Policy explained · Tata AIG
Tata AIG Medicare Premier: what your policy covers
We found no room rent limit in the Tata AIG Medicare Premier wording. It has a 24-month wait for knee & hip replacement and a 24-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 30Conditions apply, see the termsPolicy wordings, page 35, read 27 Sep 2026
- ⏳24 monthsPre-existing conditions waitOver by month 30Conditions apply, see the termsPolicy wordings, page 36, read 27 Sep 2026
- 🩹CoveredConsumablesConditions apply, see the termsPolicy wordings, page 16, read 27 Sep 2026
Waiting periods, month by month
- Pre-existing conditions24 monthsOver by month 30Conditions apply, see the terms
- Knee & hip replacement24 monthsOver by month 30Conditions apply, see the terms
- Spine surgery24 monthsOver by month 30Conditions apply, see the terms
- Prostate surgery24 monthsOver by month 30Conditions apply, see the terms
- Hysterectomy24 monthsOver by month 30Conditions apply, see the terms
- Bariatric surgery24 monthsOver by month 30Conditions apply, see the terms
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
10 terms read from the Tata AIG Medicare Premier documents (UIN TATHLIP26052V052526). 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 16Condition: Pays the consumables listed in Annexure I, List I (Optional Items), when the main claim is admissible. We will pay for expenses incurred, for specified consumables listed in ‘Annexure I - List I- Optional Items (Consumables Benefit)’ which are consumed during the period of hospitalization directly related to the insured’s medical or surgical treatment of illness/disease/injury. |
| Costs before and after the hospital stay | 60 days before admission, 90 days after dischargeCovered | Policy wordings, page 11Condition: For a basic sum insured up to ₹50 lakh. From ₹75 lakh the window after discharge is 200 days. We will cover for expenses for Pre -Hospitalization consultations, investigations and medicines incurred upto 60 days before the date of admission to the hospital. The benefit is payable if We have admitted a claim under section B1 or B4 or B6 or B31 of this policy. B3. Post-Hospitalization expenses We will cover for expenses for Post-Hospitalization consultations, investigations and medicines incurred after discharge from the hospital, upto number of days as specified in the table below. Basic Sum insured Number of days Upto Rs. 50 Lacs 90 days |
| Waiting period for pre-existing conditions | 24 months of continuous coverOver by month 30 | Policy wordings, page 36Condition: Starts again on the increased part if you raise the sum insured. Expenses related to the treatment of a pre -existing Disease (PED) and its direct complications shall be excluded until the expiry of 24 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 35Condition: Not applicable to claims arising from an accident. XXIX. Joint replacement (for example: Knee replacement, Hip replacement) |
| Waiting period for spine surgery | 24 months of continuous coverOver by month 30 | Policy wordings, page 35Condition: Not applicable to claims arising from an accident. VI. Prolapsed Inter -Vertebral Disc ( Katishool, Greevashool, Grudhrasi vata) and Spinal Diseases including spondylitis/spondylosis unless arising from Accident |
| Waiting period for prostate surgery | 24 months of continuous coverOver by month 30 | Policy wordings, page 35Condition: Not applicable to claims arising from an accident. XVI. Benign Hyperplasia of prostate (Asththila vruddhi) |
| Waiting period for hysterectomy | 24 months of continuous coverOver by month 30 | Policy wordings, page 35Condition: Not applicable to claims arising from an accident. XXVIII. Hysterectomy |
| Waiting period for bariatric surgery | 24 months of continuous coverOver by month 30 | Policy wordings, page 36Condition: Not applicable to claims arising from an accident. XXXV. Obesity / Weight control procedures including Gastric bypass surgeries |
| Sub-limit for bariatric surgery | No separate sub-limit: paid up to the sum insuredNo sub-limit | Customer information sheet (CIS), page 4Bariatric Surgery Cover and In-Patient Treatment - Dental: Up to Sum Insured. |
| Exclusion rule for bariatric surgery | Covered when the policy's conditions are metConditions apply | Policy wordings, page 17B14. Bariatric Surgery Cover We will cover for reasonable and customary expenses for Bariatric Surgery if the insured fulfills all of the following conditions: |
| Room rent limit | No room rent limit found in the wording.No clause found |
Check your own policy
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Sources
- Tata AIG Medicare Premier: policy wordings (accessed 28 Aug 2026)
- Tata AIG Medicare Premier: customer information sheet (cis) (accessed 27 Sep 2026)