Affinity Health Plan Medicare Review

Affinity Health Plan offers health insurance programs for the low income and needy in the New York area.  Affinity Medicare Ultimate and Affinity Medicare Solutions are Medicare Advantage HMO-SNP plans available in Bronx, Kings, Queens, New York, and Richmond counties in New York.  They are only available to individuals with Medicare and Medicaid benefits.  The coverage does include Part D drug coverage as well as health benefits.  In addition they offer nurses to help you with your healthcare.  Below is a review of the benefits they offer:

Affinity Medicare Solutions And Affinity Medicare Ultimate HMO SNP

  • Premium – $0
  • Deductible – $0
  • $3,400 out-of-pocket limit – based on your level of Medicaid you may have no out of pocket expense
  • Network – Must go to in-network doctors and hospitals to receive benefits
  • Referrals – Required
  • Inpatient hospital – $0
  • Doctors Visits – $0
  • Outpatient Surgery – $0
  • Emergency room/Ambulance – $0
  • Part D Drug Coverage Included – You pay between $0 and $6.50 per prescription based on your level of assistance

Extra Benefits Included With Affinity Medicare Solutions

  • Dental – $0 co-pay for 2 cleanings/year; 1 x-ray every 2 years.  Includes $425 of comprehensive dental coverage
  • Hearing – Routine hearing exams and hearing aids not covered
  • Vision – $0 co-pay for an eye exam up to $100 limit on glasses

Extra Benefits Included With Affinity Medicare Ultimate

  • Dental – Routine dental care not covered
  • Hearing – $0 co-pay for 1 hearing exam and up to $1500 of hearing aid coverage
  • Vision - $0 co-pay for an eye exam up to $200 limit on glasses
  • Over-The-Counter benefit of $67/month

Since this plan is an HMO you will have to use providers and facilities that are in the plan’s network, and you will not be covered for any services received outside the network.  You want to make sure your providers are in network by visiting their website.   You may also visit for more information regarding this plan.

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