aim guaranteed issue health insurance the health max plus program
TRANSCRIPT
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AIM Guaranteed Issue Health Insurance
The Health Max Plus Program
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American Medical and Life Insurance Company presents “Health Max Plus”
AIM Health Plans utilizes America's largest PPO network (Multiplan), with over 500,000 providers nation wide.
These plans are: Guaranteed Issue HIPAA compliant Limited Medical Plan (Not a Major Medical) offering
over $120,000 in insurance benefits annually No deductibles or lifetime maximums $5.00 price on generic 30 day supply mail orders Brand name drugs covered on discounts
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Doctor’s Office Visits
Discounted rates on all PPO Doctor’s Office Visits in the Multiplan Network, then:
$100 is allocated per sick doctor’s office visit 7 sick doctors visits per year 6 sick visits per year when combined with an annual physical No limit on family visits $150 is allocated for an annual physical $250 is allocated for an annual physical when combined with a
sick doctor’s office visit Chiropractic visits can be allocated as a doctor’s office visit $400 is allocated per diagnostic tests with 5 max per year
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How Does This Work?
First, AIM belongs to the Multiplan Network (MN), the largest PPO network in the nation. As a result, your doctor’s visits will be discounted. Examples of possible discounts and how they are applied to pricing are as follows:
The amount AIM Allocates for Sick Doctors Office visits is $100.00
Doctor’s charge for an office visit $150.00 MN’s PPO discounted rate - $100.00 Savings $50.00
Total Price for this Doctor’s Office Visit is $100.00.
Result
This Sick Doctor’s office visit is covered at 100% by your AIM plan.
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Preventative Care/Routine Physical
Next, you have scheduled your annual routine physical to check your blood pressure, cholesterol, weight, etc. The price charged by your doctor for a physical is $300.00.
The amount AIM allocates for Routine Physicals & Sick Doctors visits is $150 and $100 respectively, totaling $250.00.
Doctor’s charge for routine physicals $300.00 MN’s PPO negotiated discounted rate -$250.00 Savings $50.00
Your total cost for this Routine Physical is $250.00.
Result
This Routine Physical is covered at 100% by your AIM plan.
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Diagnostic Test and X-Rays
Now, lets assume you have a medically necessary diagnostic tests such as a MRI, CAT Scan, EKG, Mammography or x-rays performed in a doctor’s office or outpatient facility. The amount AIM allocates for diagnostic test and x-rays is $400 per visit with a maximum of 5 visits per year. Total benefit is $2000 per year.
Doctor’s charge for Diagnostic Test $550.00 MN’s PPO negotiated discounted rate -$450.00 Savings $100.00
Your total cost for this Diagnostic Test is ($450 - $400) $50.00.
Result
In this example, 88% of your Diagnostic Test is covered by AIM
To maximize this benefit, have multiple tests performed on separate visits .
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Hospitalization Confinement Benefit
How do these benefits work?
First day confinement to the hospital is $3000 ($2000 1st day benefit + $1000 daily confinement benefit)
Daily hospital confinement is $1000 per day (Max 100 days per year)
ICU is $1000 per day (Maximum 15 days) Surgical Benefit: 100% of Medicare/RBVS benefit schedule Anesthesia Benefit: 25% of the surgeons benefit Critical Illness Benefit: $5000 one time benefit $20,000 Critical Illness rider available AIM Rx Card Benefits: $5 Generic Drugs AIM Rx Card Benefits: Discounts on Brand Name
Resource-Based Relative Value Scale (RBRVS) is the methodology used by the Federal Government to determine benefits payable by Medicare. Important: This is a brief description of the plans, for specific coverage; please refer to your policy.
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Additional Critical Illness Rider
Carrier will pay an additional one time benefit of $20,000 for the diagnosis of a critical illness with a 90 day waiting period.
Critical Illnesses Include:
1. Life Threatening Cancer2. Heart Attack3. Kidney Failure4. Stroke5. Coma6. Coronary Artery Bypass Graft7. Loss of Sight, Speech or Hearing8. Major Organ Transplant9. Paralysis10. Severe Burns
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Application Process
Apply on Line