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Health insurance plan protects you from financial hardships during medical emergencies, covering all the expenses your policy outlines. Read more A comprehensive health insurance plan offers several benefits, such as cashless hospitalisation, coverage for outpatient department (OPD) expenses, daily cash allowances, and diagnostic costs. You can also avail Income tax benefits under Section 80D as per applicable tax laws.Read Less

Health insurance plan protects you from financial hardships during medical Read more emergencies, covering all the expenses your policy outlines. A comprehensive health insurance plan offers several benefits, such as cashless hospitalisation, coverage for outpatient department (OPD) expenses, daily cash allowances, and diagnostic costs. You can also avail Income tax benefits under Section 80D as per applicable tax laws.Read Less

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What is health insurance?

Health insurance is a plan that covers your medical expenses up to a certain amount per year. This plan covers emergency and planned hospitalisations, day-care treatments, surgeries, pre- and post-hospitalisations, and ambulance charges. Therefore, having the best health insurance plans can save you from unnecessary financial burden in the event of a medical situation. In addition, the premiums you pay are eligible for a tax deduction under Section 80D of the Income Tax, 1961.

Our Best-Selling Health Insurance Plans

Award Winning

Tata AIA

Pro-Fit

Key Benefits:

Get health cover up to ₹20 Lakhs for Surgery¹
Get payment on diagnosis of any covered 57 critical illnesses
Avail cashless claim service with income tax³benefits

Calculate Premium Know More

Types of Health Insurance

An ideal health insurance plan caters to healthcare requirements specific to you and your family. Hence, you must choose the right type of health insurance policy for adequate coverage and exclusive benefits. Here are the common type:

Individual Health Insurance :
It is a common type of health insurance plans. As the name suggests, it offers coverage for one person, i.e., the policyholder. Therefore, all the medical or hospitalisation expenses are reimbursed to the policyholder.
However, a few health insurance plans for individuals allow you to include a certain number of family members as dependants under the same plan at an additional premium. Tata AIA Pro-Fit plan offers various benefits for holistic well-being. Moreover, it provides market-linked returns for potential wealth generation.
Family Health Insurance:
Family health insurance offers coverage for your whole family. You can raise claims for individual family members or multiple family members simultaneously until the sum insured is exhausted. The family health insurance premium is based on the age of individual family members and related health concerns.
Senior Citizen Health Insurance :
Since most basic health policies have a maximum entry age of 65 years, insurers offer a separate policy type for senior citizens. These are called senior citizen health insurance policies and can be bought by anyone over the age of 60.
It offers specialised medical coverage for health concerns that come with old age and usually includes additional features like lifetime renewability and free annual health check-ups.
Critical Illness Insurance:
A critical illness cover gives you comprehensive coverage in the form of upfront payouts upon diagnosis of life-threatening illnesses such as cancer, myocardial infarction, cardiac arrest requiring permanent cardiac pacemaker or ICD insertion, brain tumour, open heart replacement or repair of heart valves, etc. These plans provide enhanced coverage for medical treatments and procedures, medicines, and hospitalisation costs through lump sum payments.
Cancer Insurance:
Cancer insurance plans are specifically built to cover medical costs related to cancer treatments, procedures, surgeries, and medication. They provide comprehensive coverage for cancer-related expenses, ensuring that policyholders have financial protection in case of a cancer diagnosis.

Popular Tata AIA Health Insurance Plans

Tata AIA Pro-Fit

Tata AIA Health Buddy

Tata AIA Health SIP

Tata AIA Shubh Health Plus

Features and Benefits of Health Insurance

The specific procedures covered and the limits on these benefits can vary depending on your chosen health plan.

Coverage for Surgeries:
A payout ranging from 25 - 100% is provided on surgical procedures. At Tata AIA, you can benefit from 133 listed surgeries and unlimited non-listed surgeries, such as operations on blood vessels, operations on blood vessels, bones, muscles, joints, breasts, etc.
Coverage for Day-Care Procedures:
Coverage for day-care procedures that require less than 24 hours of hospitalisation is offered under health plans. With our health insurance plans, you can expect benefit payouts for 136 listed and unlimited non-listed day-care surgeries. To quote a few, operations on the nose, including excision and destruction of diseased tissue, nasal sinus aspiration; operations on the salivary glands, including incision and lancing of a salivary gland and salivary duct; operations on tonsils and adenoids, etc., are day-care procedures.
Coverage for Pre-Existing Illnesses:
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 post-waiting period.
Hospital Cover:
You can also get daily cash benefits to pay for your hospitalisation expenses when you buy health insurance. Our Tata AIA Pro-Fit Plan provides a daily cash benefit of up to ₹40,000 on hospitalisation and up to ₹80,000 on ICU admission.
Fixed Benefit Payout:
Health insurance can also help cover pre- and post-hospitalisation expenses. Our Tata AIA Pro-Fit offers a fixed benefit payout that can cover pre- and post-hospitalisation and additional benefits like diagnostic expenses. This means it will cover medical expenses incurred for an illness before being 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.
Cashless Claims and Reimbursement Claims:
You can claim the benefits of health insurance based on your necessity and convenience. We offer a cashless claim option for treatments where we can pay the hospital directly (subject to policy conditions) and the reimbursement claims option where you can get treated and pay for the same. Also, we will reimburse you for the payments later.
Comprehensive Benefits:
With health plans from life insurance providers, in addition to the life cover and health cover, you can also benefit from market-linked returns⁴ at maturity for accumulating health funds to secure funds for your financial future and health emergencies.

