Health Insurance

Health insurance, also referred to as medical insurance, is a financial tool that helps you pay for your planned & emergency medical expenses. You receive financial coverage for medical expenses like hospitalisation costs, day care treatments, outpatient (OPD) treatment, pre and post-hospitalisation, ambulance charges, etc. It also covers medical treatment costs for critical illnesses, injuries, pregnancy, surgeries, medication and preventative care.

Medical insurance is a necessity today, given the rising cost of healthcare in India. It offers financial security in times of uncertainty and allows access to the best medical care.

What is Health Insurance?

A health insurance policy is a legal document that acts as a financial cover for medical expenses/bills incurred in case of hospitalisation or other medically necessary treatment. The best health insurance plans offer comprehensive coverage, which includes emergency medical expenses, day care treatments, surgeries, injuries, pre and post-hospitalisation, outpatient (OPD) treatment, ambulance charges, etc., reducing the need to pay the huge medical costs out of pocket.

Medical insurance plans are useful since they reduce the financial burden you face for unexpected medical situations like emergency hospitalisations or accidental injuries, with the cashless treatment facility at hospitals. Health insurance plans in India will also cover AYUSH treatments and pandemics like COVID-19.

To incentivise more people to buy health insurance, the Indian government offers tax savings under Section 80D of the Income Tax, 1961. You can claim a deduction of ₹25,000, ₹50,000, ₹75,000 or ₹1 lakh against your yearly health insurance premium amount paid to your insurer under the old tax regime.

Health Insurance at a Glance

This comprehensive health insurance plan offers a wide range of features designed to provide extensive coverage and peace of mind. The sum insured can be tailored to individual needs, with flexible options ranging from ₹5 lakhs up to ₹3 crores. Policyholders gain access to an extensive network of over 12,000 hospitals across the country, ensuring quality care is always within reach. The plan covers hospitalisation expenses in full, including critical ICU charges, as well as pre- and post-hospitalisation costs, offering financial support before and after a hospital stay. Coverage for pre-existing diseases is available after the completion of a specified waiting period, and daycare procedures—those that don’t require overnight hospitalisation—are also included. Additionally, treatments under AYUSH (Ayurveda, Yoga, Unani, Siddha, and Homeopathy) are covered, reflecting a holistic approach to healthcare. Ambulance expenses are reimbursed, and for those seeking treatment abroad, global coverage for planned hospitalisation is available. The policy is built for the long term, offering lifelong renewability so you’re never left unprotected with age. Outpatient department (OPD) consultations are covered, along with maternity-related expenses, making it suitable for individuals and families alike. Preventive health check-ups are included to encourage early detection and wellness. In the event of a claim exhausting the sum insured, automatic restoration reinstates the coverage amount for the same policy period, and a cumulative bonus rewards claim-free years by increasing the sum insured. Managing claims is seamless with an online claim process, and policyholders can benefit from available tax deductions under applicable sections of the Income Tax Act. Round-the-clock, 24/7 customer support ensures assistance is always just a call away, making this plan a robust, future-ready health protection solution.

Get 100% Cashless Treatment at Any Hospital of Your Choice

Tata AIG offers 100% cashless treatment at any hospital of your choice anywhere within India.

With the GIC's 2024 ‘Cashless Everywhere’ announcement, the cashless facility is no longer restricted to our network hospitals. You can get admitted to any nearby hospital and claim cashless treatment under your TATA AIG health insurance plan, where we settle 100% of your admissible claim amount directly with the hospital.

Moreover, this process is streamlined so that your cashless claims are addressed within an hour of receiving your initial request. You will also receive the final authorisation within 3 hours of us receiving your discharge request from the hospital.

Here is how our health insurance cashless everywhere facility works:

For planned hospitalisations, you must inform us at least 48 hours before treatment.

For emergencies, we should be informed within 24 hours of hospitalisation.

The cashless claim request should align with our policy terms and conditions.

To avail of TATA AIG Cashless Everywhere via SMS:

Send “GetCashless

Our Claims Expert will call you back

We will evaluate the hospital acceptance and request

We will process your cashless health claim request

Why Do You Need a Health Insurance Policy?

