Explore Fidelis Care’s health insurance options in New York, covering addiction treatment, mental health services, and more for families.
Fidelis Care Coverage for Substance Abuse & Rehab
Explore Fidelis Care’s health insurance options in New York, covering addiction treatment, mental health services, and more for families.
Fidelis Care is a subsidiary of Centene Corporation and they offer a wide range of health insurance plans in New York. They have individual and family plans in partnership with Ambetter through the state’s Insurance Marketplace and offer Medicaid options. They also have Medicare Advantage plans in partnership with Wellcare.
There are 20 community offices throughout the state so that members who have questions can come in and get in person help. There are also regional offices in Buffalo, Albany, Syracuse, New York City, and Rochester.
The company also has a mascot, Fidelisaurus, which they use to promote child and family healthcare. It’s used to make healthcare and health coverage less intimidating to children and their families and to connect health to having fun and being active.
Does Fidelis Care Cover Addiction Treatment?
Fidelis Care plans include all the essential benefits required by the Affordable Care Act. This means that Fidelis Care plans cover addiction and mental health treatment at some level.
However, every plan has different limits and requirements for coverage. It’s essential to check the specifics of your plan before deciding on a treatment center. You may need a referral and/or preauthorization for certain types of treatment.
All insurance plans focus on medically necessary care so it’s important to work with your doctor to get a treatment plan. The treatment plan will help direct you in what type of care to look for and will show what’s medically necessary in your case.
This place change my life thanks to all the staff there treating me like family I got so much love there thank you and met some new friends.
Chubb Rock
4 weeks ago
7 years this February I was at the facility and it was sensational. I loved the staff and the food. You have to want recovery and if you do this is the place. I took the treatment in stride and used it for what it is there for. You have to decide on your own to be clean and that mentality is all that you need! The facility was to help guide me and an escape for me to see my own acceptance. Thank you. To everyone become the 1 percent and never look back. Patrick Croft
Patrick Croft
4 months ago
I don't understand these bad reviews; I know some people are forced to be there, and are defiant(possibly coming off harder stuff), but some people left and decided to come back. There were fights but not physical. I wasn't there very long, quick voluntary detox from alcohol; I found the staff all to be very nice; kitchen staff helped me with my immense food allergies, and gave me great food that I wasn't expecting, it was so good, and I'm a chef who makes almost everything from scratch. The nurses were awesome... I can't speak for others, but some disgruntled people had reasonable criticisms, and when people are detoxing, maybe sometimes, their negative attitudes require more patience and compassion. I was happy to be helped. The only reason I didn't give 5 star is because maybe cuz I was appreciative for being helped; recovering people may need, like I said, more patience, and also, I "needed" a doctor's note to go back to work; after a week of calling multiple times, and never receiving as promised, my boss brought me back on a technicality. I also was 'referred" to outside resources; I haven't received any; I received a 3rd party call, but nothing has got done. Either way, from residents I talked to, this is the best facility around, many left, and told me it was due to their addiction, and then tried other places and chose to come back to this one. It is not bad to stay there, and they give you free cigarettes, which may be questionable, and I had quit smoking, but smoked a ton. They let detox do that, but residence has scheduled smoke breaks and way more rules and requirements. It took a few days but I'm down to barely smoking. I think free cigs is good, even though it's bad for you and addictive, it actually acts as group therapy,from my own experience, and if you're coming off something, nicotine my be addictive, but doesn't require detox, and just like with a variety of meds they use to treat detox/withdrawals, it is kind of a comfort med. Either way, I thought this place was great; they definitely rely on a lot of funding,some personal, and I only stayed 5 days, my financial assistance would have paid for 7 if the nurse thought it was dire, but they weren't gonna cover programs, and I felt detoxed.
Hospital is good, staff is good! Have found some of those metal strands from a grill brush in my food on a couple different occasions and recently. I hope it is resolved soon!
Luke
6 months ago
Louis a Johnson is a really good VA hospital that seems to take really good care of their veteran patients we ve been going there for years for my father. They ve always done their job to the highest.
This place is amazing and has truly saved me! The staff made the house feel like a home.i learned so much being there. Thank you to everyone there for making this experience truly unforgettable and life changing
Amy Newson
5 days ago
Serenity mountain changed my life! Between the caring house staff, knowledgeable clinical team and great activities, this is a great place to grow, learn and recover. While I was there, I was able to learn so much, about myself, my disease, and God. We had opportunities to go to off campus activities including drum aerobics, enerchi, yoga, church and even special things like concerts, ice cream runs, local NA/AA meetings and women’s retreats! The councilors genuinely care and want the best for each and every one of the girls on the mountain, and the house staff does everything they can to keep us safe, healthy, and happy throughout our time there. Sandy and Joe genuinely do their best to help each individual woman and truly care about recovery. The food is much better than most rehabs, and the rooms are large, clean and very comfortable. There is even two house dogs, Chloe and poppi, who make adjusting to the mountain much easier and provide great emotional support when needed! Overall, I highly recommend serenity mountain if addiction is something you struggle with, the road to recovery isn’t always easy, but the mountain is a great stopping point along the journey!
