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Ambetter from Fidelis Care

Our Qualified Health Plans are changing their name to Ambetter from Fidelis Care in 2024. The standardized plans are available to qualifying families and individuals via NY State of Health, the Official Health Plan Marketplace.

Your Ambetter benefits include:

  • Telemedicine benefit with $0 copay
  • Preventive services and chronic disease management
  • Prescription drugs
  • Fitness Reimbursement Program
  • And more! (See below for more benefits)
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    Plans

    Plans fall into various "metal" levels based on their design and the level of cost sharing required: Platinum, Gold, Silver, Bronze, and Catastrophic Coverage. It is also possible to purchase these plans "off-exchange," or directly from Fidelis Care.


    Cost

    Premiums, copays, coinsurance, and deductibles vary by plan type.


    Benefits

    Our Qualified Health Plans either fully or partially cover a comprehensive list of benefits, including:

    • Dental and vision coverage options for the entire family*
    • Telemedicine benefit with 24/7 doctor visits with $0 copay
    • Preventive services and chronic disease management
    • Outpatient services
    • Emergency services
    • Hospitalization
    • Pregnancy, maternity, and newborn care
    • Mental health and substance use disorder services
    • Prescription drugs
    • Laboratory services
    • HSA-Compatible Bronze option to help cover and even lower healthcare costs
    • Fitness Reimbursement Program
    • Mail Order Pharmacy Program
    • Wellness and Silver One options that include acupuncture**

    *Gold and Silver Plan members can elect dental and vision coverage for an additional cost.
    ** In NYC, Westchester, and Rockland, Wellness and Silver One plans will include acupuncture visits.

    Mother getting telehealth visit

    Man exercising at gym

    Click here for copies of our Ambetter from Fidelis Care Qualified Health Plans' benefit and coverage summaries, drug formulary, and Subscriber Contracts. They have information about pharmacy and utilization management procedures, specific benefit inclusions and exclusions, and our provider network. To request paper copies, call Fidelis Care at 1-888-FIDELIS (1-888-343-3547); TTY: 711.


    Formularies


    How to Enroll

    Once you know the health coverage you qualify for, there are four ways you can enroll: