Fidelis Care is a health insurance provider, giving coverage to more than 1.7 million children and adults at all stages of their lives. The coverage that Fidelis Care provides is done through Child Health Plus, Medicaid, Essential Plan, Health and Recovery Plan, Medicaid Advantage Plus, and Managed Long-Term Care. The legacy plan that is provided through Fidelis is covered through Qualified Health Plans, Medicare Advantage, and Duel Advantage plans. Fidelis Care has regional and satellite offices located throughout the state of New York, along with more than 20 distinctive community offices in the state. Fidelis Care provides outreach to the inner-city neighborhoods and rural towns, and they do work closely with hundreds of different partners to reach local residents in need and provide the resources they require. Fidelis care offers many different plans, some of which will help cover some cost with drug and alcohol treatment.
The website offers helpful tools to help people find doctors and get a quote for a plan quickly. They also provide Medicare information and can help people find a plan, locate a Medicare representative, and apply for Medicare online. For example, the Essential Plan is for New Yorkers who do not qualify for Medicaid or the Child Health Plus plan Fidelis Care offers. Within the Essential Plan, Fidelis offers different income-based tiers, and those who apply will meet certain income requirements. This particular plan through Fidelis Care is good for young adults and is great for those who cannot get health coverage through their employer. The benefits provided through the essential plan include such health benefits as preventative care and chronic disease management, emergency services and hospitalization, maternity and newborn care, and prescription drugs. Those in New York who have this plan, will not need referrals, but prior authorization may be needed for certain services or needed to see an out of network provider.
There are over 15,000 drug and alcohol rehabilitation programs in the United States according to the National Institute on Drug Abuse. One of the most common problems for people accessing treatment is being able to pay for it. Since drug and alcohol addiction is a major health concern throughout the United States, there are many programs that are funded by the state, and federal governments. Along with this, health insurance plans, such as what Fidelis Care provides, may also help pay for some cost of treatment. Many of the states do actually have laws in place requiring health insurance plans to cover addiction treatment. It is important to speak with your Fidelis Care health insurance provider, and ensure you are covered for drug treatment when or if the need arises. Substance abuse does not have to be a life-long problem, and despite financial barriers that may be there, options are available to help treat all types of addiction. These options can be affordable, and an addict will get the help they need to treat the addiction.
Ask a Professional
What is private health insurance?
Private health insurance is a form of insurance where the client pays a private entity for their choice of offered health plans. The plan’s cost is known as the premium, which can usually be paid monthly, bi-annually, or annually. These plans are among the most expensive options for healthcare coverage, but they generally offer superior benefits and provider networks than subsidized or free health insurance options. Some private health insurance plans allow clients to seek treatment wherever they choose, without being restricted to a particular region or network.
Does private health insurance pay for substance abuse treatment?
Private health insurance usually gives someone the best chance of getting complete coverage for quality treatment. However, it’s important to remember that private health insurance companies aren’t required to cover services they don’t deem necessary. You will not know the exact amount of coverage until an evaluation is done and the treatment center submits a claim. Make sure you talk to the intake counselor and fully understand how they handle insurance coverage. Doing so can ensure you do not have any unexpected expenses and that treatment will not get cut short.
How do I get private health insurance?
Private health insurance is available directly from the companies that provide it. Or a person may be eligible to join a “group” policy through their employment. Group policies are purchased by employers at special rates and may be offered to eligible employees for less than the same policy would cost an individual.
What if I don't have private health insurance?
Someone without private health insurance or cash payment may be eligible for Medicaid coverage. Or, they might find a free or low-cost treatment program with bed availability. Some programs provide sliding scale payment systems or allow patients to make payment arrangements. There’s almost always a way to find help if someone wants to recover from addiction.
Want to know more?
The questions from Addicted.org’s “Learn from our Experts” are answered by Michael Leach, CCMA. If you need further clarification on any of the questions above or have any other questions you can contact him directly at [email protected].