Rhaine Reynolds
8 months ago
Breath taking views amazing landscape and peaceful presence..God's mountain is a wonderful experience to find oneself
This place has helped me save my life. Everyone was pretty amazing. Keep up the great work.
Jenny Shortell
3 days ago
It's been a few years since i stayed but time hasnt eraesed the good memories. The place is very nice with a large cobblestone court yard in the the middle. Theres some small water features as well. I will admit that the rooms could use some updating.The folks there were very kind and respectful and the food was always good, its buffet style if I remember correctly. My counselor was great and the nursing staff was freindly. It's coed and they do the classes together but do not mess arounnd with the girls because they will boot you quickly.
Caring and compassionate therapists, I am very grateful to both Jacquelyn and Alexa in particular!
Ryan Wiehl
1 year ago
Wholeview has a wonderful team of therapists and excellent evidence based innovative group therapy programs . They also work with clients to make these financially accessible. Overall wonderful!
Joseph Eviatar
1 year ago
I have a loved one that has benefited greatly from Wholeview. The team is top notch and the groups they offer have lead to a significant improvement in the lives of those who participate.
Wanna shout out to Heather and Ron!!!! You guys are huge assets to this place. Thought about you guys this morning when I woke up.. still sober today 4 months 21 days! Life is beautiful. Freedom from fear is more important than freedom from want! <3 thank you Melissa M.
Update. 362 days sober by the Grace of God!
Update 26 months sober!!!
Just celebrated 3 yrs 4-26-22 ❤️
Mel May
1 week ago
I had Destiny Mast as a counselor she helped pull me the rest of the way out of my shell. Also helped open my eyes to be a leader. I choose white deer because I know it capabilities. Go off your own experience not what people say. I'd choose it again if need be.
Chatera Maurnice Jamison
1 month ago
I wld recommend this place to anyone looking to get clean. The staff and counselors were terrific. Lots of activities. You can go to the gym everyday, go on hikes, play softball, go to music therapy and even acupuncture. Also the food was good. I almost stayed longer. But in the end it’s what you make of it.
Excellent !!!!!! Personally we love Morrissania for us they are part of our family. We always pray for them. God bless them always Amen
Nery Tavarez
3 months ago
I give them five stars because I am diabetic and they on it like definitely on it. The only thing I don t like is back to back appointments. I do not receive Medicaid and this is out come from my pockets so financially it hurts a little bit but as for the doctors, they perfectly great great, the only thing I said is back to back appointment for the same thing with different doctors but other than that, they absolutely great
Babs Cast
8 months ago
It is an excellent clinic, I and my family have been treating each other for 24 years and they have always treated us with great professionalism.
I went here and absolutely loved it and I would refer it to any body just remember if you go make sure your really ready todo the program cause its worth it if you are! You are it's with it so do it what's the worst that could happen if you try?
Jessica Pflughoft
6 months ago
Hi my name is Susie, I am an alcoholic and drug addict. My sober date is 8/19/2022. On August 19th, 2022, I entered NHM Barryville, seeking answers to my family and childhood trauma and to learn more about the disease of addiction. I am not the same woman who entered those doors in Barryville almost two years ago. What should be mentioned is that the beginning of recovery is very difficult. 28-Day programs only touch the surface I say this because at 3 months, that s when the real work began. I attended NHM Barryville Inpatient Residential Program for Women for about 6 months.At NHM Barryville, women were able to choose which groups they would like to take. There are five groups that women attend from 8am to 3pm Monday through Friday. Some examples of these groups are ACOA, Brain and Addiction Seminar,Sober Support, WRAP, Meditation Classes, Trauma: the Body Keeps Score, Team Building, Sign Language, DBT, CBT, Microsoft Office, Etc. Think of NHM Barryville as an opportunity to not only learn about how addiction affects your childhood to now, but to learn skills to cope with emotional reactivity, re-enter the workforce and explore hobbies and interests.Women are paired with a case manager/CASAC, and Clinical Social Worker. My CASAC was Abbe. She is kind-hearted, nurturing, and had unwavering patience with me as I began my journey. Deena, is a Clinical Social Worker that has been with the agency for over ten years and has profound knowledge on everything from addiction, any DSM-5 diagnosable mental illness and is a phenomenal advocate for her clients. NHM Barryville is a program that has the potential to open your innermost door to freedom, if you allow it to. It is a tough environment but well worth the time I spent there becoming reacquainted with myself. Other benefits of the program include No cell phone (This is a good thing trust me!), Weekend recreation, opportunities to take leadership roles, Living Room with a TV, Use of computers in the computer