Wellcare By Fidelis Care Notice of Privacy Practices

THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION.   PLEASE REVIEW IT CAREFULLY.

Covered Entity’s Duties

Wellcare By Fidelis Care is a Covered Entity as defined and regulated under the Health Insurance Portability and Accountability Act of 1996 (HIPAA). Wellcare By Fidelis Care is required by law to maintain the privacy of your protected health information (PHI), provide you with this Notice of our legal duties and privacy practices related to your PHI, abide by the terms of the Notice that is currently in effect and notify you in the event of a breach of your unsecured PHI. 

This Notice describes how we may use and disclose your PHI. It also describes your rights to access, amend and manage your PHI and how to exercise those rights. All other uses and disclosures of your PHI not described in this Notice will be made only with your written authorization. 

Wellcare By Fidelis Care reserves the right to change this Notice. We reserve the right to make the revised or changed Notice effective for your PHI we already have as well as any of your PHI we receive in the future. Wellcare By Fidelis Care will promptly revise and distribute this Notice whenever there is a material change to the following:

o   The Uses or Disclosures.

o   Your rights.

o   Our legal duties.

o   Other privacy practices stated in the notice.

We will make any revised Notices available on our website or through a separate mailing.

Internal Protections of Oral, Written, and Electronic PHI

Fidelis Care protects your PHI. We are also committed in keeping your race, ethnicity, and language (REL), and sexual orientation and gender identity (SOGI) information confidential. We have privacy and security processes to help.

• We train our staff to follow our privacy and security processes. 
• We require our business associates to follow privacy and security processes. 
• We keep our offices secure. 
• We talk about your PHI only for a business reason with people who need to know. 
• We keep your PHI secure when we send it or store it electronically. 
• We use technology to keep the wrong people from accessing your PHI.

Permissible Uses and Disclosures of Your PHI

The following is a list of how we may use or disclose your PHI without your permission or authorization: 

• Treatment - We may use or disclose your PHI to a physician or other health care provider providing treatment to you, to coordinate your treatment among providers, or to assist us in making prior authorization decisions related to your benefits.
  
  
• Payment - We may use and disclose your PHI to make benefit payments for the health care services provided to you. We may disclose your PHI to another health plan, to a health care provider, or other entity subject to the federal Privacy Rules for their payment purposes. Payment activities may include processing claims, determining eligibility or coverage for claims, and reviewing services for medical necessity.
  
  
• Healthcare Operations - We may use and disclose your PHI to perform our healthcare operations. These activities may include providing customer service, responding to complaints and appeals, and providing care management and care coordination. 

• Quality assessment and improvement activities.
• Reviewing the competence or qualifications of healthcare professionals.
• Case management and care coordination.
• Detecting or preventing healthcare fraud and abuse.

Your race, ethnicity, language, sexual orientation, and gender identity are protected by the health plan’s systems and laws. This means information you provide is private and secure. We can only share this information with health care providers. It will not be shared with others without your permission or authorization. We use this information to help improve the quality of your care and services.

• Better understand your healthcare needs.
• Know your language preference when seeing healthcare providers.
• Providing healthcare information to meet your care needs.
• Offer programs to help you be your healthiest        

• Group Health Plan/Plan Sponsor Disclosures – We may disclose your PHI to a sponsor of the group health plan, such as an employer or other entity that is providing a health care program to you, if the sponsor has agreed to certain restrictions on how it will use or disclose the protected health information (such as agreeing not to use the protected health information for employment-related actions or decisions).

Other Permitted or Required Disclosures of Your PHI

• Fundraising Activities – We may use or disclose your PHI for fundraising activities, such as raising money for a charitable foundation or similar entity to help finance their activities. If we do contact you for fundraising activities, we will give you the opportunity to opt-out, or stop, receiving such communications in the future.
  
  
• Underwriting Purposes – We may use or disclose your PHI for underwriting purposes, such as to decide about a coverage application or request. If we do use or disclose your PHI for underwriting purposes, we are prohibited from using or disclosing your PHI that is genetic information in the underwriting process.
  
  
• Appointment Reminders/Treatment Alternatives - We may use and disclose your PHI to remind you of an appointment for treatment and medical care with us or to provide you with information regarding treatment alternatives or other health-related benefits and services, such as information on how to stop smoking or lose weight.
  
  
• As Required by Law - If federal, state, and/or local law requires a use or disclosure of your PHI, we may use or disclose your PHI information to the extent that the use or disclosure complies with such law and is limited to the requirements of such law. If two or more laws or regulations governing the same use or disclosure conflict, we will comply with the more restrictive laws or regulations.
  
  
• Public Health Activities - We may disclose your PHI to a public health authority for the purpose of preventing or controlling disease, injury, or disability. We may disclose your PHI to the Food and Drug Administration (FDA) to ensure the quality, safety or effectiveness products or services under the jurisdiction of the FDA.
  