Health Insurance Tax Benefits

The premiums paid for a health insurance policy in any mode other than cash will qualify for a tax³ deduction benefit under Section 80D of the Income Tax Act under the old tax regime. The deduction applies to a health insurance plan purchased by an Individual or Hindu Undivided Family (HUF) for self, spouse, and dependent children. Furthermore, if you purchase a health insurance policy for your dependent parents you can claim a tax deduction in addition to the tax deduction benefit applicable to yourself and your family. Also, you can avail a tax deduction of up to ₹5,000 for payments made for a preventive health check-up for yourself, your family, and your dependent parents within the prescribed limits. The deduction is applicable to any mode of payment, including cash.

Here is a table detailing applicable annual tax deductions under the old tax regime on

Health Insurance Policy Purchased for	Deduction Applicable to Self and Family	Deduction Applicable to Parents	Preventive Health Check-up	Maximum Deduction Under Section 80D
Self, Spouse, and Dependent Children	₹25,000	-	₹5,000	₹25,000
Self, Spouse, and Dependent Children + Parents	₹25,000	₹25,000	₹5,000	₹50,000
Self, Spouse, and Dependent Children + Parents (Above 60 years)	₹25,000	₹50,000	₹5,000	₹75,000
Self, Spouse, and Dependent Children (Above 60 years) + Parents (Above 60 years)	₹50,000	₹50,000	₹5,000	₹1,00,000
Members of HUF (below 60 years)	₹25,000	₹25,000	₹5,000	₹25,000
Members of HUF (a member is above 60 years)	₹50,000	₹50,000	₹5,000	₹50,000

Therefore, you can claim deduction of up to ₹1,00,000 for the health insurance premiums paid under Section 80D in a financial year.

What Is covered in a health insurance plan?

The coverage options differ between the individual insurance providers and their policy options.

In-patient hospitalisation expenses

This covers the expense of illness and injuries treatments that require hospitalisation exceeding 24 hours.

Pre-existing illnesses or diseases

Pre-existing illnesses or diseases are covered upon completion of the policy's waiting period. You can file for a claim under this cover for the treatment and management of the pre-existing illness.

Pre and post-hospitalisation expenses

Pre- and post-hospitalisation expenses refer to the medical costs incurred due to an illness before admission, such as blood tests, x-rays, and other diagnostic checks. Similarly, medical expenses like follow-up health check-ups after discharge from the hospital are also covered.

Ambulance charges

Ambulance charges cover the cost of transportation to the hospital and transfers between hospitals for the treatment of an illness or injury. The coverage amount will vary depending on your insurer.

Maternity medical expenses

Maternity medical expenses during pregnancy and delivery are covered under the policy, along with expenses incurred for the care and treatment of the newborn, as per the specified limits and waiting period.

Preventive health check-ups

Preventive health check-ups are offered at network hospitals, usually free and available annually.

Day care procedures

Day care procedures refer to treatments that require less than 24 hours of hospitalisation. These can include short procedures like chemotherapy, appendectomies, angiography, etc.

Home treatment cover

Home treatment cover refers to medical treatments taken at home on the advice of a registered medical practitioner in the event that there is a lack of hospital rooms to facilitate a hospitalisation.

What is not covered under a health insurance plan?

The list of exclusions under a health insurance plan will vary depending on your insurer and the individual policy options. Here are some standard exclusions under most health insurance policies:

Waiting period exclusions:
Illnesses and procedures with a waiting period will not be covered under your health insurance policy until after the completion of the waiting period.
Injuries due to external factors:
Injuries caused by war, terrorism, or nuclear activity.
Self-inflicted injuries:
Self-inflicted injuries or suicide attempts are not covered.
Cosmetic procedures:
Cosmetic procedures (for aesthetics) will not be covered unless they are reconstructive and caused due to an accident or illness covered under the policy.
Specific illnesses:
Terminal illnesses, AIDS, STIs, and other similar diseases are generally not covered.
Dental and eye procedures:
Dental procedures or eye surgeries like LASIK are not covered unless the damage resulted from an accident or illness included under the policy.
Non-medical bed rest:
Bed rest is not covered if it is only for rest or recovery, such as in cases of rehabilitation or common illnesses, and not for actual medical treatment.
Infertility and reproductive treatments:
Expenses related to sterility and infertility, including contraception, sterilisation, artificial insemination, and advanced reproductive technologies like IVF, ZIFT, GIFT, and ICSI, are excluded.
Unproven treatments:
Unproven treatments, procedures, or supplies that lack significant medical documentation to support their effectiveness are not covered.

Why do you need health insurance?

