Fidelis Care Logo
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3.3

Overall Score

LAST UPDATED: April 12th, 2024

Fidelis Care offers a range of health plans in the state of New York. Some plans have treatment cost calculators that help you plan for costs. Some plans also offer case management to support preventive care and manage conditions like asthma.

Although Fidelis Care reviews are limited on BestCompany.com, its helpful treatment cost calculators and case management services make it worth considering for those interested in better cost estimates and support navigating health care.

Read Fidelis Care Reviews

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The Good

  • Treatment Cost Calculators
  • User-Friendly Site
  • Good Insurance Plan Selection
  • Case Management Services

Treatment Cost Calculators

Fidelis Care offers treatment cost calculators with some of its plans. You can use these calculators to understand and anticipate health care costs. This tool helps you budget and plan for needed care.

Few health insurers offer similar calculators, so this feature makes Fidelis Care stand out.

User-Friendly Site

Fidelis Care's website is accommodating to visitors' needs. It's easy to change the site's language from English to Spanish, Russian, or Chinese. You can also adjust the font size to make it easier to read.

Good Insurance Plan Selection

Fidelis Care offers a range of health insurance plans including Medicare Advantage, Medicaid Managed Care, Child Health Plus, and qualified health plans on the Health Insurance Marketplace. It also offers Essential Plans for people who need health care but are not eligible for Medicaid or Child Health Plus.

If you have a Fidelis Care health plan from the Marketplace, you'll also benefit from access to telemedicine, mail-order pharmacy, and fitness reimbursement. Fitness reimbursements are becoming a popular offering among health insurers, so this inclusion makes Fidelis Care's Marketplace plans competitive.

Fidelis Care also offers a Health and Recovery Plan (HARP) called HealthierLife for qualifying individuals who also have Medicaid or Managed Care plans. This program offers support for behavioral health and provides services to help members find a job, get housing, complete school, and achieve other life goals.

As you evaluate plans, consider the monthly premium amount and out-of-pocket costs (e.g. deductible, copay, etc.). Understanding the full cost of your health plan will help you find one that meets your coverage and budget needs.

Case Management Services

Fidelis Care also offers a few different case management services. It offers population case management, which provides services like reminders for preventive care and coaching for self-care.

You can also receive case management services if you have certain medical conditions like a high-risk pregnancy, organ transplant, or asthma.

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The Bad

  • Limited Availability
  • Minimal Customer Insight

Limited Availability

Fidelis Care coverage is only available in New York state. If you live outside of New York, you'll need to choose another health insurer.

Minimal Customer Insight

Fidelis Care doesn't have many customer reviews on Best Company. No conclusions about the customer experience with Fidelis Care can be drawn with a limited number of reviews.

However, Fidelis Care offers a range of health plan options and treatment cost calculators with some of them. If you're in New York, Fidelis Care is worth exploring further.

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The Bottom Line

Although a full recommendation cannot be made for Fidelis Care because of a lack of customer reviews, the insurance company is worth exploring further if you live in New York.

Fidelis Care offers Medicare Advantage, Medicaid, Essential Plans, and qualified health plans. If you're looking for an affordable health insurance plan, you can find good options from Fidelis Care. Some of its plans even include treatment calculators that help you plan for medical costs.

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Star Rating

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1.2

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22 Reviews

Review Breakdown

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4 grade

5%

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2 grade

5%

1 grade

91%

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Tony

There needs to be a ZERO STAR option for this mob. As has been said before, they don't give a damn about anything except their profit margin - a typical "profits before patients" attitude. They have denied my wife MRI's because THEY don't think they arec needed - evidently some little insignificant and irrelevant clerk knows more about what my wife needs (medically) than my wifes doctors. They have denied medications prescribed to my wife for pain UNTIL they decide to approve them and to hell with what my wifes doctors say. As for the MRI's - they are for a serious shoulder/rotor cuff injury that has her in pain 24/7, unable to sleep properly and prevents her from doing the most mundabe things such as brushing her own hair. Instead - bloody fidelis told her to go to physical therapy for 10 visits first and then they "MIGHT" approve an MRI. The whole point of the MRI is to identify the exact nature of her injury/s so they can be TREATED properly and without causing further damage!!! Therefore - fidleis deliberatly puts it's customers at risk just to save a few damn dollars. This company needs to have a major - class action law suit taken out about them. When my doctors are telling me that Fidelis is the worse of any insurance company then there is something wrong, very wrong. Fidelis needs to be investigated and for their licence as an insurance company be "DENIED" in the interest of "Public Safety"!

