Fidelis Medicare Advantage Plans in New York: Comprehensive Coverage and Benefits
Explore Fidelis Medicare Advantage plans available in New York, including the types of plans, covered benefits, and cost details to help you make an informed healthcare decision.
Fidelis is a trusted private insurer providing Medicare Advantage plans tailored for residents across New York State. These plans enhance traditional Medicare coverage by including valuable extras such as vision, hearing, and dental services.
Medicare Advantage plans are offered by private companies as an alternative to Original Medicare, combining hospital and medical coverage with additional benefits.
As of 2024, over 38 million Medicare beneficiaries—approximately 54% of the Medicare population—have chosen Medicare Advantage plans for their healthcare needs.
Fidelis specializes in Medicare Advantage offerings within New York, providing options designed to meet diverse healthcare requirements.
In this guide, we will:
- Detail the various Fidelis Medicare Advantage plan types
- Highlight the comprehensive benefits included
- Break down potential costs and fees
Fidelis Medicare Advantage Plan Options
Fidelis offers two primary Medicare Advantage plan types: Health Maintenance Organization (HMO) and HMO Point-of-Service (HMO-POS) plans. Let’s explore each option.
Fidelis HMO Plan
The HMO plan requires members to receive care exclusively from in-network providers to ensure coverage. Using out-of-network providers typically means you bear the full cost.
For 2025, Fidelis presents the Wellcare Fidelis Simple (HMO) plan, tailored to deliver coordinated care within a network of providers.
Fidelis HMO-POS Plan
HMO-POS plans closely resemble HMO plans but allow limited access to out-of-network providers for certain services. However, out-of-network care usually comes with higher copayments and coinsurance.
The Wellcare Fidelis Assist (HMO-POS) plan is available in 2025, offering more flexibility while maintaining cost-effective care.
Fidelis HMO Dual Eligible Special Needs Plans (D-SNPs)
These specialized HMO plans cater to individuals eligible for both Medicare and Medicaid, providing seamless coordination between the two programs. They are available exclusively through Medicaid rather than Medicare.
Fidelis offers two D-SNP options:
- Wellcare Fidelis Dual Access (HMO D-SNP)
- Wellcare Fidelis Dual Plus (HMO D-SNP)
These plans minimize out-of-pocket expenses and simplify access to care with a single point of contact.
Fidelis Medicare Part D Prescription Drug Coverage
Part D plans cover prescription medications and can be standalone or bundled with Medicare Advantage plans. Fidelis does not offer separate Part D plans, but most Medicare Advantage plans from Fidelis include prescription drug coverage within the plan.
Availability of Fidelis Medicare Advantage Plans in New York
Fidelis Medicare Advantage plans are accessible in many counties and ZIP codes throughout New York. However, plan availability and types may vary by location.
To find plans offered in your area, use Medicare’s Find a Plan tool by entering your ZIP code.
Coverage Highlights of Fidelis Medicare Advantage Plans
Fidelis Medicare Advantage plans cover all benefits included in Original Medicare (Part A and Part B), such as:
- Visits to primary care physicians and specialists
- Outpatient mental health services
- Diagnostic and laboratory tests
- Preventive care services
- Limited inpatient hospital and skilled nursing facility stays
- Emergency and urgent care
- Emergency ambulance transportation
- Therapies including occupational, physical, and speech-language
- Acupuncture treatments
- Durable medical equipment like wheelchairs, oxygen, and diabetic supplies
- Substance use disorder treatment programs
Beyond Original Medicare, Fidelis plans often include enhanced benefits such as:
- Prescription drug coverage (Part D)
- Vision care
- Hearing services and aids
- Dental care
- Telehealth services
- Fitness programs including SilverSneakers
- Emergency coverage while traveling abroad
Additional perks in select plans may include transportation assistance to medical appointments and access to over-the-counter medications.
Understanding the Costs of Fidelis Medicare Advantage Plans
Costs associated with Fidelis Medicare Advantage plans can include:
- Monthly premiums: Some plans offer $0 monthly premiums, while others have a set monthly fee.
- Copayments and coinsurance: These are fixed or percentage-based amounts you pay when receiving care. Out-of-network services typically incur higher costs in HMO-POS plans.
- Deductibles: Some plans require you to pay a deductible before coverage begins for medical or prescription services.
- Out-of-pocket maximums: This is the cap on your annual spending for covered services, beyond which the plan pays 100%.
Below is a cost comparison for select Fidelis plans in New York for 2025:
Wellcare Fidelis Simple (HMO) Plan Costs:
| Monthly Premium | Primary Care Copay | Specialist Copay | Max In-Network Out-of-Pocket |
|---|---|---|---|
| $0 | $0 | $45 | $7,550 |
Wellcare Fidelis Assist (HMO-POS) Plan Costs:
| Monthly Premium | Primary Care Copay | Specialist Copay | Max In- and Out-of-Network Out-of-Pocket |
|---|---|---|---|
| $27.50 | $0 | $30 | $7,550 |
Medicare Advantage (Part C) plans provide a comprehensive, private insurance alternative to Original Medicare, combining hospital, medical, and often prescription drug coverage.
What Is Medicare Advantage (Part C)?
Medicare Advantage plans vary widely in terms of costs and offered services, influenced by factors such as:
- Your geographic location
- The specific type of plan selected
- The insurance provider
Summary
Fidelis presents a range of Medicare Advantage plans in New York, including HMO and HMO-POS options designed to meet diverse healthcare needs.
All Fidelis plans cover the essential benefits of Original Medicare and often include additional services such as dental, vision, and hearing care. Plan availability and benefits may vary depending on your location.
Comparing plans in your area is essential to find the coverage that best aligns with your healthcare requirements and budget.
Discover engaging topics and analytical content in Medicare Resources as of 05-07-2024. The article titled " Fidelis Medicare Advantage Plans in New York: Comprehensive Coverage and Benefits " provides new insights and practical guidance in the Medicare Resources field. Each topic is meticulously analyzed to deliver actionable information to readers.
The topic " Fidelis Medicare Advantage Plans in New York: Comprehensive Coverage and Benefits " helps you make smarter decisions within the Medicare Resources category. All topics on our website are unique and offer valuable content for our audience.