For Financial Security:
No one can predict the future when it comes to their health and well-being. Regardless of how well you take care of yourselves and lead healthy lifestyles, injuries, and critical illnesses can affect you at any time. However, getting a health insurance policy can help you exercise a great degree of control over your medical expenses and offers a way to safeguard yourself and your family financially.
For Changing Lifestyles:
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 and lung cancer.
Therefore, buying the best 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 becomes crucial.
For Rising Medical Costs:
Medical inflation has become a significant issue over recent years, 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.
For Tax Benefits:
Not only does health insurance financially shield you during a medical emergency, but it also offers significant tax benefits under old tax regime. These benefits can be availed annually under your health insurance premium payments.
You can get a maximum deduction of ₹25,000 or ₹50,000 depending on your age and the age of your dependents included under the policy. You can avail a preventive health check-up deduction of up to ₹5,000, which is included and counted toward your overall deduction limit of ₹25,000/₹50,000. These health insurance tax⁵ benefits can be availed under Section 80D of the Income Tax Act 1961, by opting for old tax regime.
Offers Affordable Coverage:
Health insurance plans offer wide-ranging benefits at an affordable premium rate. Furthermore, if you purchase a health insurance plan at an early age, you will be offered lower premium rates, granting you access to more affordable health insurance plans.
Covers Wide-Ranging Health Complications:
With health insurance plans, you can ensure coverage against wide-ranging health complications and their treatments, including critical illnesses, surgeries, day care surgeries, and disability; wellness benefits, including free annual health check-ups, nutrition and weight loss consultations, chronic care coaching, etc.

Key factors to consider before buying a health insurance plan

When choosing a health insurance plan, you should keep the following factors in mind:

Scope of coverage

Your policy coverage will determine what types of illnesses and surgeries you can claim. While choosing a health plan, pay attention to the benefits offered, such as hospitalisation expenses, daily cash benefit, COVID hospitalisation cover, critical illness cover, maternity cover, etc.

Sum insured

An important factor in choosing a medical insurance policy is the sum insured. Inflation should be considered when determining the sum assured. Family floater policies or senior citizen insurance will have better coverage if the sum insured is higher.

Policy type

In India, there are different types of medical insurance policies. You can purchase individual health insurance, senior citizen health insurance, family floaters, or critical illness plans according to your needs. Additionally, you can enhance your coverage with Top Up and Super Top Up health insurance. It will be beneficial if your base sum insured gets exhausted during treatment. This option is available when purchasing and renewing your policy.

Waiting period clause

After the initial waiting period ends, your health insurance policy becomes active. Except for accidental hospitalisation claims, insurance companies reject claims filed during the initial waiting period. Further, the waiting period clause also covers pre-existing conditions such as thyroid, blood pressure, diabetes, etc. It also covers specific illnesses, treatments, and maternity cover. Make sure you choose a plan with a minimal waiting period.

Co-payment clause

A co-payment clause may be included in your medical insurance policy, which means a certain percentage of the claim amount should be borne by you (policyholder). The co-payment option does not affect the sum insured. While it may lower your premium to some extent, it increases your out-of-pocket costs. Hence, this clause should only be chosen if you can afford to pay off a portion of your hospital bills.

Room rent sub-limits

There are various sub-limits on health insurance plans, and the most common one is the room rent sub-limit. For example, if your medical insurance policy covers 3 lakhs with a rent sub-limit of 1%, then up to 3,000 per day your room rent will be covered. In case there is an increase in room rent, it will be your responsibility to pay it. Therefore, it is advisable to choose a health plan with no or minimal sublimit.

Network of cashless hospitals

You should review the list of network hospitals where cashless claims can be submitted for an insurance company. A higher number of network hospitals in your area increases your chances of receiving cashless hospitalisation services.

Lifelong renewability option

Every year, medical insurance policies are renewed. In order to continue insurance coverage, policyholders must pay the renewal premium when the policy term is about to expire. When purchasing health insurance, it is beneficial to choose a plan that offers lifetime renewal options.

Premium loading factor

In health insurance plans for senior citizens, premium loading refers to the additional amount charged to risk-prone individuals. Choosing a medical insurance plan without loading will save you money. Claim loading is also charged by some insurers. This aspect usually increases your out-of-pocket expenses during the claims process.

Check the claim settlement ratio

An insurer's claim settlement ratio⁷ is an important criterion to assess their credentials. Always choose a company with a good claim settlement record. The ideal settlement ratio for a claim is above 80%.

How to choose your best health insurance plan?

Here are some key points to look into to ensure you pick the best health insurance plan that suits you and your family:

Coverage:

The first thing you need to check when browsing health insurance plans is the sum insured ranges offered and the medical treatments covered under the plan. The sum insured should be enough to cover most if not all, your medical expenses – including emergencies. Look for medical coverage that is relevant to your health status. For example, coverage for hospitalisation, ambulance charges, day care treatments, maternity treatments, AYUSH treatments, etc., are some common inclusions to look for.
Premiums:

Check the affordability of the health insurance plan. You may use online health insurance premium calculators, as they provide real-time and accurate estimates while allowing you to adjust the coverage options of your policy as per your requirements.
In addition, if you purchase it at a younger age, you can benefit from even lower premium rates. Furthermore, most online insurers will also offer discounts on their best health plans when you buy them online from their website and even have preferential rates. For example, Tata AIA offers preferential rates and discounts for women policyholders.
Insurer's reputation and claim settlement ratio:

Your insurer is as important as your health insurance policy. Checking the insurance provider's reputation through reviews and testimonials can give you a good idea of their after-sales services.
Moreover, the insurer's Claim Settlement Ratio⁵ (CSR) provides insight into their efficiency in acknowledging and settling claims. Look for insurers with high CSRs and good customer reviews. For instance, Tata AIA's Individual Death Claim Settlement Ratio is 99.41% for FY 2024 - 25.
Pre-existing disease coverage:

Check if your health plan has pre-existing disease coverage and the corresponding waiting time to claim that coverage.
Add-on covers:

Check if the health insurance plan offers add-on riders⁵, as these can help extend your plan's coverage. Some common add-ons you should check for are critical illness cover, maternity cover, personal accident cover, OPD cover, accidental death cover, etc.
Family Coverage:

Check if the plan offers family floater options or variants, as these tend to be cost-effective if you want to insure your family members as well. They are also easier to maintain, as you will only need to pay health insurance premiums and track paperwork for one plan rather than multiple plans.
Pre-medical screening:

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 diseases:

Pre-existing illnesses almost always have a waiting period under health insurance plans and are only covered upon completion of the waiting period.
The waiting period can be at least 2 years and, however, depends on the type of disease and the insurer's specific policy terms and conditions.

Documents required for a health insurance plan

Documents required for a health insurance claims process are:

Duly filled and signed claims form.
Discharge card or form issued by the hospital.
In-patient hospitalisation bills signed by you (for authenticity).
Doctors' prescriptions and medical bills/receipts.
Valid investigation report.
List of all consumables and disposables prescribed by the doctor(s) with complete details.
Doctors' consultation bills.
Copies of the previous and current year’s insurance policy and a copy of your ID card of TPA.
Other document(s) required by the insurer/TPA.

For a more detailed list of documents for each claim type under Tata AIA, click here.

How to calculate your health insurance premium?

Here is how you can use a health insurance premium calculator to determine the premium for your health insurance coverage based on your requirements.

01

Determine who needs to get covered

Choose the option on who needs to get covered, whether self, spouse, children (minor or major), or parents. Or, if it is a family health insurance plan, choose the number of members and the individuals who need to be covered under the health insurance policy.
02

Provide the necessary details

These include details like your name, date of birth, lifestyle habits, qualifications, occupation, and mobile number. The exact details must also be submitted for each person you have chosen to include under the health insurance policy.
03

Determine health insurance plan features

Customise the health insurance plan by choosing options such as the premium payment term, policy term, and premium payment frequency. In addition, you can choose to include ⁶add-on riders for enhanced coverage.
04

Choose the health insurance plan

Based on your input, multiple health insurance quotes may be provided. You can compare the individual options based on their benefits, value for money, and affordability to choose the best health insurance plan for all your medical needs.
05

Get your health insurance premium quote

Upon choosing the health insurance policy, you can view the health insurance premium amount. You can also revise the inputs to determine the suitable premium for the long term.

What Factors Affect Health Insurance Premiums?

Age and Gender:

While younger applicants are charged lower health insurance premiums, older individuals tend to have higher premiums, considering the increased possibility of developing health-related issues or critical illnesses.
Health insurance premiums can also vary based on gender, with men paying more, considering factors such as their lower life expectancy rate compared to that of women.
Medical History:

If you have been suffering from pre-existing diseases or your family is prone to a critical illness, the health insurance premium will be higher to accommodate the increased risk.
Lifestyle:

Your lifestyle habits, such as smoking or the consumption of alcohol, can have a significant impact on the health insurance premium as there is a greater chance of contracting life-threatening diseases.
Type of Health Insurance Plan:

The type of plan you choose will also affect your health insurance premiums, as more coverage means higher premiums. You can determine the right option by using a health insurance premium calculator and comparing different health insurance quotes.

Why buy health insurance at an early age?

01.

To benefit from lesser premiums

Younger customers are less likely or prone to developing critical illnesses or health conditions unless they already have a pre-existing illness. Therefore, health insurance providers offer lower premium rates to them, considering the perceived lower risk.

01.
To benefit from lesser premiums

Younger customers are less likely or prone to developing critical illnesses or health conditions unless they already have a pre-existing illness. Therefore, health insurance providers offer lower premium rates to them, considering the perceived lower risk.
02.

To avoid waiting periods

Most health insurance plans often have waiting periods for pre-existing disease coverage and other specific illnesses or diseases. So, if you buy health insurance at a younger age, you can avoid this waiting period, as pre-existing illnesses are not expected at an early age.

02.
To avoid waiting periods

Most health insurance plans often have waiting periods for pre-existing disease coverage and other specific illnesses or diseases. So, if you buy health insurance at a younger age, you can avoid this waiting period, as pre-existing illnesses are not expected at an early age.
03.

To get exempted from pre-policy health check-ups

Health insurance plans do not require mandatory health check-ups from younger applicants below a certain age – under 45 years, because they are less likely to have poor health or require extensive coverage. The only exception to this is if they happen to have a pre-existing illness.

03.
To get exempted from pre-policy health check-ups

Health insurance plans do not require mandatory health check-ups from younger applicants below a certain age – under 45 years, because they are less likely to have poor health or require extensive coverage. The only exception to this is if they happen to have a pre-existing illness.

How to Buy Health Insurance Online?

Step 01

Visit the Tata AIA website and hover over the Plans tab.

Step 02

Click on the health policy you want to purchase

Step 03

Scroll down and enter your details in the given fields.