3 months ago

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Lilliana Hernandez White Plains, NY

I have child health plus for my kids. So far I do not complain of the coverage, but to make payments is terrible. It's like their system is from the 80's. If I pay online I have to pay for my 2 kids 2 months ahead. there is no other way to pay online. the other option is by phone, So I do this and they always assign the payment to only one of my kids and the other one have ended up with no insurance because they not do split the payment between them. I cannot pay of them individually, the system won't allow it. This is so aggravating that I will probably will just change insurance next month.

8 months ago

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Wilton Widman Brooklyn, NY

They don't assist in helping find doctors. Their website is completely inaccurate. Tried calling four doctors today two were not taking new patients and two were not even practicing medicine anymore. One of them stopped practicing about five years ago according to the office. The proper filters were applied while searching for a new doctor but ended up totally fruitless.

9 months ago

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Ellie Monroe, NY

I am very upset with the service of Fidelis Care. Through my health plan, I am entitled to 1 annual check up per year. I signed into my member portal on their website and used the "Find a Doctor" search tool in my area for an OBGYN covered by Fidelis. I booked an appointment with an OBGYN in network and had my annual. Later, I received a notice that my claim was denied and when I called, they claimed that this provider was out of service for my specific plan with Fidelis. They informed me that my plan (Fidelis Care Catastrophic Coverage) ALSO has two other names- "Qualified Health Plans" and "Metal Coverage." They claimed I should have known this and known to check that the provider, which accepts Fidelis Health Insurace, accepts "Qualified Health Plans." Fidelis purposely creates confusion and misleading information on their website by allowing me to "Find a Doctor" on their website that doesn't cover my specific plan while I am logged into their website. Furthermore, the website doesn't even have an option to search for my Catastrophic plan, and instead lists it under a different name (Qualified Health Plans).

1 year ago

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Roda Lu Queens, NY

My son has had Fidelis Care for the past 3 months and already I can tell this is the worst managed care plan we’ve ever joined. Unfortunately for us, we couldn’t continue to use UHC Community Plan which was excellent by comparison. My son is disabled, and I’ve been trying to submit a home health aide request for the past 5 weeks to no avail. I called to request a copy of the application on 3/3, and even after consistent follow-up by me, I didn’t receive the application until 3/21 … 18 days later. The employees are also extremely careless with private information because Fidelis did send me a complete stranger’s benefit request by error - I don’t need to go into detail about privacy laws and how such carelessness infringes upon that. Fidelis has absolutely zero follow-through and they take no accountability for being called out on their lack of communication. I faxed my son’s application back to them on 4/3 and when I called today (4/13) they informed me that something was missing from the application. When asked why no one contacted me, the manager made up a call attempt which was weak and clearly not true since a message would have been left if I hadn’t answered (and I had no missed calls). If I had a choice to switch to someone else … I would, but I don’t. However I do have the right to start filing complaints about their lack of professionalism, and I will!

1 year ago

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K Asa Wynantskill, NY

Fidelis care is absolutely the worst insurance company I’ve ever dealt with. They will do whatever it takes not to answer calls and get you the runaround when they do. Good luck getting a claim paid by them. Beware, the bills will start piling in long after the the timeframe for fighting it. They make certain of that! If you have options I strongly suggest you go with a reputable company, one that actually pays for your services. I would imagine that it’s only a matter of time before the state shuts them down for their practices. If you have options please look into all of them and ask people that have felt with them before you get stuck in a contract.

1 year ago

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S Ringers Massapequa, NY

Horrible. My son started with them 10/1/2022. Claim from October was paid. In November my son needed significant testing and medical treatment for a newly diagnosed illness. They start denying claims. We call and I'm told that the doctor has been asked to provide medical information and he has not yet responded. 2 weeks later the dr bills start coming to us. We call Fidelis Care again and now they are claiming my son has other insurance. NYS of Health had already verified he had no other insurance, but I email them proof the other insurance ended months earlier. No response. All the many thousands of dollars of claims are now denied. We have sent in paperwork allowing me to speak on behalf of my son and they still refuse to speak to me and won't even say if they received any of the faxes. We filed a fast track appeal that was supposed to be decided within 72 hours. Nothing. I called Friday and was hung up on three times! Nothing enrages a person like waiting 30 minutes on hold for a supervisor only to be connected and after half a sentence you get the post phone call survey start playing. As of Friday they tell me it will be at least another 7 - 10 days before they will have a decision. At this point we have filed a complaint with the New York State Department of Financial Services. My son cannot schedule any follow up appointments until this is resolved. Oh and the representative from NYS of Health advised me to switch to another carrier as they have numerous complaints about unpaid claims from Fidelis Care. Do not choose Fidelis Care. They are literally not planning on paying any of your medical claims. They have given me inaccurate reasons for the failure to pay claims. I wonder what they'll claim next week?

