Welcome, Essential Plan Members

We are proud to be your healthcare partner and want to help you access essential health benefits and services to keep you as healthy as possible.

  • Important News for Members Moving from Ambetter from Fidelis Care to Essential Plan 200-250
  • Important Information Regarding Pregnancies for Essential Plan Members
  • Get Started

    Step 1: Sign Up for Our Member Portal

    The Member Portal is the easiest and most secure way to access information about your plan. With 24/7 access to your Fidelis Care account, you can view and print new ID cards, check your claims, and access your plan documents. To create a secure online member account, visit and click “Register.”

    Step 2: Fill Out Your Health Risk Assessment

    Return this brief survey to us in the postage-paid envelope provided with your welcome materials. The answers you provide will help us serve you better and get you connected to whatever services you may need.

    Step 3: Review Your Plan Documents

    You can access your Summary of Benefits and Coverage, Subscriber Contract, Formulary, and other important plan documents by logging into the Member Portal. The Summary of Benefits and Coverage outlines some of your plan’s key benefits, and explains how much they could cost. The cost examples are estimates only, and serve as a guide for how your particular plan might cover different conditions; not the exact dollar amount you will pay. Your Subscriber Contract provides a full description of the services included in your benefit package, as well as cost information for those services.

    Step 4: Choose a Primary Care Provider

    Fidelis Care is committed to ensuring you have access to the preventive care and screenings you need to stay healthy. To ensure that access, please select a Primary Care Provider (PCP) who can help make sure you get the care you need when you need it. You will not need a referral from your PCP to see a specialist.

    Find PCPs near you by using our Find a Doctor tool. Once you find a PCP, please call Member Services at 1-888-FIDELIS (1-888-343-3547); TTY: 711, and a Representative will update your account.

    If you are a new Essential Plan member, you are required to select a PCP. For members whose coverage renews on or after April 1, 2024, you will be required to select a PCP at the time of renewal. If you do not designate a PCP, Fidelis Care will assign a PCP to you. You can review your PCP from your Member Portal account.

    Step 5: Schedule Your Annual Checkup

    It’s important to see your PCP every year for a checkup to see if there are any changes to your health. Seeing your PCP every year can help you stay healthy and keep down your medical costs. Call your PCP to make an appointment. There is no copay for your annual checkup.

    Member Portal

    Log in or register to view and print ID cards, check your claims history, and much more.

    Member Resources

    Click a plan below to view reference documents. If you’re a member, log in to the Member Portal to view your contract and benefits

    Prescription Drug Information

    Your pharmacy benefits are covered by Express Scripts (by clicking on this link, you will leave the Fidelis Care website). Log in to your Member Portal account to easily access your pharmacy benefits.

    Mail Order Pharmacy
    Summaries of Benefits and Coverage
    Essential Plan 1
    Essential Plan 2 

    Essential Plan 3
    Essential Plan 4
    Essential Plan 200-250
    Subscriber Contracts
    Essential Plan 1
    Essential Plan 2
    Essential Plan 3
    Essential Plan 4
    Essential Plan 200-250
    Additional Benefits
    Virtual Support
    Fitness Reimbursement
    Prenatal Care Program


    Dental Benefits

    Essential Plan members receive dental coverage as part of their plan. Your benefits are covered through DentaQuest. Visit our DentaQuest Resource Page for more information on getting started, and preventive dental care best practices.


    Vision Benefits

    Vision coverage is included as part of the Essential Plan. Your benefits are covered through Davis Vision. Visit our Davis Vision Resource Page (by clicking on this link, you will leave the Fidelis Care website) for information on getting started. 

    To review Fidelis Care's best practice guidelines for healthy vision, click HERE


    Immunizations Coverage

    Fidelis Care encourages you to get flu and COVID-19 vaccines every year. The vaccines are free as part of your Essential Plan coverage. Learn more about other important immunizations and talk to your primary care provider about the vaccines that are right for you. 

    Find a Doctor

    Search for a medical professional, service, or facility in the Fidelis Care Network.

    Member Newsletter

    Read our latest member newsletter (HealthyNOW) and browse the archives.

    Understand Your Benefits

    Learn how health insurance helps manage expenses, and prepare for the unexpected.

    Renew Your Coverage

    Questions about renewing health insurance? Fidelis Care can help.

    Your Health Information is Protected

    The Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule provides national standards to protect individuals’ medical records and other personal health information. The Privacy Rule applies to all forms of your protected health information, whether electronic, written, or oral. 

    To learn more about HIPAA and your privacy rights, visit the U.S. Department of Health and Human ServicesBy clicking this link, you will leave the Fidelis Care website.

    Authorization to Use and Disclose Health Information (PDF)

    Revocation of Authorization to Use and/or Disclose Health Information (PDF)

    Member Rights and Responsibilities

    As a Fidelis Care member, you have a right to participate with practitioners in making decisions about your health care. You also have the right to be treated with respect and with recognition of your dignity and your right to privacy.

    General Statement of Member Rights and Responsibilities (PDF)

    Patient Bill of Rights (PDF)

    Important Information on Coverage Decisions

    Each day, Fidelis Care's Utilization Management (UM) Department makes decisions on many health insurance claims. These decisions are based only on appropriateness of care and the existence of coverage. 

    Fidelis Care does not reward providers or other individuals for issuing denials of coverage, and does not offer financial incentives to UM staff based on decisions that promote underutilization of services. 

    Fidelis Care is committed to ensuring that members have the care and services they need.