Tata AIG’s Senior Citizen Health Insurance : Ageing makes you more inclined to health conditions and injuries that might not have been an issue in your more youthful years however presently need consistent clinical consideration. This is on the grounds that more seasoned individuals are more inclined to specific illnesses and recuperate all the more leisurely.
These circumstances require customary medicines and drugs to make due, which can rapidly get pricey. Given rising clinical expenses, these costs can consume your retirement investment funds and be monetarily troublesome. In such occasions, having a senior resident Mediclaim strategy makes a difference.
Key Features Of Tata AIG’s Senior Citizen Medi-claim Policy
| Senior Health Insurance Features | Details |
| Waiting Period | 30 days from policy inception. Day 1 coverage for accidents/emergencies |
| Minimum/Maximum Entry Age | 60 years and above (Medi Senior). 91 days to 71 years and above (Medi Care). |
| Pre-Policy Checkup | Tele- Medical Examination Report (Tele MER) |
| Pre and Post-Hospitalization Cover | Available up to the sum insured |
| Domiciliary Treatment | |
| No Co-Pay | Available |
| Cashless Facilities | Available at network hospitals |
| Emergency Ambulance Cover | Up to a maximum of ₹2,000 per hospitalization for registered ambulances. |
| Preventative health care checkups | Up to 1% of the previous sum insured subject to a maximum of ₹10,000 in Medi Care policies |
| Sum Insured | Medi Senior: ₹2 lakhs to ₹5 lakhs Medi Care: ₹3 lakhs to ₹20 lakhs |
| Long-Term Policy Benefit | 5% discount on premium for a 2-year tenure. 10% discount on premium for a 3-year tenure. |
| Renewability | Lifelong on timely premium payments |
| Tax Benefit | Maximum deduction of ₹75,000 under Section 80D |
Note: According to the IRDAI, insurance providers can not reject health insurance applications and renewals from senior citizens without valid reasons such as:
- Moral Hazard (The intention to claim money from the insurance provider on death by committing fraud).
- Why Do You Need Separate Health Insurance For Senior Citizens In India?Here are some reasons why you should consider getting senior citizen health insurance.
– Annual Health Checkups: Health becomes an important factor as you age, totally affecting your quality of life. Under most plans, senior citizens can avail free annual health checkups to undergo medical checkups regularly.
– Critical Illness Cover: With old age, the possibility of wounds and critical illness diagnosis increases. If this is the case, your policy will provide the necessary coverage for treatment at this time, or you can add a critical illness cover to your senior health insurance plans to increase coverage during emergencies.
– Rising Medical Costs: The Influencing Factors like rising medical costs, inflation, and medical emergencies due to unforeseen accidents or injuries can quickly deplete your savings.
– Stress-Free Retirement: Clinical cost can be distressing for anyone to pay off, but they can be especially distressing in your retirement years as they can deplete your savings.
A benefit to doing this is that diseases are detected in their earlier stages, making them easier to treat, and it reduces out-of-pocket expenses.
Having medical insurance for senior citizens can help alleviate this stress and give you peace of mind by securing your savings, as there is less risk of prematurely depleting your savings.
Some of the best age health Insurance policies for senior citizens will cover your hospitalization costs and medical emergencies, so you do not have to worry about paying out of pocket for these expenses.
Features Of Tata AIG’s Senior Citizen Mediclaim Policy
– Comprehensive Health Coverage for Senior Citizens
The extensive feature of Tata AIG’s senior citizen health is that it provides a huge range of health Insurance . You can get a sum insured starting from ₹2 lakhs up to a maximum of ₹20 lakhs under our Medi Care policy.
Our Medi Care plans for senior citizens also provide extensive base covers that cover medical expenses for pre and post-hospitalization, a global cover for planned hospitalizations, day care procedures and much more.
– AYUSH Benefits
Under this feature, medical insurance plan will cover expenses incurred for treatments in AYUSH hospitals for senior Citizen. As a result, you are insured not only for modern medical procedures but also for treatments under Ayurveda, Yoga and Naturopathy Unani, Siddha, and Homeopathy as a part of our AYUSH benefit.
– Preventative Health Checkups
Tata AIG’s Health Insurance coverage for senior residents offers protection wellbeing exams for policyholders. This advantage can be utilized by different individuals protected under the strategy up to a most extreme measure of ₹10,000.
