MediCare Premier in one table
| Insurer | Tata AIG General Insurance Company Limited |
|---|---|
| Sum insured | ₹5 lakh to ₹3 crore, in tiers of 5 / 10 / 15 / 20 / 25 / 50 / 75 / 100 / 200 / 300 lakh |
Claim settlement and complaint figures are IRDAI-published and held centrally by NYVO, not taken from the insurer's marketing.
What MediCare Premier covers
These are the terms that decide what you are actually paid when you claim. Room rent, co-pay and restoration do more to shape a settlement than the sum insured does, and they are read from Tata AIG's own policy wording.
| Feature | This plan | What good looks like |
|---|---|---|
| Co-payment | No co-payment | No Co-payment |
| Room Rent Limit | No room rent capping | No room rent capping |
| Disease sub-limit | No illness sub-limits · benefit caps on maternity, OPD, diagnostics and ambulance | No sub-limit |
| No Claim Bonus | 50% of base sum insured per claim-free year, capped at 100% · halves after a claim year | 50% each year (Minimum upto 100%) |
| Restoration Benefit | 100% of base sum insured, once a policy year · same illness allowed 45 days after discharge | 100% restoration once in a year |
| Pre-Hospitalization | 60 days | At least 60 days |
| Post-Hospitalization | 90 days up to ₹50 lakh cover · 200 days from ₹75 lakh upwards | At least 120 days |
| Consumables | Consumables Benefit built in, up to the sum insured, for the insurer's listed items | Consumables covered |
| Emergency Air Ambulance | Up to ₹5 lakh · up to the full sum insured at a network provider from ₹75 lakh cover upwards | Included |
| Maternity | ₹50,000 up to ₹50 lakh cover, ₹1 lakh above it · higher for a girl child · 36-month wait | Included |
| OPD Treatment | ₹5,000 to ₹20,000 a year plus a separate dental limit, after two continuous years | Included |
| Day-Care Procedures | Covered up to the sum insured | Covered without a capped list |
| Entry age | Adults 18 to 65 · children 91 days to 25 years · no maximum cover-ceasing age | No maximum entry age |
MediCare Premier add-ons you can buy with it
Each of these costs extra and each has its own conditions. Some are genuinely worth it; several exist to patch a gap in the base plan. Ask what each one adds before it goes on your quote.
MediCare Premier discounts you can ask for
Published discounts on this plan. Most are applied at quote stage rather than offered, so it is worth naming the ones you qualify for. Every figure is a ceiling, not a promise - what you actually get depends on the case.
| Discount | Worth | When it applies |
|---|---|---|
| Family floater discount | Up to 22% to 32% | 22% for two members, rising to 28% with at least one child and 32% with at least two children. |
| Long-term discount | Up to 5% or 7.5% | 5% on a two-year policy and 7.5% on three years, single premium only. |
| Opting out of overseas planned treatment | Up to 2% | Automatic if anyone insured is a foreign national, NRI or OCI, since the global cover is unavailable to them. A resident Indian can also choose to give it up for the same discount. |
From the plan brochure and prospectus. Applied to the base premium; the insurer's stacking rules apply.
MediCare Premier waiting periods: when each part of the cover starts
Waiting periods run from the day cover began, not from the day you fall ill, and they run in parallel rather than one after another.
| Initial Waiting Period | 30 days |
|---|---|
| Specific Illness | 24 months |
| Pre-Existing Disease | 24 months |
| Maternity | 36 months |
| OPD and OPD dental | 24 months |
The named illnesses that wait 24 months
Payable once the policy has run 24 months without a break; the wait does not apply to an accident. This list is indicative – the policy wording carries the full set, which also names cataract, joint replacement and hernia repair.
MediCare Premier exclusions: what the plan will not pay for
Every policy carries exclusions, and they are the clauses people read for the first time at claim stage. These are the ones worth knowing before you buy.
Where MediCare Premier falls short
No plan is right for everyone, and a page that only lists strengths is not much use to you. These are the gaps we would raise on a call before recommending it.
MediCare Premier questions, answered
Is the pre-existing disease waiting period really shorter than base MediCare?
Yes, and it is the single biggest reason to move up. MediCare Premier waits 24 months on a declared pre-existing condition against 36 months on base MediCare. If you are buying because of blood pressure, diabetes or thyroid already on record, that is a full year of exposure removed, and it costs nothing extra because there is no add-on to buy.
Does MediCare Premier cover air ambulance?
Yes, and it is built in, which is unusual. Up to ₹50 lakh cover the limit is ₹5 lakh. From ₹75 lakh upwards you get ₹5 lakh at any non-network provider and the entire sum insured at a network one. The limit sits over and above your base cover and using it does not touch your no-claim bonus.
How much maternity does it actually pay?
₹50,000 up to ₹50 lakh cover, rising to ₹60,000 if the baby is a girl. From ₹75 lakh upwards it is ₹1 lakh, or ₹1.2 lakh for a girl. The wait is 36 months from the first policy, so you must buy three years before you plan to use it. Delivery complications and the newborn's first-year vaccinations sit on separate small limits.
What is the catch on the overseas treatment benefit?
It is unavailable if the policyholder or anyone insured is a foreign national, an NRI or an OCI holder, at purchase or at any point during the policy year. That covers a lot of Indian families with a child abroad. In exchange you receive a 2% premium discount, which is not a like-for-like trade. Check passports before you buy the plan for this feature.
How does the restore benefit work?
Once the sum insured and accrued bonus are exhausted, an amount equal to the base sum insured is restored, once in the policy year. It works for the same illness as well as a different one, provided the fresh admission comes at least 45 days after discharge from the earlier one. Unused restore does not carry into the next renewal.
Are consumables covered?
Yes, up to the sum insured, from the insurer's published list of optional items. Gloves, syringes and the supplies hospitals bill separately are paid by the insurer instead of being deducted from your claim. It is a base benefit here, not a rider, which is a genuine advantage over most plans at this price.
Read it from the insurer
We summarise. The policy wording is the contract, and it is the only document that settles a dispute. These links go to the insurer's own pages.
Understand the terms before you commit
A plan page tells you what this policy does. These explain why each term matters and what it costs you when it is missing.
Other Tata AIG plans we have read
Tata AIG files these separately, and the terms differ between them. If you are choosing within the range, compare the waiting periods and the exclusions rather than the sum insured.