AIM Health Plans
Guarantee Issue-- Despite Pre-Existing Conditions!!
PLAN BENEFITS
• Doctor & Chiropratic Visits • Daily Hospital Confinement • Surgical Benefits (same benefit inpatient or outpatient) • Diagnostic, X-Ray & Lab Benefit (DXL) • Wellness Care • Accident Benefit • Critical Illness Benefit • Maternity Coverage • Aetna Dental Discount PPO • PPO Network Repricing for Hospital, Doctor and Outpatient Services. http://www.multiplan.com • Prescription Discount Card
PLAN HIGHLIGHTS
• Guaranteed Issue to Individuals & Small Groups • Guaranteed Renewable • Portable • Assignable Benefits • Stable Rates • First Dollar Coverage (No Co-pays) • 50 State Availability • HIPAA Compliant • Fully insured • No participation requirements for groups • Three Plans: Silver, Gold, & Diamond
INPATIENT MEDICAL EXPENSE BENEFITS
• Daily Hospital Benefit*- Hospital benefit of $1,000 per day for up to 100 days per covered person, per calendar year. Unlimited re-admission • ICU/CCU Hospital Benefit* - Plan will pay an additional $1,000 per day (max of 5 days) • Surgical Benefit* - Plan provides scheduled benefits for surgery per incident payable at 100% of Medicare Reimbursement Schedule(No Annual Maximum). Benefits are paid on inpatient or outpatient basis. • Anesthesia Benefit* - Plan provides a 20% benefit (This benefit is calculated by multiplying the surgeons’ benefit times 20%)
OUTPATIENT MEDICAL EXPENSE BENEFITS
• Office Visit* $75 paid per visit for up to 5 visits per calendar year per covered person • Surgical & Anesthesia Benefit* Same as inpatient coverage • One (1) Preventative Test Paid at $150 per year per covered person • Office Visits can be used for Chiropractic Visits • Prescription Discount* See A.I.M. Member RX • Plan Diagnostic Tests, X-Rays & Lab Testing* $150 paid for up to 3 visits per person per calendar year for diagnostic tests, X-rays and lab testing. Benefits paid on inpatient or outpatient basis.
OTHER BENEFITS
• Accident Benefit - Up to $5,000 paid per accident, subject to $100 deductible & 80% coinsurance per accident. One accident per covered person per year. • Critical Illness Benefit - The carrier will pay a one-time benefit amount of $2,500 if the primary applicant has been diagnosed with a critical illness (for primary applicant only)* . • PPO Network Discounts - The plan offers PPO network (Multiplan) repricing when network providers are used. Multiplan offers one of the largest seamless national networks. Over 500,000 providers in 50 states. Visit http://www.multiplan.com to locate a provider. *Benefit amounts are based on the Diamond Plan.
This policy has a preexisting conditions limitation. Preexisting conditions are not covered until the policy has been in effect for more than 12 months. A preexisting condition is any condition you have now or had within a 12 month period prior to the effective date of coverage for each covered person.
The A.I.M. Health Solutions Plan is HIPAA compliant.
Persons who leave the plan will receive a HIPAA Certificate of Credible Coverage. Those who enter the plan presenting a Certificate of Credible Coverage will receive credit toward this plan’s preexisting conditions limitation.