TATA AIG Medicare Select Plan Features and Discussion
IntroductionÂ
TATA AIG Medicare select is one the leading comprehensive health insurance plans being offered by TATA AIG. This offers basic features like IPD, Day care coverage , Domiciliary treatment, no disease based capping , organ donor cover. But it also allows you to select the various features as add-on The plan can be customised to design as per your needs and use. It also provides infinite cover advantage along with advance cover possibility. With add ons like women Suraksha, OPD, cancer benefits it offers various features missing in a lot of other insurance plans.Â
Interested to know more about this plan you can BOOK 1-on-1 consultation today How is TATA AIG as health insurance company
| Net Incurred Claims to Net Earned Premium | 2017-18 | 2018-19 | 2019-20 | 2020-21 | 2021-22 | 2022-23 | 2023-24 | 2024-25 | Q1 2025-26 |
| TATA AIG | 71% | 78% | 77% | 69% | 69% | 75% | 71% | 75% | 70% |
TATA AIG has good Net incurred claims to Net Earned Premium
| TATA AIG | 2017-18 | 2018-19 | 2019-20 | 2020-21 | 2021-22 | 2022-23 | 2023-24 | 2024-25 | Q1 2025-26 |
| Total no.of Policy Complaints (Current year) per 10,000 policies Current year | 0.81 | 0.76 | 0.61 | 1.18 | 1.14 | 1.01 | 0.63 | 0.46 | 0.75 |
| Total no.of Claim Complaints (Current year) per 10,000 Claims registered (Current year) | 7.07 | 5.75 | 6.15 | 8.15 | 10.22 | 10.08 | 12.11 | 9.75 | 11.55 |
| Network of Hospitals | 12,000 |
Verdict:Â Company seems to have good ratios a low double digit Total claim complaints per 10,000 claims registered is very good .
Net incurred claims to net premium earned of more than 70% shows the company is stable in terms of claims. Also Network hospitals are also great.
All in all a good insurance company.
BASE PLANÂ
| Max cover | 5 / 7.5 / 10 / 15 / 20 / 25 / 50 / 75 / 100 / 200 / 300 L |
| Person to be Covered | Family Floater: Self, spouse and up to 3 dependent children, up to 2 parents/parents-in-law. Individual/Multi-individual: Self, Spouse/Partners, Upto 3 Dependent Children, Parents & parents-in-law, Grandparents, Grandchildren, Siblings (Sister/Brother), Uncle, Aunt, Nephew, Niece, Employee, Domestic Help and Legal Guardian. |
| Age | No minimum / maximum entry age |
| Waiting Period | 30 days |
| Pre existing diseases | 36 months /Advance Cover ( Add on) PED after 30 days a. Diabetes Mellitus (Type 2), b. Hypertension, c. Hyperlipidaemia & d. Asthma |
| Specified diseases | 24 months |
| Maternity waiting period | 24 months /Add on Waiting period reduced to 1 year |
| Mental illness cover waiting period | Add on ( Mental Well being Rider) |
| OPD waiting period | Add On ( pocket Saver 2.0) 30 days |
| Dental OPD waiting period | Add On ( pocket Saver 2.0) 30 days |
| Critical illness waiting period | NA |
| Co -payment | NA |
| Deductibles | Aggregate deductible ( Add on ) 10/25/50/100 K |
| Room Rent caping | Single Private AC room |
| Daily Hospital Cash | Twin sharing – Rs 1200 per day ( Over and above SI) Multi sharing- Rs 1,500 per day ( Over and above SI) |
| ICU cover | upto SI |
| Disease Based caping | No |
| IPD | Upto SI |
| Pre Hospitalization | 90 Days , Upto SI |
| Post Hospitalization | 90 Days , Upto SI |
| Day Care procedure | 541 Procedure have been listed |
| Advance technology method | Covered, upto SI |
| Domiciliary treatment Healthcare | Covered, upto SI |
| Alternate treatment ( AYUSH) | Covered, upto SI |
| Organ Donor expenses | Covered, upto SI |
| Road Ambulance | Covered, upto SI |
| Restore benefit | Unlimited (Restore Infinity plus) |
| Renewal benefits | 50% increase in case of no claim max by 100% of SI OR 1% Discount in Renewal Premium Add on Super Charge Rider 100% upto Max 500% |
ADD On Features
| Unlimited Coverage | Infinite Advantage ( Add on) – for any one claim during Lifetime – In-Patient Treatment/Daycare Procedures |
| Early Access | Single premium multi-year policies, the Sum Insured of the Policy Period shall be available anytime during the Policy Period, |
