-Essential Plans Plus Vision & Dental : Beginning January 1, 2020 Fidelis will offer two new plans available to individuals eligible for Essential plans 1 or 2 which include vision and dental coverage.
Our policies cover preventative care – routine dental cleanings and vision screenings to help our clients preserve their vision and dental health. Our policies also cover vision correction, including glasses and contact lenses, as well as fillings, root canals and extractions.
Covered benefits include: Preventive care , including well visits, immunizations, and preventive screenings. Dental and vision care . Prescription and non-prescription drugs.
Many private practices are unable to accept Medicaid patients because the reimbursement rate still lags far behind private insurance. Also, the Medicaid credentialing and claims process is so burdensome that it would require extra dedicated staff just to manage the administrative aspects.
Eligibility and Cost
|Family Contributions||Monthly Income by Family Size*|
|$15 Per Child Per Month ( Maximum of $45 per family)||$2,659||$4,525|
|$30 Per Child Per Month ( Maximum of $90 per family)||$3,190||$5,430|
|$45 Per Child Per Month ( Maximum of $135 per family)||$3,722||$6,335|
Medicaid recipients can enroll in this plan year-round, a benefit not offered by all Medicaid care providers. Fidelis had high rankings in almost all health sectors and rating categories. Fidelis Care has better coverage of medications and ranked especially high in the illness care sector.
Fidelis had the largest market share in the state for private Obamacare plans as of Jan. 31. It also provides Medicaid plans, Medicare Advantage and managed long-term care plans.
Once you know the health coverage you qualify for, there are four ways you can enroll: Call 1-888-FIDELIS (1-888-343-3547), TTY: 711. Find a Fidelis Care office near you. Enroll Online via NY State of Health. Select the ‘Get Started’ button below to contact a certified representative at Fidelis Care.
Glasses $0 Not covered Limits may apply. If you have questions, please call Davis Vision at: 1-800-999- 5431. Excluded Services & Other Covered Services: Services Your Plan Generally Does NOT Cover (Check your policy or plan document for more information and a list of any other excluded services.)
Fidelis Care operates several government-sponsored health insurance programs, including Medicare, Medicaid and Child Health Plus, which was introduced in 1997. In May 2004, Fidelis Care began Fidelis Medicare Advantage and Dual Advantage to serve the members.
Qualified Health Plan members and their spouses are eligible for Fitness Reimbursements, which pay you and a covered spouse up to $600 per year when you enroll in a qualified fitness facility and each visit at least 50 times in a six-month period.
NYS Medicaid covers all essential dental services. “Essential” means that only medically necessary procedures will be covered , such as extractions to prevent disease. Kids (under 21) can receive a bit more dental care thanks to the EPSDT (Early Periodic Screening, Diagnosis, and Treatment) program.
The Emergency Medical Treatment and Active Labor Act While a doctor has every right to deny treatment for various reasons, they can ‘t refuse to treat a person with life-threatening or serious injuries even if they don’t have health insurance or the ability to pay.
Low payment rates are often cited as the main reason doctors don’t want to participate in Medicaid . Doctors also cite high administrative burden and high rates of broken appointments. Under the Affordable Care Act, primary-care doctors who see Medicaid patients received a temporary pay raise.
Second, there may be differences in the characteristics of physicians who predominantly serve patients with a certain insurance status. A study of hospitals in Florida has found some evidence that, compared to other patients in the same hospital, uninsured and Medicaid patients are treated by lower-quality physicians .