Health Insurance in Goa

In its simplest definition, a medical insurance policy is a contract between the insurer and the insurance seeker. Under this contract, the insurer agrees to pay for the policyholder’s healthcare costs in return for the payment of a monthly premium.

As Goa is located on the coast, the tropical climate can cause dehydration, stroke, and cardiovascular diseases. To add to this, the cost of healthcare in cities is very high which means without a health insurance plan, these medical contingencies can potentially drain your savings.

Another critical factor in medical insurance is the zone-based classification. Insurance providers have segregated Indian cities into three tiers based on their population. These zones are as follows:

As cities in Goa fall under Zone C, health insurance in Goa is amongst the cheapest in the country. With medical inflation and increased healthcare costs, it is advised to find the best medical insurance in Goa for yourself for wholesome protection.

Acknowledging the diverse healthcare needs of insurance seekers, health insurance companies in Goa have outlined different kinds of healthcare plans:

Individual Health Plans: Individual insurance covers a single individual. The premium is charged based on the insurance seeker’s age, medical history, and respective sum insured.

Family Floater Health Plans: Under a family health insurance plan, an entire family is covered under a single policy. If you are looking for the best Mediclaim policy for your family in Goa, opt for a policy that considers the healthcare needs of every member.

Under the family floater plan the whole family is covered with a single premium which is based on the age of the oldest member. All members are covered under a single sum assured.

Senior Citizens’ Health Insurance: These healthcare plans are for individuals above the age of 60. As the elderly are more susceptible to illnesses, the premiums for this plan are the highest.

Critical Illness Insurance: Critical illness insurance offers coverage against life-threatening diseases such as cancer, kidney failure, stroke, etc. The sum assured is paid in a lump sum that can be used to cover treatment costs.

If you are looking for the best health insurance in Goa, you need a policy that secures you against your specific health concerns. To help you make an informed decision and find the best Mediclaim policy we have outlined the common inclusions and exclusions.

Inclusions:

In-Patient Hospitalisation: If the insured member is admitted to the hospital for at least 24 hours, their insurance will cover in-patient expenses, including room rent, ICU treatment, medicines, diagnostic tests, consultation, etc.

Pre-Existing Conditions: Coverage for pre-existing ailments after a waiting period of 2-4 years.

Pre- and Post-Hospitalisation: Pre-hospitalisation expenses coverage for 30 to 60 days for consultation, diagnosis, medicines, etc., and post-hospitalisation expenses for 60 to 90 days for follow-up consultations, medications, physiotherapy, etc.

Daycare Treatments: Certain health conditions don’t need hospitalisation for more than 24 hours yet, the cost for their treatment is also covered under health insurance.

Annual Check-Ups: Insurance holders can avail of preventive annual health checkups.

Mental Health Cover: After the IRDAI mandate medical insurance plans also cover mental illnesses such as bipolar disorder, depression, dementia, etc.

AYUSH Treatment: In addition to modern medicine, your medical insurance policy will also provide coverage for alternative medicine treatments, collectively known as AYUSH (Ayurveda, Yoga & Naturopathy, Unani, Siddha, and Homeopathy).

Domiciliary Treatment: Coverage for at-home treatments in cases where hospital beds are unavailable or the insured member has a specific medical condition.

Exclusions:

Pre-existing conditions: If you have a health condition prior to investing in medical insurance, you cannot raise a claim against it until the waiting period is over.

Cosmetic surgery: Hygiene-related therapies and cosmetic surgeries are not covered under health insurance.

Dental and Auditory: Outpatient procedures such as dental and auditory treatments are not covered by insurance.

Self-inflicted injury or suicide attempt: If the patient has intentionally injured themselves or attempted to commit suicide the treatment is not covered under insurance. Misuse of intoxicating substances is also not covered under insurance.

Specific illnesses: Certain illnesses are not covered by insurance such as congenital diseases or genetic disorders, STDs, infertility treatments, voluntary abortions, etc.

The best health insurance company is one that helps you get the best medical insurance in Goa. If you are on the lookout for the best health insurance, here are the factors you must consider:

Policy Coverage: The best mediclaim policy in Goa offers coverage against diverse health concerns and also covers pre and post-hospitalisation cover, ambulance charges, cashless treatment, etc. If you are for the best mediclaim policy for a family in Goa, ensure that the policy accommodates the healthcare needs of every member.

Flexibility: Your policy should be flexible enough for you to add a new family member to your plan with ease without losing on benefits.

Waiting Period: Keep an eye out for the waiting period on maternity expenses, pre-existing ailments, and specific health conditions.

Co-Payment: This is a percentage of the amount that the policyholder is liable to pay from their pocket. Some policies come without a co-payment clause.

Lifetime Renewability: Health insurance gets more expensive as you grow older so look for a lifetime renewability plan that will cover you for the later years of your life.

Check the Claim Settlement Ratio (CSR): CSR is the claims settled against the claims received. So, a higher CSR indicates a greater probability of getting your claims settled.

If you are looking for “health insurance near me” there is no better place than seeking a policy online. Here are some additional benefits of buying a medical insurance policy online:

Discounted Premiums: Buying a health insurance plan online cuts down the operational costs of your insurance provider and they reward you with discounted premiums.

Varied Choices: Insurance seekers can analyse different plans in terms of benefits, coverage, premiums, claim process, etc. which helps them find the best health insurance.

