AIM

AIM (Access for Infants and Mothers)

恭喜準媽媽們!!! 歡迎申請加州州政府補助的懷孕婦女與嬰兒健保計劃.

我們是州政府指派的協助申請專員，免費幫您申請此一補助計劃. 只要您符合申請資格，我們便可以幫助您加入這個福利計劃. 如果您已經懷孕，但沒有保險，或是您的保險自付額度很高，請您儘快與我們聯絡! 我們也許可以幫助您得到這個州政府補助的健保計劃!

以下是此計劃的福利簡介，如需中文服務，請與我們聯絡!!

請電: (626) 581-9267 或 E mail: georgechiuinsurance@gmail.com

Congratulations!
You have a new baby on the way! The State of California wants to help you get good health care while you’re expecting and after your baby is born, even if your finances are a little tight. Going without prenatal care could cause many problems for you and your baby. Studies show that women who do not get prenatal care often have more complicated (and expensive) births. If you don’t have insurance to cover your health care during pregnancy and childbirth, or if your insurance company’s maternity deductible or co-payment is more than $500, the Access for Infants and Mothers (AIM) and Healthy Families programs may be just the helping hand you and your baby need.

What Is AIM?

The AIM Program is low-cost health coverage for pregnant women and their newborns. Their newborns are covered by the Healthy Families Program. It has been designed for middle-income families who don't have health insurance and whose income is too high to qualify for no-cost Meid-Cal. AIM is also available to those who have health insurance if their deductible or co-payment for maternity services is more than $500. If you qualify for AIM, your baby is automatically eligible for enrollment in the Healthy Families Program.

Applying for AIM

How Can You Get an Application?

See or print an application now: You can open an Adobe Acrobat version (.pdf) of the application and print it from the computer.
See or print the entire AIM Program Handbook: The AIM Handbook is about 50 pages and includes the five-page application. Open an Acrobat version of the handbook.
Call us and ask that a handbook and application be sent to you. Call 626 581-9267

Sample Forms

Services

What Services Are Covered in AIM?
The AIM Program covers all your medically necessary services from your effective date of coverage in the AIM Program until 60 days after your pregnancy has ended. If you submit the required registration information and premium, the newborn will be covered from the date of birth through the Healthy Families Program. For a list of benefits and services available for your baby, see Services Available to Your Baby through the Healthy Families Program. While enrolled in the AIM Program, coverage for pregnant women and new mothers includes:

AIM Services for Pregnant Women and New Mothers
NOTE: Benefits are provided if the insurance plan determines them to be medically necessary. Benefits, exclusions and limitations described in this handbook are representative and not intended to be all-inclusive or comprehensive. Refer to the health plan’s Evidence of Coverage or Certificate of Insurance for further detail.
AIM Benefits	Services for Women	Exclusions/Limitations
Physician and Professional Services	• Services and consultations by a physician or other licensed health care provider • Hospital, nursing facility and office visits • Medically necessary home visits
Preventive Care	• Periodic exams, routine diagnostic testing and laboratory services • Screening/diagnosis of cancer • Direct patient care nutrition services, nutritional assessment • Eye examinations/refractions, to determine need for corrective lenses, dilated retinal eye exams • Cataract spectacles or contact lenses, intraocular lenses following surgery, related visits • Hearing tests and aids, allergy tests and treatment, related visits	• Batteries, ancillary equipment other than included in original covered aids purchase • Equipment exceeding prescribed specifications • Replacement parts or repair for hearing aids after the covered one-year warranty period • Replacement of hearing aid more than once in any 36-month period • Surgically implanted hearing devices
Maternity Care	• Prenatal care, postnatal care • Inpatient delivery, complications of pregnancy
Hospital Services	• Inpatient or outpatient general services and related supplies	• Personal, comfort items • Private room unless medically necessary
Diagnostic X-ray and Laboratory Services	• Diagnostic services necessary to evaluate, diagnose, treat and follow up on care • X-ray, laboratory procedures • Electrocardiography, electro-encephalography • Prenatal diagnosis of genetic disorders of the fetus in high risk pregnancies • Lab test for management of diabetes, including cholesterol, triglycerides, microalbuminuria, HDL/LDL and Hemoglobin A-1 (Glycohemoglobin) • Radiation therapy, chemotherapy, dialysis treatment
Prescription Drugs	• Medically necessary prescription drugs • Injectable medication, needles, syringes • Insulin, glucagon, testing and delivery systems • Oral and injectable contraceptive drugs, prescriptive contraceptive devices	• Experimental, investigational drugs • Patent or over-the-counter medicines • Medicines not requiring a prescription (Insulin and smoking cessation drugs are not excluded from coverage.) • Appetite suppressants, other diet drugs or medicines • Health plan may specify generic equivalent drugs be dispensed where no contraindication exists
Health Education Services	• Effective services including information regarding personal health • Recommendations on optimal use of services, organizations affiliated with the health plan • Health services related to tobacco use prevention, cessation
Mental Health Services	• No visit limits for diagnosis and treatment of severe mental illnesses • Outpatient and inpatient services • Certain appropriate substitutions of residential treatment, day care or outpatient treatment may be substituted for inpatient hospitalization • Some health plans may choose to provide additional visits or group therapy options	• Maximum of 30 days inpatient and 20 days outpatient per benefit year
Emergency Health Care Services	• 24-hour emergency care for illness, injury or severe pain requiring immediate diagnosis and treatment to avoid placing the subscriber in danger of loss of life, serious illness or disability • Provided both in and out of the health plan’s service area and participating facilities
Medical Transportation	• Emergency ambulance for emergency services to first hospital accepting subscriber for care • Ambulance, transport services provided through “911” response system • Non-emergency transportation for transfer to another hospital or facility to home when medically necessary upon prior request of and prior authorization by a health plan	• Coverage for transportation by airplane, passenger car, taxi or other form of public conveyance
Durable Medical Equipment	• Equipment appropriate for use in the home • Oxygen and oxygen equipment • Blood glucose monitors, insulin pumps, related supplies • Nebulizer machines, tubing, related supplies • Ostomy bags, urinary catheters and supplies	• Comfort, convenience items • Disposable supplies (Ostomy bags, urinary catheters and related supplies consistent with Medicare coverage guidelines are not excluded from coverage.) • Experimental or research equipment • Sauna baths, elevators, other non-medical devices • Modifications to home or automobile • Deluxe equipment • More than one piece of equipment for any same function • Health plan may determine whether to rent or purchase
Alcohol and Drug Abuse	• Health education services and crisis intervention related to alcohol, drug abuse • Inpatient: As medically appropriate to remove toxic substances from the system • Outpatient: 20 visits per benefit year • Some health plans may choose to provide additional medically necessary visits
Skilled Nursing	• Medically necessary prescribed services by a health plan physician or nurse practitioner in a licensed skilled nursing facility on a 24-hour basis	• Skilled nursing benefit is limited to a maximum 100 days per benefit year
Home Health Services	• Health services provided in home by health care personnel • Prescribed or directed by attending physician or appropriate designee of the health plan	• No custodial care • Discretion of attending physician or appropriate designee of the health plan to choose between mutually appropriate health care settings • Health plans utilize case management to consider cost-effective choice of mutually appropriate alternative health care settings
Blood and Blood Products	• Inpatient and outpatient processing, storage, administration of blood and blood products • Collection and storage of autologous blood when medically indicated
Family Planning	• Family planning counseling services • Sterilization • Diaphragms, other FDA-approved devices • Prescription contraceptives

Note: The Benefits charts on this Web site are only a summary of benefits provided by each health plan in the AIM and Healthy Families programs. These summaries are for information only. This is not a contract. For exact terms and conditions of the health care benefits, provisions, exclusions, and limitations for each plan, refer to the Evidence of Coverage booklet or Certificate of Insurance available from each health plan. Call the phone number listed on each health plan’s description page in Plans and Providers.

George Chiu Insurance & Financial Services

1139 Coiner Ct., #105 City of Industry, CA 91748 Phone: 626 581-9267 Fax: 626 581-9268 georgechiuinsurance@gmail.com