Overview
The TATA AIG Medicare LITE plan is a basic health insurance policy offering essential coverage at an affordable price. It includes features like in-patient treatment, pre- and post-hospitalization expenses (up to 60 and 180 days), daycare procedures, organ donor expenses, and domiciliary treatment all up to SI. The plan also provides a restore benefit to reinstate 100% of the sum insured once per policy year (if exhausted). Additionally, it offers annual health check-ups and teleconsultations for preventive care.
Experts Review
Written by Nikhil Nair
Senior Writer
The TATA AIG Medicare LITE is a basic health insurance plan designed for budget-conscious buyers. Its affordability and staple features like pre- and post-hospitalization coverage, daycare treatments, and domiciliary care make it a viable option for basic healthcare needs. The restore benefit ensures that the sum insured can be reinstated once per policy year if exhausted, providing some financial security during multiple claims.
However, the plan has notable limitations. Room rent is restricted to a single private room, which may limit comfort during hospitalization. A mandatory 20% co-payment applies if the policyholder is 61 years or above at the time of purchase, increasing out-of-pocket expenses.
Pros
Feature set is satisfactory.
Insurer has a solid track record with great claim and service metrics.
Cons
Maternity benefits not offered, which is a notable gap.
Doctor consultations are not covered, which could be a drawback for some.
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
Co-payment
If you bought this policy after you turned 61, you have to pay 20% of the bill every time you make a claim. Otherwise, you are good to go. The insurer will pay all costs up to the sum insured.
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
No funny business here. If your insurer hasn’t explicitly stated they won’t cover a certain illness, you can claim the full amount up to the sum insured, irrespective of the disease you’re dealing with. Meaning this policy doesn't impose the dreaded disease wise sub-limits.
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 you wait for 3 years.
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 - 180 days before you are hospitalized and 60 days after discharge. This includes the cost of medication by the way.
Add-ons
Consumables Cover
Recommended
Covers list of 68 non-medical items as per list I
Personal Accident Cover
Paid out as a lump sum of 100% of sum insured for Accidental Death upto defined limits.
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 for 2 years.
Tumors, cysts, polyps (benign, including breast lumps)
Polycystic ovarian disease
Fibromyoma
Adenomyosis
Endometriosis
Waiting Period
30 days Initial waiting period
2 years Specific illness waiting period
3 years Pre-existing disease waiting period
Ditto's Take
◦ Standard ◦
After a close look at the waiting periods, it’s safe to say they are fairly standard.
What's missing in the policy
Maternity benefits not offered.
Doctor consultations are not covered.
Customer Reviews
A
Ajay Kumar
Very affordable plan, perfect for my budget! Covers the basics well.
B
Bharati Singh
Pre and post hospitalization being covered is a must, glad this plan has it.
C
Chetan Patel
The restore benefit is a good safety net, even if it's once a year.
J
Jatin Mehta
It's very basic, so don't expect fancy features like global cover.
H
Harish Jha
Room rent limit (single private room) thoda restrictive hai for bigger hospitals.
F
Fatima Begum
Tata is a trusted brand, so I went for this basic plan. Happy so far.
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Frequently Asked Questions
Does Medicare LITE 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-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 3-year waiting period for any pre-existing disease you may have while buying the policy.
Does Medicare LITE have room rent restrictions?
Does Medicare LITE offer a restoration benefit?
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