  
• Victims of Abuse and Neglect - We may disclose your PHI to a local, state, or federal government authority, including social services or a protective services agency authorized by law to receive such reports if we have a reasonable belief of abuse, neglect or domestic violence.
  
  
• Judicial and Administrative Proceedings - We may disclose your PHI in response to an administrative or court order. We may also be required to disclose your PHI to respond to a subpoena, discovery request, or other similar requests.  
  
  
• Law Enforcement - We may disclose your relevant PHI to law enforcement when required to do so for the purposes of responding to a crime.

• Substance Use Disorder (SUD) Records — We will not use or disclose your SUD records in legal proceedings against you unless:
  • We receive your written consent, or
  • We receive a court order, you’ve been made aware of the request and been given a chance to be heard. The court order must include a subpoena or similar legal document requiring a response.
     
  • Coroners, Medical Examiners and Funeral Directors - We may disclose your PHI to a coroner or medical examiner. This may be necessary, for example, to determine a cause of death. We may also disclose your PHI to funeral directors, as necessary, to carry out their duties.
    
    
  • Organ, Eye and Tissue Donation - We may disclose your PHI to organ procurement organizations. We may also disclose your PHI to those who work in procurement, banking or transplantation of cadaveric organs, eyes, and tissues.
    
    
  • Threats to Health and Safety - We may use or disclose your PHI if we believe, in good faith, that the use or disclosure is necessary to prevent or lessen a serious or imminent threat to the health or safety of a person or the public.
    
    
  • Specialized Government Functions - If you are a member of U.S. Armed Forces, we may disclose your PHI as required by military command authorities. We may also disclose your PHI to authorized federal officials for national security concerns, intelligence activities, The Department of State for medical suitability determinations, the protection of the President, and other authorized persons as may be required by law.
    
    
  • Workers’ Compensation - We may disclose your PHI to comply with laws relating to workers’ compensation or other similar programs, established by law, that provide benefits for work—related injuries or illness without regard to fault.
    
    
  • Emergency Situations – We may disclose your PHI in an emergency situation, or if you are incapacitated or not present, to a family member, close personal friend, authorized disaster relief agency, or any other person previous identified by you. We will use professional judgment and experience to determine if the disclosure is in your best interest. If the disclosure is in your best interest, we will only disclose the PHI that is directly relevant to the person's involvement in your care.
    
    
  • Inmates - If you are an inmate of a correctional institution or under the custody of a law enforcement official, we may release your PHI to the correctional institution or law enforcement official, where such information is necessary for the institution to provide you with health care; to protect your health or safety; or the health or safety of others; or for the safety and security of the correctional institution.
    
    
  • Research - Under certain circumstances, we may disclose your PHI to researchers when their clinical research study has been approved and where certain safeguards are in place to ensure the privacy and protection of your PHI.
   

  ---

   

  Uses and Disclosures of Your PHI That Require Your Written Authorization

  We are required to obtain your written authorization to use or disclose your PHI, with limited exceptions, for the following reasons:   
  • Sale of PHI – We will request your written authorization before we make any disclosure that is deemed a sale of your PHI, meaning that we are receiving compensation for disclosing the PHI in this manner.
    
    
  • Marketing – We will request your written authorization to use or disclose your PHI for marketing purposes with limited exceptions, such as when we have face-to-face marketing communications with you or when we provide promotional gifts of nominal value.
    
    
  • Psychotherapy Notes – We will request your written authorization to use or disclose any of your psychotherapy notes that we may have on file with limited exception, such as for certain treatment, payment or healthcare operation functions.
  You have the right to revoke your authorization, in writing at any time except to the extent that we have already used or disclosed your PHI based on that initial authorization.

  ---

   

  Individuals' Rights

  The following are your rights concerning your PHI. If you would like to use any of the following rights, please contact us using the information at the end of this Notice.
  • Right to Request Restrictions - You have the right to request restrictions on the use and disclosure of your PHI for treatment, payment, or healthcare operations, as well as disclosures to persons involved in your care or payment of your care, such as family members or close friends. Your request should state the restrictions you are requesting and state to whom the restriction applies. We are not required to agree to this request. If we agree, we will comply with your restriction request unless the information is needed to provide you with emergency treatment. However, we will restrict the use or disclosure of PHI for payment or health care operations to a health plan when you have paid for the service or item out of pocket in full.
    
    
  • Right to Request Confidential Communications - You have the right to request that we communicate with you about your PHI by alternative means or to alternative locations. This right only applies if the information could endanger you if it is not communicated by the alternative means or to the alternative location you want. You do not have to explain the reason for your request, but you must state that the information could endanger you if the communication means or location is not changed. We must accommodate your request if it is reasonable and specifies the alternative means or location where you PHI should be delivered.
    
