• Grievances

  • A grievance is a complaint about any problem you had with Affinity or one of our network providers. A grievance can be filed by the member, or by a person the member authorizes to act on his/her behalf.

    If the grievance is about something Affinity can correct, such as updating your address, we will do so immediately upon notification. Other types of grievances may require time for Affinity to research and respond.

    In order for Affinity to respond, you must make your grievance known to us within 60 calendar days of the incident.

    You may file a grievance with Affinity either by telephone or in writing.

    By telephone:

    • Contact Customer Service at 877.234.4499. Calls to this number are free. We are open 8:00 am to 8:00 pm, Monday through Sunday. TTY users can call 711.
    • If you do not wish to call (or you called and were not satisfied), you can put your grievance in writing and send it to us. If you put your grievance in writing, we will respond to your grievance in writing.

    In writing:

    Send your written grievance to

    Affinity Health Plan Customer Service/Medicare
    Affinity Health Plan
    Metro Center Atrium
    1776 Eastchester Road
    Bronx, NY 10461

    Affinity will send an acknowledgement letter within 5 days of receiving your grievance. The letter will summarize your grievance, tell you who is working to resolve your grievance, how to contact this person, and whether we need more information from you. We will notify you by mail of our decision about your grievance as quickly as your case requires, based on your health status, but no later than 30 days after receiving your grievance. However, the timeframe can be extended by up to 14 days if you request an extension, or if we need additional information to make a decision that is in your best interest.

  • Pharmacy Grievances

  • A grievance is a complaint about any problem you had with Affinity or one of our network pharmacies. Grievances do not relate to payment for or approval of a prescription drug, which are known as coverage determinations.

    Contact Us Immediately

    If you (your appointed representative) have a grievance, please:

    • Call Customer Service:
      866.362.4002
      TTY: 711
    • Fax: 866.633.7673
    • Mail:
      CVS Caremark Inc
      Part D Services
      MC109
      P.O. Box 52000
      Phoenix, AZ 85072-2000

    Expedited Grievances

    If you are grieving the decision by Affinity not to expedite an initial determination or an appeal, you can request an expedited grievance. In these situations, Affinity will respond to you within 24 hours.