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 your visit is free. It provides savings to patients 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.

Health Insurance Market Place
• Cigna Connect

• AmBetter Health

Medicare

Medicare Advantage Plans
• CIGNA Medicare Access Plans (Private Fee for Service Plans)

• 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

• 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)
• United Healthcare Community Plan

• Home State/Cenpatico

• 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)

• 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
- Choice; Choice Plus

Specialized Plans
• Dental
- Advantica Dental Benefits
- Avesis
- Aetna/SRC
- Ameritas
- Anthem
- Coventry Dental
- Dearborn National
- Delta Dental
- DentaMax
- DentaQuest
- Envolve
- Guardian Dental
- Humana One
- IPMG Employee Benefit Services
- Liberty Dental
- Lincoln Dental Connect
- Medicaid

• SEIU Local 2000
- Sunlife
- United Healthcare Community dental plan
- United Health Care Dental/United Health Care MR Complete Denta

Vision Plans
• AlwaysCare

• Envolve

• Eye Med Managed Care

• March Vision Care

• Opticare

• Spectra

• Sunlife

To verify coverage and benefits for all insurance plans, call the Customer Service number on the back of your insurance card.

Worker’s Compensation Cases – contact Billing at 314-814-8780.