Policy explained · Tata AIG
Tata AIG Medicare Plus: what your policy covers
We found no room rent limit in the Tata AIG Medicare Plus wording. It has a 24-month wait for knee & hip replacement and a 36-month wait for pre-existing conditions, and it covers consumables. On a typical ₹4,50,000 knee & hip replacement bill, the insurer pays about ₹4,41,000 to ₹4,50,000 and you pay about ₹0 to ₹9,000 (estimate).
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At a glance
- ⏳24 monthsKnee & hip replacement waitOver by month 30Policy wordings, page 11, read 28 Aug 2026
- ⏳36 monthsPre-existing conditions waitNot over at month 30Policy wordings, page 9, read 28 Aug 2026
- 🩹CoveredConsumablesPolicy wordings, page 8, read 28 Aug 2026
Waiting periods, month by month
- Pre-existing conditions36 monthsNot over at month 30
- Knee & hip replacement24 monthsOver by month 30
- Spine surgery24 monthsOver by month 30
- Prostate surgery24 monthsOver by month 30
- Hysterectomy24 monthsOver by month 30
Worked example: a knee & hip replacement bill
The example person joined the policy before age 61, is treated at a network hospital in the zone their policy covers, has no add-ons, and has a ₹5,00,000 sum insured on a policy running 30 months.
Room rent ₹9,000 a day for 4 days (example), a semi-private room, on a typical NCR knee & hip replacement bill of ₹4,50,000 (estimate).
₹0 to ₹9,000 could go either way: non-payable items, 0% to 2% of the bill because consumables are covered (estimate)
| Step | Amount (estimate) |
|---|---|
| Bill total | ₹4,50,000 |
| Insurer's share before non-payable items and co-pay | ₹4,50,000 |
| Non-payable items, 0% to 2% of the bill because consumables are covered | minus ₹0 to ₹9,000 |
| Insurer pays | ₹4,41,000 to ₹4,50,000 |
| You pay | ₹0 to ₹9,000 |
The terms, with the policy text
8 terms read from the Tata AIG Medicare Plus documents (UIN TATHLIP21253V022021). Open a source to read the policy text, its conditions and the page.
| Term | What it means | Policy text and source |
|---|---|---|
| Consumables (gloves, masks and other non-medical items) | Covered (Covered) | Policy wordings, page 8We will pay for expenses incurred, for specified consumables listed in 'Annexure I - List I of Optional Items (Consumables Benefit)' which are consumed during the period of hospitalization directly related to the insured's medical or surgicaltreatment of il lness/disease/inju ry. |
| Costs before and after the hospital stay | 60 days before admission, 90 days after dischargeCovered | Policy wordings, page 7B2. Pre-Hospitalization expenses We will cover for expenses for Pre Ho sp ita Ii z a ti on co ns ulta tio ns , investigations and medicines incurred upto 60 days before the date of admission 7 to the hospital. The benefit is payable if We have admitted a claim under B1 or B4 or B6. B3. Post-Hospitalization expenses We will cover for expenses for Post Ho sp i ta Ii z at io n co ns ulta tio ns , investigations and medicines incurred upto 90 days after discharge from the hospital. |
| Waiting period for pre-existing conditions | 36 months of continuous coverNot over at month 30 | Policy wordings, page 9Expenses related to the treatment of a pre-existing Disease (PED) and its direct complications shall be excluded until the expiry of 36 months of continuous coverage after the date of inception of the first policy with us. |
| Waiting period for knee & hip replacement | 24 months of continuous coverOver by month 30 | Policy wordings, page 11a waiting period of two years irrespective of the illness for which it is done: XXVII. Adenoidectomy XXVIII. Mastoidectomy XXIX. Tonsillectomy XXX. Tympanoplasty XXXI. Surgery for nasal septum deviation XXXII. Nasal concha resection XXXIII. Surgery for Turbinate hypertrophy XXXIV. Hysterectomy XXXV. Joint replacement surgeries Eg: Knee replacement, Hip replacement |
| Waiting period for spine surgery | 24 months of continuous coverOver by month 30 | Policy wordings, page 10XI. Prolapsed Inter Vertebral Disc (due to injury or otherwise) |
| Waiting period for prostate surgery | 24 months of continuous coverOver by month 30 | Policy wordings, page 10XXL Benign Hyperp lasia of prostate |
| Waiting period for hysterectomy | 24 months of continuous coverOver by month 30 | Policy wordings, page 11XXXIV. Hysterectomy |
| Exclusion rule for bariatric surgery | Covered when the policy's conditions are metConditions apply | Policy wordings, page 11iii. 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 /P rocedu 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 |
| Room rent limit | No room rent limit found in the wording.No clause found |
Check your own policy
Send your policy on WhatsApp. A person reads it and works out what your stay would cost you before you are admitted.
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Sources
- Tata AIG Medicare Plus: policy wordings (accessed 28 Aug 2026)
- Tata AIG Medicare Plus: customer information sheet (cis) (accessed 28 Aug 2026)