Chronic Disease Management

Non-communicable diseases such as cancer, heart disease, diabetes, and asthma are responsible for nearly 71% of all global fatalities. Managing these conditions often requires long-term treatment, regular monitoring, and ongoing medication—expenses that can accumulate rapidly. A robust health insurance policy can significantly ease this financial burden by covering the costs associated with chronic disease management, ensuring you receive consistent and quality care without compromising your financial stability.

Rising Medical Costs

Healthcare expenses have surged dramatically in recent years, making quality medical care increasingly unaffordable for many. From diagnostic tests and pre-hospitalisation evaluations to prescription drugs and post-treatment consultations, the costs add up quickly. A comprehensive health insurance plan helps bridge this affordability gap by covering a wide spectrum of medical expenses, allowing you to access necessary care without delay or financial strain.

Financial Security

Medical emergencies can strike without warning, potentially draining your life savings in a matter of days. A health insurance policy acts as a crucial financial safeguard, covering hospitalisation and treatment costs so your hard-earned savings remain intact. With insurance bearing the brunt of medical bills, you can focus on what truly matters—your health and recovery—without the added stress of financial insecurity.

Comprehensive Health Coverage

TATA AIG’s health insurance plans are designed to offer extensive protection against a broad array of medical conditions. Whether it’s critical illnesses like cancer, kidney failure, or infectious diseases such as COVID-19, or preventive services like annual health check-ups, vaccinations, and wellness programs, the coverage is all-encompassing. This holistic approach ensures not only treatment when you’re unwell but also support for maintaining long-term health and well-being.

For Peace of Mind

Knowing you’re protected by a reliable health insurance policy brings invaluable peace of mind. During emergencies, you won’t have to hesitate before seeking medical attention or worry about falling into debt due to unexpected hospital bills. Your policy serves as a dependable safety net, covering treatment costs and allowing you to concentrate fully on healing and recovery—free from financial anxiety.

Types of TATA AIG Health Insurance Plans

Individual Health Insurance

Ideal for young professionals or sole earners, the Individual Health Insurance plan offers a sum insured of up to ₹3 Crores* with the assurance of lifelong renewability. It provides comprehensive coverage for pre- and post-hospitalisation expenses, daycare procedures, advanced diagnostics, and even global coverage for planned hospitalisation overseas*. Additionally, you can extend protection to your spouse and children by assigning them separate sum insured amounts under the same policy, offering flexibility and convenience.

Family Health Insurance

The Family Health Insurance plan enables you to cover up to seven family members* under a single policy, with a total coverage of up to ₹3 Crores*. This consolidated approach is not only more cost-effective and easier to manage than purchasing individual policies for each member but also comes with added benefits like a Family Floater Discount of up to 32% and additional savings on long-term policy options*.

Super Top-Up Health Insurance

When your existing health insurance coverage falls short, the Super Top-Up Health Insurance plan steps in. It activates once your base policy’s sum insured is exhausted during a claim, covering the remaining medical expenses. This solution is significantly more affordable than upgrading or buying a new high-sum-insured policy, making it a smart choice for enhanced financial protection without a heavy premium burden.

Critical Illness Health Insurance

Designed to safeguard against life-altering health events, the Critical Illness Health Insurance plan covers up to 100 severe conditions*, including cancer, heart attack, stroke, kidney failure, and paralysis. It offers valuable features like lifelong renewability, discounts on long-term policies, and the option to include family members under the same coverage—ensuring holistic protection during medical crises.

Senior Citizen Health Insurance

Tailored specifically for individuals aged 61 years and above, this plan addresses age-related health concerns with coverage of up to ₹25 Lakhs*. Beyond hospitalisation, it includes preventive health check-ups, home-based physiotherapy, home assessments and modifications for elderly care or disability support, and wellness services—all backed by lifelong renewability to ensure continuous care in later years.

Personal Accident Insurance Policy

The TATA AIG Personal Accident Insurance Policy (part of TATA AIG Medicare) provides crucial financial support in the event of accidental death or permanent disability. It offers a lump-sum payout to you or your nominated beneficiary, helping maintain financial stability and peace of mind during unforeseen and difficult times.

