Rehab Centers That Accept Fidelis Care in New York
Fidelis Care is the largest Medicaid Managed Care plan in New York State, serving over 1.7 million members. If you have Fidelis Care — whether through Medicaid, the Essential Plan, Child Health Plus, or Ambetter Marketplace — you likely have coverage for addiction treatment. Fidelis covers medical detox, residential rehabilitation, outpatient counseling, and medication-assisted treatment (MAT). Their HealthierLife plan specifically supports members with behavioral health needs including substance use disorders.
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Rehab Centers That Accept Fidelis Care in New York
Featured 30 Centers Accepting Fidelis Care
From 548 facilities that accept Fidelis Care, we've highlighted 30 starting points based on clear criteria.
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Showing 30 of 548 total facilities accepting Fidelis Care
What Fidelis Care Covers
Fidelis Care provides comprehensive substance abuse treatment coverage across all plan types. Medicaid members typically pay $0 for most addiction services. Marketplace (Ambetter) members have standard deductibles and copays but still receive full behavioral health coverage. All plans cover detox, inpatient, outpatient, and MAT as required by the ACA and NY State law.
Deductible Status
Whether you've met your annual deductible
Example range: $0 (Medicaid) / $1,000-$3,000 (Marketplace) (varies by plan)
Network Status
In-network vs out-of-network rates
Per-Session Costs
Copays or coinsurance amount
Example range: $0-25 per session copay or 0-20% coinsurance
Level of Care
Inpatient vs outpatient rates differ
Get your exact costs: Call 1-888-343-3547
Common Plan Structures
- HMO:Requires in-network care, lower costs
- PPO:Can use out-of-network, higher flexibility
- EPO:In-network only, no referrals needed
- POS:Hybrid of HMO and PPO
Plan Source Matters
- Employer plan:Group benefits vary by company
- Marketplace:ACA plans with metal tiers
- Largest Medicaid Managed Care plan in NY (1.7M+ members)
- Ambetter Marketplace plans with low premiums
- HealthierLife plan for behavioral health needs
- No or low copays on Medicaid plans
- Covers transportation to treatment
- Wide network across all NY regions
- Must use Fidelis network providers
- Marketplace plans have deductibles
- Prior authorization required for inpatient
- Some plans require referrals
What to Have Ready Before Calling
💡 Having this ready reduces call time and ensures you get accurate information
1Call Your Benefits Line
Call 1-888-343-3547 or the number on your card
1-888-343-35472Ask These Questions
- • What is my deductible and how much have I met?
- • What is my copay for outpatient therapy?
- • Does my plan cover inpatient treatment?
- • Do I need prior authorization?
- • General coverage information for the insurance plan
- • Whether a specific facility is in-network
- • Typical copays and deductibles for the plan
- • Prior authorization requirements
- • General admission process questions
- • Specific treatment history or records
- • Whether someone is currently in treatment
- • Details about their specific claims
- • Dates of service or diagnoses
- • Any personal health information
How to Talk to Insurance as a Family Member:
"Hi, I'm calling to understand what addiction treatment benefits are covered under [plan type]. I'm not asking about a specific person's claims, just what the policy covers in general." This approach gets you the information you need while respecting privacy laws.
Ask for a formal denial letter that includes:
- Specific reason for denial
- Policy section reference
- Appeal rights and deadlines
You have the right to appeal. Most insurers have 2-3 levels of appeals. The facility's billing team can often help you with this process.
- Different level of care (e.g., IOP instead of inpatient)
- In-network facility alternatives
- Single-case agreement for out-of-network
Federal law requires insurers to cover mental health and substance abuse treatment at the same level as medical/surgical care. If denied, ask if the same restriction would apply to medical treatment.
Frequently Asked Questions About Fidelis Care
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