Fidelis Care is a managed care organization that provides Medicaid coverage to people in New York State. It is committed to providing high-quality, affordable health care to its members. Fidelis Care uses a variety of tools and strategies to improve the health of its members, including care management, preventive care, and member education. The organization also works closely with providers to ensure that members receive the care they need. Fidelis Care is a valuable resource for people in New York State who need health insurance.
Fidelis Care: A Comprehensive Health Plan for Medicaid Recipients
Fidelis Care is a prominent health plan that offers comprehensive and high-quality healthcare services to individuals and families enrolled in Medicaid. It is a not-for-profit health plan founded in 1993 and has been dedicated to delivering accessible and affordable healthcare to low-income New Yorkers. Fidelis Care is committed to providing its members with a wide range of medical services, preventive care, and support programs to improve their overall health and well-being.
Eligibility for Fidelis Care
- Fidelis Care is available to individuals and families who meet the eligibility criteria for Medicaid in New York State.
- Eligibility is determined based on factors such as income, family size, and specific circumstances.
- Individuals can apply for Fidelis Care through the New York State Department of Health or through community-based organizations that assist with enrollment.
Benefits of Fidelis Care
Fidelis Care provides a comprehensive range of healthcare benefits to its members, including:
- Medical care: Fidelis Care covers a wide range of medical services, including doctor visits, hospitalizations, specialist care, and prescription drugs.
- Preventive care: The plan emphasizes preventive care to promote good health and early detection of potential health issues. Members have access to routine checkups, screenings, and vaccinations.
- Mental health and substance use disorder services: Fidelis Care provides support for individuals struggling with mental health conditions or substance use disorders. Services include therapy, counseling, and medication management.
- Dental and vision care: Fidelis Care offers dental and vision coverage to its members, ensuring they receive necessary preventive and routine care to maintain their oral and eye health.
Provider Network
Fidelis Care has a vast network of healthcare providers, including doctors, specialists, hospitals, and clinics. Members have the flexibility to choose their healthcare providers within the network, allowing them to access quality care that meets their unique needs and preferences.
Member Services
- Fidelis Care offers a range of member services to ensure satisfaction and support. These services include:
- 24/7 customer service: Members can access customer service representatives around the clock to address their inquiries, concerns, or schedule appointments.
- Online portal: Members have access to a secure online portal where they can view their coverage information, manage appointments, and communicate with their care providers.
- Care management programs: Fidelis Care provides personalized care management programs to members with chronic conditions, helping them manage their conditions and achieve better health outcomes.
How to Enroll in Fidelis Care
To enroll in Fidelis Care, individuals can follow these steps:
- Determine eligibility: Individuals can check their eligibility for Medicaid through the New York State Department of Health website or by contacting a community-based organization that assists with enrollment.
- Complete an application: Once eligibility is confirmed, individuals can complete an application for Fidelis Care either online or through a paper application.
- Submit the application: The completed application can be submitted online, by mail, or in person at a designated enrollment center.
- Enrollment confirmation: Once the application is processed, individuals will receive a confirmation of enrollment and information about their coverage and benefits.
| Service | Description |
|---|---|
| Medical Care | In-patient and out-patient care, specialist visits, prescription drugs |
| Preventive Care | Routine checkups, screenings, vaccinations |
| Mental Health and Substance Use Disorder Services | Therapy, counseling, medication management |
| Dental and Vision Care | Routine and preventive dental and eye care |
| Provider Network | Vast network of doctors, specialists, hospitals, and clinics |
| Member Services | 24/7 customer service, online portal, care management programs |
| Enrollment | Eligibility check, application process, confirmation of enrollment |
Eligibility Requirements for Medicaid Provided by Fidelis Care
Fidelis Care provides Medicaid coverage to eligible residents of New York State. To qualify for Medicaid through Fidelis Care, individuals must meet certain eligibility requirements, which vary based on age, income, and family situation.
Income Eligibility
- For individuals under age 19: Gross income must be below 133% of the Federal Poverty Level (FPL).
- For pregnant women: Gross income must be below 266% of the FPL.
- For parents and caretaker relatives: Gross income must be below 133% of the FPL for a family of three, with limits increasing for larger families.
- For people with disabilities: There is no income limit, but assets must be below $10,000 for an individual or $30,000 for a couple.
- For people 65 and older: There is no income limit, but assets must be below $10,000 for an individual or $30,000 for a couple.
Other Eligibility Factors
- Residency: Individuals must be New York State residents.
- Citizenship and Immigration Status: U.S. citizens, lawful permanent residents, and certain qualified non-citizens may be eligible.
- Age and Disability: Medicaid is available to children under age 19, pregnant women, people with disabilities, and people age 65 and older.
| Group | Gross Income Limit (% of FPL) |
|---|---|
| Individual under age 19 | 133% |
| Pregnant women | 266% |
| Family of three (parents and caretaker relatives) | 133% |
| People with disabilities | No income limit |
| People age 65 and older | No income limit |
To apply for Medicaid through Fidelis Care, individuals can:
- Visit the Fidelis Care website to apply online.
- Call the New York State Department of Health Medicaid hotline at 1-800-541-2831.
- Visit a local Medicaid office.
Fidelis Care Medicaid: Benefits and Eligibility
Fidelis Care Medicaid is a health insurance program that provides comprehensive coverage to low-income individuals and families. The program is administered by the New York State Department of Health and Human Services and offers a wide range of benefits, including medical, dental, vision, and prescription drug coverage. To be eligible for Fidelis Care Medicaid, individuals and families must meet certain income and residency requirements.
Benefits Covered under Fidelis Care Medicaid
- Medical Coverage: Fidelis Care Medicaid covers a wide range of medical services, including doctor’s visits, hospital stays, surgeries, and emergency care. The program also provides coverage for preventive care, such as screenings and vaccinations.
- Dental Coverage: Fidelis Care Medicaid covers a variety of dental services, including cleanings, fillings, and extractions. The program also provides coverage for dentures and other dental appliances.
- Vision Coverage: Fidelis Care Medicaid covers routine eye exams and eyeglasses or contact lenses. The program also provides coverage for certain eye surgeries.
- Prescription Drug Coverage: Fidelis Care Medicaid covers a wide range of prescription drugs, including generic and brand-name medications. The program also provides coverage for certain over-the-counter medications.
- Additional Coverage: Fidelis Care Medicaid also provides coverage for a variety of additional services, including transportation to medical appointments and home health care.
Eligibility for Fidelis Care Medicaid
To be eligible for Fidelis Care Medicaid, individuals and families must meet certain income and residency requirements. Income limits vary depending on the size of the household and the age and disability status of the applicant. Residency requirements vary depending on the county in which the applicant lives. To apply for Fidelis Care Medicaid, individuals and families can contact their local Department of Social Services office.
Benefits Comparison Table
| Benefit | Covered Services |
|---|---|
| Medical Coverage | Doctor’s visits, hospital stays, surgeries, emergency care, preventive care |
| Dental Coverage | Cleanings, fillings, extractions, dentures, dental appliances |
| Vision Coverage | Routine eye exams, eyeglasses or contact lenses, certain eye surgeries |
| Prescription Drug Coverage | Generic and brand-name medications, certain over-the-counter medications |
| Additional Coverage | Transportation to medical appointments, home health care |
What is Fidelis Care Medicaid?
Fidelis Care Medicaid is a government-sponsored health insurance program that provides coverage to low-income individuals and families in New York State. The program is jointly funded by the federal and state governments. Fidelis Care is a Managed Care Organization (MCO) that has been contracted by the state to provide Medicaid benefits to eligible individuals.
How to Apply for Fidelis Care Medicaid
Who is Eligible?
- Pregnant women
- Children under 19 years of age
- Parents or caretakers of children under 19 years of age with income below certain limits
- Adults with disabilities
- Adults 65 years of age or older
How to Apply
- You can apply for Medicaid online at the New York State of Health website. You can also apply in person at a local Department of Social Services (DSS) office. You can also apply over the phone at the number provided on the DSS website.
- You will need to provide proof of identity, residency, and income. You will also need to provide information about your household composition and any medical conditions you have.
- Once you have submitted your application, it will be reviewed by the DSS. You will be notified of the status of your application within 45 days.
- If you are approved for Medicaid, you will be issued a Medicaid card. You can use this card to get medical care from any provider that accepts Medicaid.
Benefits of Fidelis Care Medicaid
- Free or low-cost health care
- Coverage for a wide range of medical services, including doctor visits, hospital care, prescription drugs, and mental health services
- No or low co-payments or deductibles
- Access to a network of healthcare providers that accept Medicaid
How to Find a Fidelis Care Medicaid Provider
You can find a Fidelis Care Medicaid provider by using the online provider directory. You can also call the customer service number on your Medicaid card to get help finding a provider.
| Phone Number | Website |
|---|---|
| 1-888-FIDELIS (1-888-343-3547) | www.fideliscare.org |
And that’s a wrap folks! I hope this article has helped you understand the ins and outs of Fidelis Care Medicaid. It’s a complex topic, I know, but I tried to break it down in a way that’s easy to understand. If you have any other questions, feel free to reach out to Fidelis Care directly. And don’t forget to check back later, as I’ll be updating this article with any new information or changes to the program. Thanks for reading!