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Fees & Pricing

Affinia Healthcare offers a sliding fee scale to unisured patients that is based on household income. Patients who apply and are eligible will pay a discounted fee. Proof of income is required. Payments are due at time of service.

Patients whose income does not exceed 100% of the federal poverty level are charged the following nominal fees for services (additional fees may apply for other services):

  • Medical/Optometry/Behavioral Health Visit  – start at $20
  • Dental discounts are available, including dental urgent care at
    the St. Louis Dental Center. Please call 314-814-8700.
  • Eye glasses fee $60
  • Prescription fee start at $13
  • Medical Urgent Care $75  *Additional fees may apply

 

Discounts are also provided for patients with income between 100-200% of the federal poverty level.

Sliding Fee Scale Policy

As a federally qualified health center under Section 330 of the Public Health Service Act, Affinia Healthcare provides essential services to patients regardless of their ability to pay.  Affinia Healthcare does not discriminate in the provision of care for patients due to their socioeconomic status, race, ethnic origin, gender, religious beliefs and practices, or sexual orientation.

 

Affinia Healthcare provides a sliding fee discount to unisured patients with incomes below 200 % of the Federal Poverty Guidelines. No discount is provided to patients with incomes exceeding 200% of the Federal Poverty Guidelines. Section 330 grant regulations require Affinia Healthcare to collect co-pays and other amounts due from patients based on their ability to pay. Ability to pay is determined by household income and family size.

 

To qualify for our Sliding Fee Discount, patients must submit current information documenting household income and family size on an annual basis. One (or in some circumstances, a combination) of the following is acceptable documentation to assess eligibility:

 

  • Copy of most recent pay stubs for all members of household
  • Letter from employer stating annual income
  • W-2 forms for all members of household for recent year
  • Federal tax return 1040 from previous year
  • Social Security / entitlement statement from previous month or
  • Letter from the Division of Employment Security

 

Changes to income level should be brought to our attention so we can assess your income level and co-pay accurately.
The Sliding Fee Discount does not mean that your visit is free. It provides savings to patients without insurance who have incomes below 200% of the federal poverty guidelines. A co-payment is expected at time of service. You may pay by cash, check, Master Card/Visa or Debit.
Patients must pay balance within sixty (60) days of the visit. If a patient has not made a payment within sixty days or has a balance of $50 or more and is scheduled for an appointment, the patient may be re-scheduled for non-emergent services or care until payment or partial payment is rendered.

Accepted Insurance Plans

Health Insurance Market Place

  • Carelink from Coventry One
  • FocusedCareHPN
  • Coventry One

Medicare

Medicare Advantage Plans

  • CIGNA Medicare Access Plans (Private Fee for Service Plans)
  • Coventry Total Care HMO, POS
  • Care Improvement Plus Dual Advantage PPO
  • GHP Advantra (Advantra Only, no other Medicare Plans
  • Humana Group Medicare HMO
  • Humana Gold Choice (Private Fee For Service)
  • Humana Gold Choice HMO
  • Humana Choice PPO
  • Secure Horizons Medicare Complete Plus HMO (UHC)
  • Sterling Life Insurance Company (Private Fee for Service Plan)
  • Wellcare Medicare Advantage Plan (Dental/ Liberty Dental)

Please contact the Affinia Billing Department at 314.814.8780 for
more information on Medicare Advantage plan participation. If we do not participate in your plan, we would be happy to contact your plan to become a provider.

Medicare Railboard

MO HealthNet (Medicaid)

  • HealthCare USA
  • Home State
  • Missouri Care

Commercial Plans

  • AARP (Medicare Supplemental ONLY)
  • AETNA

Choice POS (Open Access)
Choice POS II
Choice POS II (Open Access)
Elect Choice EPO
Health Fund
Managed Choice (POS)
Open Access Elect Choice
Open Access HMO
Open Access Managed Choice
Open Access Select
Open Choice (PPO)
Quality Point of Service
Select
National Advantage Program

  • Blue Cross/Blue Shield Anthem

Blue Access
Blue Access Choice
Traditional

  • Care Improvement Plus (Medicare Advantage Plan)
  • CIGNA

HMO; POS; PPO
HMO/PPO Open Access III (plan has PPO access with out of network benefits)
Indemnity
Medicare Access Plans (Private Fee for Service Plans)

  • First Health
  • Great West Healthcare

    HMO/POS /PPO

  • Great-West Life (purchased by CIGNA)

    Member cards will have CIGNA tree logo on it

  • Group Health Plan (GHP)/Coventry

    Advantra (Advantra Only, no other Medicare Plans)
    Care Management Resources (CMR) (for Carpenters Local)
    Coventry National of Missouri (First Health and Mail Handlers)
    HMO and POS (Commercial Products)
    PPO (for IBEW)

  • Healthlink, HMO; PPO; Open Access III
  • Mercy Health Plans, HMO; PPO
  • Humana

Humana Medicare Supplement
Humana Group Medicare HMO
Humana Gold Choice (Private Fee For Service)
Humana Gold Choice HMO
Humana Choice PPO

  • Mail Handlers

Value Plan (PPO); Standard Plan (PPO)
Consumer Option Plan (High Deductible)

  • MultiPlan/Private Healthcare System (PHCS)
  • Sterling Life Insurance Company (Private Fee for Service Plans)

Basic Plus
Option I; Option II; Option IV

  • Tricare (formerly Champus and now part of AETNA)

    Tricare Extra
    Tricare Prime

  • United Healthcare

    Choice; Choice Plus
    EPO; POS
    Options PPO
    Select; Select Plus

  • Unicare

Specialized Plans

  • Dental

Advantica Dental Benefits
Avesis
Aetna/SRC
Ameritas
Anthem
Coventry Dental
Dearborn National
Delta Dental
DentaMax
DentaQuest
Guardian Dental
Humana One
IPMG Employee Benefit Services
Liberty Dental
Lincoln Dental Connect
Medicaid; SEIU Local 2000
United Health Care Dental

Mental/Behaviorial Health Plans

  • Centpatico
  • Comprehensive Behavioral Health (CompCare)
  • Magellen
  • Mental HealthNet (MHN)
  • MO Care

Vision Plans

  • AlwaysCare
  • March Vision Care
  • Opticare
  • Spectra
Verification of Coverage and Benefits for all insurances.
Call Customer Service number on the back of your Insurance Card.
Worker’s Compensation Cases – contact Billing at 314-814-8780.