Tata AIA Life Health Insurance Plans

With the ever-changing nature of our world, today's lifestyles bring a range of health issues, from lifestyle disorders like obesity and diabetes to pollution-induced illnesses like asthma or lung cancer. Moreover, mental illnesses from leading a high-stress lifestyle are on the rise.

This is why buying a good health insurance plan that covers your emergency medical expenses and provides opportunities to improve your current lifestyle issues through annual check-ups or wellness programs is crucial.

Medical inflation in recent years has far exceeded its retail counterpart by a large margin, and nearly everyone has felt its impact. If you live in a large metropolitan city, you are already aware of how much hospitalisations, medicines, and medical examinations can cost.

Looking at it through this lens, buying a health insurance policy makes sense - even if it is only bought with the intention to cover emergency medical costs. It can mitigate the need to pay exorbitant medical bills if you fall ill or get injured.

Not only does health insurance financially shield you during a medical emergency, but it also offers policyholders significant tax5 benefits. These benefits can be availed annually under your health insurance premium payments.

You can get a maximum tax deduction of ₹25,000, which is further increased to ₹50,000 if you are a senior citizen (over 60 years). These health insurance tax benefits5 can be availed under Section 80D of the Income Tax Act 1961.

Most health insurance plans come with coverage for pre-existing illnesses. They usually have a waiting period, and these covers are activated once you have held your policy for a certain period. If you have a pre-existing condition and are looking for health coverage, we recommend you opt for a health insurance plan with a short waiting period.

Moreover, if you are predisposed to developing certain illnesses due to your lifestyle or family medical history, getting a health insurance plan sooner is advised as it will allow you to quickly complete the waiting period to immediately claim pre-existing illness coverage when needed.

Health insurance providers offer their policyholders cashless facilities. This means your insurer will settle your medical bills directly with the hospital if you opt to get treated at any of their network hospitals, mitigating the need to file for reimbursement or to gather last-minute funds.

A health insurance policy will cover your hospitalisation bills in the wake of planned or emergency treatments and surgeries. Your insurer uses your sum insured to cover your hospital bills by giving you a daily cash benefit or through reimbursement.

At Tata AIA, we offer linked and non-linked health insurance plans that allow you to grow your savings while you get medical coverage. So, under the Tata AIA Pro-Fit and Tata AIA Smart Health plans, you can build your corpus by choosing among a wide range of funds.

An ideal health insurance plan caters to your specific healthcare requirements. Hence you must choose the right type of health insurance policy as it will determine the type of coverage you get and also how much coverage you receive.
 

There are many types of health insurance plans that you can choose from. We have listed the most popular types of health insurance plans below and listed which Tata AIA products offer the following types of health insurance.

This is the most common type of health insurance plan most insurance providers offer. As the name suggests, it offers coverage for one person, i.e., the policyholder (you). Some individual health insurance plans also allow you to include a certain number of family members as dependants under the plan. The premiums for this plan are paid by the policyholder only, so if the policy is under your name, you must pay the premiums. This plan is usually recommended for adults between the ages of 25 - 60, and it covers hospitalisation expenses and emergency medical care up to the sum insured limit of the policy.
 

Tata AIA Products That Offer Individual Health Insurance:

• Tata AIA Pro-Fit.
• Tata AIA Smart Health.
• Tata AIA Sampoorna Health.
• Tata AIA OPD Care.

Cancer insurance plans are specifically built to cover medical costs related to cancer treatments, procedures, surgeries, and medication. This insurance type is usually included as an optional cover under other health plans and often has higher premium rates. You receive a portion of the sum insured paid upfront upon diagnosis; if the cancer is diagnosed at a later stage, you will receive the full assured amount.
 

• Tata AIA Sampoorna Health

These are a type of health insurance plan that offers coverage for your whole family. Under a family health insurance plan, all the insured family members share the sum insured amount. They can raise claims for their medical expenses until the sum insured is exhausted. Family health insurance plans also have set minimum and maximum entry.  Lastly, these plans have lower premium rates than individual health plans as the sum insured is shared among the insured family members.
 

Tata AIA Products That Offer Family Health Insurance

• Tata AIA Pro-Fit
• Tata AIA Smart Health

As a rider health plan:

• Tata AIA OPD Care
• Tata AIA Sampoorna Health

Health insurance plans give you the benefit of removing the upper limit on your hospital rent expenses. This means you can get treated at any hospital room if its rent falls within your policy's coverage (sum insured).
 