| Home care treatment | Upto SI/ The pandemic care will be covered upto 25% of the sum insured. |
| Air Ambulance | Upto 5 lacs for non network; Upto SI for network provider ( over and Above SI) |
| Consumables | Non- Medical Expenses ( Specified Consumables ) Annexure 1 List 1 |
| Maternity cover | 10% of SI , max Upto Rs 1Lakh) Delivery Complication of new Born Baby First Year vaccination Waiting Period 24 months Add on Waiting period reduced to 1 year |
| Additional Sum Insured For Accidental Hospitalization | Extra SI Upto For each Insured Person |
| Annual health check up | |
| Domestic Second Opinion | |
| International Second Opinion | |
| Accidental Death benefit Rider.  | 100% SI Max upto 50 lacs (Over and above SI ) |
| Cancer Benefit | As per chosen SI max upto 1 cr (Over and above SI ) Waiting period of 30 days Survival Period of 30 days |
| Women Suraksha | Gynaecologist Consultation PMS consulting Menarche Counselling Infertility Counselling Dermatologist Consultation Polycystic ovarian cover Cancer screening : –Â Breast Cancer screening – mammography – Ovarian cancer screening – ultra Sound And CA 125 – Cervical Cancer screening – Pap Smear |
| Health Condition Management Program Health Condition Management Program | Maintaining good health and improving it through various health condition management programs including but not limited to nutrition management, weight management, chronic condition management, cancer care assistance program, stress management |
| Mental illness | •Mental Health Screening •Psychological Therapy and Procedures •Diet Consultation Rider •Vocational Rehabilitation •Stress Management Rider •Addiction Cessation Program |
| OPD Dental | Add On ( pocket Saver 2.0)Out patient Treatment Dental 5L- 7.5K 7.5L-10K 10L – 15K 15L – 20K 20L-32K 25L -50K 50L- 70K 75L-90K > 1 Cr – Rs 1 L | –Â RCT ( Single or multiple sittings ) – Tooth extraction – Restoration / Filling – All form od dental Xray – Crown -Pulpectomy – Therapeutic pulpotomy |
| OPD treatment | Outpatient Treatment and Consultation( pocket Saver 2.0 5L- 5K 7.5L-6K 10L – 8K 15L – 15K 20L-22K 25L -25K 50L- 50K 75L-70K > 1 Cr – Rs 1L | Customary Charges for in-person consultations and diagnostic tests |
| OPD Vision Care | Pocket Saver 2.0 5L- 1.5K 7.5L-2.5K 10L – 5K 15L – 12K 20L-12K 25L -20K 50L- 20K 75L-25K > 1 Cr – Rs 30K | consultations with Ophthalmologist on an Outpatient basis and Reasonable and Customary Charges for corrective spectacle lenses as prescribed by the ophthalmologist or optometrist once after every block of two continuous Policy Year with Us |
| Teleconsultation Pocket Saver 2.0 | Teleconsultations for insured person’s health related complaints or preventive health care by a qualified Medical Practitioner/ Health Care Professional |
Discounts offered
| Long Term Discount(This discount is available only with ‘Single’ Premium Payment mode. ) | 7.5% for a policy term of 3 years | ||
| 5% for a policy term of 2 years | |||
| Family Floater Discount | 1 member | No discount | |
| 2 member | 22% | ||
| 3 member | At least 1 child: 28% | No child: 22% | |
| 3+ member | At least 2 children: 32% | ||
| At least 1 child: 28%Â | No child: 22%Â | ||
| Multi-Individual Discount | 5% (Applicable, if more than one member is covered in a policy on individual basis) | ||
| Professional Discount | 7.5% (This discount is applicable for salaried employee of public or a private company) | ||
| Young Family Discount | 0% (Applicable for policies where all insured persons are of age 40 years or below at first inception. This discount will be effective from the first year of the policy and will continue for the lifetime of the policy, irrespective of claims.)Â | ||
| Favorable Experience Discount | 20% at the inception of the policy. At Renewal, the Favorable Experience Discount may vary based on established criteria. | ||
Note : Discounts other than Long term discount, Family floater discount, Multi-Individual Discount, Favorable Experience Discount and Discount in Renewal Premium (No Claim Bonus) are subject to a maximum cap of 25%.
