Health Insurance in West Bengal

• Medical Inflation: Over the last few years, the cost of securing quality medical treatment has risen significantly in West Bengal.
• Securing Your Savings: A sudden illness can drain your savings. Medical insurance helps you alleviate the stress of seeking treatment.
• Financial Protection - A good medical insurance policy ensures safety during unexpected medical emergencies in West Bengal.
• Reduced Costs - It covers hospitalisation, medicines, and diagnostics, easing the burden of sudden healthcare expenses.
• Quality Care - Choosing the right health policy plan helps you access treatment without draining personal savings.
• Cashless Facilities - Health insurance provides cashless options at a wide hospital network for timely care.
• Family Coverage - Families benefit from protection, including pre- and post-hospitalisation expenses.
• Tax Benefits - When you buy health insurance, you also gain tax deductions under Section 80D.
• Long-Term Security - It offers renewability and riders for added protection against critical illnesses.

Acknowledging the varying healthcare needs of every individual, health insurance companies in West Bengal have curated diverse plans. The common ones include:

Individual Health Insurance

It offers coverage to a single individual, securing them against medical and hospitalisation costs. Premiums for individual plans depend on age, lifestyle, and health history. It is ideal for individuals seeking personal healthcare coverage tailored to their unique needs.

Buy Individual Health Insurance

Family Floater PlanFamily Floater Plan

It covers the entire family under a single policy. The sum assured is higher in family plans and is shared equally among the policy members. When you buy the best mediclaim policy for your family in West Bengal instead of buying an individual plan for every member, you have made a cost-effective choice.

Buy Family Health Insurance

Senior Citizen Health Insurance

These insurance plans are curated for senior citizens who are above the age of 61. As older individuals are more likely to raise a claim, the premiums payable for this policy are higher. It ensures timely care and financial support during critical health situations.

Buy Senior Citizen Health Insurance

Critical Illness Insurance

Critical illness insurance covers serious health conditions such as kidney diseases, heart attacks, cancer, or paralysis. It helps manage treatment costs, offering crucial financial support during serious health challenges.

Buy Critical Illness Insurance

Super Top-up Plans

A super top-up plan activates after your base cover ends. It provides additional financial protection against high medical costs, ensuring extended coverage. This plan is ideal for people seeking affordable healthcare security in West Bengal.

Buy Super Top-Up Health Insurance

Group Health Insurance

Group health insurance covers employees or members under one West Bengal medical insurance plan. It ensures access to medical benefits at lower premiums. Employers generally provide this health coverage for teams and their families.

Buy Group Health Insurance

• TATA AIG Health Policy Plans	Features
  TATA AIG Medicare	Offers global coverage with automatic sum restoration. Provides a 100% cumulative bonus for claim-free years. Covers AYUSH, bariatric surgery, and vaccinations. Includes health checkups, mental wellness, and teleconsultations
  TATA AIG MediCare LITE	Covers hospitalisation, pre-/post care, and day care treatments. Includes domiciliary and organ donor cover up to the sum insured. Offers a yearly restore benefit for the sum insured. Ensures broad inpatient and outpatient medical protection.
  TATA AIG MediCare Premier	Wide coverage ranging from ₹5 lakh to ₹3 crore with worldwide cashless hospitalisation. Offers full 100% automatic restoration along with a cumulative bonus. Covers advanced treatments and medical costs for organ donors. Includes dental OPD care, diagnostic services, and flexible room choices.
  TATA AIG Medicare Select	Completely flexible with a wide range of add-ons and riders. Gives unlimited restoration of the insured sum. Grants early benefits on long-term multi-year policies. Offers a daily cash allowance for added support. Available in 1, 2, or 3-year options with discounts up to 25%.
  TATA AIG Elder Care	Tailored for people aged 61 years and above with a dedicated personal health manager. Covers inpatient care, pre- and post-hospitalisation, ambulance, AYUSH, and COVID-19 treatments. Includes support for home nursing, physiotherapy, and home modifications. Provides up to ₹25 lakh coverage with lifetime renewability.
  TATA AIG MediCare Plus (Super Top Up)	Activates after the base policy limit is used. Offers coverage up to ₹1 crore with ₹2–20 lakh deductible options. Covers AYUSH, dental, ambulance, and domiciliary care. Includes lifetime renewability, tax benefits, and family discounts. Requires no pre-policy medical check-up.