Step 04

An insurance agent will contact you to guide you through the process.

Step 05

Alternatively, you can also contact us via SMS, email, or by giving us a missed call for a callback.

How To File a Health Insurance Claim?

Health insurance policies allow you to claim compensation or insured medical treatments by filing claims. You can file two types of claims:

Cashless claims where your insurer pays the hospitals directly
Reimbursement claims where you pay for the expenses, and your insurer will reimburse you for the payments later.

So, if you are wondering how to claim health insurance with Tata AIA, we have provided step-by-step instructions for both claims processes below:

How to initiate a cashless health insurance claim with Tata AIA? How to file a reimbursement health insurance claim online with Tata AIA?

Go to your nearest hospital that applies for a cashless claim.
For planned admissions, you must inform your authorised TPA 2 days in advance about your hospitalisation. For emergencies, the TPA must be notified within 24 hours of you being admitted to the hospital.
Show the hospital your valid ID proof and your TPA E-health card at the hospital Insurance/TPA help desk.
The hospital will provide a Cashless claim form to initiate the claims process. You can also download the claim form from the TPA website.
The hospital will share the duly filled cashless claims form and send the request to the authorised TPA for verification.
After the pre-authorisation is approved by the Insurance Company/TPA, ensure that your hospitalisation takes place within 15 days of receiving approval from the help desk.
In case you fail to get TPA/Insurer approval, you can still file for a reimbursement claim.

If you are receiving treatment and paying at a hospital for an insured treatment or procedure, you file for a reimbursement claim through our website.

Ensure that you maintain all original bills and receipts, as you must submit them for reimbursement.

Here is how you can file for a reimbursement claim online:

Visit our Claims page on the Tata AIA website.
Provide the necessary details, such as Policy Number, and click on Authenticate.
Download the relevant claim forms, fill them and upload them back onto the website along with your supporting documents.
Once your documents and claim application have been processed and verified, the claim amount will be paid to you.

Difference between Mediclaim and health insurance

Basis	Health Insurance	Mediclaim Insurance
Coverage offered	Provides comprehensive medical coverage, including hospitalisation, pre- and post-hospitalisation expenses, ambulance charges, and in some cases, compensation for loss of income due to an accident.	Covers only hospitalisation treatment for injury due to accidents up to a pre-specified limit.
Add-on covers	Offers various add-on covers such as personal accident cover, critical illness cover, maternity cover, etc.	Does not offer any add-on cover.
Flexibility	Provides flexibility to enhance or reduce coverage. Policyholders can also reduce premiums after a specified period by changing policy duration (e.g., long-term policies may offer premium discounts).	Offers no flexibility in coverage.
Critical illness cover	Covers more than 30 critical illnesses (e.g., kidney failure, stroke, cancer), depending on the policy.	Covers critical illnesses as per plan eligibility.
Sum insured	Ranges from ₹50,000 to ₹6 crore per year, depending on the plan.	Usually does not exceed ₹5 lakh.
Hospitalisation	Not always required; day-care procedures can be claimed without 24-hour hospitalisation.	Hospitalisation is mandatory to claim benefits.
Premium	Higher, as it offers extensive coverage.	Lower, as coverage is limited.

Myths About Health Insurance

Lastly, let us clear a few presumptions you may have about health insurance policies. Despite growing awareness, health insurance penetration in India is low. Moreover, there are many health insurance myths. Some common misconceptions include:

01

Health insurance is not required for healthy individuals

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.
02

Health insurance is denied for smokers

Insurers may charge higher premiums for smokers as they have 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.
03

Health insurance is expensive

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.
04

Corporate group health insurance from my employer is enough

While they may cover your medical needs, these plans are linked to your employer, and you lose your health insurance benefits once you switch organisations. Hence a corporate health insurance policy is not enough, especially if you have chronic illnesses.

Why buy health insurance from Tata AIA?

Wide-ranging health cover benefits:

Health cover applies to different types of medical expenses such as Surgical Cover, Daycare Cover, Hospital Cover, Disability Cover, OPD etc.
Global coverage:

The health cover benefits apply to worldwide treatment, providing the opportunity to avail of best-in-class treatment for your health issues.
Lifestyle:

Your lifestyle habits, such as smoking or the consumption of alcohol, can have a significant impact on the health insurance premium as there is a greater chance of contracting life-threatening diseases.
Life cover:

In addition to health coverage, you will also get life insurance coverage to secure your family in the event of your unexpected demise.
Market-linked returns:

With our various fund options, you get the opportunity to invest for the long term and earn market-linked returns3 to build your health corpus.
Discounts:

You also have options to save funds with different types of discounts such as No Claim Rewards, Smart Lady benefits for female/girl child life assured, Digital Discount, Auto-Debit Discount, Super 30 Discount for life assured less than or equal to 30 years, Existing Customer Discount, etc., that can reduce your applicable premium.