lab, In-House physician, family style meals at Holidays, visits with family, etc. I can go on about NHM Barryville, however, rehab is what you make of it. I implore anyone who has a desire to stop using drugs and alcohol and reform their life to take a chance and try it out.After Barryville I had the opportunity to live at NHM Poughkeepsie Transitional Living (Sober House). At NHM POK I learned how to transition back into society. I learned about community resources that could help me in Dutchess County. I overcame numerous fears (i.e. re-entering the workforce, dealing with conflict at work, and with peers, choosing healthy relationships, etc.). I learned the importance of how programs such as outpatient, mental health therapy and Alcoholics Anonymous, would be vital to my recovery when I was discharged and living on my own (all of which I attend today). At NHM POK women have the opportunity to see the CASAC Clinical Social Worker (Elisa) once a week, and attend 2 house meetings. Women are required to re-enter the workforce, with the intention to save money to transition to independence. The Clinical Program Director, Erika, is available every single day from 7am to 3pm. These women have been pivotal in my recovery as well. Lorraine is the Vocational Counselor, She teaches us how to be financially responsible and take accountability in how we manage our professional lives. In addition to Erika, Lorraine and Elisa, Clinical Support Staff is available at all times these women provided me with comfort and safety every step of the way.The key takeaway is that I am blessed to have the opportunity to make contact with women across the board at NHM, Inc. who are aspirational role models of grace and dignity as well as dedicated advocates that helped me reach my goals.
Susan Taylor
1 year ago
I was in the rehab for 9 months and I went to the reintegration house in Poughkeepsie for 15 months. New Hope has had the best impact on my life. I'm still connected with some of the staff. They genuinely care. If your ready to get sober this is theeeee best choice I will always advocate for New Hope when it comes to women in addiction. I recieved support and guidance in the areas much needed at that time.
This is hands down the best place I've ever been to. The counselors and employees are great. Also the food is so good better than any other rehab I have gone to.The Chef prepares the best tasting food. A special thanks to Jazzy jazz- absolutely amazing - she really treated me well..She motivated me to start writing poems again as well as Ms Sherry. my couseor Ashley was very helpful and she really cares. I am now in the outpatient program which was set up by Maryville and I am happy and that peace. There's ANGELS surrounding this place
Charlene Chapman
3 months ago
I have been in and out of this treatment center numerous times, but they always welcomed me back with open arms. Now I m able pay it forward and take someone so precious to me here to start their journey. I had to do a drop off and a man Kirby helped me and was just so kind. It s little things. Kirby & the rest of the Maryville family thank you so much for never giving up on me and taking care to my loved one! I can t express my gratitude enough.
Wonderful organization. They help so many in the community. I'm very grateful for their services.
Tate Burke
11 months ago
A great recovery place. Very helpful, staff is very committed to the clients.
Darryl Edmunds
3 years ago
Thanks joe. Incredible staff that cares.
Tommy Rutherford
5 years ago
No results Found.
The combination of filters you have selected has no results. Please refine your selections and try again.
What Insurance Plans Does Fidelis Care Offer?
Fidelis offers a wide range of plans that span across individual and family plans as well as Medicare and Medicaid.
Individual and family plans are offered in partnership with Ambetter and can be purchased on the Insurance Marketplace in New York. These plans will be separated by “medal level”, designated as Bronze, Silver, and Gold. Bronze plans cost less per month but only cover an average of 60% of the cost of care. Gold plans have more expensive premiums but cover 80% of the cost of care. Silver plans are in the middle, balancing the premium and out of pocket costs.
Fidelis Care also has multiple Medicaid plan options. Those who qualify can get regular Medicaid coverage but also have access to Fidelis’s HealthierLife Plan. HealthierLife is a Medicaid plan that supports those with specific behavioral health needs such as addiction or mental health diagnoses.
The company also offers Child Health Plus for children of families that earn too much to qualify for Medicaid. If you qualify for both Medicaid and Medicare you can also look at the Dual Advantage plan from Fidelis Care. Finally, those who need long term care to live independently at home can get Fidelis Care at Home as Managed Long Term Care coverage.
For those who qualify for Medicare Fidelis Care offers a Medicare Advantageplan. An Advantage plan replaces Orginal Medicare and often gives you additional benefits that Original Medicare doesn’t such as vision and dental care. However you also need to use the provider network of the Advantage plan rather than using any Medicare provider in the country.
What Inpatient Addiction Treatment Does Fidelis Care Cover?
