AIM Specialty Health
Reviews and Complaints

They say that because they didn't even look at your medical records. I have the same issue where I work. I fax them clinicals the second I finish initiating the prior auth and I get a notification from them saying that the procedure is "Not Medically Necessary". When the fax was not even opened. There's nothing anyone can do about it. I am BEYOND frustrated and disgusted with these people. Absolute laziness and disrespect!

This AIM outfit has just screwed me over the same way: I had a decent policy with a New York Insurance Co. called "AMLI". after two months, AIM wrote me a letter saying that they are discontinuing their relationship with AMLI, and will switching me over to another company called "Town & Country Ins. Co." I looked up Town & Country, and they are a two bit nobody outfit with no track record. SO...ELEVEN DAYS BEFORE THE DEADLINE to cancel the policy, I contacted AIM & cancelled everything after the AMLI Insurance expires. They acknowledged the cancellation with plenty of time to spare, so no premium would be taken out the next month.
HO!HO!HO! AIM took the next month's premium out ANYWAy, they told me they didn't get the cancellation through soon enough, and it will take 30 days to refund (maybe more)! TOUGH LUCK! My agent is trying to accomplish something at his end, but it is doubtful if I'll see the money for a long time. BEWARE! SPREAD THE WORD...DO NO DEAL WITH AIM IN ANY WAY SHAPE OR FORM!

Being laid off (after nearly 20 years of service to the company) as of Nov 2008 due to all our jobs being outsourced overseas, our family was forced to switch from an awesome health plan coverage through United Health Care, to the Aetna plan that my husband carried through his employer. Two months later he suffered a stroke and was out on medical for a month, only to return to work and find that his employer of 15 years had closed their doors also, and left their employees with medical coverage through the end of the month . . . which was approximately a weeks worth. Immediately we started searching for health care coverage. What a joke! You can't afford much when you're both on unemployment and the Cobra act that was supposed to have gone into affect per President Obama didn't offer much in financial assistance to be able to afford it either. In fact they told us that it would only apply if the employer still had a payroll -- and obviously with them closing their doors . . . there was no payroll and we didn't qualify for the discounted Cobra -- our payments would still be close to $600/month for the three of us. With a mortgage of over $1300 a month and vehicle insurance of $400 a month . . . $600 for health care was out of the question when you only had $2400 a month to live on and still have to pay utilities and maybe afford more than popcorn and water to live on . . . not to mention fuel to job hunt and go to school. So, a fellow ex-co-worker says he's found awesome health coverage and it's more than affordable and when you call these wonderful people in Chicago, (keep in mind we live in St Louis area Missouri) they will walk you through the plan while you're on the phone and show you everything on your own computer as they're talking (which was pretty amazing in itself) and you don't have to worry about any pre-existing conditions or anything else. So . . . I called them and yes they were wonderful over the phone and addressed all issues and an affordable rate for all three of us and did the paperwork right then and there over the phone and I was more than excited that I'd done something to help my family and it was so easy that I couldn't believe it. And so . . . I told others too . . . and I remained excited. I was told that all payments have to be done as automatic withdrawals and so they now have access to my checking account too . . . that I wasn't happy about.
September came around and my husband's retina in his left eye collapsed out of the clear blue. No accident had occurred and the physician said it's something that could happen to anyone at any age. Our family physician, who's on the health care plan as a provider, advised us to take him to ER immediately and have this all checked out due to his having a stroke a couple months prior . . . and we did. The hospital, Barnes-Jewish St Peters, and the attending physician Dr Joe Kohout were wonderful. Dr Joe contacted a specialist immediately to confirm what he believed and the specialist, Dr Barry Milder, left a black tie affair to come to the hospital and examine my husband, agreed with the diagnosis and set up for my husband to be seen and possibly placed into surgery the following morning. We went home that night from ER with no idea what we were about to go through. The following morning we were called to run into down town St Louis to "big" Barnes Hospital to the Retina center and they would have scheduled surgery for that day, but by the time we got through all the construction traffic and detours off Hwy 40, the operating rooms were booked up for the day and we had to return yet the next morning for surgery. Thank God the surgery went well and the surgeon Dr P Kumar Rao, MD was fantastic. I have to say everyone involved has gone out of their way to help my husband and it's been so appreciated. His eye sight is returning, a little blurry, but he's almost like new.