Arogya Sanjeevani Policy

As a standardized, entry-level health insurance product, the Arogya Sanjeevani Policy delivers essential coverage for hospitalisation and related medical expenses at an affordable premium. With sum insured options up to ₹10 Lakhs*, lifelong renewability, and the ability to include family members, it serves as a reliable and accessible foundation for basic health protection.

Key Features of Standard TATA AIG Health Insurance Plans

Tata AIG Health Insurance – Comprehensive Benefits at a Glance

Tata AIG Health Insurance offers a robust and flexible suite of benefits designed to provide complete health protection without straining your finances. The plans start with affordable premiums, making quality healthcare accessible to a wide range of customers. You can choose from a wide range of Sum Insured options—up to ₹3 Crores—ensuring coverage that aligns with your health needs and financial goals.

To enhance affordability further, Tata AIG provides attractive discounts: up to 10% for opting for longer policy tenures and up to 32% when insuring multiple family members under a family floater plan. Policyholders gain access to an extensive network of over 12,000 hospitals across India, enabling cashless treatment and seamless care delivery.

The coverage is all-encompassing: it includes hospitalisation expenses for any medically necessary treatment covered under the policy, along with pre- and post-hospitalisation expenses—typically 60 days before and 90 days after hospitalisation. Additionally, the plan covers more than 540 daycare procedures, which do not require overnight hospital stays, such as chemotherapy, dialysis, or minor surgeries.

Recognizing the growing preference for traditional medicine, Tata AIG also includes AYUSH treatment (Ayurveda, Yoga, Unani, Siddha, and Homeopathy) within its coverage. Filing claims is simple and efficient thanks to quick and hassle-free online claim processes, reducing paperwork and wait times.

For those seeking treatment abroad, the policy offers worldwide coverage—applicable both for ailments diagnosed in India and treated overseas, as well as for emergencies occurring during international travel. You can also enhance your base plan with a wide range of additional covers, including Maternity Cover, OPD (Outpatient Department) consultations, Consumables Cover, and more—tailoring your policy to your lifestyle.

In the event your sum insured is exhausted during a policy year due to a claim, the Automatic Restoration benefit reinstates the full sum insured for subsequent unrelated claims. Furthermore, policyholders enjoy a Cumulative Bonus of 5% to 50% of the Sum Insured for every claim-free year, rewarding wellness and continuity.

Preventive care is encouraged through annual preventive health check-ups at network facilities, promoting early detection and long-term well-being. You can also avail of tax benefits under Section 80D of the Income Tax Act, with deductions of up to ₹1 lakh on health insurance premiums paid.

Round-the-clock peace of mind comes standard with 24/7 customer support, ensuring prompt assistance whenever you need it—whether it’s for claim guidance, policy queries, or emergency coordination.

Together, these features make Tata AIG Health Insurance a trusted partner in safeguarding your health and financial future.

Inclusions/Exclusions of TATA AIG Health Insurance Plans

TATA AIG Medical Insurance Coverage Inclusions

• Hospitalisation Expenses: The hospitalisation expenses related to the treatment of medical condition or injury are covered as specified under the policy conditions.

• Pre- and post-hospitalisation Expenses: TATA AIG medical insurance coverage provides for pre- and post-hospitalisation expenses for specified number of days as mentioned in the policy.

• AYUSH Cover: TATA AIG health insurance plans cover the expenses related to treatments under Ayurveda, Yoga, Naturopathy, Unani, Siddha and Homeopathy.

• COVID-19 Treatment: COVID-19 medical treatment expenses are covered for insured patients.

• Daycare Procedures: Minor treatments requiring less than 24 hours of hospitalisation, such as tonsil removal and cataract removal, are covered.

• Global Cover for Planned Hospitalisation – Covers inpatient and daycare treatment abroad if diagnosed in India. Claims are reimbursed, with cashless available case-by-case. Visa service fees are covered for sum insured of ₹7550 lakhs and above.