Important health insurance terms explained

Here are some of the most common health insurance terms:

AYUSH treatment
: The term AYUSH refers to Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy treatment. There are several health insurance plans that cover AYUSH treatments.
Bariatric surgery
: The term bariatric surgery or weight loss surgery refers to the surgery performed to treat obesity or reduce a person's weight.
Co-payment
: A co-payment is a fixed amount that the policyholder has to pay at the time of claim settlement. By choosing a co-payment, you can reduce your premium.
Cumulative bonus
: It refers to an increase in the sum insured amount without raising premiums as a reward for not making a claim the previous year.
Day care procedures
: A day care procedure is a medical procedure or surgery performed using advanced medical technology and requiring less than 24 hours in the hospital. The majority of basic health insurance plans cover day care procedures, for example, cataract surgery.
Domiciliary treatment
: A domiciliary treatment is medical treatment provided at home under the supervision of a medical professional when hospital admission is not possible. Health insurance plans cover this treatment under domiciliary hospitalisation.
Exclusions
: An exclusion is a condition or circumstance that is not covered by a health insurance policy. When a medical expense or circumstance is excluded, the insurance company will not pay out any claims.
Family floater
: A family floater is a type of coverage in which the insured family members share one sum insured amount. A family floater policy is more affordable than an individual policy for each member.
Indemnity plan
: An indemnity plan is a type of insurance coverage that pays based on actual medical expenses. To receive payment under this type of plan, the policyholder must submit medical bills to the insurance company.
Network hospitals
: Network hospitals are hospitals that offer cashless hospitalisation benefits to policyholders who are contracted by the insurance company.
No claim bonus
: It is a premium discount offered by insurance companies to policyholders if they have not filed a claim in the previous policy year.
Portability
: Portability means changing an existing insurance company or health insurance policy without losing continuity benefits, such as waiting periods. People who are unhappy with their current insurer or policy may benefit from this service.
Restoration benefit
: The restoration benefit refers to the option of refilling your sum insured amount before the policy renewal date if your original amount gets exhausted.
Room rent limit
: A room rent limit is the amount the insurance company will pay for hospital room charges incurred by the policyholder. In the event that the hospital room charges exceed the room rent limit, the additional amount will be borne by the policyholder.
Waiting period
: The waiting period refers to the period after the policy is issued during which the policyholder cannot make a claim. The insurance company will reject any claims raised during this period.

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Frequently Asked Questions (FAQs)

General Policy Cover Premium Claim Renew TATA AIA

Why is health insurance important?

There are several reasons why you should get health insurance, but the main reason would be to safeguard your finances from future medical emergencies and to ensure that you and your family stay covered.
Which health insurance is best in India?

The best health insurance plans are ones that will suit your needs and medical requirements. They are exclusive to your needs and specifications. But, if you are looking for health plans that offer comprehensive healthcare coverage, consider exploring Tata AIA Health Plans.
Which health insurance is best for a family?

A family floater or family health insurance plan is ideal if you want comprehensive medical insurance for your family members — all under one plan.
Is health insurance tax deductible?

Yes, you can claim a tax³ deduction on your annual health insurance premiums under Section 80D of the Income Tax Act 1961. You can claim additional deductions under Section 80DDB.
Which act provides health insurance requirements for workers?

The Employees State Insurance (ESI) Act of 1948 offers health benefits to workers and their dependents in case of any unfortunate eventualities at work.
How does health insurance work?

A health insurance plan is a legal contract between the insurer and the policyholder. The insurer promises to cover the insured individual's medical expenses in exchange for regular premium payments.
How many health insurance companies are there in India?

There are about 5 insurance companies that are registered under the IRDAI as health insurance providers. Apart from these companies, 26 other general insurance providers are registered under the IRDAI.
Can health insurance be bought by a minor?

A minor cannot buy health insurance. However, their parents can include them in a family floater plan. As soon as they turn 18, they can buy their own health insurance.
What does network/non-network hospitalisation mean?

Network hospitalisation refers to treatment provided at hospital with pre-established agreements with your insurance provider, usually offering cashless services. Here, the policyholder pays first and then seeks reimbursement from the insurer after treatment.
How long does it take to settle a mediclaim?

Insurers and types of claims determine how long it takes to settle a mediclaim. Cashless claims are generally processed within a day, while reimbursement claims may take few days.
How many times can medical insurance be claimed?

There is no limit on how many claims can be made. As long as the claim falls within the sum insured and terms of the policy, multiple claims may be filed in a given year.
I’ve health insurance from my company. Should I also purchase a separate health insurance policy?

Yes. If you change jobs or leave your job, your employer-provided health insurance ends. A personal health insurance policy offers long-term financial security beyond group coverage offered by employers.

Is a medical check-up needed when buying health insurance in India?

A medical check-up may not be mandatory. However, it is subject to the underwriting terms of the insurer and the policy. However, for younger individuals (below 45 years), a pre-policy medical check is often waived, unless they suffer from a pre-existing illness.
What are the 4 recommended types of health insurance?

The 4 most purchased types of health insurance plans in India are individual health insurance, family health insurance, group health insurance and senior citizen health insurance.
Can I have more than one health insurance plan?

Yes, you can buy more than one health insurance plan. For enhanced benefits, you can buy a traditional health insurance plan along with a fixed-benefit health plan such as our Tata AIA Life Insurance Pro-Fit.
Can I buy health insurance if I am not an Indian national but live in India?

Yes, you do not have to be an Indian citizen to buy health insurance. Foreign nationals and NRIs residing in India are eligible to buy health insurance, subject to the insurer's terms and conditions.
Can cancer patients buy a health insurance policy after diagnosis?

