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Welcome, Fidelis Care Members!

We are proud to be your healthcare partner and want to help you access essential health benefits and services to keep you as healthy as possible.

  • Electronic Noticing Available for Medicaid, HARP, MLTC, and MAP Members
  • Social Care Network Information for Medicaid, HARP, MLTC, and MAP Members
  • Important Information for People Turning 18 Years Old

    • Here’s how to get started:

    Step 1: Sign Up for Our Member Portal

    The Member Portal is the easiest and most secure way to access information about your plan. With 24/7 access to your Fidelis Care account, you can pay your monthly premium, request and print new ID cards, and access your plan documents. To create a secure online member account, visit members.fideliscare.org and click “Register.”

    Step 2: Fill Out Your Health Risk Assessment

    Return this brief survey to us in the postage-paid envelope provided with your welcome materials. The answers you provide will help us serve you better and get you connected to whatever services you may need.

    Step 3: Review Your Plan Documents

    You can access your Summary of Benefits and Coverage, Subscriber Contract, Formulary, and other important plan documents by logging into the Member Portal. The Summary of Benefits and Coverage outlines some of your plan’s key benefits, and explains how much they could cost. The cost examples are estimates only, and serve as a guide for how your particular plan might cover different conditions; not the exact dollar amount you will pay. Your Subscriber Contract provides a full description of the services included in your benefit package, as well as cost information for those services. 

    Step 4: Choose a Primary Care Provider
    Fidelis Care is committed to ensuring you have access to the preventive care and screenings you need to stay healthy. To ensure that access, we recommend you select a Primary Care Provider (PCP), even if your plan does not require one. If you already have a PCP who is in the Fidelis Care network, then that provider should have been automatically assigned as your PCP. You can review, select, or change your PCP from your Member Portal account. Your PCP will work with you to make sure you get the care you need.

    To find PCPs near you, use our Find a Doctor tool. If you need help finding a doctor or choosing your PCP, call Member Services at 1-888-FIDELIS (1-888-343-3547); TTY: 711.

    Pharmacy Benefits

    Members in Medicaid and HARP receive prescription drugs through NYRx, the Medicaid Pharmacy Program effective April 1, 2023. 

    For all other members with pharmacy coverage, your benefits are covered     by Express Scripts. (by clicking on these links, you will leave the Fidelis Care website)

    To learn more about your pharmacy benefit, click HERE

    Dental Benefits

    For members with dental coverage, your benefits are covered through DentaQuest. Visit our DentaQuest Resource Page (by clicking on this link, you will leave the Fidelis Care website) for more information on getting started, and preventive dental care best practices.

    Vision Benefits

    For members with vision coverage, your benefits are covered through Davis Vision. Visit our Davis Vision Resource Page (by clicking on this link, you will leave the Fidelis Care website) for information on getting started. 

    To review Fidelis Care's best practice guidelines for healthy vision, click HERE

    Prior Authorization Requirements

    If you are a member in Medicaid Managed Care, HealthierLife (HARP), Child Health Plus (CHPlus), or an Ambetter from Fidelis Care Qualified Health Plan (QHP), there are some treatments and services that require an approval before you receive them or continue receiving them. Please click here to view the service list.


    How to obtain a referral from your PCP

    If you need care that your PCP cannot give, then they will refer you to a specialist who can. The listing services requiring a PCP referral can be found here. If you need help getting a referral contact Member Services at
    1-888-FIDELIS (1-888-343-3547).


    Find a Doctor

    Search for a medical professional, service, or facility in the Fidelis Care Network.
    Search

    Understand Your Benefits

    Learn how health insurance helps manage expenses, and prepare for the unexpected.

    Benefits

    Member Resources

    View and download documents for your Fidelis Care health plan. 

    Visit

    Your Health Information is Protected

    The Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule provides national standards to protect individuals’ medical records and other personal health information. The Privacy Rule applies to all forms of your protected health information, whether electronic, written, or oral. 

    To learn more about HIPAA and your privacy rights, visit the U.S. Department of Health and Human Services. By clicking this link, you will leave the Fidelis Care website.

    Authorization to Use and Disclose Health Information (PDF)

    Revocation of Authorization to Use and/or Disclose Health Information (PDF)

    Member Rights and Responsibilities

    As a Fidelis Care member, you have a right to participate with practitioners in making decisions about your healthcare. You also have the right to be treated with respect and with recognition of your dignity and your right to privacy.

    General Statement of Member Rights and Responsibilities (PDF)

    Language Assistance Services (PDF)

    Notice of Non-Discrimination (PDF)

    Patient Bill of Rights (PDF)

    Important Information on Coverage Decisions

    Each day, Fidelis Care's Utilization Management (UM) Department makes decisions on many health insurance claims. These decisions are based only on appropriateness of care and the existence of coverage. 

    Fidelis Care does not reward providers or other individuals for issuing denials of coverage, and does not offer financial incentives to UM staff based on decisions that promote underutilization of services. 

    Fidelis Care is committed to ensuring that members have the care and services they need. 

    Member Portal

    Log in or register to make payments, print ID cards, choose or change a PCP, and much more.

    Log In

     

    Renew Your Coverage

    Questions about renewing health insurance? Fidelis Care can help.

    Renewal Help

     

    Make A Payment

    Need to pay your premium? Start here.

    Pay Online

     

    Care Management Services

    Fidelis Care offers Care Management services to help members who need extra health support. Care Management helps members coordinate their care, learn about their health conditions, and find helpful resources within their community.

    Learn More

    Member Newsletter

    Read our latest member newsletter (HealthyNOW) and browse the archives.

    Read