New York State of Health, Affinity Healthcare, and My Health

I’ve written several posts about my problems with New York State of Health and Affinity Health Plan. Today I want to write what I hope will be the last entry in this miserable saga. In a nutshell, I lost my health insurance at the beginning of this year. Whether the fault lies with Affinity or with New York State of Health, my health insurance policy was canceled. The problem is that, once it was canceled, it took six months to get it reinstated.

Yes, you saw that correctly, it took SIX MONTHS!

Along the way, Affinity tried to justify the loss of coverage by saying that I had canceled my account and, when that didn’t work, they retroactively canceled my policy back to September 2015 for lack of payment. We can, of course, prove that isn’t true because the money was automatically deducted from my checking account every month. I finally had to get Representative Sean Patrick Maloney involved to resolve the issue and finally received coverage as of July 1st.

The question is, what did that do to me?

In addition to the constant aggravation of talking to people at the New York State of Health and Affinity Health Plan, the fact that I had no insurance combined with a temporary lack of a job meant no doctor visits and no medications. Going to the doctor without health insurance is an expensive proposition, and that’s if they don’t want to do any tests!

The Cost of Staying Healthy

I found an explanation of benefits for a regular doctor’s visit. It said that the cost was $245.00 just for the visit. That’s not what the insurance company paid, by the way. (They paid only $128.61, but that’s a whole other story.) Chances are that the cost would be more for an uninsured patient.

I couldn’t find any receipts for my own blood work, but I did some research and, according to Walk-In-Lab, “On average, to get blood work done at a lab when the patient is uninsured will cost around $1,500.” (See: So between the tests and the doctor’s fees, we’re looking at about $1700 to $1800. And that would have had to happen twice during the time I was unemployed and uninsured. I didn’t even count the cost of prescriptions because I have no clue how much it would cost without insurance co-pays. But, even if it were free, the doctor isn’t going to extend my prescriptions without an office visit so no medications either.

Why didn’t I get Medicaid? Because, even on unemployment, I make too much money, so with no insurance, I’m responsible for the full cost of doctor’s visits, lab tests, and prescriptions. And yet, the amount of money I received on unemployment doesn’t even cover my mortgage. We were living on savings for that six months, even with no doctor’s visits. All of the health issues that I had successfully gotten under control are now out of control. It will probably take a good six months to get back to where I was last December.

NOTE: I want to thank Sean Patrick Maloney’s office for the help they gave me in resolving the issue. They did everything they could to resolve the issue quickly, but thanks to Affinity and New York State of Health, it still took six months. And I’m sure that if I had continued to deal with the issue on my own, I’d still be fighting.