    
  • Right to Access and Receive a Copy of your PHI - You have the right, with limited exceptions, to look at or get copies of your PHI contained in a designated record set. You may request that we provide copies in a format other than photocopies. We will use the format you request unless we cannot practicably do so. You must make a request in writing to obtain access to your PHI. If we deny your request, we will provide you a written explanation and will tell you if the reasons for the denial can be reviewed. We will also tell you how to ask for such a review or if the denial cannot be reviewed.
    
    
  • Right to Amend your PHI - You have the right to request that we amend, or change, your PHI if you believe it contains incorrect information. Your request must be in writing, and it must explain why the information should be amended. We may deny your request for certain reasons, for example if we did not create the information you want amended and the creator of the PHI is able to perform the amendment. If we deny your request, we will provide you a written explanation. You may respond with a statement that you disagree with our decision, and we will attach your statement to the PHI you request that we amend. If we accept your request to amend the information, we will make reasonable efforts to inform others, including people you name, of the amendment and to include the changes in any future disclosures of that information.
    
    
  • Right to Receive an Accounting of Disclosures - You have the right to receive a list of instances within the last 6—year period in which we or our business associates disclosed your PHI. This does not apply to disclosure for purposes of treatment, payment, health care operations, or disclosures you authorized and certain other activities. If you request this accounting more than once in a 12-month period, we may charge you a reasonable, cost-based fee for responding to these additional requests. We will provide you with more information on our fees at the time of your request.
    
    
  • Right to File a Complaint - If you feel your privacy rights have been violated or that we have violated our own privacy practices, you can file a complaint with us in writing or by phone using the contact information at the end of this Notice.
  You can also file a complaint with the Secretary of the U.S. Department of Health and Human Services Office for Civil Rights by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201 or calling 1-800-368-1019 (TTY: 1-800-537-7697) or visiting hhs.gov/ocr/privacy/hipaa/complaints/.  WE WILL NOT TAKE ANY ACTION AGAINST YOU FOR FILING A COMPLAINT.
  • Right to Receive a Copy of this Notice - You may request a copy of our Notice at any time by using the contact information listed at the end of the Notice. If you receive this Notice on our web site or by electronic mail (email), you are also entitled to request a paper copy of the Notice.
   

  ---

  Contact Information

  Questions about this Notice:  If you have any questions about this notice, our privacy practices related to your PHI or how to exercise your rights you can contact us in writing or by phone by using the contact information listed below. Fidelis Care
  Attn: Privacy Official, Compliance Department
  25-01 Jackson Avenue
  Long Island City, NY 11101
  Toll Free Phone Number 1-888-343-3547
  TTY: 711

  ---

   

  Google Analytics

  We use a tool called "Google Analytics" to collect information about use of this site. Google Analytics collects information such as how often users visit this site, what pages they visit, and what other sites they used before visiting this site. We use the information from Google Analytics only to improve this site. Google Analytics collects only the IP address assigned to you on the date you visit the site, rather than your name or other identifying information. We do not combine the information collected through the use of Google Analytics with personally identifiable information. Although Google Analytics plants a permanent cookie on your web browser to identify you as a unique user the next time you visit this site, the cookie cannot be used by anyone but Google. Google's ability to use and share information collected by Google Analytics is restricted by the Google Analytics Terms of Use and the Google Privacy Policy. You can prevent Google Analytics from recognizing you on return visits to this site by disabling cookies in your browser. 

  ---

  Microsoft Internet Explorer Policy Update

  Microsoft Internet Explorer 11- Microsoft has deprecated IE 11 in Windows 10 and recommends using Edge as the default browser. Given that Microsoft has deprecated Internet Explorer 11, beginning in July 2020, Fidelis Care will stop supporting Internet Explorer as a valid browser client to access our sites. There are significant security and performance concerns with Internet Explorer 11 (see  Microsoft FAQ), and Fidelis Care encourages customers to move to a modern browser such as Microsoft Edge, Google Chrome, Mozilla Firefox, or Apple Safari. For mobile device operating systems, Fidelis Care provides support for the most recent browser delivered by the device operating system only.

  	Chrome	Firefox	Microsoft Edge	Safari
  Android	Supported *	Not Supported	N/A	N/A
  iOS	Supported	Not Supported	Not Supported	Supported
  Mac OS X	Supported	Supported	Not Supported	Supported
  Windows	Supported	Supported	Supported	Not Supported

    * Chrome for Android only, not the native Android browser In the case where feature parity is not consistent for the same browser version across platforms and devices, those features are only supported by Fidelis Care to the extent that the vendor has enabled.