1 year ago

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Simmone Adams-Duckett Hoffman, NJ

Horrible, Nurse Case Managers and Coordinators for Long Term Care Clients are worthless. They take their time returning phone calls and will only do so when you tell them that you will call their corporate offices. When you finally get them, they do nothing to assist the client. Transportation department is undependable. They will keep you on hold while they say that are trying to get a vendor for transportation only to tell you that a vendor is not available to transport you to your medical appointment even though it is listed as a benefit. They do not care about their patients. Stay away from this company.

1 year ago

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WastedTalent Binghamton, NY

I just got it because I moved to upstate NY from Long Island. The nearest doctor with availability to see new patients is 25 miles away. The nearest CVS is 22 miles away. The nearest lab for bloodwork is almost 30 miles away. I have a Walgreens about 10 minutes away, but they're not part of CVS Caremark. Fidelis stopped shipping meds with Medicaid, so I have to drive a half hour to pick them up. Don't they understand that most people on Medicaid already have limited funds and accessibility? I am unemployed right now and it costs me a quarter tank of gas to pick up my meds. I'll gladly pay the $5 to ship my meds every 3 months if it means I don't have to make a special trip just to pick them up.

2 years ago

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sharon yager Buffalo, NY

I would give zero stars if it were an option. Fidelis continues to allow difficult protocols and algorithms to impede patient care. They lock in their patients to one prescriber when they feel like it, resulting in patients not getting life saving meds like Suboxone. They do not accept letters of medical necessity. They make you provide a tax ID just to have a conversation over the phone after waiting 15-20 minutes just to get a live person Would not recommend. Many providers will not participate with them because of how unethical and difficult they are to work with

1 year ago

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K M Endicott, NY

DO NOT TRUST! They do not pay their vendors and several home health aide agencies and transportation companies have told me they do not work with Fidelis because they do not pay their bills! Four transports out of four were cancelled last second! Incredibly unprofessional and incompetent. Three weeks and no home health aide and no transportation and no returned calls. Avoid this company at ALL costs. I would leave 0 stars if I could!

2 years ago

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Teresa Quinones

Try finding a dentist that excepts Fidelis Medicaid, right!! They don't want to pay these doctors and the doctors are dropping coverage because of it!! Start paying more so we can get our teeth fixed!! Even when I was paying, couldn't find a denist!! You should be ashamed of yourselves...also, get a new updated dental list...the one you have isn't any good, there are no dentists on there that take your insurance or aren't taking new patients!! Bad bad bad...I switched to another insurance!!

2 years ago

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Saundra Besecker Perry, NY

I would give zero stars but I can't. You are constantly lied to by representatives. You are given false extension numbers to try to resolve your issues. When dealing with CDPAC services,home care, they are totally in denial as to what care and how many hours you actually need! They lie. They lie they lie. This is the most frustrating insurance company myself or even my care managers have had to deal with! They refuse to talk to my care managers and badger them too! Even though papers were signed that they can talk on my behalf! Evil company!! Evil company!!

2 years ago

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Andrew Bahnken Bay Shore, NY

They deny the medicine that your doctor prescribed because they want to save money. When you call customer service they can't help and are rude. When you ask to speak to a manager they get mad and say they can't help you either and hang up. They just want your money and couldn't care less about their customers. I wish I could rate them 0 they rum such a disgusting practice

2 years ago

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lori jarhoud Mount Vernon, NY

Appears to offer a lot but in actuality, many good docs do not accept Fidelis. The dental plan part of their qualified health plans is with dental students. Want to see a specialist, well if you have a qualified health plan that you pay for every month , you are limited. Fellows and PA's is what you'll get. The docs that do accept Fidelis, are paid small amounts, so don't expect the best serve HORRIBLE

2 years ago

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Robert Granata Ambler, PA

They are awful. I've only had 3 submissions to them and on all 3 they sent a cryptic letter requesting a prior authorization. It seems like they are hoping that members will discontinue the submission of their claim. They don't code these as claims either. I've never seen anything like this.

2 years ago

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Review Source

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Nikhila B

Terrible customer service ! Extremely rude people . They need a refresher on soft skills . Definitely will not renew with them.

8 months ago

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Gioacco Mahopac, NY

I like the choice of doctors, and the customer service is great. But they are lacking in preventative care.

3 years ago

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Emmy Elmasry Staten Island, NY

If I could give this company zero star I will do it,I requested a new ID card 5 times in 3 months and I got nothing! I don’t know what is their problem!

2 years ago

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William Lank Rome, NY

Totally worthless CSRs.Tried unsuccessfully to enroll for over 2 weeks.Gave up,f them

6 months ago

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Laura Jones Niagara Falls, NY

Very poor customer service, uninformed phone representatives.

2 years ago

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Terry Mudge Canandaigua, NY

They take the money, but don't cover anything.

1 year ago