Medicaid Advantage Plus


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What is Wellcare Fidelis Dual Plus (HMO D-SNP)?

Wellcare Fidelis Dual Plus is a health plan for individuals who have Medicare and Medicaid coverage. Enrollment in the program includes coverage for all of your Medicare and Medicaid services.

Members enrolled in Wellcare Fidelis Dual Plus plans receive individualized support and flexible care planning to help them live in their own homes and communities for as long as possible. This plan is a Medicaid Advantage Plus (MAP) plan, which means both your Medicaid and Medicare benefits are provided by the same insurance provider.

At a glance, benefits in 2024 include:

  • Home health aides
  • Adult day health care
  • Some mental health services
  • Dental care
  • Nursing home care 
  • Doctor visits
  • Hospital stays
  • $0 prescription copays*
  • Wellcare Spendables card to use toward the purchase of healthy food, over the counter items, assistance with utilities, and more.

Moreover, your traditional fee-for-service (FFS) Medicaid benefit may fund some services not covered by MAP, such as specific behavioral health services. For a full list of benefits, please review the Summary of Benefits for Wellcare Fidelis Dual Plus 003 and Wellcare Fidelis Dual Plus 008.

Who is eligible for Wellcare Fidelis Dual Plus?

Individuals are eligible for a MAP plan in New York if they are: 
  • 18 years or older
  • Eligible for Medicare Part A and Part B and enrolled in both programs
  • Eligible for full Medicaid (FBDE & QMB+)
  • Eligible for nursing home level of care:
    • Require long-term care for more than 120 days from the date that they join our plan, including: nursing services and/or therapies in the home, home health aide services, personal care services, adult day health care, private duty nursing, or consumer directed personal assistance services
  • Capable at the time of enrollment of returning to or remaining in their home or community without jeopardy to their health

Where is Wellcare Fidelis Dual Plus Available?

Wellcare Fidelis Dual Plus is available in 52 counties in New York State. The downstate plan is Wellcare Fidelis Dual Plus (HMO D-SNP) Plan 003. It is available in the following counties:

  • Bronx
  • Kings
  • Nassau
  • New York
  • Queens
  • Richmond
  • Rockland
  • Suffolk
  • Westchester

The upstate plan is Wellcare Fidelis Dual Plus (HMO D-SNP) Plan 008. It is available in the following counties:

  • Albany
  • Allegany
  • Broome
  • Cattaraugus
  • Cayuga
  • Chemung
  • Chenango
  • Clinton
  • Columbia
  • Cortland
  • Delaware
  • Dutchess
  • Erie
  • Essex
  • Franklin
  • Fulton
  • Greene
  • Hamilton
  • Lewis
  • Montgomery
  • Niagara
  • Oneida
  • Onondaga
  • Orange
  • Orleans
  • Oswego
  • Otsego  
  • Putnam
  • Rensselaer
  • Saratoga
  • Schenectady
  • Schoharie
  • Schuyler
  • Seneca
  • St. Lawrence
  • Steuben
  • Sullivan
  • Tioga
  • Ulster
  • Warren
  • Washington
  • Wyoming
  • Yates

MAP Care Management

Wellcare Fidelis Dual Plus provides coordinated patient-centered care. This means doctors, therapists, and caregivers work together with the member to ensure the best care and treatment. 

Members will be given a care manager, who works for Wellcare By Fidelis Care and whose responsibility it is to make sure the member receives the help he or she needs. In order to support a member's care plan, the care manager also assists in coordinating access to non-covered services that are related to the covered services. 


Ready to enroll?

To enroll in Wellcare Fidelis Dual Plus plan, you will need a Conflict Free Evaluation and Enrollment Center Evaluation. Call us at 1-800-860-8707; (TTY: 711) to schedule an evaluation. From October 1 to March 31, our hours are 7 days a week from 8 a.m. to 8 p.m. From April 1 to September 30, our hours are Monday through Friday from 8 a.m. to 8 p.m.

If you are not currently receiving Community Based Long Term Care (CBLTC) services or have not received CBLTC services in 45 days, you need to call 1- 855-222-8350 (TTY: 1-888-329-1541) from Monday through Friday 8:00 a.m. to 8:00 p.m. to arrange for a  New York Independent Assessors Program (NYIAP) evaluation.

To quickly compare Medicaid Advantage Plus (MAP) health plan options through the New York State of Health website, click here.

*Medicare approved Wellcare By Fidelis Care to provide these benefits and lower copayments as part of the Value-Based Insurance Design program. This program lets Medicare try new ways to improve Medicare Advantage plans.

**Benefits mentioned may be a part of Special Supplemental Benefits for the Chronically Ill. Not all members will qualify.


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Additional Information

Wellcare is the Medicare brand for Centene Corporation, an HMO, PPO, PFFS, PDP plan with a Medicare contract and is an approved Part D Sponsor. Our D-SNP plans have a contract with the state Medicaid program. Enrollment in our plans depends on contract renewal.

From October 1 to March 31, you can call us 7 days a week from 8 a.m. to 8 p.m. From April 1 to September 30, you can call us Monday through Friday from 8 a.m. to 8 p.m. A messaging system is used after hours, weekends and on federal holidays.

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Last Updated 10.1.2023