Interested to know more about this plan you can BOOK 1-on-1 consultation today List Of Specific Excluded Disease Â
| Tumors | Gynaecological | Genito Urinary | Gastro intestinal | ENT |
| Tumors, Cysts, polyps including breast lumps (benign) | Polycystic ovarian disease Fibromyoma Adenomyosis Endometriosis Prolapsed Uterus Hysterectomy | Calculus diseases of Urogenital system Example: Kidney stone, Urinary bladder stone, Benign Hyperplasia of prostate, Surgery/procedure for Benign prostate enlargement Varicocele, Surgery for Hydrocele, Spermatocele | Cholelithiasis, Cholecystectomy, Pancreatitis Fissure/fistula in anus, Perineal Abscesses,Perianal / Anal Abscesses haemorrhoids, pilonidal sinus. Ulcer & erosion of stomach & duodenum Gastro Esophageal Reflux Disorder (GERD) Hernioplasty or Herniorraphy surgery of Rectocele Liver Cirrhosis | Adenoidectomy, Mastoidectomy, Nasal concha resection,Surgery for Turbinate hypertrophy Tonsillectomy, Tympanoplasty, Surgery for nasal septum deviation |
| EYE | Ortho / Spine | Immune system | Miscellaneous | |
| Cataract Retinal detachment Glaucoma | Joint replacement surgeries eg: Knee replacement, Hip replacement systemic connective tissue disorders, inflammatory polyarthropathies, Osteoarthritis and Osteoporosis Gout and Rheumatism Non-infective arthritis Prolapse inter Vertebral Disc and Spinal Diseases including spondylitis / spondylosis unless arising from Accident Ligament, Tendon or Meniscal tear | Rheumatoid arthritis | Surgery of Varicose veins and Varicose ulcers Congenital Internal |
Permanent Exclusions
| Std Exclusion | |
| Investigation and evaluation | Expenses related to any admission primarily for diagnostics and evaluation purposes only are excluded. |
| Any diagnostic expenses which are not related or not incidental to the current diagnosis and treatment are excluded. | |
| Rest cure, rehabilitation and respite care | Expenses related to any admission primarily for enforced bed rest and not for receiving treatment. This also includes: |
| Custodial care either at home or in a nursing facility for personal care such as help with activities of daily living such as bathing, dressing, moving around either by skilled nurses or assistant or non- skilled persons. | |
| Any services for people who are terminally ill to address physical, social, emotional and spiritual needs. | |
| Obesity/ Weight Control (Code- Excl 06) | Expenses related to surgical treatment of obesity that does not fulfil the below conditions: a. Surgery to be conducted is upon the advice of the Doctor; b. Th e su rgery/Procedu re conducted should be supported by clinical protocols; c. The member has to be 18 years of age or older and d. Body Mass Index (BMI); i. greater than or equal to 40 or ii. greater than or equal to 35 in conjunction with any of the following severe co-morbidities following failure of less invasive methods of weight loss: 1. Obesity-related cardiomyopathy 2. Coronary heart disease 3. Severe Sleep Apnea 4. Uncontrolled Type2 Diabetes |
| Change-of-Gender treatments | Expenses related to any treatment, including surgical management, to change characteristics of the body to those of the opposite sex. |
| Cosmetic or Plastic Surgery | Expenses for cosmetic or plastic surgery or any treatment to change appearance unless for reconstruction following an Accident, Burn(s) or Cancer or as part of medically necessary treatment to remove a direct and immediate health risk to the insured. For this to be considered a medical necessity, it must be certified by the attending Medical Practitioner. |
| Hazardous or Adventure Sports | Expenses related to any treatment necessitated due to participation as a professional in hazardous or adventure sports, including but not limited to, para-jumping, rock climbing, mountaineering, rafting, motor racing, horse racing or scuba diving, hand gliding, sky diving, deep- sea diving. |
| Breach of law | Expenses for treatment directly arising from or consequent upon any Insured Person committing or attempting to commit a breach of law with criminal intent. |
| Excluded Providers | Expenses incurred towards treatment in any hospital or by any Medical Practitioner or any other provider specifically excluded by the Insurer and disclosed in its website / notified to the policyholders are not admissible. However, in case of life threatening situations or following an accident, expenses up to the stage of stabilization are payable but not the complete claim. |
| Treatment for, Alcoholism, drug or substance abuse or any addictive condition and consequences thereof. | |
| Treatments received in heath hydros, nature cure clinics, spas or similar establishments or private beds registered as a nursing home attached to such establishments or where admission is arranged wholly or partly for domestic reasons. | |
| Dietary supplements and substances that can be purchased without prescription, including but not limited to Vitamins, minerals and organic substances unless prescribed by a medical practitioner as part of hospitalization claim or day care procedure. | |
| Refractive error | Expenses related to the treatment for correction of eye sight due to refractive error less than 7.5 dioptres |
| Unproven treatments | Expenses related to any unproven treatment, services and supplies for or in connection with any treatment. Unproven treatments are treatments, procedures or supplies that lack significant medical documentation to support their effectiveness. |
| Sterility and Infertility | Expenses related to Sterility and infertility. This includes: i. ii. iii. iv. Any type of contraception, sterilization Assisted Reproduction services including artificial insemination and advanced reproductive technologies such as IVF, ZIFT, GIFT, ICSI Gestational Surrogacy Reversal of sterilization |
| Maternity | a. Medical treatment expenses traceable to childbirth (including complicated deliveries and caesarean sections incurred during hospitalization) except ectopic pregnancy; b. Expenses towards miscarriage (unless due to an accident) and lawful medical termination of pregnancy during the policy period. |
| Specific Exclusions | |
| Dental treatment or surgery of any kind unless as a result of Accidental Bodily Injury to natural teeth and also requiring hospitalization & any dental treatment other than specified in ‘Inpatient Treatment – Dental’; | |
| Congenital External Diseases, defects or anomalies | |
| Nuclear, chemical or biological attack or weapons, contributed to, caused by, resulting from or from any other cause or event contributing concurrently or in any other sequence to the loss, claim or expense. For the purpose of this exclusion: • Nuclear attack or weapons means the use of any nuclear weapon or device or waste or combustion of nuclear fuel or the emission, discharge, dispersal, release or escape of fissile/ fusion material emitting a level of radioactivity capable of causing any Illness, incapacitating disablement or death • Chemical attack or weapons means the emission, discharge, dispersal, release or escape of any solid, liquid or gaseous chemical compound which, when suitably distributed, is capable of causing any Illness, incapacitating disablement or death. • Biological attack or weapons means the emission, discharge, dispersal, release or escape of any pathogenic (disease producing) micro-organisms and/or biologically produced toxins (including genetically modified organisms and chemically synthesized toxins) which are capable of causing any Illness, incapacitating disablement or death. | |
| War or any act of war, invasion, act of foreign enemy, civil war, public defence, rebellion, revolution, insurrection, military or usurped acts, nuclear weapons/materials, chemical and biological weapons, ionising radiation. Any Ins ur ed Person’s participation or involvement in naval, military or air force operation. | |
| Items of personal comfort and convenience like television (wherever specifically charged for), charges for access to telephone and telephone calls, internet, foodstuffs (except patient’s diet), cosmetics, hygiene articles, body care products and bath additive, barber or beauty service, guest service. | |
| Alcoholic pancreatitis; | |
| 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; | |
| Sleep-apnoea; | |
| 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; | |
| All preventive care, vaccination including inoculation and immunisations; | |
| Intentional self- injury or attempted suicide while sane or insane | |
| Treatment rendered by a Medical Practitioner which is outside his discipline. | |
| Doctor’s fees charged by the Medical Practitioner sharing the same residence as an Insured Person or who is an immediate relative of an Insured Person’s family. | |
| Provision or fitting of hearing aids, spectacles or contact lenses including optometric therapy. | |
| Any treatment and associated expenses for alopecia baldness, wigs, or toupees, medical supplies including elastic stockings, diabetic test strips, and similar products. | |
| Any treatment or part of a treatment that is not of a reasonable charge, not medically necessary; drugs or treatments which are not supported by a prescription. | |
| Crutches or any other external appliance and/or device used for diagnosis or treatment (except when used intra- operatively and explicitly stated and covered in the policy). | |
| Any existing disease specifically mentioned as Permanent exclusion in the Policy Schedule. | |
| Any illness diagnosed or injury sustained or where there is change in health status of the member after the date of proposal and before commencement of policy and the same is not communicated and accepted by us. | |
| Any claim within the deductible limit as specified in the policy schedule. | |
What is Good in the TATA AIG Medicare SelectÂ
- You can add or remove add onsÂ
- Various features likes OPD, Maternity, Air ambulance, Home care are covered as riders so only if required you can chose or leave
- Extra Benefits like Mental well being , Women SurakhsaÂ
- Unlimited coverage for one claimÂ
- Early Access in case of multi years single premium policy
- Various discounts offered , in fact best for professionalÂ
What is not Good ?