• Ambulance Expenses: The cost of hiring ambulance services for transportation of insured patient to a hospital or from one hospital to another hospital for better medical facilities and treatments are covered under TATA AIG medical insurance coverage.

• Pre-Existing Illnesses: The expenses related to pre-existing illnesses are covered after the mentioned waiting period.

• Domiciliary Hospitalisation: Our insurance plan covers the cost of receiving medical treatment at their home, under certain conditions.

• Preventive Health Check-up Expenses: Some health insurance plans cover preventive health check-up expenses.

• Infertility Treatment Expenses: Infertility treatment expenses, like IVF, etc., are covered under the EmpowerHer rider*.
  *TATA AIG EmpowerHer UIN: TATHLIA25036V012425).
  Please refer to the policy wording and brochure for further reading.

• Out-patient Treatment - Dental: Expenses related to in-person consultations with Dental Specialist and dental treatments/procedures are included under our OPD Care rider*.
  *OPD Care UIN:TATHLIA25035V012425
  Please refer to the policy wording and brochure for further reading.

• HIV AIDS Treatment Expenses: Treatment expenses for HIV/AIDS are covered by medical insurance coverage under our Model Policy for HIV/AIDS and Persons with Disability*.
  *TATA AIG Model Policy for Persons with Disabilities and HIV/AIDS, Tata AIG UIN: TATHLIP23190V012223
  Please refer to the policy wording and brochure for further reading.

Health Insurance Covers*/Add-ons/Riders

Critical Illness Cover

This cover offers a lump sum payout when the policyholder is first diagnosed with a covered critical illness like cancer, stroke, heart failure, etc. The policyholder can use the lump sum payout to get treated at any medical facility of their choice.

Preventive Annual Health Check-Up

You are covered for a comprehensive medical check-up each year under this cover. This benefit includes a range of medical tests designed to assess your overall health and catch any potential issues early.

Accident Cover

Under this cover, you or your family/policy nominee receive compensation in case of an accidental death (policyholder) or partial or total disability caused by an accident. You can buy this coverage either as an add-on to your existing policy or as a standalone policy.

Day Care Procedures

Offers coverage for day care procedures that do not require an overnight hospital stay or hospitalisation. It covers procedures like cataract surgery, dialysis, routine check-ups, etc.

Domestic Second Opinion Rider

Get a second opinion on your initial diagnosis or treatment from a network provider, empanelled service provider, or medical practitioner in India. The second opinion will be sent directly to you through various modes of communication, like audio, video, online portals or digital applications.

International Second Opinion

Get a second opinion on your initial diagnosis or treatment from a network provider, empanelled service provider, or medical practitioner located outside of India. The second opinion can be for covered illnesses like cancer, kidney failure, etc., and will be sent directly to you through various modes of communication, like audio, video, online portals or digital applications.

Emergency Assistance Services

Get access to emergency assistance services like ambulance service, first aid service and more arranged by an empanelled service provider. This cover kicks in in the event of injury due to an accident during the policy period.

Inflation Protect

Receive additional increases to your sum insured based on current inflation rates when you renew your health insurance plan. The inflation rate will be applied to your base sum insured of the expiring policy. If this cover is not renewed before the base policy expires, all the carried forward and accrued inflation protection amounts will lapse.

Cumulative Bonus Shield

Your accumulated cumulative bonus will not be reduced under the base medical insurance policy on renewal so long as the total claims made during the year do not exceed the limit specified in your policy schedule. If the number amount of claims you’ve made do exceed the limit, your cumulative bonus will be reduced according to the rules in the base policy.

Carry Forward Unutilised Sum Insured

Carry forward any unused in-patient treatment sum insured from your current policy to the next year on renewal, so long as the policy is renewed with us without any break. Note that the total amount carried forward under cannot exceed 200% of the base policy’s sum insured.

Vaccination Cover

Get reimbursed for vaccination costs for illnesses like COVID-19, hepatitis, etc., under this cover. Vaccination costs can be high for certain diseases and this cover offers protection against various diseases without draining your bank account.

Consumables Expenses

Consumables like injections, cotton gauze, masks, gloves, bandaids, and other one-time use medical supplies used during treatment and hospitalisation will be covered. These smaller expenses can add-up during extended hospital stays so this cover acts as a viable safety net.

