Affinity Health Plan

  • Important News Regarding AffinityAccess Qualified Health Plans

    Effective January 1, 2018, Affinity Health Plan will no longer offer AffinityAccess, AffinityAccess 2.0., or AffinityAccess Direct plans. We will continue to provide Medicaid, Child Health Plus (CHPlus), the Essential Plan, Enriched Health (HARP) and Medicare coverage.

    Although coverage for AffinityAccess members will end on December 31, 2017, Affinity will continue to provide customer support and pay claims for 2017 dates of service through the remainder of 2017 and early 2018. As part of the transition, AffinityAccess members will receive letters informing them of the change and providing helpful information on selecting a new plan for 2018. If you are currently covered by AffinityAccess, AffinityAccess 2.0., or AffinityAccess Direct, our FAQs may help answer your questions. You may also call our Customer Service Department at 888.543.6973.

    For more information about other Qualified Health Plans, visit www.nystateofhealth.ny.gov or call 855.355.5777 (TTY: 800.662.1220), Monday - Friday, 8 a.m. - 8 p.m. and Saturday, 9 a.m. - 1 p.m.

    Deciding on a New Plan is a couple of points to help you with this change.

  • Important Contact Information

    Affinity Health Plan – Customer Service
    Phone: 888.543.6973
    Fax: 718.794.7804
    TTY/TDD: 800.662.1220
    Monday - Friday: 8:30 a.m. - 6:00 p.m. EST

    New York State of Health
    Phone: 855.355.5777
    TTY: 800.662.1220
    Monday – Friday: 8 a.m. - 8 p.m. EST
    Saturday: 9 a.m. - 1 p.m. EST

    Affinity Health Plan – Pharmacy
    Phone: 855.582.2022
    Monday – Friday: 8 a.m. - 8 p.m. EST
    Saturday: 9 a.m. - 1 p.m. EST



    Frequently Asked Questions (FAQs)

    • Why is Affinity Health Plan not offering Qualified Health Plans in 2018? More

      New York State has determined that it is in Affinity’s best interest to focus on its core business and no longer offer a Commercial Individual product through the New York State of Health Marketplace in 2018. Toward that end, we look forward to continuing to serve our members and their communities through our other product lines: Medicaid, Child Health Plus (CHPlus), the Essential Plan, Enriched Health (HARP) and Medicare.

    • Is Affinity Health Plan going out of business? More

      Adjustments to business lines are a common industry occurrence and is not an indication that Affinity is going out of business. We are refocusing our efforts on our core programs – Medicaid, Child Health Plus (CHPlus), the Essential Plan, Enriched Health (HARP) and Medicare – and will continue to serve the needs of our members and their communities.

    • When will this change take affect? More

      Effective January 1, 2018, Affinity will no longer offer any Qualified Health Plans on the New York State of Health Marketplace. Members currently enrolled in AffinityAccess and AffinityAccess 2.0, and Affinity Access Direct health coverage will end on December 31, 2017.

      Affinity Health Plan will continue to provide Medicaid, Child Health Plus (CHPlus), the Essential Plan, Enriched Health (HARP) and Medicare plans.

    • Will providers still accept AffinityAccess, Affinity Access 2.0 or Affinity Access Direct insurance? More

      Participating providers will continue to accept AffinityAccess until December 31, 2017. Affinity will provide customer support and pay QHP member claims through the remainder of 2017 and early 2018 for 2017 dates of service.

    • How will claims be handled? More

      Affinity Health Plan will pay all valid claims for 2017 dates of service. The process for reimbursement of prescription will remain the same. Members must complete and submit the prescription reimbursement form. All other claims will be handled in the same manner, with no change to the current process.

    • How can I get new coverage? What other options do I have after my coverage expires? More

      You may choose to shop for a new health insurance policy through the New York State of Health, the Official Health Plan Marketplace. The Marketplace offers a variety of coverage options from a number of insurers. Your monthly premium may be reduced if you are eligible for financial assistance through the Marketplace. If your income is below 400% of the federal poverty level (the poverty level is currently at $97,200 for a household of four, $47,520 for a household of one) you may be eligible for premium tax credits. Consumers with lower incomes may also be eligible for assistance to reduce deductibles and copays and with other cost-sharing. You or your family may also qualify for Medicaid or Child Health Plus (CHPlus) through the Marketplace. The website for the Marketplace is www.nystateofhealth.ny.gov.

      You may also choose to buy a new health insurance policy outside the Marketplace directly from another insurance company, or with the help of an agent or broker. However, if you qualify for financial help, you can get those savings only if you enroll through the Marketplace.

    • When do I need to choose a new health policy? More

      In order to have health coverage on January 1, 2018, you must purchase a plan by December 15, 2017 from an insurer, through a broker, or directly through the New York State of Health Marketplace. Visit www.nystateofhealth.ny.gov for more information.

      The next open enrollment period for Qualified Health Plans starts on November 1, 2017. Information about replacement policies will be available in October 2017. To be covered on January 1, 2018, you must make a policy selection by December 15, 2017 and the new insurer must receive the premium before January 1, 2018.

    • Will Affinity help members enroll in a new plan? More

      Deciding on a New Plan is a resource with tips to help members select a new health plan. Although Affinity cannot enroll members into a new plan, we can assist with finding a replacement plan. To speak with a Customer Service Representative, call 888.543.6973. Members can view other plan options or enroll in a new plan by visitingwww.nystateofhealth.ny.gov.

    • Will I lose access to my primary care provider/doctor? More

      Under certain circumstances members will be able to remain with their current primary care provider/doctor. Refer to Deciding on a New Plan for more details.

      Although Affinity is no longer offering Qualified Health Plan’s AffinityAccess, AffinityAccess 2.0 plans, and AffinityAccess Direct, we will continue to offer Medicaid, Child Health Plus (CHP), the Essential Plan, Enriched Health (HARP) and Medicare. Contact an Affinity representative at 888.543.6973 for assistance determining which one of Affinity’s other health plans best serve your needs.

      If you plan on selecting a new health plan from the Marketplace (www.nystateofhealth.ny.gov), be sure to contact that health plan to determine if your doctor and/or specialist are listed as a provider. You may also contact your doctor and/or specialist to find out if they accept the health plan you are considering.