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With a $0 premium, the Essential Plan offers low-cost coverage, including free preventive care, to eligible New Yorkers who don’t qualify for Medicaid or Child Health Plus. Coverage includes no-cost dental and vision, as well as a low or no-cost prescription benefit.
Medicaid Managed Care offers comprehensive coverage with no copays for covered services and no monthly premium for those who qualify. Who can apply? Children and adults who meet income, resource, age, and/or disability requirements can apply for Medicaid.
Interested in New York State Health Insurance or in need of customer support? We'll connect you with the right Fidelis Care Representative.
Members in Medicaid and HARP receive prescription drugs through NYRx, the Medicaid Pharmacy Program effective April 1, 2023. For all other members with pharmacy coverage, your benefits are covered by Express Scripts.
Use our 'Find-A-Doctor' Tool to find a local physician in New York who fits your personal plan! For members and prospective members interested in NY Health Insurance plans.
The Essential Plan is for New Yorkers who do not qualify for Medicaid or Child Health Plus, but still need access to quality health care. Fidelis Care offers five income-based tiers of the Essential Plan – all with $0 premium.
Fidelis Care wants members to know that your health insurance is no longer being automatically renewed. If you are a member in Medicaid Managed Care, Essential Plan, HealthierLife (HARP), or Child Health Plus, you MUST RENEW your health insurance to keep your coverage without interruption.
Fidelis Care has partnered with Ophelia to provide free, fully virtual opioid use disorder treatment for all Fidelis Care, Ambetter from Fidelis Care, and Wellcare by Fidelis Care members. Ophelia is available in every county in New York State.
Effective April 1, 2023, members enrolled in Fidelis Care Medicaid Managed Care and HealthierLife (HARP) plans will receive their pharmacy benefits through NYRx, the Medicaid Fee-for-Service (FFS) Pharmacy Program. For more information regarding the pharmacy benefit transition, please visit NYRx, the Medicaid Pharmacy Program.
Clinical policies and payment policies (PDF) library for Fidelis Care & Centene providers in the NYS Health Insurance payment plans.