11/7/2018
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Posted by Fidelis Care
in
Provider News
As your health care partner, Fidelis Care is notifying you about key changes to how we will manage our members’ benefits for family planning and reproductive health services. These changes will take place on January 1, 2019.
Starting January 1, 2019, Fidelis Care members will obtain family planning and reproductive health benefits by using their Fidelis Care Member ID card. There are no changes to our members’ covered family planning and reproductive health benefits. However, the changes in how members obtain these benefits from Fidelis Care are listed below by product.
| Product |
Entity providing coverage through 12/31/2018 |
Entity providing coverage as of 1/1/2019 |
| Medicaid Managed Care (including Healthier Life Health and Recovery Program) |
Medicaid FFS |
Fidelis Care |
| Child Health Plus |
Affinity, GHI/Emblem, Healthfirst |
Fidelis Care |
| NYS of Health Exchange, Essential Plan 1&2 |
Unified, IPA |
Fidelis Care |
| NYS Essential Plan 3&4 |
Medicaid FFS |
Fidelis Care |
| New York State of Health Exchange, Metal Level Products |
Unified, IPA |
Fidelis Care |
Members can obtain the following family planning services through Fidelis Care: birth control drugs, birth control devices (IUDs and diaphragms) that are available with a prescription, plus emergency contraception, sterilization, pregnancy testing, prenatal care, and abortion services. Members can also see a family planning provider for HIV and sexually transmitted infection (STI) testing and treatment and counseling related to their test results. Screenings for cancer and other related conditions are also included in family planning visits.
Members do not need a referral from their PCP and should present their Fidelis Care Member ID card to obtain these services from a participating family planning provider.
As a result of these changes, you should begin billing Fidelis Care directly for any such services provided on or after January 1, 2019.
If you have any questions, please contact Provider Services at 1-888-FIDELIS (1-888-343-3547).
Please visit our Family Planning webpage to read family planning member notices by plan.