Health Insurance Plans from Fidelis Care vs Healthfirst | HelpAdvisor.com (2024)

Christian Worstell | November 16, 2023

Finding the correct health insurance coverage can feel like a hassle, but getting your medical bills covered is important. When weighing available health plans, it’s vital to see what coverage you’re eligible for and get clear on the premium and copays you may need to pay. If you’re a New Yorker, Fidelis Care and Healthfirst are two well-known companies that provide a range of plans for individuals, families and small businesses. Keep reading to learn more about the plans each company offers so you can decide which works best for you.

What Plans Does Fidelis Care Offer?

Fidelis Care provides health insurance coverage to over 2 million New Yorkers. There are plans to suit adults and children, with online tools to help you make a payment and find a doctor in your area. While some plans are only available in selected counties, there are several options to choose from depending on your specific needs.

Available plans include:

• Medicaid managed care: For low-income adults, families and people with disabilities. It may cover ER, prescriptions, vision and dental care.
• HealthierLife: For people who struggle with behavioral difficulties and qualify for Medicaid. It can help with finding housing and employment, among other services.
• Low-cost child health: This covers children under 19 and may include benefits such as speech and hearing services, prescriptions and hospital care.
• Fidelis Care at Home: For Medicaid-qualifying enrollees who need ongoing support, this coverage could help with social care, therapy and nursing.
• Bronze, Silver, Gold or Platinum Health Plans: These may cover individuals and families for a wide range of services including dental, vision, childbirth and chronic illness management.
• Medicare Advantage: Comprehensive coverage to help manage Original Medicare (Medicare Part A and Part B) plus other benefits that Fidelis Care offers.

Fidelis Care also provides a wealth of resources in its online databases. This includes cost calculators, downloadable forms and member handbooks.

Does Fidelis Care Cover Emergency Room Visits?

Some plans offered by Fidelis Care may provide coverage for emergency room visits and the use of ambulatory services. These could include the Medicaid managed care, Essential and Quality Health plans.

What Plans Does Healthfirst Offer?

Healthfirst is also a New York-based health insurance provider, focused on coverage for individuals, families and small businesses with 100 employees or fewer.

Healthfirst offers the following plans:

• Medicaid managed care: May help people under 65 with low-income pay for services such as doctor’s visits, lab tests and hospitalization.
• Essential plans: May cover basic health services such as prescription drugs with a $0 monthly premium.
• Child health plus: Provides coverage for children under 19 with no copays and a premium based on the household income.
• Leaf plans: Includes customizable plans for families of all sizes, with premiums depending on household income and coverage level.
• Personal wellness plan: For people who receive Medicaid and are eligible for help with behavioral health issues.

Healthfirst’s app provides lots of useful benefits for its members, including a digital ID card, access to virtual care and a tool to help you find a local doctor. Some eligible Healthfirst members may also claim a free Android smartphone with an unlimited data plan to encourage the use of digital services.

Does Healthfirst Provide Coverage in New Jersey?

Healthfirst doesn’t currently provide coverage in New Jersey. Healthfirst may only cover enrollees living in The Bronx, Brooklyn, Queens, Manhattan, Staten Island, Long Island or Westchester, Orange or Sullivan counties.

Fidelis Care vs Healthfirst: Before You Decide

Before choosing a health insurance marketplace, see if you receive coverage through your employer. If you don’t, then first consider what health needs you or your family have to determine the best coverage. From there, you may want to compare the plans available. It may be wise to weigh out-of-pocket costs like copays and premiums along with what services are covered to make the best decision for you.