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Medicaid Managed Care Members

Welcome! Fidelis Care is proud to be your healthcare partner.


Get Started

Take charge of your health! Get the care and services you need to stay as healthy as possible.
Step 1: Sign Up for Our Member Portal

The Member Portal is the easiest way to get information about your plan. You will have 24/7 access to your account. You can:

  • View and print new ID cards
  • Check your claims
  • Access your plan documents
  • Choose to get certain notices electronically
  • Create an account now. Visit members.fideliscare.org and click “Register.”

    If you need help creating your Member Portal account, watch this video.

    Step 2: Fill Out Your Health Risk Assessment
    The Health Risk Assessment is a brief survey. It helps us understand your healthcare needs and get you connected to services. Complete the survey that came in your welcome materials which is mailed within 14 days of coverage. Then mail it to us in the postage-paid envelope.
    Step 3: Get to Know Your Benefits

    Fidelis Care's Medicaid Managed Care plan offers a wide range of services. They include:

  • No-cost annual checkups
  • Immunizations
  • Preventive care
  • Routine screenings
  • Hospital and emergency care
  • Mental health and substance use services (no PCP referral needed)
  • Transportation to doctor visits
  • Eye exams
  • Dental care
  • Family planning
  • You can learn more about your benefits by reading your Member Handbook. To request a paper copy, call Fidelis Care at 1-888-FIDELIS (1-888-343-3547); TTY: 711. 

    Fidelis Care offers Care Management services to help members who need extra health support with scheduling healthcare appointments or arranging transportation to your doctor's visit. To see if you are eligible for Care Management Services or to enroll in our texting program, call 1-800-247-1441 (TTY: 711) from 8:30 AM to 5 PM Monday through Friday.

    Step 4: Choose a Primary Care Provider

    Fidelis Care wants to make sure you get the best care. A primary care provider (PCP) helps keep you healthy. If you already have a PCP who is in the Fidelis Care network, then that provider should have been automatically assigned as your PCP. You can view, confirm or change your PCP from your Member Portal account. If you need help changing your PCP through the member portal, watch this video.

    Find PCPs near you by using our Find a Doctor tool. Watch this video if you need help with the 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.

    Step 5: Schedule Your Annual Checkup
    It’s important to get a checkup every year to see if there are any changes to your health. Your PCP can help you stay well and take control of your health. There is no copay for your annual checkup.

    Here are some questions you might ask your PCP:

  • Do I need any vaccinations?
  • Do I need any health screenings or blood tests?
  • Do I need any changes to my prescriptions?
  • What lifestyle changes can I make to improve my health?
  • When should I schedule my next visit?
  • Follow your PCP’s advice. Listen to your PCP and ask questions if you don't understand. Be sure to keep all follow-up visits. Also, take medications as prescribed.

    Member Portal

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

    Member Resources

    Click below to view reference documents. Remember, you can always log in to the Member Portal to view your handbook and benefits.

    Plan Basics

    Your Medicaid Managed Care plan offers comprehensive coverage for children and adults. There are no copays for covered services, including preventive services. Always check with your PCP to find out if a referral is required for any additional health services you might need.

    Your coverage also helps you:

  • Get high quality care. Access high quality in-network care for little to no out of pocket cost.
  • Stay healthy. Health insurance helps you get preventive care that keeps you healthy and in touch with a doctor.
  • Prepare for the unexpected. If you or a family member has an emergency or becomes seriously ill, health insurance helps give you peace of mind knowing your healthcare needs will be met.

  • You can also review common health insurance terms to help you better understand your plan.

    Prescription Drug Information
    NYRx

    Members enrolled in Fidelis Care Medicaid Managed Care receive their pharmacy benefits through NYRx, the Medicaid Fee-for-Service (FFS) Pharmacy Program.

    For additional resources, visit our pharmacy webpage.

      Member Handbook, Inserts and Notices
      Member Handbook

      Medicaid Managed Care Member Handbook


      Member Handbook Inserts

      Behavioral Health Appointment Wait Times  (Effective July 1, 2025)

      Children and Family Treatment and Support Services (CFTSS) (Effective January 1, 2020)

      Children's Home and Community Based Services (Effective July 1, 2024)

      Chronic Disease Self-Management Program (CDSMP) for Arthritis (Effective June 1, 2025)

      Dental Services (Effective January 31, 2024)

      Doula Services (Effective April 1, 2025)

      Electronic Notice Option

      Family Planning  (Effective January 1, 2025)

      Medicaid NYRx, the Medicaid Pharmacy Program (Effective April 1, 2023)

      Mobile Crisis Telephonic Triage Response Service (Effective March 1, 2024)

      Social Care Network (SCN) (Effective January 1, 2025)

      Undocumented Non-Citizens Age 65 and Over


      Member Notices

      Applied Behavior Analysis (ABA) Therapy  (Effective January 1, 2023)

      Gambling Disorder Treatment  (Effective January 1, 2023) 

      Healthmap Kidney Health Management

      Social Care Network and Support Services

      You may be eligible for free access to support services through a Social Care Network. A Social Care Network (SCN) is a group of local community organizations that will provide essential support for housing, nutrition, transportation, and care management. SCNs are designed to help you and your family thrive. Visit our Social Care Network page for more information.

      There also are other community and government resources that may be available to you, including the Supplemental Nutrition Assistance Program (SNAP) and the Home Energy Assistance Program (HEAP). To learn more about available services, visit our Health-Related Social Needs page.

      Renew Your Coverage

      You need to renew your health insurance every year. We can help answer all your questions so you stay covered. 



      Connecting with a Primary Care Provider (PCP)

      Having a PCP can improve your healthcare and overall well-being.Our videos can guide you through:
      • Finding a PCP near you
      • Changing your PCP through the member portal 

      Schedule your annual checkup.
      Click here to learn why an annual checkup matters.

      Need help? Call Fidelis Care at 1-888-FIDELIS (1-888-343-3547).



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      Visit a Dentist

      Medicaid 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-Icon

      Schedule an Eye Exam

      Vision coverage is included as part of the Medicaid 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

      Shot-Icon

      Get Your Immunizations

      Fidelis Care encourages you to get flu vaccine every year and any other recommended vaccines. The vaccines are free as part of your Medicaid coverage. Learn more about other important immunizations and talk to your PCP about the vaccines that are right for you. 

      We're here to help!

      Contact Fidelis Care with any questions you may have.

      Are You Turning 18 Years Old Soon?

      When you turn 18, you become a legal adult and your role will change regarding your health. Click here to learn more.


      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.

      Electronic Noticing

      Go paperless! You can choose to get some of your notices electronically.

       

      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 healthcare. 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)

      Language Assistance Services (PDF)

      Notice of Non-Discrimination (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.