Home care, physio covered: Now a health policy designed for senior citizens

Private insurer Tata AIG General Insurance has introduced a robust health insurance policy exclusively for senior citizens named “Tata AIG Elder Care”, which offers a combination of extensive medical coverage along with a range of home care services, preventive health measures, and wellness features. 

To address the rising cost of medical expenses, and to offer respite for senior citizens after a medical episode, Tata AIG has introduced the plan, which is customised to meet the diverse healthcare needs of individuals aged 61 years and above. It offers coverages related to in-patient treatment, day care procedures, High end diagnostics, Home Nursing Services, home physiotherapy, compassionate Care and a host of wellness services.

It also covers home assessment and modification benefits, which require to use wheelchair/ambulatory support to suit mobility needs for elderly care/disability.

The policy not only focuses on covering curative health care, but also on preventive and assisted health care ecosystem. Additionally, this policy offers annual preventive health consultations for specified specialities every year irrespective of claims. 

In cases of dire circumstances, the compassionate care feature plays a vital role if one requires care and attention at home. 

This policy also focuses on providing health care at home apart from providing assistance to senior citizens with the help of personalized health manager.

Premium: For those wanting a health cover of at least Rs 25 lakh, and are in the 61-56 age bracket, should be willing to shell out anywhere between Rs 45,000 to Rs 50,000 as premium annually.

The premium will be charged on the completed age of the Insured Person. For the family floater, the premium is calculated by adding the premium of respective individual members and applying the family floater discount.

For the purpose of premium computation, the country is categorized into  three Zones. 

Zone A: Mumbai including MMR/ Thane, Delhi NCR/ Faridabad/ Ghaziabad, Ahmedabad, Surat and Baroda

Discounts on Premium:

5% long term discount on premium in case insured opts for policy term of 2 years

Family floater discount on premium:

2 members -20%

Zone B: Hyderabad, Bengaluru, Kolkata, Indore, Chennai, Chandigarh/ Mohali/ Punchkula/Zirakpur, Pune/Pimpri Chinchwad

and Rajkot

Zone C covers the rest of India

Unique features 

Home Nursing Services: Insured person can avail home nursing services as a part of post-operative care at home for up to 7 days per person in a policy year.

Personalized Health Manager: A dedicated health manager will assist insured persons in scheduling appointments and coordinating services, ensuring seamless access to healthcare as a part of post operative care.

Home Physiotherapy: Insured person can avail of up to 10 physiotherapy sessions at home within India in case they undergo a joint replacement surgery, stroke, or paralysis. 

 Wellness Services: Insured person can also access wellness services at their fingertips through our customer app, such as tele-consultations, diet and nutrition consultations, and discounts on diagnostic tests, medicine, medical devices, health supplements and other health related services. 

Home delivery services for pharmacy are also offered upon request wherever available.

Compassionate care giver at home is also provided within India, to assist in Activities of Daily Living, for a maximum up to 14 days per person per policy year within post hospitalization period. 

Other important aspects you are covered for: 

 In-patient Treatment– Covers medical expenses for hospitalization in a single private room for period more than 24 hrs.

2. Pre-Hospitalization expenses- Medical Expenses incurred in 30 days before the date of admission to the hospital

3. Post-Hospitalization expenses - Medical Expenses incurred in 60 days after the date of discharge from the hospital

4. Day-Care procedures– Medical expenses for Day Care Treatment due to disease/illness/Injury during the policy period taken at a hospital or a Day Care Centre

5. AYUSH benefit - Medical Expenses incurred for In-patient treatment taken in AYUSH Hospital, subject to a maximum of 50% of the sum insured

6. Road Ambulance cover–For utilizing ambulance service for transporting the insured person to hospital in case of an emergency, subject to a maximum of Rs 5000 per Hospitalization.

7. Preventive Health Check-up- Preventive Health Check-up for tests specified in the policy, through our empanelled service provider after a block of every two continuous claim free policy years.

8.. Annual Preventive Health Consultation – Annual health consultation for preventive dental check-up, eye check-up and orthopaedic consultation

9.  Medical Second Opinion - Tata AIG will provide You a medical second opinion from Network Provider, if an Insured Person is diagnosed with any of the illnesses specified in the policy.

10. High End Diagnostics- We will pay the insured for the diagnostic tests on OPD basis for tests listed in the policy, if required as part of a treatment subject to a maximum of Rs 20,000 per policy year.

Cost sharing 

Mandatory co-payment of 20%. Customer shall be liable to pay 20% of the admissible claim amount of each and every claim.

The expenses payable during the entire policy year for cataract surgery and joint replacement surgery is limited to the amount specified in the policy.

Waiting period: 

Initial waiting period of 30 days for all illnesses (not applicable for accidents or on renewals)

24 months /48 months waiting period for specified diseases/ procedures.

 Pre-existing disease covered after 24 months