Profiting this advantage will likewise not influence your gathered combined reward in any capacity, as it has a different breaking point.
– Restore Advantages
In situations where your aggregate protected has been depleted during the strategy’s term, we offer a reclamation benefit up to the fundamental total guaranteed sum and your gathered combined reward.
Advantages Of Purchasing Goodbye AIG’s Clinical Protection For Senior Residents
No Co-Pay and Sub Cutoff on Emergency clinic Room Lease
With Goodbye AIG’s senior resident Mediclaim strategy, you never again need to stress over room lease limits when hospitalized. You can have as far as possible on your clinic lease costs eliminated as long as it falls under your aggregate safeguarded.
So, you can pick the best clinic space to get treatment in, and the sum will be covered under your aggregate safeguarded. You need to stress over no personal costs from you, considering calm hospitalizations.
– Cashless Facilities
With our senior resident clinical protection plan, you can select credit only cases at network emergency clinics for arranged and spontaneous (crisis) hospitalizations. We have restricted with over 8,000+ medical clinics container India to guarantee you approach quality medical services benefits regardless of where you are.
The rescue vehicle cost likewise gets covered under the aggregate safeguarded in your arrangement, so you need to stress over no personal costs being caused after crisis hospitalizations. You just have to advise us of any hospitalizations, and we will deal with the rest.
–Easy Claim Process
At Tata AIG, we give a simple cases interaction to repayments on health care coverage for guardians over 60. Our web-based offices have permitted us to digitize this interaction, making it more open and quicker.
To record a case, you basically have to visit our site, finish up a cases structure and transfer the expected reports.
– Paperless Strategies
One more advantage of digitizing our cycles has permitted us to go completely paperless in our exchanges and application processes. So when you apply for a senior resident Mediclaim strategy, the application cycle should be possible completely on the web and in no time flat.
– Tax reductions
some other health care coverage plan, our senior resident Mediclaim strategy makes you qualified for health care coverage charge allowances under Area 80D of the Annual Assessment Regulation.
As a senior resident, you are qualified for derivations up to ₹50,000 on the off chance that you pay the expenses yourself and an extra ₹25,000 if a relative (under 60) safeguarded under a similar arrangement pays the premium all things considered.
– Combined reward
On strategy years where you make no cases, you are qualified for a Total Reward or a No-Guarantee Reward. Basically, we will expand your total protected by a specific rate without expanding your medical coverage charge. Along these lines, you can appreciate higher inclusion without paying any extra charges.
– Benefits With Isolated Cutoff points (Far beyond the Total Guaranteed Sum) That Don’t Influence the Combined Reward:
Wellbeing Exam: Covers costs for preventive wellbeing tests for 1% of the past total guaranteed, dependent upon a limit of ₹10,000 per strategy.
Beyond what one protected individual can use this sum. This is payable once after each two constant case free strategy years.
– Compassionate Travel: Covers travel costs for a full circle economy class air ticket or top of the line railroad pass to a close relative on the off chance that the safeguarded individual is hospitalized for in excess of five successive days where no grown-up individual from their close family is available.
This is payable assuming we have acknowledged an in-patient hospitalization guarantee for the safeguarded individual. The cost will not surpass ₹20,000 during a strategy year.
What Is Covered Under Tata AIG’s Health Insurance For Senior Citizens In India
In-patient Hospitalization: This cover offers monetary help for the hospitalization of the senior resident as an in-patient because of sickness/ailment/injury during the strategy time frame. This likewise covers dental treatment under sedation because of similar causes.
Pre and Post-Hospitalization: Inclusion for pre-hospitalization costs like interviews, examinations, and medicine as long as 60 days before hospitalization and 90 days after release from the emergency clinic for post-hospitalization costs.
This advantage is payable assuming that you have directed claims under in-patient treatment/childcare strategies/domiciliary treatment under your senior resident mediclaim strategy.
Day Care Strategies: Inclusion for costs for recorded childcare medicines because of sickness/disease/injury during the strategy term taken at an emergency clinic or a childcare community.
You check our rundown of childcare techniques covered so that all our Federal medical care variations might see what strategies are covered.
Organ donor: Inclusion for clinical and careful costs of the organ giver for gathering the organ where the safeguarded individual is the beneficiary. These costs will be covered in the event that the organ gift is in agreement and consistent with The Transplantation of Human Organs Bill (Altered), 2011.