Inclusions

• Inpatient Hospitalisation: If you are admitted to the hospital for at least 24 hours, your insurance will cover inpatient expenses, including room rent, ICU treatment, medicines, diagnostic tests, consultation, etc.
• Pre-Existing Conditions: Coverage for pre-existing health conditions 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, and post-hospitalisation expenses for 60 to 90 days for follow-up consultations, medications, physiotherapy, etc.
• Daycare Treatments: Some treatments don’t need the patient to be hospitalised for more than 24 hours. Even so, your insurance will compensate for these expenses.
• Annual Checkups: Coverage for preventive annual health checkups.
• Mental Health Cover: The Insurance Regulatory and Development Authority of India (IRDAI) has made it mandatory to offer coverage for mental illnesses such as bipolar disorder, depression, dementia, etc.
• AYUSH Treatment: Your health insurance policy will also provide coverage for alternative medicine treatments, collectively known as AYUSH (Ayurveda, Yoga and Naturopathy, Unani, Siddha, and Homoeopathy)
• Domiciliary Treatment: If the patient needs to receive at-home treatments in cases where hospital beds are unavailable or the insured member has a specific medical condition, your insurance will compensate for them.

Exclusions

• Pre-Existing Conditions: There is generally a waiting period before one can raise a claim to secure treatment for pre-existing health conditions.
• Cosmetic Surgery: Hygiene-related therapies and cosmetic surgeries are not covered under a health insurance policy.
• Dental and Auditory: Outpatient procedures such as dental and auditory treatments are not covered by insurance.
• Self-Inflicted Injury or Suicide Attempt: Insurance providers will not entertain a claim if the policyholder intentionally injures themselves or attempts to commit suicide. Misuse of intoxicating substances is also not covered under insurance.
• Specific Illnesses: Certain illnesses, such as congenital diseases or genetic disorders, STDs, infertility treatments, voluntary abortions, etc., are not covered by insurance.

Please note: This is a general list of inclusions and exclusions. Please refer to the policy document for the complete list and its terms and conditions.

It is natural to want to find the best medical insurance policy in West Bengal to safeguard healthcare needs and finances. However, with so many options to choose from, it can be challenging to find a suitable policy.

So, to help you pick the best health insurance for yourself and your loved ones, we have highlighted the key factors you must consider:

Policy Coverage

The best health insurance in West Bengal is one that not only offers coverage against a wide range of health concerns but also covers pre- and post-hospitalisation cover, ambulance charges, critical illness coverage, maternity benefits, cashless treatment, etc. If you are looking at a family plan, ensure it accommodates the healthcare needs of every member.

Flexibility

Check if your policy enables you to add a new family member to your plan with ease without losing out on benefits. Flexibility ensures that your health insurance adapts to life changes such as marriage, childbirth, or dependent parents joining your plan.

Waiting Period

Typically, there is a waiting period for maternity expenses, pre-existing ailments, and specific health conditions. Ensure that you check this duration and select a policy that comes with a lower waiting period. Policies with shorter waiting periods are always more convenient during unexpected medical needs.

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, while others may reduce premiums if you accept co-payment. Choose based on what balances affordability and long-term financial security for your family.

Lifetime Renewability

Health insurance gets more expensive as you grow older, so look for a lifetime renewability plan that guarantees uninterrupted coverage. This feature ensures that you stay protected at every stage of life and do not lose benefits due to age restrictions.

TATA AIG offers unique benefits to health insurance plan seekers for comprehensive protection. These add-ons can help strengthen your basic health insurance:

• Consumables Cover: Expenses beyond hospitalisation with surgical and medical supplies coverage.
• Global Coverage: Option of seeking medical treatment abroad for specific medical conditions.
• Maternity Cover: Maternity cover (four-year waiting period) to tackle maternity expenses up to ₹50,000 per policy year and an additional ₹10,000 if the newborn is a baby girl.
• Newborn Cover: An additional ₹10,000 to tackle complications during delivery.
• OPD Cover: Medical consultation and medicine costs of up to ₹5,000 can be offset (two-year waiting period).
• Seamless Process: With more than 650 claim experts, our claim settlement process is simple.
• Automatic Restoration: Automatic restoration of the sum assured to take care of medical emergencies. If you exhaust your coverage in a year, it gets replenished.
• Cumulative Bonus: Earn up to 50% cumulative bonus annually for claim-free years. Associated benefits include cashless treatments, tax benefits, and more, to meet specific healthcare requirements.

