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Fidelis Care Plan Updates for 2026
11/13/2025 • Posted by Provider Relations

Fidelis Care would like to inform our providers of plan changes that will be effective January 1, 2026. 

 

Wellcare By Fidelis Care

Wellcare Fidelis Dual Plus (HMO D-SNP) – Plan 003

Effective January 1, 2026, the plan name will change from Wellcare Fidelis Dual Plus (HMO D-SNP) to Wellcare Fidelis Dual Align (HMO D-SNP).

Wellcare Fidelis Dual Access (HMO D-SNP) Plan 001

Effective January 1, 2026, Fidelis Care members currently enrolled in this plan will be enrolled in Wellcare Fidelis Dual Liberty Sync (HMO D-SNP).

 

There are two segments for this plan. The service area for Plan 013-001 will be Albany, Allegany, Broome, Cattaraugus, Cayuga, Chemung, Chenango, Clinton, Columbia, Cortland, Delaware, Dutchess, Erie, Essex, Franklin, Fulton, Genesee, Greene, Hamilton, Herkimer, Jefferson, Lewis, Livingston, Madison, Monroe, Montgomery, Niagara, Oneida, Onondaga, Ontario, Orange, Orleans, Oswego, Otsego, Putnam, Rensselaer, Saratoga, Schenectady, Schoharie, Schuyler, Seneca, St. Lawrence, Steuben, Sullivan, Tioga, Ulster, Warren, Washington, Wayne, Wyoming, Yates.

 

The service area for Plan 013-002 will be Bronx, Kings, Nassau, New York, Queens, Richmond, Rockland, Suffolk, Westchester.

Wellcare Fidelis Patriot Simple (HMO-POS) Plan 010

Effective January 1, 2026 Fidelis Care will offer a new Medicare Advantage product named Wellcare Fidelis Patriot Simple (HMO-POS).

 

The service area for this plan will be Albany, Allegany, Bronx, Broome, Cattaraugus, Cayuga, Chemung, Chenango, Clinton, Columbia, Cortland, Delaware, Dutchess, Erie, Essex, Franklin, Fulton, Genesee, Greene, Hamilton, Herkimer, Jefferson, Kings, Lewis, Livingston, Madison, Monroe, Montgomery, Nassau, New York, Niagara, Oneida, Onondaga, Ontario, Orange, Orleans, Oswego, Otsego, Putnam, Queens, Rensselaer, Richmond, Rockland, Saratoga, Schenectady, Schoharie, Schuyler, Seneca, St. Lawrence, Steuben, Suffolk, Sullivan, Tioga, Ulster, Warren, Washington, Wayne, Westchester, Wyoming, Yates.

 

 

 

Ambetter From Fidelis Care (Metal-Level Products)

Wellness Rewards

Effective January 1, 2026, members can participate in the Wellness Rewards program where they can earn up to $350 by completing eligible activities and screenings. Eligible activities are worth $25 each and include an Adult Well Visit, Adult Immunization Flu Shot, Breast Cancer Screening, Chlamydia Screenings (women), Controlling High Blood Pressure/Blood Pressure Screening, Colorectal Cancer Screening, Diabetes – HbA1c Control, Diabetes – Eye Exam, Diabetes – Statin Therapy, Follow-up After Acute Care Visit for Asthma, Kidney Health Evaluation, Statin Therapy – Cardiovascular Disease.

Ambetter from Fidelis Care Silver Enhanced

Effective January 1, 2026, the plan name will change from Ambetter from Fidelis Care Silver Enhanced to Ambetter from Fidelis Care Silver+.

 

 

Essential Plans

Wellness Rewards

As EP members renew into 2026 coverage, they will become eligible for the Wellness Rewards program where they can earn up to $325 by completing eligible activities and screenings. Eligible activities are worth $25 each and include an Adult Well Visit, Adult Immunization Flu Shot, Breast Cancer Screening, Chlamydia Screenings (women), Controlling High Blood Pressure/Blood Pressure Screening, Colorectal Cancer Screening, Diabetes – HbA1c Control, Diabetes – Eye Exam, Diabetes – Statin Therapy, Follow-up After Acute Care Visit for Asthma, Kidney Health Evaluation, Statin Therapy – Cardiovascular Disease.

 

In addition to the plan changes listed above, please be aware that formulary changes will take effect on January 1, 2026. Providers can review the details by selecting the appropriate link below:

 

 

If you have any additional questions, please contact your Fidelis Care Provider Engagement Account Manager. To find your designated representative, please visit Contact Your Designated Provider Relations Specialist.

Thank you for partnering with us to support the health and wellness of our members!

 

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