Fidelis Health Insurance, officially known as Fidelis Care, is one of the leading health insurance providers in New York State. As a part of Centene Corporation, Fidelis Care offers a wide range of health coverage plans for individuals, families, seniors, and those with special needs. With a strong mission to provide quality, affordable health coverage to all, regardless of income, Fidelis has become a trusted name across the healthcare landscape. This article explores the key features, plans, benefits, and eligibility requirements of Fidelis Health Insurance.
What is Fidelis Care?
Fidelis Care is a New York-based health insurance company that provides coverage through government-sponsored programs such as Medicaid, Child Health Plus, Essential Plan, Medicare Advantage, and Qualified Health Plans under the Affordable Care Act (ACA). The organization serves more than 2.3 million members statewide and has a deep-rooted commitment to health equity and accessibility.
Founded in 1993 by the Catholic Medical Center of Brooklyn and Queens, Fidelis Care has grown exponentially, providing coverage across all 62 counties of New York. In 2018, it became part of Centene Corporation, a Fortune 25 company and a leading multi-national healthcare enterprise.
Types of Fidelis Health Insurance Plans
Fidelis Care offers a variety of health plans tailored to different demographics and financial situations. Here’s a breakdown of the most popular options:
1. Medicaid Managed Care
Fidelis Care’s Medicaid Managed Care plan is available to individuals and families who meet New York State’s income and eligibility requirements. It covers doctor visits, hospital care, prescription drugs, preventive care, mental health services, and more — all at little to no cost.
2. Child Health Plus
This plan is specifically for children under the age of 19, regardless of family income. It includes regular checkups, dental and vision care, immunizations, hospital stays, and emergency services. Monthly premiums vary based on income, but many families qualify for free or low-cost coverage.
3. Essential Plan
The Essential Plan is a popular low-cost option for adults aged 19 to 64 who don’t qualify for Medicaid but still need affordable insurance. It includes all essential health benefits such as emergency services, maternity care, mental health services, and prescription drugs. Monthly premiums are either $0 or $20, depending on income.
4. Qualified Health Plans (Marketplace Plans)
Fidelis Care offers several ACA-compliant plans through the New York State of Health Marketplace. These plans are ideal for individuals and families without employer coverage. Subsidies may be available to lower monthly premiums and out-of-pocket costs.
5. Medicare Advantage (Fidelis Medicare Advantage Flex)
Designed for seniors aged 65 and older, this plan includes Medicare Part A and B benefits, with added services such as vision, hearing, dental, fitness, and over-the-counter benefits. It may also include prescription drug coverage (Part D).
6. HIV SNP (Special Needs Plan)
This specialized plan is for people living with HIV/AIDS. It includes comprehensive care management and access to providers with expertise in treating complex health conditions.
Key Benefits of Fidelis Health Insurance
Fidelis Care goes beyond just offering insurance. It focuses on complete care coordination and member support. Here are some standout features:
- Affordable Premiums: Many plans are free or have very low monthly premiums, making healthcare accessible for all income levels.
- Comprehensive Coverage: Fidelis plans cover preventive care, hospital services, maternity care, behavioral health, prescription drugs, and more.
- Large Provider Network: Fidelis Care has a wide network of hospitals, primary care physicians, and specialists across New York State.
- 24/7 Nurse Helpline: Members have access to healthcare professionals for advice any time, day or night.
- Telehealth Services: Many Fidelis plans include virtual visits for both medical and mental health services.
- Multilingual Support: Fidelis provides support in multiple languages, ensuring communication is never a barrier to care.
How to Apply for Fidelis Health Insurance
Applying for Fidelis Care is simple and can be done online, by phone, or in person. Here’s how:
- Online: Visit fideliscare.org to check eligibility and apply directly through the site.
- By Phone: Speak with a representative by calling the Fidelis Care toll-free number.
- In Person: Local Fidelis Care representatives are available throughout New York to assist with enrollment and plan selection.
- Through the NY State of Health Marketplace: If you’re applying for Marketplace or Essential Plans, you can do so through nystateofhealth.ny.gov.
Applicants will need to provide information such as proof of income, identification, Social Security numbers, and household size to determine eligibility and premium costs.
Who Is Eligible?
Eligibility depends on the type of plan and your household income. Here’s a general guide:
- Medicaid: Low-income individuals and families.
- Child Health Plus: All children under 19 who are New York residents.
- Essential Plan: Adults aged 19-64 not eligible for Medicaid.
- Qualified Health Plans: Anyone can apply, especially those not covered through work.
- Medicare Advantage: Individuals aged 65+ or those with certain disabilities.
Fidelis Care also has options for immigrants, refugees, and undocumented individuals, depending on plan eligibility and state guidelines.
Why Choose Fidelis Care?
Choosing a health insurance provider is a major decision, and Fidelis Care stands out for several reasons:
- Community-Based Approach: Fidelis has outreach teams across New York who connect with local communities and offer support.
- Trusted History: With over 30 years of experience, Fidelis is a trusted name in New York healthcare.
- Part of Centene: Backed by one of the largest healthcare enterprises in the U.S., members benefit from innovation, stability, and expanded services.
- High Member Satisfaction: Surveys often show strong satisfaction scores for customer service, ease of care access, and plan affordability.
Fidelis and Preventive Healthcare
Fidelis Care emphasizes preventive healthcare through initiatives that encourage regular check-ups, screenings, and vaccinations. These efforts aim to reduce long-term health risks and ensure early detection of serious conditions. Wellness programs, including smoking cessation and weight loss support, are also available.
Member Resources
Fidelis members have access to a user-friendly online portal and mobile app where they can:
- View ID cards
- Track claims and benefits
- Find doctors and hospitals
- Access health and wellness resources
These digital tools make it easy for members to stay informed and in control of their healthcare.
Final Thoughts
Fidelis Health Insurance offers a wide range of affordable, accessible health plans designed to meet the diverse needs of New York residents. Whether you’re a child, adult, senior, or individual with specific health needs, Fidelis Care provides the tools and coverage necessary to lead a healthier life.