Now on the other hand we look at the insurance company . . . everyone's good friends at AIM insurance. Oh my God! I hate to say it, but the old adage that if it looks too good to be true . . . it is. Although we'd received insurance cards that showed myself, husband and our son as being covered . . . all of my husbands claims were denied . . . all of them. Reason -- they say my husband is not on the policy. Begging your pardon, but all my paperwork and confirmation paperwork says he is. I've called the Agent and we're all on the policy; I've been referred to several different offices and they say we're all on the policy. And this goes on from September till a week ago. Initially they wouldn't speak to me even though I'd taken out the plan, due to HIPPA and I can understand that, but at the same time they're saying he's not on the plan . . . and I'm the one seeing the money leaving our checking account monthly -- so if you're not going to pay the claims, you'd better talk to one of us. He had to get on the phone and tell them it was okay to speak to me, even though they said he wasn't on the plan . . . go figure . . . and then we had to download a privacy form per HIPPA (which being in the medical profession schooling I understand all that) and sign, witness and fax it back before they will talk to us. It took 6 phone calls and 3 more weeks before they managed to get their IT department online with the rest of the office to be able to speak with us and they still said he wasn't on the plan and refused to pay. Meanwhile, they paid a minor amount on the pharmacy bill at the surgical hospital . . . but he's not on the policy!?!?!? Again I'm rattling cages to get answers and it continues yet another month and finally a representative at AIM says, it was an ENTRY ERROR ON THEIR PART AND IT SHOULD BE RESOLVED WITHIN THE NEXT 4 DAYS . . . it's happened to many policy holders -- MANY POLICY HOLDERS! Four days later . . . he's still not on the policy and the new person on the phone has no idea what I'm talking about and the agent that I've been dealing with thinks I'm a total irate witch and at that point I'm ready to pull out hair and go to Chicago to his office personally, or to Springfield MA where AIM - Consolidated Health Plans is located and deal with everyone IN PERSON - UP CLOSE. After almost three months of this and the medical providers getting very upset for nonpayment and actually getting hateful with me . . . one woman in AIM-Consolidated Health Plans discovers that the automatic withdrawals have been for $403 a month . . . and they should have been for $560 and that's why my husband isn't being covered. So, now it's my fault that they can't make the accurate automatic withdrawals . . . and the bills still aren't paid. Four weeks later . . . I receive a check from the insurance company for God knows what, since there's not explanation as to why I'm getting paid and not a Physician or Hospital . . . and a stack of EOBs (Explanation of Benefits) that show they've paid the surgeon a small amount, denied the hospital any money because "IT's NOT A COVERED PLAN EXPENSE". Apparently the Surgeon is to perform his operations on the street corner, as the hospital isn't covered . . . sure as hell was on my policy when I took it out for us.

Each claim sent by a provider has been in turn mailed a copy to us asking for the patient's diagnosis of services rendered. Okay . . . as the insurance company, wouldn't you contact the provider if there was a question on medical coding? Why would you contact the patient for a diagnosis? Funny, they can't respond to that either, but they will give you 30 days to respond or they'll throw the claim out.

We're sitting here on close to $30, 000 of medical debt, no jobs, no money, and a mortgage company that's just about as intelligent and about to start foreclosure. Welcome to the American Dream. Work hard, live nice, own a home . . . and let your employers outsource you life overseas to feather their pockets and inevitably screw the Americans over. I'm impressed . . . how about you?

Oh, and I've just canceled my AIM insurance. Received a confirmation copy back that they'd cancel . . . and I'm going to my bank to make sure they prohibit any additional withdrawals for these wonderful people. Sadly, here in this case, I could have applied all the money they took out to the medical bills all on my own . . . and still be looking at close to the amount I've got staring me in the face that I still owe the medical providers. I hope someone at AIM is having a Happy Holiday season . . . as we aren't having any celebration here.

Good luck.