Important Change for Medicaid, HARP, MLTC, and MAP Managed Care Enrollees: Appeals and Fair Hearing Rights - May 1, 2018
New federal Medicaid managed care rules take effect in New York State on May 1, 2018. These rules change the way Medicaid managed care plans make decisions about health care services and Plan Appeals. All of the information is available as an insert to your Fidelis Member Handbook. Click the link below for the product you are enrolled in to see the changes.
Medicaid Managed Care
Health and Recovery Program (HARP)
Managed Long Term Care
Medicaid Advantage Plus
Fidelis Care provides the following services and programs for our Members:
A secure member portal where you can order new or additional member ID cards, change your primary care provider, check your claims history, and much more. All Fidelis Care members should use the button below to access the Member Portal.
Not on the member portal yet? Select 'Register' below to create an account and begin managing your profile.
Making your first payment as a new member? Select 'Pay First Premium' below to complete this first payment.
Visit our Pay Online page and make a SECURE payment for your monthly Fidelis Care premium:
Need help choosing your Primary Care Provider (PCP)*? We can help.
*Not required for Metal-Level Product or Essential Plan members.
Important Information on Coverage Decisions
As required by NCQA accreditation guidelines, Fidelis Care is providing the following information to employees, providers, and members.
Each day, Fidelis Care's Utilization Management (UM) Department makes decisions on numerous health insurance claims. These decisions are based only on appropriateness of care and the existence of coverage.
Fidelis Care does not reward practitioners or other individuals for issuing denials of coverage, and does not offer financial incentives to UM staff that would encourage decisions that result in underutilization of services.
Fidelis Care is committed to ensuring that members have the care and services they need.
Fidelis Care offers case management services to members by phone. Our Case Managers can provide support and assistance in identifying alternatives and resources when benefits have been exhausted. Case Managers are health professionals available to assist you in managing your health, learning more about your health or conditions, coordinating care with providers and receiving necessary services. To receive more information, please call Fidelis Care Clinical Services at 1-800-247-1441.
Find a Doctor
Our Member Services team is always here to help and answer any questions you may have. Just call 1-888-FIDELIS (1-888-343-3547) or answer these questions to find the right Fidelis Care Representative.
Ownership/Controlling Interest Information
This information is being provided in accordance with 42 CFR 438.602(g)(3):
No individual or entity has an ownership or controlling interest in the New York State Catholic Health Plan, Inc. (d/b/a Fidelis Care).