  ---

  ---

  Text Messaging Disclosure and Authorization

  SMS Messaging. Customers will be opted-in to text based on the Medicaid program enrollment file and member eligibility. Standard Message & Data Rates May Apply. Reply STOP to opt-out. Reply HELP for additional assistance. No purchase necessary. Message frequency may vary.Compatible carriers include: AT&T, Sprint, T-Mobile®, Verizon Wireless, Boost, Cricket, MetroPCS, U.S. Cellular, Virgin Mobile, ACS Wireless, Appalachian Wireless, Bluegrass Cellular, Breakaway Wireless, Cabelvision (Optimum Mobile), Carolina West Wireless, Cellcom, Cellular One of East Central Illinois, Centennial Wireless, Chariton Valley Cellular, Chat Mobility (Hawkeye), Cincinnati Bell Wireless, Coral Wireless, Cox Mobility, Cross/ Sprocket, C-Spire Wireless (formerly Cellsouth), CTC Telecom, DTC Wireless (Advantage Cellular), Duet IP (AKA Max/Benton/Albany), Element Mobile, Epic Touch, GCI Communications, Golden State, Illinois Valley Cellular, Immix (Keystone Wireless/ PC Management), Inland Cellular, iWireless, Leaco, Mobi PCS, Mosaic, MTPCS/ Cellular One (Cellone Nation), Nemont, Nex-Tech Wireless, nTelos, NW Missouri Cellular (Hawkeye), Panhandle Telecommunications, Peoples Wireless, Pioneer, Pine Cellular, Plateau, Revol, Rina - Custer, Rina - All West, Rina - Cambridge Telecom Coop, Rina - Eagle Valley Comm, Rina - Farmers Mutual Telephone Co, Rina - Nucla Nutria Telephone Co, Rina - Silver Star, Rina - Syringa, Rina - UBET, Rina - Manti, Rural Cellular Corporation, SI Wireless, Simmetry, SouthernLINC, SRT, Strata Networks, Thumb Cellular, Union Wireless, United, Viaero Wireless, West Central Wireless. T-Mobile is not liable for delayed or undelivered messages.

  ---

   

  Sites that are not Maintained by Fidelis

  You should be aware that when you are on our website, you could be directed to other sites that are beyond our control.  There may also be links to other sites from the website that take you outside our service.  Since we do not maintain those sites, we take no responsibility and assume no liability for the privacy policies and practices of any sites outside of our control.  Please review the privacy policies and practices of those sites to learn how other entities may store and use your information.

  ---

   

  Complaints

  If you believe your privacy rights have been violated, you may file a complaint with Fidelis or the Secretary of the U.S. Department of Health and Human Services. You may file a complaint with Fidelis by writing to Vice President, Compliance, 25-01 Jackson Avenue, Long Island City, NY 11101. You will not be penalized or retaliated against by Fidelis for filing a complaint.

  ---

   

  Changes to this Notice

  Fidelis may change the terms of this Notice of Privacy Practices at any time. If we change the terms of this Notice, the new terms will apply to all of your health information, whether created or received by Fidelis before or after the date on which the Notice is changed. We will notify you of changes to this Notice by mailing you a copy of the new Notice within 60 days of the date on which it becomes effective.

  ---

   

  Additional Information

  If you have any questions or would like additional information about this Notice or Fidelis' privacy practices, please contact Vice President, Compliance, 25-01 Jackson Avenue, Long Island City, NY 11101

  • Legal Requests and Lien Inquiries
  • Medicare Complaint Form

  ---

  Centene | Notice of Privacy Practices
  Fidelis Care | Notice of Privacy Practices
  Wellcare By Fidelis Care | Notice of Privacy Practices
  

  Alternative Languages | Notice of Privacy Practices (Wellcare By Fidelis Care)

  Wellcare By Fidelis Care - Notice of Privacy Practices (Urdu) Wellcare By Fidelis Care - Notice of Privacy Practices (Yiddish) Wellcare By Fidelis Care - Notice of Privacy Practices (Haitian Creole) Wellcare By Fidelis Care - Notice of Privacy Practices (French) Wellcare By Fidelis Care - Notice of Privacy Practices (Italian) Wellcare By Fidelis Care - Notice of Privacy Practices (Polish) Wellcare By Fidelis Care - Notice of Privacy Practices (Tagalog) Wellcare By Fidelis Care - Notice of Privacy Practices (Arabic) Wellcare By Fidelis Care - Notice of Privacy Practices (Korean) Wellcare By Fidelis Care - Notice of Privacy Practices (Spanish) Wellcare By Fidelis Care - Notice of Privacy Practices (Bengali) Wellcare By Fidelis Care - Notice of Privacy Practices (Chinese) Wellcare By Fidelis Care - Notice of Privacy Practices (Greek) Wellcare By Fidelis Care - Notice of Privacy Practices (Russian) Wellcare By Fidelis Care - Notice of Privacy Practices (Albanian)

  ---

  Updated 12/15/2025