Qualified Health Plan Products
Fidelis Care Qualified Health Plan Products are standardized plans offered by Fidelis Care via NY State of Health, the Official Health Plan Marketplace.
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.
Treatment Cost Calculator
Availability
Qualified Health Plans are available during Open Enrollment.
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
- Fitness Reimbursement Program
- Mail Order Pharmacy Program
Beginning in 2020, Qualified Health Plan members can elect dental and vision coverage.
Click here for copies of our 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.
Benefit Comparisons
2020
Compare 2020 Qualified Health Plans
Compare 2020 Qualified Health Dental and Vision Plans
Compare 2020 Silver Plans
How to Enroll
Once you know the health coverage you qualify for, there are three ways you can enroll: