EmblemHealth to provide Medicare Advantage benefits to former Affinity Health Plan members

Date Issued: 1/18/2019

As of January 1, 2019, EmblemHealth administers the benefits for four Medicare Advantage plans to approximately 10,000 former Affinity members.

These members now have access to EmblemHealth providers in the VIP Prime Network. Providers will be paid in accordance with EmblemHealth’s contracted Medicare rates.

Members received 2019 EmblemHealth member ID cards in December. The member ID cards have new ID numbers that start with the letter “K” and include the plan name, “no referral needed,” and EmblemHealth’s claims submission information. Any claims for care provided to Affinity Medicare Advantage members before January 1, 2019 should be sent to Affinity.

Below are highlights of the four Affinity Medicare Advantage plans and sample member ID cards:

There are two HMO plans that vary by service area and copays. Each offers dental, vision and hearing coverage, acupuncture, and a fitness program.

  • EmblemHealth Affinity Medicare Passport Essentials (HMO)
    • Orange, Rockland, Westchester, and Nassau counties
    • $5 PCP copay
  • EmblemHealth Affinity Medicare Passport Essentials NYC (HMO)
    • New York City (5 counties)
    • $10 PCP copay

There are two dual eligible Medicare/Medicaid Special Needs Plans. Each offers dental, vision, and hearing coverage.

  • EmblemHealth Affinity Medicare Ultimate (HMO SNP)
    • New York City, Long Island, Orange, Rockland, and Westchester
    • $0 PCP copay, $0 Specialist copay
    • OTC benefit at $60 per month/$720 per year
  • EmblemHealth Affinity Medicare Solutions (HMO SNP)
    • New York City, Long Island, Orange, Rockland, and Westchester
    • $0 PCP copay
    • Routine transportation
Affintity Medicare Passport Essentials (HMO)
Affintity Medicare Passport Essentials HMO
Affinity Medicare Passport Essentials NYC (HMO)
Affinity Medicare Passport Essentials NYC HMO
Affinity Medicare Ultimate (HMO SNP)
Affinity Medicare Ultimate HMO SNP
Affinity Medicare Solutions (HMO SNP)
Affinity Medicare Solutions HMO SNP