Why Super top-up?
medical expenses then a super top-up plan is a cost effective option
to ensure that you are insured for any medical uncertainties in life.
What is Deductible ?
Deductible refers to the amount payable by the policyholder (via out-of-pocket/other medical insurance/corporate group health insurance) before the super top-up kicks in.
Product Highlights
Limit of Coverage
Sum insured options up to One Crore
Cashless Claims
Wide network access with 4000+ hospitals
Cumulative bonus- First in industry
50% increase in cumulative bonus for each claim free year
Tax Benefits
Tax benefit under Section 80D
Zero Copay
Covers 100% of the eligible expenses
Annual Check-up
Annual health check-ups for you and your family up to 1% of the sum insured to a maximum of Rs 10,000 per policy
Global Cover
If you're diagnosed with a medical condition in India but choose to receive treatment abroad, our Global Cover offers a Zero Copay option, covering 100% of eligible expenses.
AYUSH benefit
Treatment expenses incurred under Ayurveda, Unani, Sidha, or Homeopathy are covered, provided they are conducted in a govemment recognized hospital or center.
Consumables Benefit
(Non-medical items)Expenses directly related to medical or surgical treatment during Hospitalization is covered.
TATA AIG- Medicare Plus Super Top Up
Why Super top-up?
If your health insurance sum insured is not enough to meet the rising medical expenses then
a super top-up plan is a cost effective option to ensure that you are insured for any medical uncertainties in life.
What is Deductible ?
Super Top-up works for any number of claims in a policy year. It kicks in once the threshold deductible is reached.
Illustration
Mr. Ravi is holding a mediclaim policy for Rs 5 lacs & Super Top-up for the sum insured of Rs 10 Iacs with deductible limit of Rs 5 lacs
Key Features
In- Patient benefits-Covers expenses for hospitalization due to disease/illness or injury during the policy period that requires an insured person’s admission in a hospital as an in-patient. Medical expenses directly related to the hospitalization would payable
- Pre hospitalisation
- Ambulance charges
- Organ Donor
- Day care procedures
- Post hospitalisation
- Road Ambulance charges
- Patient treatment- Dental
- AYUSH benefit
- Domiciliary Treatment
- Second Opinion
- Portability
- Deductible
Key Features
In- Patient benefits-Covers expenses for hospitalization due to disease/illness or injury during the policy period that requires an insured person’s admission in a hospital as an in-patient. Medical expenses directly related to the hospitalization would be payable
In- Patient Treatment
Pre Hospitalisation
Ambulance Charges
Organ Donor
Day Care Procedures
Post Hospitalisation
Road Ambulance Charges
Dental
AYUSH Treatment
Domiciliary Treatment
Second Opinion
Portability
Deductable
Medicare Plus Premium Chart
Product Highlights
Limit of Coverage
Sum insured options up to One Crore
Cashless Claims
Wide network access with 4000+ hospitals
Cumulative bonus- First in industry
50% increase in cumulative bonus for each claim free year
Tax Benefits
Tax benefit under Section 80D
Zero Copay
Covers 100% of the eligible expenses
Annual Check-up
Annual health check-ups for you and your family up to 1% to a maximum of Rs 10,000 per policy
Global Cover
If you're diagnosed with a medical condition in India but choose to receive treatment abroad, our Global Cover offers a Zero Copay option, covering 100% of eligible expenses.
AYUSH benefit
Treatment expenses incurred under Ayurveda, Unani, Sidha, or Homeopathy are covered, provided they are conducted in a govemment recognized hospital or center.
Consumables Benefit
(Non-medical items)Expenses directly related to medical or surgical treatment during Hospitalization is covered.
Claim procedure and documents required
How do you file a claim if you have Medicare Plus Super Top-up?
- In the case of planned treatment, you have to intimate the insurer 48 hours before admission. But if you can do it sooner, you should probably consider doing that as insurance companies may take a while to investigate the veracity of your request.
- Check for partnered hospitals — Each insurer will have a dedicated network of hospitals they’ll have partnered with. Once you find a partner hospital of your liking, you can try to make the claim on a cashless basis.
- All you have to do is fill out a pre-authorization request form available at the hospital and ask them to send it to insurer for Pre-Approval.
- Once the request for pre-authorization has been granted, you have to avail the treatment within 15 days of the pre-authorization date.
- If you don’t find a network hospital or the cashless claim doesn’t go through, then you’ll have to fill the claim form post-discharge and send it to the insurer with all the other hospital records deemed necessary within 30 days.
What documents do I need to file a claim if I have Medicare Plus Super Top-up?
- Duly completed and signed Claim form, in original.
- Valid photo-id proof.
- Medical practitioner’s referral letter advising Hospitalization.
- Medical practitioner’s prescription advising drugs/diagnostic tests/consultation.
- Original bills, receipts, and Discharge cards from the Hospital/Medical Practitioner.
- Original bills from pharmacy/Chemists.
- Original pathological/diagnostic tests reports/radiology reports and payment receipts.
- Indoor case papers.
- First information Report, final police report, if applicable.
- Post mortem report, if conducted.
- Any other document as required by the company to assess the claim.
Frequently Asked Questions
No. Medicare Plus Super Top-up does not offer a restoration benefit.
Medicare Plus Super Top-up offers cover options ranging from ₹3 lakhs up to ₹1 crore.
Medicare Plus Super Top-up offers deductible options ranging from ₹2 lakhs up to ₹20 lakhs.
Yes. Medicare Plus Super Top-up does cover AYUSH Treatments up to 100% of the sum insured.
No. Medicare Plus Super Top-up does not have any capping on room rent.
Yes. Medicare Plus Super Top-up offers a no-claim bonus. Every year, you go without making a claim, your sum insured grows by 50% up to a maximum of 100% of the sum insured.
No. Medicare Plus Super Top-up does not offer maternity benefits.
No. Medicare Plus Super Top-up does not offer dental protection.
Yes. Medicare Plus Super Top-up imposes 3 kinds of 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.
Yes. Medicare Plus Super Top-up offers Global Cover (Optional) which covers medical expenses of the insured incurred outside India, up to the sum insured, provided that the diagnosis was made in India and the insured travels abroad for treatment.