Time-Saving: You can buy medical insurance online in just a few clicks. Once you pay for your policy, it is issued instantaneously.

Convenient: You can buy insurance online anytime, anywhere.

Online Reviews: You can check reviews of existing customers online which can help you effectively choose the best health insurance.

Online Services: You can avail of a host of services online including downloading policy documents, calculating insurance premiums using a health insurance calculator, policy renewal, raising a claim, etc.

Here are some unique benefits of choosing Tata AIG for your medical insurance policy:

Consumables cover: Covers expenses for surgical and medical supplies beyond the cost of hospitalisation.

Global coverage: Policyholders can receive treatment for their health concerns abroad.

Maternity cover: The maternity cover (with a four-year waiting period) compensates for maternity expenses up to ₹50,000 per policy year. If the newborn is a baby girl, this coverage is extended by an additional ₹10,000.

Newborn cover: In the case of complications during delivery, insurance holders will receive an additional ₹10,000 for necessary treatment.

OPD cover: With the OPD cover medical consultation and medication costs of up to ₹5,000 can be offset after a two-year waiting period.

Seamless process: With more than 650 claim experts we ensure a seamless claim settlement process to support you in distressing times.

Automatic restoration: Receive automatic restoration of the sum assured to tackle medical emergencies. Your coverage is replenished if exhausted in a year.

Cumulative bonus: Earn up to 50% cumulative bonus annually for claim-free years. You can avail of cashless treatments, tax benefits, and more, all designed to meet your healthcare requirements.

The liberty to remove the cap on hospital room rent expenses to ensure treatment access without worrying about additional bills

• Financial support at the time of pregnancy with reimbursement up to ₹50,000 (extendable to ₹60,000 for newborn girls).

• Coverage for pre-hospitalisation expenses 30-60 days before admission and post-hospitalisation expenses 60-90 days after discharge.

• Coverage for pre-existing health ailments after a waiting period of two to five years.

• Cashless claims at any authorised hospital across the country.

• Tax benefits under section 80D of the Income Tax Act, 1961.

• Coverage for the cost of ambulance.

• NCB for not raising a claim in one year.

• Coverage for Ayurveda, Yoga and Naturopathy, Unani, Siddha, or Homeopathy (AYUSH).

• Coverage for daycare processes that take less than 24 hours.

• COVID-19 cover

Tata AIG has made it easy for insurance seekers to buy and renew their insurance online. Here’s how:

Process for Buying Medical Insurance Online

• Visit the official Tata AIG website and select “Health Insurance.”

• You can buy a health insurance plan for several members. You will only need to add their ages.

• Share your contact information, medical history, and pre-existing illness (if any).

• Choose the medical insurance policy that is aligned with your healthcare requirements.

• Pay for the policy online using your preferred mode of digital payment and your coverage will be issued almost instantaneously.

Process for Renewing Medical Insurance Online

• Visit the Tata AIG website, click on “Renew” and then select “Health.”

• Share your contact information along with your policy number and other essential details.

• Select the policy you wish to renew. You can even strengthen your policy with add-ons, however, this will slightly increase your premium.

• Once you successfully clear the premium payment, your policy will be renewed.

Documents Required to Buy Tata AIG Health Insurance in Goa

• A correctly filled out proposal form.

• Proof of income (salary slips, bank statements, etc.).

• Proof of identity (Aadhaar card, PAN card, passport, etc.).

• Proof of address (Aadhaar card, utility bills, etc.).

• A cancelled bank cheque.

There are two kinds of claim settlement processes: reimbursement and cashless. For reimbursement claims, you pay for the treatment from your pocket and file for a reimbursement later. In cashless claims, the payment is directly settled by the insurer by paying the hospital on your behalf.

Cashless Claim Settlement Process

Initiate a cashless claim on our claim page or give us a call to notify us.

Look for a hospital of your choice in Goa and inform us within 48 hours of hospitalisation in case of emergencies and 48 hours before admission for planned hospitalisation.

Submit the policy documents of the insured patient at the insurance desk of the hospital.

Fill out the pre-authorisation form.

Once your application is approved, you can receive cashless treatment at the hospital.

Reimbursement Claim Settlement Process

Initiate a reimbursement claim on our claims page.

Inform us about the medical treatment required and the hospital where you would be receiving your treatment

Once you receive the necessary treatment, pay the bills from your pocket

Raise a reimbursement claim by filling out the form and submitting all invoices, medical bills, prescriptions, and other essential documents

Once your claims and documents have been verified, the process for reimbursement is initiated.

Documents Required for Reimbursement Claim

A duly signed claim form (available on request or can be downloaded from our website).

Medical reports and treatment details of the patient.

All medical bills, including consultation bills, pharmacy receipts, prescriptions, and any other payments made towards the treatment.

A certificate from the treating doctor that clearly indicates the medical procedures undertaken.

First Information Report (FIR) in case of accidents or theft.

A clear copy of your medical insurance policy.

Bank details for processing reimbursement payment.

Any other additional documentation to support your claim.

In its continued endeavour to facilitate insurance for people, the IRDAI has now made it possible for health insurance policy holders to get cashless treatment at any authorised hospital of their choice across the country, including Goa.

With Tata AIG, you can choose a network/non-network hospital best suited to your treatment needs in Goa and file your cashless treatment claim with us by following a simple and straightforward process.