Pharmacy Services

Update Regarding Pharmacy Benefit Change for Medicaid and HARP Members

4/9/2021 • Posted by Provider Relations

Providers, please be aware that your Medicaid and HARP patients recently received a letter from Fidelis Care informing them that their pharmacy benefit was going to change from CVS Caremark to fee-for-service Medicaid effective May 1. However, as part of the recently approved New York State budget,  no changes will be made to the pharmacy benefit.  Your patients will continue to use their Fidelis Care ID card to access their pharmacy benefit, and  no action is needed from you or your patients. Fidelis Care is proud to be your health care partner, and thank you for your assistance on this important update.


Click the categories below for important pharmacy documents and resources. 

Formularies

Child Health Plus (CHP)

2021 Drug Formulary (PDF)

2021 Formulary Quick Reference Guide (PDF)


HealthierLife (HARP) and Medicaid Managed Care

2021 Drug Formulary (PDF)

2021 Formulary Quick Reference Guide (PDF)


Qualified Health Plans (Metal-Level Products)

2021 Formulary (PDF)


Essential Plan

2021 Formulary (PDF)


Fidelis Medicare Advantage and Dual Advantage Plans

2021

2021 Formulary (PDF)

Changes to Fidelis Care’s Medicare Formulary (PDF)

2021 Step Therapy Criteria (PDF)

2021 Prior Authorization (PA) Criteria (PDF)


Provider Access Online

Verify member eligibility, check claims, and more.

Manuals and Forms

Provider manuals, tip sheets, important forms, and applications. 

Authorization Grids

Authorization Grids for Medicare, Medicaid, CHP, and NYSOH Marketplace plans.