There are no deductibles with Fidelis Care Essential Plans, and medical treatments and prescription medicines have copays of either $0 or $15-$35.
Is Fidelis good insurance?
Fidelis Care also achieved a 5-star overall quality rating for health plan performance in the 2017 Consumer’s Guide to Medicaid and Child Health Plus Managed Care Plans from the New York State Department of Health.
Is Fidelis public or private insurance?
The Catholic Medical Center of Brooklyn and Queens, Inc. and the Diocese of Brooklyn founded Fidelis Care in 1993 as the NYC Catholic Health Plan Inc. to serve the poor and medically disadvantaged.
Fidelis expanded into Western New York in 1997 when it purchased Better Health Plan, a Buffalo-based HMO.
Fidelis Care manages a number of government-sponsored health insurance programs, including Medicare, Medicaid, and the 1997-launched Child Health Plus. On the NY State of Health Marketplace, the company also offers managed long-term care plans and Qualified Health Plans.
Fidelis Care acquired CenterCare, a Medicaid managed care plan based in New York City, in 2005.
Is Medicaid and Fidelis the same?
Fidelis Care, a premier health insurer serving the entire state of New York, provides free or low-cost comprehensive health coverage, including Medicaid Managed Care, Medicare Advantage, Child Health Plus, and plans available through NY State of Health, The Official Health Plan Marketplace.
Does Fidelis cover bloodwork?
50 percent diagnostic test (x-ray, blood work) After the deductible, coinsurance is required. It’s not covered. Diagnostic radiology, with the exception of x-ray, requires prior authorization. 50 percent imaging (CT/PET scans, MRIs) After the deductible, coinsurance is required. It’s not covered. Except for x-rays, certain blood tests and diagnostic imaging require prior authorisation.
Does Fidelis cover ambulance?
Fidelis Dual Advantage subscribers get access to non-emergency transportation in all counties where the plan is available. Public transportation, livery, ambulette, and ambulance are all examples of this.
Can you use Fidelis insurance out of state?
No, it isn’t. Because each state has its own Medicaid eligibility standards, you won’t be able to transfer coverage from one state to another, nor will you be able to utilize your coverage when visiting another state temporarily, unless you require emergency medical treatment.
Medicaid provides health insurance to millions of Americans, and in many places, it matches or even exceeds the coverage provided by commercial health insurance. Medicaid is funded jointly by the federal government and state governments, although each state has the option of establishing its own eligibility rules and restrictions. As a result, it’s not always practical to move your Medicaid coverage from one state to another.
Transferring Medicaid benefits to another state
Technically, you can’t transfer your Medicaid coverage from one state to another because there isn’t an official program or alternative. As a result, if you move, you’ll need to reapply for Medicaid in the new state.
The good news is that you can apply for Medicaid in your new state right away once you move, which can help you avoid losing your benefits. Once you apply for Medicaid, you should receive a letter of approval within 15 to 90 days, and you may usually submit your application online.
One thing to keep in mind with Medicaid is that you cannot get coverage in two states at the same time. As a result, if you want to “transfer” your Medicaid coverage, you’ll need to cancel your current coverage first and then apply in your new state once you’ve moved.
Most states provide retroactive Medicaid coverage, allowing you to have coverage up to three months before your application is approved. However, until that retroactive coverage comes in and makes you eligible for reimbursement, you may be compelled to pay for healthcare services out of pocket. As a result, keep copies of all medical receipts for services received during your coverage gap.
Eligibility requirements
The difficulty with enrolling for Medicaid in a new state is that each state has its own eligibility rules, so just because you’re eligible in one state doesn’t imply you’ll be eligible in another. Several variables influence Medicaid eligibility:
With the notable exception of adult Medicaid expansion under the Affordable Care Act, state income and asset eligibility limits are very similar. The Affordable Care Act mandated that all states expand Medicaid eligibility to persons aged 19 to 64 who have a household income of up to 138 percent of the federal poverty level. However, the Supreme Court eventually determined that this would be optional (i.e., states would not forfeit Medicaid funds if they refused to extend eligibility), and as of mid-2021, 13 states have yet to increase their Medicaid eligibility requirements.
Let’s imagine you live in Illinois and are enrolled in Medicaid as a result of the Affordable Care Act’s adult population eligibility expansion requirements. If you move to Florida, Texas, or another state that hasn’t expanded Medicaid, you will almost certainly lose your Medicaid coverage.
State-by-state standards for the Medically Needy program and the degree of care required for long-term care coverage differ. So, while you might be eligible for Medicaid (or Medicaid-funded nursing home care) in one state based on the amount of care you require, you might not be in another. To ensure that your coverage will continue in the state to which you’re relocating, do some research on the rules of the state to which you’re relocating.
Keep in mind that if you’re eligible for SSI, you’ll almost certainly be eligible for Medicaid as well. People receiving SSI are automatically eligible for Medicaid in 33 states and the District of Columbia. The remaining states determine eligibility on their own, though the rules are essentially the same as for SSI. As a result, those who receive SSI are normally eligible for Medicaid, although in some jurisdictions, they must apply separately for medical care.
Medicaid supplements Medicare and provides long-term care coverage for millions of people with low income and assets who are 65 or older. You may learn more about state-specific programs and eligibility restrictions by clicking on a state on this map.
Traveling to another state
If you become ill while visiting another state, you may be out of luck because Medicaid will not pay the cost of services provided in a state other than your own. In general, you can only use your Medicaid coverage outside of your home state if you have a serious life-threatening emergency that requires immediate care (i.e., there isn’t enough time to transfer you back to your home state for care).
However, Medicaid will sometimes cover pre-approved treatment in an out-of-state facility, but only if proper authorization is acquired. Similarly, if you obtain treatment in an out-of-state institution that borders yours and where people of your state frequently seek care, Medicaid coverage may apply. Again, you must confirm that Medicaid will cover such care before proceeding, or you risk being responsible for the accompanying costs.
Who does Fidelis cover?
Fidelis Care is a non-profit organization that provides high-quality, low-cost health insurance to children and people of all ages. We think that everyone deserves to be treated with dignity and respect, and we have over 2.3 million members.