Important Information on the Expansion of the Essential Plan

New York State has expanded the eligibility of the Essential Plan. Individuals with an annual income between $30,121 to $37,650 are now eligible for Essential Plan 200-250. Essential Plan 200-250 is a low-cost alternative to your Ambetter from Fidelis Care Qualified Health Plan and has a $0 monthly premium.

Carefully read any communications from New York State to understand your options. You have choices. You can:

• Switch to Essential Plan 200-250: New York State will automatically move you to Fidelis Care's Essential Plan 200-250 unless you opt out of the change.
• Stay in your Ambetter from Fidelis Care Qualified Health Plan: You can choose to stay in your current plan by opting out of the Essential Plan 200-250. Follow the directions in the letter from New York State by the provided deadline. If you opt out of the Essential Plan 200-250, you will lose any subsidies that you receive to lower the cost of your premium.

The Essential Plan 200-250 is a quality, low-cost health plan from Fidelis Care - the same health plan you know and trust. The plan features a $0 monthly premium, $0 deductible, and no or low out-of pocket costs. 

The Essential Plan 200-250 includes a full range of benefits to support your health and wellness, including: 

• FREE preventive care like checkups with your primary care provider and routine screenings 
• Dental and vision care with $0 copay 
• Hospital care 
• Prenatal care 
• Prescription drugs 
• Lab tests, X-rays, and more 
• $400 fitness reimbursement each year 
• And much more!

New York State will determine the date that you are moved to the Essential Plan 200-250. The dates are either April 1, 2024, or May 1, 2024. Read the communication from New York State. Fidelis Care will also communicate this information to you. You will receive a Welcome Kit from Fidelis Care in the mail 6-10 days after your enrollment date. It will contain your ID card and other important information.

Your Essential Plan 200-250 member ID card will say Fidelis Care instead of Ambetter from Fidelis Care. While the cards look different, both plans are from Fidelis Care. You are still getting the same care from the company you know and trust. You will still use the Fidelis Care Member Portal, visit the Fidelis Care website, and call Fidelis Care Member Services. For your convenience, you can use the Essential Plan Member page. You can call 1-888-FIDELIS (1-888-343-3547) when you need to contact Member Services. 

If you don't already have a primary care provider (PCP), you will need to choose one. If you already have a PCP or see a regular doctor, then the doctor can probably be your PCP. Use our Find a Doctor tool to make sure your provider is in the Essential Plan. If the provider is in the Essential Plan, call Member Services at 1-888-FIDELIS (1-888-343-3547) and ask your Representative to assign the provider as your PCP.

You should also check to see if other providers that you see are in our Essential Plan network. If they aren't and you are currently receiving treatment, then you will be notified by Fidelis Care about your options to maintain care. We want to make sure there are no gaps in your care.