No, individuals already diagnosed with cancer cannot get insured under a new health plan unless it is a group health insurance policy under an employer. Therefore, you must purchase a health insurance policy that offers cancer or critical illness coverage.
Is it possible to change the nominee during mid-term of a policy?

During the policy term, the nominee can be changed. To update records, fill out a nomination form or write to the insurer.
In case a policy lapses during hospitalisation, what happens in that situation?

Insurance companies will not cover expenses incurred after a policy lapses. To ensure uninterrupted coverage and claim settlement, renew within the grace period.
Is there any impact on health insurance premiums due to smoking or chewing tobacco?

Smoking or chewing tobacco increases health risks and can raise insurance premiums. Insurance company takes lifestyle habits into account, and smokers or tobacco users may face higher premiums.
What do you mean by a cumulative bonus in a health insurance policy?

A cumulative bonus is the increase in insurance sum insured given by the insurer after every claim-free year. It acts as a reward for maintaining good health and not filing claims.
Can my health insurance be cancelled? In that case, can I get my premium back?

Health insurance can be cancelled for reasons like non-disclosure or fraud. Premium refunds depend on policy terms and whether claims have been made.

How much health insurance is sufficient?
While there is no standard coverage amount for health insurance, there are two broadly accepted rules:
- First, your health coverage should be at least 50% of your annual income.
- Second, your health insurance should cover the total cost of a coronary artery bypass graft in a hospital of your choice.
Is Rs 5 lakh health insurance enough?

Today, a 5 lakh Mediclaim policy may only be enough to cover one person living in a Tier-3 city. This is because medical expenses can get extremely expensive in Tier 1 and 2 cities. Moreover, factors like medical inflation can also increase the treatment costs.
Does a basic health insurance plan cover critical illness?

Generally, basic plans will only cover hospitalisation expenses and pre-existing diseases (after a waiting period). If you need critical illness insurance, consider looking for plans that offer ⁶add-on critical illness cover or built-in critical illness coverage.
Is home isolation covered under health insurance?

Generally, only home isolations under the prescription of a doctor or certified healthcare professional through in-person or telemedicine consultations are covered by health insurance plans subject to the policy's terms and conditions.
What is waiting period in health insurance?

The waiting period in health insurance is a time frame within which you will not receive coverage even if your policy tenure has been initiated. Most health insurance policies have a waiting period of 30 days, after which they will receive coverage.
What is a pre-existing disease in health insurance?

In health insurance, a pre-existing disease (PED) is a health condition or illness you already would have been diagnosed with before buying the health insurance plan. These can be ailments like asthma, diabetes, high blood pressure, etc.
Is dental treatment covered under health insurance?

Generally, dental treatment is considered cosmetic procedures and are not covered under basic health insurance plans. Most insurers will only cover dental treatments or surgery if the damage to your teeth was the result of an accident or insured illness.
Are diagnostic charges like X-ray, MRI or ultrasound covered in Health Insurance policies?

Yes, most diagnostic tests such as X-Rays, MRIs, and blood tests are covered under health insurance plans.
Are robotic surgery & modern treatments covered under health insurance plans?

Insurance covers robotic surgeries only if they are advised by a surgeon. Insurance companies will not pay claims if a qualified surgeon does not recommend them.
Will I get covered for my pre-existing illnesses?

Generally, health insurance covers pre-existing illnesses after a defined waiting period, which can range from several months to several years.

How much does health insurance cost in India?

This will depend on several factors like your sum insured amount, policy type, location, current health status, etc. To determine your health insurance quotes, use tools like an online health insurance premium calculator.
Do health insurance premiums increase every year?

Yes, health insurance policies do increase their premium rates on renewal every year. This is due to the steady increase in medical inflation rates. Health insurers need to match that rate and increase your sum insured amount every year to ensure you get adequate coverage.
What is a co-pay in health insurance?

A co-pay is a clause added to your health insurance policy where the insurer agrees to pay a fixed percentage of the medical expenses during claims while you pay the rest..
Can health insurance be paid monthly?

Yes, most health insurance policies come with flexible payment terms and modes where you get to pick the frequency and mode of payment. With Tata AIA you can opt for payment frequencies like monthly/quarterly/half-yearly/annual and payment terms like single/ limited/ regular.

Can I claim health insurance coverage immediately?

Generally, no. Insurers have a general/overall waiting period of 30 days before you can file any medical insurance claims. This waiting period is only waived in the case of accidents and other medical emergencies.
What can I do if my claim request has been rejected?

The first thing you can do is contact us, find out the reason for your claim refusal and file a complaint under our grievance redressal mechanism. If this does not work, you can always approach the IRDAI's Grievance Redressal Cell under their Consumer Affairs Department.
What is the health insurance claim process for non-network hospitals?

First, you must avail treatment from the hospital, pay your bills, and then contact us to initiate your claims process. Make sure you keep all the receipts/bills relating to your treatment.
What is a No Claim Bonus (NCB) in health insurance?

A No Claim Bonus or No Claim Discount in health insurance is a percentage discount that is applied to your overall premium amount on renewal in the next policy year if you have not filed any claims in the previous policy year.
What happens to my health insurance policy after a claim is filed?