For example, in our TATA AIA Sampoorna Health Rider, you get the flexibility to choose your daily hospital cash benefit and the number of days per year where you will require this benefit - such as 15/30/45/60 days per year as per your need. We will pay your per day benefit upon hospitalisation for medically necessary treatment of any illness or injury due to an accident for a minimum period of continuous 24 hours.

Health insurance plans also offer coverage for pre-existing illnesses, albeit after a certain waiting period.

Therefore, you should always inform your insurer of any pre-existing illnesses before a policy purchase to ensure you are covered and to know your waiting period. For example, Tata AIA's Sampoorna Health rider offers coverage for pre-existing illnesses if you have informed us of any pre-existing conditions before the policy purchase and are covered after a specific waiting period upon approval.

Under our Tata AIA health insurance benefits, you can expect coverage for day care procedures from our health plans. Here day care procedures imply medical procedures requiring at least 24 hours of hospitalisation.
 

With our health insurance benefits, you can expect benefit payouts for 136 listed and all other non-listed day care surgeries under our plans. The specific procedures covered under each health plan will differ, so we encourage you to carefully read our policy terms before purchasing.

If you have opted for any of Tata AIA's Health Plans or health riders⁶, you can avail of our health insurance benefits that provide coverage for hospitalisation expenses.

This includes getting a daily cash benefit of up to `₹20,000 on hospitalisation and up to `₹40,000 on ICU admission under our Tata AIA Pro-Fit plan. Remember that these limits can vary depending on your chosen health plan or rider.

Health insurance benefits cover pre- and post-hospitalisation expenses. This means it will cover medical expenses incurred for an illness before getting hospitalised and medical expenses after getting discharged.

These expenses are usually covered up to a fixed number of days under each policy, so always check your policy terms or ask your insurer to ensure you get adequate coverage.

Most health insurance policies offer coverage for ectopic pregnancies and miscarriages due to an accident. Maternity covers, in particular, are offered as add-on covers.

Under this cover, you will be eligible for maternity medical expenses like childbirth, pre- and post-natal care. However, some health policies have a waiting period to avail of this benefit, so always check the policy wording to ensure you can get maternity coverage on time.

In case of emergencies where you require ambulance transportation, your health insurance plan will take care of your transportation costs and even assist in connecting to an ambulance service provider. You can find this particular health insurance benefit under our Tata AIA Sampoorna Health rider.

The best health insurance benefits come with zero co-payment. This means you do not have to worry about paying any out-of-pocket expenses for each claim you file. Your insurer will take care of the costs so long as it is covered by your health insurance plan.  Always check the policy terms before buying to know about any applicable co-payments.

Cashless claims are a unique health insurance benefit that Tata AIA policyholders can avail of at our network hospitals. This service feature mitigates the need to gather last-minute funds and saves you time, as you won't have to later file for reimbursement.

Health insurance providers offer lower premium rates to younger customers as lower age ranges are associated with lower risk. This is because younger customers are less likely or prone to developing critical illnesses or health conditions unless they already have a pre-existing illness.

Most health insurance plans often have waiting periods for pre-existing disease coverage, maternity covers or coverage for other illnesses and diseases. Hence buying a health insurance plan at a younger age allows you to complete waiting periods sooner as you are less likely to require coverage for such conditions when you are young.

Health insurance plans do not require mandatory health check-ups from younger candidates below a certain age. This is because they are less likely to have poor health or require extensive coverage. The only exception to this is of course if they happen to have a pre-existing illness.

The stated age ranges for adults and children are the most common upper and lower limits given by insurers for health insurance eligibility. At Tata AIA, we offer plans under similar eligibility conditions, with some plans like Tata AIA Pro-Fit offering whole-life coverage up to a maximum age of 100 years.

Mandatory pre-medical screenings are mostly only required for candidates over the age of 45 and for senior citizen health insurance plans before policy purchase

Pre-existing illnesses almost always have a waiting period under health insurance plans and are only covered upon completion of the waiting period. Most insurers will ask you before policy purchase if you suffer from any medical conditions or about lifestyle choices like whether you drink or smoke at the time of policy purchase.

Even if you are young and have no recurring medical expenses, investing in health insurance, especially during your younger years, has benefits in the long run. You also stay covered for medical emergencies giving you peace of mind.

Insurers may charge higher premiums for smokers as they present an increased risk of developing health complications in the future. However, neither smoking nor drinking, for that matter, is the basis for denying health insurance altogether.

Most insurance companies allow to pay their policy premiums in monthly, quarterly, and half-yearly instalments. Many health insurers also provide flexible payment options and ways to reduce your premiums through co-pays and more by offering more affordable policies.

As its name suggests, a critical illness health insurance rider will offer coverage for illnesses like cancer, heart disease, etc., diagnosed during your policy tenure. You will be offered a lump sum amount from your sum assured upon diagnosis.

It comes with a waiting period of 90 -180 days and a survival period of 30 days. Under Tata AIA's Health riders, based on the stage of diagnosis. You are paid the entire sum assured if the illness was diagnosed at a later stage during the policy tenure. This rider must also be bought in advance if you are predisposed to certain health conditions.
 

This is because if you have been diagnosed with a critical illness before the policy purchase, it will be considered a pre-existing condition and only be covered upon completion of the waiting period for pre-existing illness - which has a separate waiting period to the one mentioned above.

A maternity cover will offer coverage for maternity medical expenses during pregnancy, delivery, and newborn medical expenses. This health insurance rider will also offer pre- and post-natal coverage for up to a specific number of days before and after delivery.

Most maternity covers often come with a waiting period of two to six years, so you cannot buy them if you are already pregnant, as you cannot benefit from the cover. Hence it is recommended you get one well in advance if you want coverage for maternity expenses.

A personal accident health insurance rider helps you get compensation in case of accidental injuries that lead to permanent disability or death.

You are paid the entire sum assured for total disability and a part of the sum assured for partial disability. It is also called a double indemnity rider as it offers an additional death benefit to your family will in case of accidental death.

Under this health insurance rider, you get a fixed daily cash allowance from your insurer to cover incidental expenses incurred during hospitalisation for an injury or illness. It offers twice the coverage amount if you are admitted to the ICU.

The daily cash amount will vary as per your policy terms and chosen coverage. You must also be hospitalised for at least 24 hours to use this add-on rider.

This rider ensures that no upper limit on room rent applies to you and allows you to choose a room with higher or no sub-limits without paying extra money out of your pocket.
 

In other words, you can get treated at any hospital room of your choice without paying any out-of-pocket expenses, as your insurer will cover the room rent, so long as it falls within your total insurance coverage.

Health insurance premiums will vary depending on your age. Older candidates tend to have higher premiums as they present more risk of developing critical illnesses and other health issues.

While younger candidates are charged lower health insurance premiums as they are considered a lower risk to insurers. This is why getting health insurance at a younger age is recommended.

Moreover, medical care costs vary between genders due to their unique needs and medical requirements. Men are more at risk of developing chronic conditions in their later years, and they tend to seek stress-related illness coverage under health policies.

In contrast, women are at less risk for stroke or heart disease. They are also more likely to seek specific coverage, such as maternity covers.

Transgender or nonbinary individuals may have to identify themselves as a man or woman when applying for health insurance, depending on the insurance company, by providing the gender identifier on their birth certificate or driver's licence.
 

Under Tata AIA Sampoorna Health, women can avail of a Smart Lady Benefit. At the same time, transgender individuals can get a Transgender Discount, where they receive a discount on their health insurance premiums during their first policy year.

However, unlike age, your gender will not play a significant role when determining your health insurance premiums since the differences in premium rates are not as notable between genders as they are across age bands.

Almost all health insurance providers require pre-policy medical screenings over a certain age (usually over 45) before you can buy any of their policies. This is especially true for senior citizen health insurance.
 

Your medical history is also important if you have any pre-existing conditions and require critical illness insurance. Insurers will consider your required treatments and recurring medical expenses to calculate your health insurance premiums.  
 

Moreover, they consider lifestyle-related health risks and the medical background of your family. That is why health insurance premiums for smokers are usually higher, and critical illness insurance covers usually have higher premiums.

Most insurance providers offer discounts for longer policy tenures than they do for yearly policies, as longer tenures usually have higher health insurance premiums.

The type of plan you choose will also affect your health insurance premiums, as more coverage means higher premiums. You can determine what plan to buy by using an online premium calculator and comparing different health insurance quotes.

A No-Claim Discount will help to reduce your overall premium payments under your policy. It is one of the first things considered when calculating health insurance premiums.
 

You can be eligible for this discount on your next policy year if you have not filed any claims in your previous policy year. The No Claim Discount is applied during your policy renewals.

Certain lifestyle choices like consuming alcohol regularly or smoking can impact your health insurance premiums as they increase your risk of developing health issues. So, if you are a smoker or drink regularly, you will be charged a higher premium.