Pharmacy Services
Express
Scripts
Fidelis Care is pleased
to announce that, effective January 1, 2024, Express Scripts® began processing
pharmacy claims for our plan members.
Providers can direct
members to call the Member Services phone number listed on their ID card should
they have questions about this change. Alternatively, Fidelis Care has created
an
Express
Scripts FAQ
for providers to reference in order to assist members. The FAQ
also includes information on mail order services for members that are currently
using this method of delivery.
Please note that Acaria
remains in network under Express Scripts as an option for your members
Specialty Medication needs.
For additional questions,
or if we can be of assistance in any way, please contact your Fidelis Care
Provider Relations Specialist. To find your designated representative, please
visit
Contact
Your Designated Provider Relations Specialist
.
NYRx
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. Please note, members will continue to receive their medical benefits through Fidelis Care.
Certain durable medical equipment such as nebulizers, wheelchairs, hospital beds, etc are available under the Fidelis Care medical benefit for these members. For a complete list of covered items, please refer to section 4.4, 4.5, 4.6, and 4.7 in The New York DMEPOS Manual. Please use the Find-A-Doc Tool to locate a Durable Medical Equipment supplier.
Drug Shortage Information
Please refer to the FDA website for the most current and full list of drug shortages. Please refer to the plan-specific formulary for a full comprehensive list of potential alternatives. For NYM/HARP Plans, please refer to the State's Preferred Drug List.