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.

Contact a Representative Today to Determine your Eligibility for QHP


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, Gold and Silver Wellness and Silver One plans will include acupuncture visits.


    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.



    Formularies


     

    Benefit Comparisons

    2022

     

    2021



    How to Enroll

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

    • Call 1-888-FIDELIS (1-888-343-3547), TTY: 711
    • Find a Fidelis Care office near you. Make an appointment, or visit during regular business hours!
    • Enroll Online via NY State of Health. Visit www.nystateofhealth.ny.gov and click on "Start Enrollment."
    • Select the 'Get Started' button below to contact a certified representative at Fidelis Care.

     

    Get Coverage Today

    Tell us more about yourself to find qualifying plans and estimate costs.

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