To be qualified, the safeguarded individual should present an in-patient hospitalization guarantee under the in-patient hospitalization treatment cover, which then, at that point, should be supported.
AYUSH Therapy: We cover clinical costs on an in-patient premise at AYUSH emergency clinics.
Domiciliary Treatment: For situations where the senior resident can not be moved to a medical clinic, inclusion for costs connected with at-home therapies of the safeguarded individual is conceded on the off chance that the therapy surpasses three days for sickness the board. This doesn’t cover end-of-life care or enteral feedings.
– 
Cover: Emergency vehicle costs of the guaranteed individual on enrolled ambulances for crises or transportation starting with one clinic then onto the next for better offices and treatment.
This cover is payable up to ₹3000 per hospitalization and is allowable for claims recorded under in-patient treatment and childcare methods.
Worldwide Cover: In-patient costs of the safeguarded individual are covered external India assuming the finding was made in India and the guaranteed individual needs to travel abroad for treatment.
Just the base aggregate protected and combined reward can be utilized for this cover, not the reestablished total safeguarded.
Accidental Death Benefit (Discretionary): In the event that a safeguarded individual experiences a mishap during the strategy term and it is the sole and direct reason for their demise in something like a year from the date of the mishap, then we will pay 100 percent of the base total guaranteed as a passing advantage.
What Is Not Covered Under Tata AIG’s Health Insurance For Senior Citizens In India
Medical Exclusions
– Cosmetic or Plastic Surgery: Cosmetic or plastic surgery expenses purely for aesthetic reasons and not for medically necessary reconstructive surgery after an accident/injury are not covered.
– Investigation and Evaluation: Diagnostic and investigative expenses unrelated to the diagnosis of the current illness of the insured person are not covered.
– Obesity/Weight Control: Expenses related to surgical treatment of obesity that does not fulfil the medical insurance policy’s eligibility requirements.
– Refractive Error: Eyesight correction treatments for refractive error less than 7.5 diopters are not covered.
– Rest Cure, Rehabilitation, and Respite Care: Admissions only related to enforced bed rest are not covered. This includes custodial care at home or in a nursing facility or non-medical treatment/services for terminally ill people.
– Sterility And Infertility: Medication or treatments for sterility or infertility, like contraceptives, assisted reproduction services (IVF, ZIFT, GIFT, ICSI), surrogacy, and sterilization reversal.
– Unproven Treatments: Treatment, services, and supplies that lack valid medical documentation to support their effectiveness are not covered.
– Non-Medical Exclusions
- Any treatment or medication not medically necessary or supported by a prescription.
- Items for personal comfort and convenience that are not medically necessitated, like internet, foodstuffs, cosmetic and personal hygiene products, etc.
- Self-inflicted injuries or suicide attempts regarding mental state/sanity.
– Treatments prescribed by medical practitioners that are outside their discipline.
– Fees from medical practitioners who share the same residence as the insured or are immediate relatives.
- Crutches or other external appliances and/or devices used for diagnosis or treatment unless specifically covered under the policy.
- Fitting of hearing aids, spectacles, or contact lenses unless stated in policy terms.
- Illness or injuries where there is a change in the health status of the insured person after the date of proposal and before the commencement of the policy, which is not communicated to or accepted by us.
- Injuries from the insured person’s participation in naval, military or air force operations.
- Injuries from war, acts of war, war-like operations, and medical complications from ionizing radiation are not covered under medical insurance for senior citizens.
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Treatment and expenses for baldness, alopecia, toupees, diabetic test strips, and other similar products.
- How To File A Claim For Your Tata AIG Senior Citizen Mediclaim Policy?
- Reimbursement ClaimsIf you file a reimbursement claim, we must be informed as soon as possible. This is because there are chances of the claim getting rejected if the treatment or procedure is not pre-approved by us. To avoid this, ensure that you check the policy terms and coverage carefully.
Lastly, after getting discharged from the hospital, you must pay their bills and raise a claim through our website. You must present all the necessary documents and submit your claim.
– Cashless Claims
This facility can be claimed only in cases of treatment and hospitalization at network hospitals and applies to planned and emergency hospitalizations. For a global cover, the cashless facility would be available for in-patient and daycare hospitalizations only and approved on a case-by-case basis.
- To process your cashless claim under medical insurance for senior citizens, we must be informed:
- At least 48 hours before planned treatments, procedures and consultations.
