Fidelis Care Ridgewood Community Office

Fidelis Care focuses on serving people who are underinsured or uninsured and on making health coverage easier to understand and access throughout New York State.

• Medicaid Managed Care

Health coverage for eligible New Yorkers through the state Medicaid program.

• Child Health Plus

Coverage for eligible children in New York State.

• Essential Plan

A health insurance option with a $0 premium for eligible New Yorkers who do not qualify for Medicaid or Child Health Plus. The Essential Plan includes:

• Free preventive care
• No-cost dental and vision benefits
• Low or no-cost prescription benefits

• Health and Recovery Plan (HARP)

Behavioral health-focused Medicaid coverage for eligible adults (offered as the HealthierLife plan by Fidelis Care).

• Managed Long Term Care (MLTC)

Long-term care coverage options, including:

• Fidelis Care at Home (MLTC)
• Medicaid Advantage Plus

• Qualified Health Plans (Ambetter from Fidelis Care)

Marketplace health plans for individuals and families who buy coverage through the New York State of Health Marketplace.

• Medicare Advantage and Dual Advantage (Wellcare By Fidelis Care)

Medicare Advantage plans, including Dual Advantage plans for people who are eligible for both Medicare and Medicaid. Many plans include Part D prescription drug coverage.

Service Area

Fidelis Care plans are offered across New York State. Availability and eligibility depend on factors such as county, age, income, disability status, and program rules.

For the most up-to-date information about which plans are available and whether you may qualify, use the plan-finder tools on the Fidelis Care website or contact Fidelis Care directly.

Lists Albany, Buffalo, New York City, Ridgewood, Rochester, and Syracuse as a location. Names New York, United States, and Ridgewood as a service area. Areas beyond these are not published.

1-888-FIDELIS (1-888-343-3547) TTY: 711

Representatives can answer questions and assist you by phone. For medical emergencies, call 911 or go to the nearest emergency room immediately.

Mailing Address

Member Services Department Fidelis Care 480 Crosspoint Parkway Getzville, NY 14068

Online Help

• The Contact Us section of the Fidelis Care website guides you through a few questions to connect you to the appropriate Fidelis Care representative or resource.
• Members can also use online self-service tools (such as the Member Portal) to review benefits, make payments, and manage their coverage.

Community Offices

Fidelis Care operates community offices throughout New York State.

• You can use the Visit Us feature on the Contact Us page to find a nearby Community Office.
• Community Offices are designed to help members and prospective members learn about coverage options, get help with questions, and complete certain enrollment and renewal steps in person.

If you are experiencing a crisis or emotional distress, Fidelis Care references the national Suicide Prevention Lifeline (now 988) and similar resources; these services provide confidential crisis support 24/7.

• Helps Medicare members better manage their Original Medicare and Medicare Part D benefits.
• Offers programs and services designed to meet the unique health care needs of Medicare members.

Who Can Get Medicare (Overview)

According to the information Fidelis Care provides:

You are generally eligible for Medicare at age 65 or older if:

• You are a U.S. citizen or a permanent legal resident, and
• You have lived in the United States for at least five years, and
• You or your spouse has worked long enough to be eligible for Social Security or railroad retirement benefits (even if not yet receiving them), or
• You or your spouse is a government employee or retiree who has paid Medicare payroll taxes while working.

You may qualify for Medicare before age 65 if:

• You qualify for Social Security Disability Insurance (SSDI) and have been receiving SSDI checks for at least 24 months, or
• You have End-Stage Renal Disease (ESRD), or
• You are "dual eligible" (eligible for both Medicare and Medicaid) due to certain health conditions and income.

The ABCs (and Part D) of Medicare

Fidelis Care describes the four main parts of Medicare as follows:

• Part A (Hospital Insurance) – Covers inpatient hospital stays, care in skilled nursing facilities, hospice care, and some home health care. Part A is part of Original Medicare.

• Part B (Medical Insurance) – Covers certain doctors' services, outpatient care, medical supplies, and preventive services. Part B is also part of Original Medicare.

• Part C (Medicare Advantage) – Medicare Advantage plans, offered by private insurance companies working with the federal government, combine Part A and Part B in one package.

Many Wellcare By Fidelis Care Medicare Advantage plans include prescription drug coverage (Part D) as part of a comprehensive package.

• Part D (Prescription Drug Coverage) – Covers prescription drugs. Wellcare By Fidelis Care plans may include Part D coverage that follows Medicare Prescription Drug Plan rules.

Star Ratings and Resources

• Wellcare By Fidelis Care publishes annual Medicare Star Ratings information in multiple languages.
• Additional Medicare resources, documents, forms, and applications are available on the Fidelis Care website.
• Members can use online tools, live help sessions, and enrollment resources provided through Wellcare By Fidelis Care.

For specific plan availability, benefits, premiums, and enrollment details, members and prospects should use the "Help Me Find a Plan" and enrollment tools on the website or contact Fidelis Care directly.

• Participating providers are assigned a designated Provider Relations Specialist based on region and provider type.
• Providers can look up their assigned Provider Relations Specialist on the Contact Provider Relations page of the Fidelis Care website.
• The listed email addresses on that page are intended only for participating providers and their staff.

For immediate needs or for non-participating providers:

• Call the Fidelis Care Provider/Call Center at 1-888-FIDELIS (TTY: 711).

Provider Access Online (Provider Portal)

Provider Access Online is Fidelis Care's secure provider portal.

Through Provider Access Online, provider offices can access:

• Authorization information
• Claims status
• Patient eligibility
• Plan benefits
• Other key self-service tools

The portal is available 24/7 to help provider offices manage administrative tasks more efficiently.

Providers who do not yet have access can submit a request for a Provider Access Online account through the Fidelis Care website.

Ask anyway — the agent will say plainly that it is not published rather than guess.