After your health insurance claim with Tata AIA has been filed and settled, your policy coverage (sum insured) will be reduced by your claim amount. As an example, if you have a health plan with a sum insured of 5 lakhs and file a claim for 3 lakhs, your health insurance coverage will be 2 lakhs after your insurer settles.

How do I renew my mediclaim policy?

By paying the renewal premium before the due date, you can renew your mediclaim policy. Ensure timely renewal to avoid policy lapses.
Is my health insurance policy transferable without losing renewal benefits?

If you meet the insurer's requirements and apply within the stipulated time frame, health insurance policies can be transferred without losing renewal benefits.
If I increase my sum insured at the time of renewal, does a waiting period apply?

According to the insurer's guidelines, any increase in the sum insured is usually subject to a fresh waiting period.
Do I get a discount on the renewal of the policy with the same health insurance policy?

Long-term policies or claim-free years may qualify for renewal discounts. Such discounts depend on the policy terms and conditions of the insurer.
If my policy is not renewed in time before expiry date, will it be denied for renewal?

The policy may lapse if not renewed before expiry. There is usually a grace period for renewal. Benefits may not continue after this period.
Is it possible to modify my add-on cover while renewing health insurance policy?

Yes, renewal allows you to modify or add riders⁶. According to the insurer's rules, the revised terms will apply.
Is there a grace period for renewal?

Yes. A grace period of 15 to 30 days is usually offered by insurers for renewals.
If I choose to renew my health insurance policy online, how long will it take?

Renewals are usually instant when done online. Upon receiving payment, the insurer will issue the renewed policy documents immediately, ensuring uninterrupted coverage.
If I miss the renewal date of my health insurance policy, what should I do?

Contact your insurer immediately if you miss the renewal date. Renewals are still possible during the grace period. After this, the policy lapses and fresh application may be required.

Are Tata AIA Pro fit Health Insurance and Vitality Protect Advance Policy the same plans?

They’re not the same plan. The features and benefits of each plan are tailored to meet the needs of different individuals. The policy details should be reviewed before purchasing.
Can I buy the Tata AIA Health Insurance plan online?

Yes, Tata AIA health insurance plans can be purchased online through the official website.
Are pre-existing conditions covered in Tata AIA plan?

Pre-existing conditions are generally covered after a waiting period is completed. Depending on the specific plan selected, coverage details may vary.
How is the premium for Tata AIA Pro fit Health Insurance calculated?

The premiums are calculated according to factors such as age, sum insured, medical history, lifestyle, and added benefits.
Which riders⁶ are included with Tata AIA Health Insurance?

Riders⁶ may include options like critical illness cover, accidental death cover, or hospital cash benefit. Riders⁶ are available depending on the plan and policy terms.
How can I reach Tata AIA for health insurance inquiries?

You can contact Tata AIA by their toll-free customer service number, official email id, or at a nearest branch office.
Is Tata AIA health insurance good?

Tata AIA is a regulated insurer offering health insurance solutions under IRDAI regulation. Whether it suits you depends on your coverage needs, budget, and policy features.

Health Insurance Plans

What is health insurance?

Our Best-Selling Health Insurance Plans

Pro-Fit

Solution Composition

Types of Health Insurance

Individual Health Insurance :

Family Health Insurance:

Senior Citizen Health Insurance :

Critical Illness Insurance:

Cancer Insurance:

Popular Tata AIA Health Insurance Plans

Tata AIA Pro-Fit

Tata AIA Health Buddy

Tata AIA Health SIP

Tata AIA Shubh Health Plus

Features and Benefits of Health Insurance

Coverage for Surgeries:

Coverage for Day-Care Procedures:

Coverage for Pre-Existing Illnesses:

Hospital Cover:

Fixed Benefit Payout:

Cashless Claims and Reimbursement Claims:

Comprehensive Benefits:

Health Insurance Tax Benefits

What Is covered in a health insurance plan?

In-patient hospitalisation expenses

Pre-existing illnesses or diseases

Pre and post-hospitalisation expenses

Ambulance charges

Maternity medical expenses

Preventive health check-ups

Day care procedures

Home treatment cover

What is not covered under a health insurance plan?

Waiting period exclusions:

Injuries due to external factors:

Self-inflicted injuries:

Cosmetic procedures:

Specific illnesses:

Dental and eye procedures:

Non-medical bed rest:

Infertility and reproductive treatments:

Unproven treatments:

Why do you need health insurance?

For Financial Security:

For Changing Lifestyles:

For Rising Medical Costs:

For Tax Benefits:

Offers Affordable Coverage:

Covers Wide-Ranging Health Complications:

Key factors to consider before buying a health insurance plan

Scope of coverage

Sum insured

Policy type

Waiting period clause

Co-payment clause

Room rent sub-limits

Network of cashless hospitals

Lifelong renewability option

Premium loading factor

Check the claim settlement ratio

How to choose your best health insurance plan?

Coverage:

Premiums:

Insurer's reputation and claim settlement ratio:

Pre-existing disease coverage:

Add-on covers:

Family Coverage:

Pre-medical screening:

Pre-existing diseases:

Documents required for a health insurance plan

How to calculate your health insurance premium?

Determine who needs to get covered

Provide the necessary details

Determine health insurance plan features

Choose the health insurance plan

Get your health insurance premium quote

What Factors Affect Health Insurance Premiums?

Age and Gender: