Fidelis Care, a prominent player in the insurance landscape, offers a diverse range of coverage options tailored to meet the needs of various individuals and families. From Medicaid and Medicare to commercial plans, Fidelis Care provides comprehensive protection against healthcare expenses.
In this comprehensive guide, we delve into the intricacies of Fidelis Care insurance, exploring the types of coverage available, eligibility criteria, benefits, and more. Whether you’re seeking Medicaid assistance, Medicare coverage, or commercial insurance, this guide will provide valuable insights to help you make informed decisions about your healthcare needs.
Overview of Fidelis Care
Fidelis Care is a not-for-profit health insurance company that provides affordable, quality health coverage to low-income New Yorkers. Fidelis Care offers a range of insurance plans, including Medicaid, Child Health Plus, and Qualified Health Plans (QHPs).
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Fidelis Care’s mission is to improve the health and well-being of the people of New York State by providing access to affordable, quality health insurance. Fidelis Care serves more than 2.2 million members across the state.
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Types of Insurance Coverage Offered by Fidelis Care
Fidelis Care offers a range of insurance plans to meet the needs of its members. These plans include:
Medicaid
Child Health Plus
Qualified Health Plans (QHPs)
Medicaid is a government-funded health insurance program for low-income individuals and families. Child Health Plus is a government-funded health insurance program for children under the age of 19. QHPs are health insurance plans that are offered through the New York State of Health Marketplace.
Target Audience for Fidelis Care Insurance Plans
Fidelis Care’s target audience is low-income New Yorkers. This includes individuals and families who are eligible for Medicaid or Child Health Plus, as well as individuals and families who are looking for affordable health insurance plans through the New York State of Health Marketplace.
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Fidelis Care is committed to providing affordable, quality health insurance to all New Yorkers. The company’s mission is to improve the health and well-being of the people of New York State.
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Fidelis Care Medicaid Coverage: What Type Of Insurance Is Fidelis Care
Fidelis Care is a Medicaid managed care provider that offers a range of health insurance plans to low-income individuals and families in New York State. Medicaid is a government-sponsored health insurance program that provides coverage for essential health services to those who meet certain income and eligibility requirements.
Fidelis Care Medicaid plans provide comprehensive coverage for a wide range of health care services, including:
Doctor visits
Hospital stays
Emergency care
Prescription drugs
Mental health services
Substance abuse treatment
Dental care
Vision care
Eligibility Criteria, What type of insurance is fidelis care
To be eligible for Fidelis Care Medicaid, you must meet certain income and residency requirements. Generally, you must be a New York State resident and have an income that is below a certain level. The income limits vary depending on your family size and other factors.
You can apply for Fidelis Care Medicaid online, by phone, or by mail. You can also apply in person at a local Medicaid office.
Benefits and Services
Fidelis Care Medicaid plans offer a range of benefits and services to help you stay healthy. These benefits include:
Access to a network of providers
Preventive care services
Chronic disease management
Case management
Transportation to medical appointments
Translation services
Fidelis Care Medicaid plans also offer a variety of optional benefits, such as:
Dental care
Vision care
Over-the-counter medications
Transportation to non-medical appointments
Fidelis Care Medicare Coverage
Fidelis Care offers a range of Medicare coverage options to meet the needs of individuals 65 and older, or those with certain disabilities. These plans provide comprehensive coverage for a wide range of healthcare services, including hospital stays, doctor visits, prescription drugs, and more.
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There are several different types of Fidelis Care Medicare plans available, including:
Medicare Advantage (MA) plans: These plans combine Medicare Part A (hospital insurance) and Part B (medical insurance) into a single, comprehensive plan. MA plans typically offer additional benefits, such as prescription drug coverage, vision and dental care, and fitness programs.
Medicare Supplement (Medigap) plans: These plans help to cover the out-of-pocket costs associated with Original Medicare, such as deductibles, copayments, and coinsurance.
Prescription drug plans (Part D): These plans provide coverage for prescription medications.
To be eligible for Fidelis Care Medicare plans, individuals must meet certain requirements, including:
Be 65 years of age or older, or have certain disabilities
Be a resident of New York State
Be enrolled in Medicare Part A and Part B
The benefits and services covered by Fidelis Care Medicare plans vary depending on the type of plan selected. However, all plans provide coverage for essential healthcare services, such as:
Hospital stays
Doctor visits
Prescription drugs
Preventive care
Mental health care
Fidelis Care Medicare plans also offer a number of additional benefits, such as:
Vision and dental care
Fitness programs
Transportation to medical appointments
Fidelis Care Commercial Insurance
Fidelis Care offers a range of commercial insurance plans tailored to meet the needs of individuals, families, and businesses. These plans provide comprehensive coverage for various health care expenses, including medical, dental, vision, and prescription drugs.
Fidelis Care commercial plans offer a wide range of coverage options and benefits, including:
Preventive care services
Hospitalization
Doctor visits
Prescription drug coverage
Mental health and substance abuse treatment
Dental and vision care
To be eligible for Fidelis Care commercial insurance, individuals must meet certain criteria, such as:
Residing in the Fidelis Care service area
Not being eligible for other health insurance programs, such as Medicare or Medicaid
Meeting income and asset requirements
Individuals can apply for Fidelis Care commercial insurance through the New York State of Health Marketplace or directly through Fidelis Care.
Fidelis Care Provider Network
Fidelis Care offers a comprehensive network of providers to ensure that members have access to quality healthcare services. The network includes primary care physicians, specialists, hospitals, and other healthcare facilities. Members can choose from a wide range of providers to find the right fit for their needs.
To find in-network providers, members can use the Fidelis Care website or mobile app. The website allows members to search for providers by location, specialty, and other criteria. Members can also call Fidelis Care’s customer service number for assistance.
Referrals and Authorizations
Some Fidelis Care plans require members to obtain referrals from their primary care physician before seeing a specialist. Referrals can be obtained by calling the member’s primary care physician’s office. Members may also need to obtain prior authorization from Fidelis Care before receiving certain services, such as surgery or hospitalization. Prior authorization can be obtained by calling Fidelis Care’s customer service number.
