitions of eligible treatment.

Question 29

Does Medicare Premier cover AYUSH/alternative treatments?

Accepted Answer

Yes, inpatient AYUSH treatments like Ayurveda, Homeopathy and Unani are covered when provided at recognised treatment centres under the policy terms.

Question 30

Are diagnostic tests and pathology covered under Medicare Premier?

Accepted Answer

Yes, diagnostic tests and pathology expenses are covered when they are part of a covered hospitalisation or linked pre/post-hospital care.

Question 31

Is ambulance service covered under Medicare Premier?

Accepted Answer

Yes, emergency ambulance costs are covered up to specified limits when medically necessary and linked to an eligible hospitalisation.

Question 32

Is organ donor surgery covered under Medicare Premier?

Accepted Answer

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

Question 33

Are congenital conditions covered for children under Medicare Premier?

Accepted Answer

Congenital external conditions are covered; congenital internal conditions become eligible after completing waiting periods if specified in the policy.

Question 34

Does Medicare Premier cover vaccinations?

Accepted Answer

Routine vaccinations are generally excluded but specific vaccines may be included under wellness or maternity benefits if defined in the policy.

Question 35

Does Medicare Premier provide international coverage?

Accepted Answer

Medicare Premier mainly provides coverage within India. International treatment coverage is typically not included unless specified under add-ons.

Question 36

Are occupational hazards or accident injuries covered under Medicare Premier?

Accepted Answer

Yes, accidental injuries including occupational hazards are covered subject to policy terms and admissibility conditions tied to hospitalisation.

Question 37

Are cosmetic surgeries covered under Medicare Premier?

Accepted Answer

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

Question 38

Does Medicare Premier include chronic disease management support?

Accepted Answer

Yes, the plan supports chronic condition care, helping manage diseases over the long term once waiting periods are completed.

Question 39

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

Accepted Answer

Yes, the plan includes preventive health check-ups and wellness incentives aimed at early detection and healthier lifestyles.

Question 40

Does Medicare Premier provide any death benefit?

Accepted Answer

No, Medicare Premier does not offer a separate death benefit. Its focus remains on hospitalisation and medical expense coverage.

Question 41

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

Accepted Answer

Pre-existing diseases are conditions you had before buying the policy. They become eligible only after completion of the waiting period defined in the plan.

Question 42

Is day-1 PED coverage available under Medicare Premier?

Accepted Answer

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

Question 43

What is the waiting period for PEDs under Medicare Premier?

Accepted Answer

The waiting period for pre-existing diseases is typically around 36 months from the first policy start date before those conditions become claim-eligible.

Question 44

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

Accepted Answer

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

Question 45

Does Medicare Premier offer cashless hospitalisation?

Accepted Answer

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

Question 46

How long does TATA AIG take to approve cashless claims?

Accepted Answer

Cashless pre-authorisation requests are typically processed quickly once all required medical documents are submitted by the treating hospital.

Question 47

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

Accepted Answer

Documents usually include a completed claim form, hospital bills, prescriptions, discharge summary, investigation reports and identity proof as required.

Question 48

Is pre-authorisation mandatory under Medicare Premier?

Accepted Answer

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

Question 49

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

Accepted Answer

There is no fixed limit on the number of claims per year as long as total claimed amounts remain within the purchased sum insured.

Question 50

Is the hospital network list available for Medicare Premier?

Accepted Answer

Yes, network hospital lists are available for cashless treatment, and non-network treatment can be availed through reimbursement subject to policy conditions.

Question 51

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

Accepted Answer

TATA AIG has a strong claim settlement ratio, indicating reliable processing, timely approvals and responsive service across its health insurance plans.

Tata AIG Medicare Premier

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Expert Review: TATA AIG Medicare Premier

Final Verdict

What Is Medicare Premier?

Medicare Premier

Insurer Rating

9.07

Insurance Rating

8.25

Additional Benefits (Informational Only — Not part of score)

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TATA AIG Medicare Premier Inclusions and Exclusions

Outpatient Department Cover (OPD Expense)

Pre-Hospitalisation

Co-payment

Daycare Treatment

AYUSH Treatment

ICU Charges

Disease-wise sublimits

Restoration Benefit

Cumulative Bonus

Consumable Cover

Initial Waiting Period

Specific Waiting Period

PED Waiting Period

Annual Health Checkup

Post-Hospitalisation

Deductible Option

Coverage Options

Claim Settlement Ratio

Maternity Cover

Modern Treatment

Cashless Healthcare Providers

Room Rent

Exclusions

Medicare Premier Add-Ons and Riders

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