Over the next few months MetroPlusHealth (MetroPlus) and Affinity Health Plans (Affinity) are bringing Mental Health coverage in-house and leaving Beacon Health Strategies.  If you are in-network with Beacon, and in their service area, you are most likely an in-network provider for MetroPlus and Affinity.  Once the change takes place you will no longer be able to see their beneficiaries as an in-network provider without contracting directly with MetroPlus and Affinity.

MetroPlus and Affinity have been reaching out to providers contracted with Beacon to begin the credentialing process before the change occurs.

Here are the important facts

Effective Date of Change:

  • MetroPlus – 10/1/2021
  • Affinity – 1/1/2022

Service Locations (You must have an office in one of these locations to contract with the plan)

  • MetroPlus – (Boroughs) Bronx, Brooklyn, Manhattan, and Queens
  • Affinity – (Counties) Kings, New York, Nassau, Orange, Queens, Richmond, Suffolk, Rockland, and Westchester

What If I have Current Patients with this coverage and I am not in one of the above locations?

You must transfer the patients to an in-network provider before the effective date.  You will not be able to see these patients as “self-pay” since these are Medicaid plans.

Do I need to be a Medicaid Provider to contract with these plans?

Yes.  You may have been added to these plans as a contracted provider with Beacon, even if you were not participating with Medicaid, but this will no longer be the case for these 2 plans.

If you would like Health Assets to submit an application to MetroPlus, Affinity, or Medicaid on your behalf, there is a fee of $230 for our billing clients, $400.00 for our credentialing-only clients.  If you do not wish to credential with MetroPlus, Affinity and/or Medicaid, we advise that you review your Beacon Health patients’ insurance cards to identify those with MetroPlus or Affinity plans, so they can be provided ample time to find a new provider in their network.  Please reach out if you would like to proceed with the application(s) and we will send out a work order.

Please feel free to reach out with any questions.

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Carmel L Gold, LCSW
Advisor
Health Assets Management, LLC