Daily Cash Allowance

This covers your daily expenses during hospitalisation. It includes coverage for travel expenses, food, etc. You receive a fixed amount daily for these expenses.

Voluntary Co-Payment

With this cover you get a discount on your premiums when you buy your health insurance policy. In exchange, you’ll need to pay a specific co-payment amount anytime you file a claim under your policy.

Room Eligibility Modification

If you get a premium discount under this add-on, the room entitlement in your base policy will be adjusted to the limit specified. In case you’re admitted to a room that is a higher category than the entitled room, you will need to pay a proportion of the total associated medical expenses. This excludes pharmacy charges, diagnostic costs, costs of implants, medical devices and consumables.

The amount you need to pay will be calculated using the following formula:
Expenses to be paid by the policyholder = (Associated Medical Expenses) × (Incurred Room Rent – Eligible Room Rent) / Incurred Room Rent

Premium Waiver Benefit

Under this cover, if the policyholder dies from an accident within 365 days or is diagnosed with a specific type of cancer, the premium for the next policy year on renewal will be covered by TATA AIG. This payment will only cover the insured under the policy for that year.

If there are changes to the base policy or new members are added other than a newborn or newly married spouse, the policyholder will need to pay the difference in premium.

Modification in Pre-Existing Disease Waiting Period

With this add-on, the waiting period for pre-existing diseases can be revised to 12 or 24 months under the base policy.

Waiver of Age Linked Co-Payment

Under this cover, any age-linked co-payments that apply in the base policy will be removed and will not apply to eligible claims made under the base policy.

Extension of Pre and Post-Hospitalisation Cover

The coverage period for pre and post-hospitalisation expenses such as consultations, tests and medicines covered under the base policy will be extended for 90/120/180 Days.

High-End Diagnostics

Diagnostic tests like Brain Perfusion imaging, CT guided Biopsy and Urography, Digital Subtraction Angiography (DSA), PET CTs and MRIs, Renograms, Liver Biopsy and Magnetic Resonance Cholangiography Scans will be covered on an OPD basis.

OPD Treatment

OPD treatments like consultations and pharmacy expenses up to ₹20,000* will be covered when you complete 2 years of continuous health insurance coverage with TATA AIG. This benefit has a separate limit (over and above the base sum insured) and does not affect the cumulative bonus.

OPD Dental Treatment

Dental treatments like tooth extractions, fillings and root canal treatment for single and multiple sittings will be covered for up to ₹25,000* when you complete 2 years of continuous health insurance coverage with TATA AIG. This benefit has a separate limit (over and above the base sum insured) and does not affect the Cumulative Bonus.

Global Cover for Planned Hospitalisation

Planned hospitalisation overseas up to the plan’s sum insured is covered, provided your diagnosis was made in India and you need to travel abroad for treatment. The medical costs covered will be for inpatient and daycare hospitalisation.

Any claims made under this cover will be paid for on a reimbursement basis, and cashless services will be provided on a case-by-case basis. Plus, this benefit will also cover visa service fees for obtaining a valid visa for medical treatment overseas. Coverage for Visa Services Fees is available for sum insured options of ₹75 lakhs and above.

Compassionate Travel

If the insured is hospitalised for more than 5 days in a place with no adult or immediate family member, we will cover the costs for a round trip economy class air ticket or first class railway ticket for an immediate family member to be at their bedside for the duration of the hospitalisation.

If the insured is hospitalised overseas for planned treatment, expenses for a round-trip economy-class air ticket will be covered by an immediate family member. Compassionate travel for overseas treatment is available only for sum insured options of ₹50 lakhs and above.

First Year Vaccinations

Vaccination expenses up to one year after the birth of the child will be covered, provided the child is covered under the plan. You get maximum coverage of ₹10,000 (₹15,000 in the case of a girl child). This coverage limit is a lifetime limit and not a policy limit which will be applicable for each child.

Domiciliary Treatment

Domiciliary or at-home treatment for an illness of the insured person is covered if the treatment exceeds 3 days. This coverage will only be provided for the management of an illness and not for enteral feedings or end-of-life care.