- The Room limited to “ Single AC Private Room “Â
- Missing Critical illnessÂ
- Maternity cover new born baby cover is not includedÂ
- Venereal disease, sexually transmitted disease or illness is not coveredÂ
- Alcoholic Pancreatitisis is not covered in policyÂ
Want to Understand what all policy does not cover ? Watch the video Below
Policy WordingÂ
You Want to read Policy Wordings , here is the list , though in Video we have discussed in lengthÂ
Policy Wording TATA Medicare select Policy Wording
Day Care Procedure list : Day_Care_Procedures
Here is the list of policy wording for the Add on : Please read it all the features mentioned in each are not part of the policy.
OPD Care ( Pocket Saver ) : opd_care
Cancer Care : Cancare
Mental WellBeing :Â Mental_wellbeingÂ
Women Suraksha( Empwer Her) : Empowerher
Miscellaneous Riders :Â flexi_shield_rider_policy_wordings
Interested to know more about this plan you can BOOK 1-on-1 consultation today Where to SettleYour Claims For TATA AIGÂ
Click on the link : https://www.tataaig.com/claims-process
Aviraj Sharma
November 12, 2025Thanks for the detailed breakdown of the plan’s features — the unlimited restoration of sum insured really stands out.
admin
November 12, 2025Well i would be bringing out more products breakdowns going forward, do watch the videos if you want to get a very comprehensive view of the product.
Yes Unlimited Sum insured being offered by insurer does provides a very good protection.
Hemant Thakur
November 12, 2025Really helpful article. I didn’t know the plan’s sum-insured goes up to ₹3 crore, that’s impressive.
admin
November 12, 2025Yes Recent years, the sum insured in polices have moved upwards of 1 Cr.
Lokesh Kumar
November 12, 2025Good to see the discussion of add-ons like maternity care and consumables cover — makes it easier to see if the plan fits my needs.
admin
November 12, 2025Yes one of the best feature offered by TATA medicare Select it does offer high customisation so maternity care , and various others can be opted at the right time.
Ranveer Singh
November 12, 2025I appreciate how you’ve highlighted both the discounts (like Young Family/Professional) and the core benefits — makes comparison simpler.
admin
November 13, 2025Yes available discounts are very attractive in this policy , but you have to read policy beyonds discount to before buying it.
Chaitanya Boora
November 12, 2025This is a clear and timely post. Health insurance can be confusing, but this makes the options under this plan much more transparent.
admin
November 13, 2025Yes customisation feature add a lot things to the health insurance plans
Dheeraj Gupta
November 13, 2025Nice explanation of how customization works (policy term, sum insured, add-ons) in this plan. I feel more confident exploring it now.
admin
November 13, 2025Yes with each customisation you can know how much you are paying for that customisation
Manish Choudhary
November 13, 2025Thanks for pointing out the network hospital size and the restoration benefit. those are key for hospitalisation claims.
Brijesh Choudhary
November 14, 2025Great write-up! The maternity waiting period reduction feature is something young families will value.
Simran Kaur
November 20, 2025Thanks for showing how this plan supports different life stages (young singles, families, seniors) — that helps in deciding what to pick.
Himanshu Varma
November 20, 2025Very good article! I’ll definitely use this as a reference when checking quotes and coverages — it’s important to know what you’re getting.