MediCare in one table
| Insurer | Tata AIG General Insurance Company Limited |
|---|---|
| Sum insured | ₹3 lakh to ₹20 lakh, in tiers of 3 / 4 / 5 / 7.5 / 10 / 15 / 20 lakh |
Claim settlement and complaint figures are IRDAI-published and held centrally by NYVO, not taken from the insurer's marketing.
What MediCare 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 | None by default · 10% if you take the shared-room discount and then use a higher room category | No Co-payment |
| Room Rent Limit | No cap unless you opt for the 6% shared-accommodation discount | No room rent capping |
| Disease sub-limit | No illness sub-limits · ambulance capped at ₹3,000 per hospitalisation | 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 | At least 120 days |
| Consumables | Consumables Benefit built in, up to the sum insured, for the insurer's listed items | Consumables covered |
| Day-Care Procedures | Covered up to the sum insured | Covered without a capped list |
| Global Cover | Up to the sum insured if the diagnosis was made in India · reimbursement only | Included |
| AYUSH Treatment | In-patient and day care covered up to the sum insured | Included |
| Entry age | Adults 18 to 65 · children 91 days to 25 years · no maximum cover-ceasing age | No maximum entry age |
MediCare 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 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 |
|---|---|---|
| Favourable experience discount | Up to 20% | 20% at the start of the policy. At renewal it scales with your record: 20% for no claims in three years, 10% after one claim year, 5% after two, nothing after three. |
| 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. |
| Shared room category | Up to 6% | Cheaper, but a 10% co-payment then applies to the whole claim if you are admitted to a higher room category. |
From the plan brochure and prospectus. Applied to the base premium; the insurer's stacking rules apply.
MediCare 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 | 36 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 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 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 questions, answered
Are consumables covered by Tata AIG MediCare?
Yes. The Consumables Benefit is built into the base plan rather than sold as an add-on, and pays up to the sum insured for the items on the insurer's published list – the gloves, syringes and similar supplies hospitals bill separately and most policies refuse. That list is fixed, so read it rather than assuming every non-medical line on a bill qualifies.
Does MediCare have a room rent limit?
Not as standard. The catch is the 6% premium discount for opting into a shared room category. Take it and a 10% co-payment lands on the full admissible claim, not just the room charge, if you are then admitted to a higher category. On a ₹6 lakh bill that discount costs ₹60,000. Keep the room freedom unless you are certain you will never upgrade.
How does the restore benefit work here?
Once your sum insured and accrued bonus are both exhausted, an extra amount equal to the base sum insured is restored, once in the policy year. It can be used for the same illness as well as a different one, provided the new admission is at least 45 days after you were discharged from the earlier one. Anything left over does not carry into the next renewal.
Which no-claim bonus option should I pick?
You have to choose one at purchase. The cumulative bonus adds 50% of your sum insured for every claim-free year up to 100%, and halves in the year after a claim. The alternative is a 1% cut in renewal premium per claim-free year. On any realistic sum insured the extra cover is worth far more than 1% off the premium, so the cumulative bonus is the sensible default.
Can I use this plan for treatment abroad?
Yes, up to the sum insured, but on two conditions that matter. The diagnosis must have been made in India before you travel, and payment is reimbursement only – there is no cashless arrangement overseas, so you fund the hospital first and claim afterwards. Only in-patient and day-care treatment counts.
What are the waiting periods?
Three run at once. Any illness other than an accident waits 30 days. A named list of conditions – cataract, hernia, stones, benign growths and the rest – waits 24 months. Declared pre-existing conditions wait 36 months. After five continuous years the moratorium applies and the insurer can no longer contest a claim except for proven fraud or a stated permanent exclusion.
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.