Emergency Air Ambulance Cover

Ambulance transportation via aeroplane or helicopter for emergency life-threatening conditions that require immediate medical attention will be covered. Coverage up to ₹5 lakhs for sum insured options up to ₹50 lakhs is available, and for sum insured options of ₹75 lakhs and above, coverage up ₹5 lakhs for Non-Network Providers and coverage up to the base sum insured for network providers is available. A medical practitioner should prescribe a medical evacuation and should be medically necessary.

Prolonged Hospitalisation Benefit

If you’re hospitalised for more than 10 continuous days for a disease, illness or injury, you will be paid a fixed amount of 1% of the sum insured*. This cover will come into effect if the claim is admissible under in-patient treatment coverage.

Wellness Services

Wellness services designed to assist insured persons in maintaining and improving good health and fitness will be provided. These include teleconsultations, ambulance booking facilities, an emergency “Help Me” feature, redeemable vouchers and discounts on services and health condition management.

Wellness Program

Earn wellness points through our Wellness Program by hitting health and fitness milestones. These points can be redeemed and used to pay for services and items like OPD consultations and treatments, pharmaceuticals and supplements, and health check-ups and diagnostics. You can also use your points to pay for non-payable items during claims.

Daily Cash For Accompanying An Insured Child

A daily fixed amount of 0.25% of the base sum insured and a maximum of ₹2000 per day* will be paid to an adult accompanying the hospitalised insured child. The child must be under 12 years of age, and the hospitalisation claim must be admissible under in-patient treatment.

Daily Cash For Choosing Shared Accommodation

A daily fixed amount of 0.25% of the base sum insured up to a maximum of ₹2000 per day will be paid to the insured person for each day they are hospitalised in shared accommodation in a network hospital. The hospitalisation claim must be admissible under in-patient treatment.

Hearing Aid

We will cover costs for a hearing aid every third year. The maximum amount paid will be 50% of the actual cost or ₹10,000*, whichever is lower. The items must be medically necessary and prescribed by a specialised medical practitioner.

Women-Specific Covers/Add-ons

• Maternity Cover:Maternity expenses will be covered, provided you’ve completed the 3-year waiting period under the plan. Coverage provided will be up to ₹50,000 (60,000 in case of birth of a girl child)* for sum insured options up to ₹50 lakhs and ₹1 lakh (1.20 lakhs in case of birth of a girl child) for sum insured options over ₹75 lakhs*.

• Delivery Complications Cover:Medically necessary treatment for the newborn baby in case of complications related to delivery will be covered for admissible claims filed under the maternity cover. You get maximum coverage of ₹10,000* for a sum insured up to ₹50 lakhs and ₹25,000* for a sum insured of ₹75 lakhs and above.

• Reduction of Maternity Benefit Waiting Period:With this add-on, the maternity benefit waiting period can be reduced to 36 Months, 24 months or 12 months.

*TATA AIG MediCare Premier and UIN - TATHLIP24159V042324/ Flexi Shield UIN: TATHLIA25039V012425
Refer to the product documents for complete details

What is the Ideal Coverage for Health Insurance?

Health insurance coverage is decided based on the individual policy buyer’s coverage requirement. However, a general rule of thumb is that the sum insured by the health plan must at least be equal to half of the policy buyer’s annual income. Moreover, as per expert’s suggestions, buying the best health insurance policy coverage of at least ₹10 lakhs might be required to cover rising health expenses.

Additionally, policy buyers must keep these points in mind to buy the right health insurance coverage for them:

Age of the policy buyer

Residential city (tier 1, 2, 3)

Future health costs as per rising inflation

For example, If person A is living in a Tier 1 city with a high cost of living and medicine, then buying health insurance coverage of up to ₹10 to ₹20 lakhs would be wise for them. While another person, B, is living in a Tier 3 city with a lesser cost of living and medical care, then health insurance cover of ₹5 lakhs might be sufficient for them. However, various other factors, like the insured person’s age, medical history, lifestyle and more, affect their coverage requirement.

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