To make it easier and more convenient for insurance seekers to find the best medical insurance policy in West Bengal for themselves, insurance companies have enabled online insurance purchases. Here are some key reasons why it is better to buy medical insurance online:

• Affordable Premiums: When you buy a health insurance policy online, you directly communicate with the insurance company, thereby saving commissions to agents and distributors. The insurer shares these savings with the customers by giving them discounted premiums.
• Informed Decision: Insurance seekers can analyse different plans in terms of benefits, coverage, features, premiums, claim process, renewal, etc., which helps them find the best health insurance for themselves and their loved ones.
• Time-Saving: Online insurance purchase is characterised by less paperwork and a hassle-free process. You no longer need to queue up to buy a policy. This makes it time-saving.
• Convenient: You can buy insurance online anytime, anywhere, which is particularly beneficial with a busy routine.
• Online Reviews: You can check reviews of existing customers online, which can help you effectively choose the right health insurance plan.
• Online Services: With online insurance purchases, 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.

Steps to Buy Medical Insurance Policy Online

• Visit the official TATA AIG website and select “Health Insurance.”
• In the next step, select how many members you are going to buy insurance for and their respective ages.
• Enter your contact details, medical history, and pre-existing illness (if applicable).
• Choose an appropriate health insurance policy.
• Pay for the policy online, and your coverage will be issued instantaneously.

Documents Required to Buy TATA AIG Health Insurance in West Bengal

• A cancelled bank cheque
• A signed and properly filled proposal form
• Proof of identity (Aadhaar card, PAN card, passport, etc.)
• Proof of address (Aadhaar card, utility bills, etc.)
• Proof of income (salary slips, bank statements, etc.)

Steps to Renew Medical Insurance Policy Online

• Visit the TATA AIG website, click on “Renew” and then select “Health.”
• Enter your contact details, policy number, and other essential information.
• Choose the policy that needs to be renewed. You can even include add-ons, but this will increase your premium.
• Once you pay the premium, your policy will be renewed.

There are two kinds of claim settlement procedures: cashless claims and reimbursement claims. In the cashless process, the claims are settled directly by the insurer and the hospital, and the policyholder need not pay anything. For reimbursement claims, the policyholder pays upfront and files for reimbursement later.

Cashless Claim Settlement Process

• Go to our claims page to initiate a cashless claim. You can also contact us by phone.
• Inform us within 48 hours of hospitalisation in case of emergencies and 48 hours before admission for planned hospitalisation in a network or non-network hospital.
• Submit the policy documents to the hospital’s insurance desk and fill out a pre-authorisation form.
• Once the application is approved, you are eligible to receive cashless service at the hospital.

Reimbursement Claim Settlement Process

• Visit our claims page to initiate a reimbursement claim or contact us by phone.
• Inform us about the hospital where you will be receiving your medical treatment and the dates.
• After you receive your treatment, pay for the medical expenses from your pocket.
• Submit the reimbursement form along with all invoices, medical bills, prescriptions, and other important documents.
• Once the claim and the documents are verified, the process for reimbursement is initiated.

Documents Required for Reimbursement Claim

• A duly signed claim form.
• All medical reports and treatment details or reports.
• 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 health insurance policy.
• Bank details for processing reimbursement payment.
• Additional documentation to support your claim.

With the TATA AIG medical insurance policy, you can avail of cashless claims at a wide network of hospitals across West Bengal. This facility ensures that during a medical emergency, you do not need to worry about arranging funds immediately.

The process is simple. Once admitted to a network hospital, you can show your TATA AIG health card or provide your policy details. The hospital then coordinates with the insurer to approve your cashless claim. Whether it is inpatient care, pre- and post-hospitalisation, or day care procedures, the benefits are easily accessible.

When you compare health insurance options, choosing a plan with an extensive cashless network adds immense value. A well-designed plan from TATA AIG offers cashless treatment everywhere, ensuring financial security and uninterrupted medical care when you need it most.