- Within 24 hours after the hospitalization or treatment for emergency medical procedures.
How To File A Cashless Claim For Treatment At A Tata AIG Network Hospital?
- If approved, we will directly settle the bill with the network hospital.
- In case of a rejection of the cashless claim, you can still apply for a reimbursement claim, as a rejection of cashless claims in no way indicates rejection of the claim itself.
- Notify the TPA/us 48 hours before any planned hospitalizations/treatments. For emergency hospitalizations, we must be notified 24 hours after the treatment/hospitalization.
- Upon notification, we will check your coverage and eligibility and send an authorization letter to the provider.
- You have to provide the ID card issued to you along with any other information or documentation that is requested by the TPA/us to the network hospital.
How To File A Reimbursement Claim For Treatment At A Non-Network Hospital?
- Visit the Tata AIG official website.
- Click on ‘Claims‘ on the top tab.
- Click ‘Initiate Claim‘ and choose your product; in this case, it will be ‘Health.’
- Log in to the site using your registered details.
- Fill out the claims form and upload the required documents.
- After submitting your claim, an insurance agent will contact you to guide you through the process.
What To Consider While Buying Health Insurance Policies For Senior Citizens
Maximum Age of Entry: While some individual health care coverage plans give inclusion to individuals over 60, the base passage age for senior plans is 60 years or more.
– Sum insured : Your senior resident medical coverage plan should have a sufficient aggregate protected. It ought to cover all your wellbeing related costs, similar to preventive wellbeing tests, meds, and hospitalizations, and health related crises.
While concluding your aggregate safeguarded sum, consistently ensure you represent all your clinical costs and for health related crises to guarantee sufficient inclusion.
– Your senior resident Mediclaim strategy should be sufficiently adaptable to give inclusion upgrade. This can be accessible through:
- Improving the total guaranteed sum on strategy restoration,
- By an expansion in the total safeguarded through a combined reward, or both.
– Waiting Period: A few covers in your senior resident medical coverage plan have explicit holding up periods connected. You should peruse the arrangement phrasings cautiously to know when you can get inclusion for each cover.
– Policy Inclusions and Exclusions: This is the main piece of any clinical insurance contract. While contrasting your senior resident Mediclaim strategy and other senior resident wellbeing arrangements, consistently make a point to really take a look at the approach considerations and prohibitions to realize what is covered under the arrangement.
Policy Renewability: Not all senior medical coverage plans have lifetime sustainability. This element, specifically, can save you truckload of cash as it is more financially savvy to reestablish your arrangement than it is to buy another senior resident Mediclaim strategy consistently.
Documents Required For Senior Citizen Mediclaim Policy Claims
-** The Tata AIG Claim Form:** Can be downloaded from our website. It must be filled and signed on behalf of the insured person.
– Original bills, receipts (pharmacy purchase bill, consultation bill, diagnostic bill), and any attachments like receipts or prescriptions supporting any amount claimed.
– Regulatory Requirements: KYC documents (recent ID/Address proof and recent photograph) and NEFT (to enable direct credit of claim amount in your bank account for cashless claims).
- All medical reports, case histories, investigation reports, indoor case papers/ treatment papers (in reimbursement cases, if available), and discharge summaries. These include:
–Medication prescriptions that name the insured person, their price, and a payment receipt. For pre/post-hospitalization claims, the prescription must be submitted with the corresponding doctor/hospital invoice.
- *Additional Documents: *
- All pre and post-investigation, treatment, and follow-up/consultation records about the patient’s present ailment.
- Copy of settlement letter from the other insurance company or TPA.
- For Claims of the Same Event Covered by Another Insurer: Attested copies of the above-mentioned documents and a declaration from the other insurer detailing the availability of the original copies of the treatment documents.
- For Compassionate Travel: Boarding Pass, railway ticket, or any other document to show proof of travel.
- For Global Cover: Proof of diagnosis in India and the insured’s passport and visa.
- In Case the Hospital Bill is not Available: A detailed list of the individual medical services and treatments provided with all of their individual prices.
- Legal heir/succession certificate, if required.
- PM report (wherever applicable and conducted).
- Stickers and the invoices of implants used during surgery.
- Treating doctor’s certificate regarding any missing information in case histories. For example, the circumstance of injury and alcohol or drug influence at the time of the accident, if available.