Fidelis Care insurance focuses on medically necessary care so the first step in treatment is to get a treatment plan from your doctor. You can then confirm your insurance coverage and your specific plan details.
Inpatient addiction treatment is typically recommended if you have a more severe case of addiction. Sometimes residential treatment is also recommended if you do not have a stable living environment. Your doctor will do an assessment to decide if this type of care is appropriate for your needs. You may also preauthorization from your insurance plan before you begin.
During inpatient or residential treatment you stay at the treatment center to complete the treatment plan. Depending on what substances you use you may need medical detox before the main treatment phase.
Treatment involves group and individual therapy as well as holistic treatment and recreation. The average length of stay is usually around 30 days but can be as long as 90 days or more.
What Outpatient Rehab Does Fidelis Care Cover?
Outpatient care is less intensive than residential treatment but you’ll still want to check with your insurance company to confirm coverage and get preauthorization if needed.
There are multiple types of outpatient care including partial hospitalization programs (PHPs) and intensive outpatient (IOPs) as well as general outpatient care. A PHP is a full day program in many cases and delivers similar services as inpatient or residential rehab except you are home at night. An IOP is more flexible and generally has three hour sessions a few days per week. You can often choose to have morning or evening sessions to make it easier to manage work and school schedules.
Finally general outpatient care only meets one or two hours a week. Sometimes a period of aftercare is recommended following the completion of a rehab period. Aftercare helps support your new habits and can also connect you to social services that you need to stay stable.
Does Fidelis Care Cover Methadone & Suboxone (MAT)?
Medication assisted treatment (MAT) often includes the use of drugs like methadone and suboxone which are FDA approved to treat opioid use disorders. There are also medications that can help with alcohol use.
These medications can be used during the initial detox period that may precede a residential stay for addiction treatment. They can also be used as a long term treatment to help patients stay stable and avoid relapse.
Methadone and suboxone are long acting opioid agonists which means they influence the same receptors as opioids but they don’t deliver a high. Naltrexone and Vivitrol can help control alcohol use disorder during treatment.
Does Fidelis Care Cover Other Mental Healthcare?
As mentioned earlier Fidelis Care plans provide at least some treatment for mental health conditions but it’s important to check your plan details to find out any limits or requirements.
Some treatment possibilities for mental health conditions include crisis support and behavioral therapy. These can help you if you struggle with depression or anxiety. Personality disorders and PTSD and other mental health diagnoses can also be treated.
Co occurring mental health disorders are common with addiction and it’s important to treat both the mental health condition and addiction at the same time to facilitate a long term recovery.
If you have a co occurring disorder — which is also known as a dual diagnosis — your treatment plan will take that into account and you will need to look for integrated mental health and addiction treatment. Fortunately many treatment centers specialize in this kind of care.
How Long Will Fidelis Care Cover Rehab?
Your Fidelis Care insurance plan may have limitations or requirements that affect the length of rehab. In most cases though your length of rehab is based on your medical needs.
Your doctor and the treatment center determine how long you need to be in a rehab program. A PHP or residential treatment can last between 30 and 90 days. Intensive outpatient programs (IOP) typically last between six weeks and three months. General outpatient programs are longer because they help you maintain your new habits and provide ongoing support.
Can I Travel Out of State For Treatment With Fidelis Care?
Whether you can travel out of state depends on your exact insurance plan with Fidelis Care.
If you have Medicaid you’ll be limited to the state you live in. Most other insurance plans require you to stay within a specific provider network unless you need emergency care.
Some Fidelis Care plans do include coverage for treatment outside the network but you’ll end up paying a lot more in deductible and copayment costs. Generally staying in your designated medical network ensures the most coverage and the lowest costs and your network will focus on your local area.
How to Verify Coverage With Fidelis Care
If you need to verify your coverage with Fidelis Care the best way to do so is to contact customer service by phone or by logging into your member account online.
Sometimes, you may have the opportunity to ask your treatment center if they accept your insurance plan. You can verify your coverage this way if you use the exact plan name under Fidelis Care. Not all plans offer the same coverage so even if your treatment center accepts Fidelis Care your plan may not have the coverage you need.
Calls to any general helpline will be answered or returned by a paid advertiser.
By calling the helpline you agree to the terms of use. We do not receive any commission or fee that is dependent upon which treatment provider a caller chooses. There is no obligation to enter treatment.
Sponsored Helpline
800-784-1361
Dual Diagnosis
Substance Abuse
Adult Program
Young Adult Program
LGBTQ Program
Private Insurance
Self-Pay Options
Medicare
Medicaid
Alcoholism
Drug Addiction
Mental Health and Substance Abuse
Opioid Addiction
Military Program
Financial Aid
Sliding Scale Payment Assistance
Military Insurance
