Overview
The Tata AIG Elder Care plan is a specialized health insurance policy designed for senior citizens aged 61 years and above, offering sum insured options up to 25L. Its key features include home nursing services for post-operative care, home physiotherapy sessions, and a personalized health manager to assist with healthcare coordination. The plan also features annual preventive health consultations, compassionate care for extended home treatment, and wellness services like teleconsultations and discounts on medicines. It focuses on both curative and preventive healthcare needs for seniors.
Experts Review
Written by Nikhil Nair
Senior Writer
Tata AIG’s Elder Care plan is a thoughtfully crafted health insurance policy tailored to the unique needs of senior citizens. Its standout features include home-based care options such as nursing services (up to 7 days per year) and physiotherapy sessions (up to 10 sessions annually), which are particularly beneficial for post-operative recovery.
The personalized health manager adds convenience by assisting with appointment scheduling and service coordination, reducing the burden on elderly policyholders. Preventive healthcare benefits like annual consultations ensure proactive health management, while wellness services such as diet consultations and pharmacy discounts enhance overall value.
However, the plan has a mandatory 20% co-payment on all claims, which can significantly increase out-of-pocket expenses. Additionally, there are disease-specific sub-limits for common conditions like cataracts and joint replacements, which may restrict coverage for high-cost treatments.
The lack of a restoration benefit for the sum insured is another drawback compared to other senior-focused plans. Room rent is limited to a single private room, which might not suit those seeking premium hospitalization options.
Pros
Insurer has a solid track record with great claim and service metrics.
Cons
Not very feature-rich.
No Restoration Benefit, which is a notable gap.
No coverage if you are forced to hospitalize at home, which could be a drawback for some.
Maternity benefits not offered, which is a key feature.
TATA AIG
Key Insights
Founded
2001
TATA AIG was established 24 years ago and has built strong credibility over time, backed by its long-standing presence in the market.
Claims Experience
89% claims settled in 30 Days
TATA AIG settles 89% of all claims it receives. This is reasonable performance, though there is room for improvement compared to top insurers.
Network Hospitals
11,000+
TATA AIG maintains a moderate network of 11,000 hospitals, offering reasonable coverage across key locations.
Complaints
11 complaints per 10,000 claims registered
TATA AIG experiences a moderate number of complaints, indicating room for improvement in addressing customer concerns.
Features
All
Great
Good
Bad
Co-payment
The policy will only cover 80% of the final bill. The rest is on you. They call this a co-payment.
Customisable
Waives off the mandatory 20% co-payment.
Room Rent
You can share a room or you could have a single room for yourself. But if you are looking for anything slightly fancy, be ready to foot a part of the bill.
Disease sub-limit
Your insurance cover won’t be fully available in case you are treated for Cataract, Joint Replacement Surgery and a few other diseases. Meaning the insurance company has a cap on the total amount they’ll pay out if you are treated for these specific illnesses.
Pre existing diseases waiting
If you’re already dealing with diabetes, cardiovascular problems or any such illnesses, the insurer will cover all costs arising out of these pre-existing problems after just 2 years. It’s probably the best deal you can get to be honest.
Pre/Post hospitalization
No worries if the doctor had to run a host of diagnostic tests before or after hospitalizing you. The insurer has your back. They will cover this amount in full for a pretty reasonable duration - 30 days before you are hospitalized and 60 days after discharge. This includes the cost of medication by the way.
Add-ons
Co-Payment Waiver
Waives off the mandatory 20% co-payment.
Permanent Exclusions
Conditions or treatments that the policy clearly says it will not cover.
Stem cell therapy; however hematopoietic stem cells for bone marrow transplant for haematological conditions will be covered under benefit B1 or B4 of this policy.
Growth hormone therapy.
Admission primarily for administration of Intra-articular or intra-lesional injections or Intravenous immunoglobulin infusion or supplementary medications like Zolendronic Acid.
Venereal disease, sexually transmitted disease or illness.
Expenses related to any admission primarily for diagnostics and evaluation purposes are excluded.
Disclaimer: For illustration purposes only - exact terms are in the policy wording.
Specific Illness
The following illnesses are not covered under the policy .
Tumors, cysts, polyps (including benign breast lumps)
Polycystic ovarian disease
Fibromyoma
Adenomyosis
Endometriosis
Waiting Period
30 days Initial waiting period
2 years Pre-existing disease waiting period
Ditto's Take
◦ Excellent ◦
Waiting periods on this policy are excellent. There is no specific illness waiting period which is a plus and the PED waiting period is better than usual.
What's missing in the policy
No Restoration Benefit.
No coverage if you are forced to hospitalize at home.
Maternity benefits not offered.
Doctor consultations are not covered.
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Frequently Asked Questions
Does Elder Care have waiting periods?
- 30-Day Waiting Period: Hospitalizations won’t be covered for the first 30 days of the policy unless it’s an accident.
- Specific Illness Waiting Period: There’s a 2 to 3-year waiting period for a list of diseases which is a mandate before you can start claiming.
- Pre-Existing Disease Waiting Period: There's a 2-year waiting period for any pre-existing disease you may have while buying the policy.
Does Elder Care have room rent restrictions?
Does Elder Care offer a restoration benefit?
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