Low-cost Catholic health plan provides for NYS residents
By Katherine Long
Sun associate editor
Every day, for reasons of unemployment, economy or access, New Yorkers go without health insurance. Across the state, approximately 2.6 million individuals do not have health insurance; of those, 343,000 are children.
“The face of the uninsured has changed so much in recent years,” said Tom Julian, Fidelis Care’s director of marketing for Central New York. In light of the economic downturn there are more people than ever needing assistance, he said. Fidelis Care is working to reach them and others who need it.
Fidelis Care is New York State’s Catholic health plan, a not-for-profit health insurance company that administers government-based insurance programs. Started in 1993 in the Diocese of Brooklyn to meet the needs of the poor and underserved in the borough, the program has since expanded statewide to ensure “every resident, regardless of income, age, religion, gender or ethnic background, has access to quality health care.” Today, Fidelis Care provides approximately 770,000 members in 59 counties with free or low-cost health insurance through Child Health Plus, Family Health Plus, Medicaid Managed Care, Medicare Advantage, Dual Advantage and Managed Long Term Care programs. Through these programs, clients have access to a network of more than 49,000 healthcare providers and comprehensive health services that include preventive care, emergency treatment, prescriptions and more.
Child Health Plus covers children under 19 who are residents of New York State regardless of family income. Depending on parents’ incomes, coverage may be subsidized or free. Family Health Plus covers adults aged 19 to 64 who are residents of New York State and who meet set income guidelines based on the federal poverty level, family size and monthly earnings. Medicaid Managed Care covers both children and adults who meet requirements that include age, income and disability. These programs are available in all seven counties of the Diocese of Syracuse.
Medicare Advantage and Dual Advantage typically cover individuals over 65. Dual Advantage clients are eligible for both Medicaid and Medicare; the program seeks to effectively coordinate care available to clients under these programs. Within the Diocese, these programs are currently available in Onondaga, Oswego and Oneida Counties.
Fidelis Care at Home is a managed long-term care program that provides nursing home-level services for adults in the client’s home. This program has just become operational in Onondaga County and the company has plans to expand the program statewide, according to Fidelis public relations specialist Michael Bucci.
An eligibility screening tool to help identify the proper public health insurance plan is available through the New York State Department of Health website (www.health.ny.gov). Given the complicated nature of health insurance and the formula used to determine eligibility, however, Julian suggests individuals contact Fidelis Care directly for assistance.
“Facilitated enrollers are available to pre-screen and help walk [potential clients] through the application process, either by phone or in person [at a client’s home],” Julian said. Several sites in the community are available for in-person meetings.
Thirty-five facilitated enrollers, as well as retention and outreach personnel, cover the 15 counties in the Central New York region. Fidelis Care has staff available from as early as 7 a.m. to as late as 8 p.m. in order to work around clients’ schedules. The staff is multi-lingual and able to serve clients whose primary language is not English.
Applications can be submitted at any time. Facilitated enrollers now help clients complete their applications electronically via portable tablets, which speeds up the application process tremendously, Julian said. Applications for Child Health Plus submitted by the 20th of the month are generally approved fairly quickly, Julian said, with coverage beginning on the 1st of the following month in most cases. Applications and eligibility criteria for Family Health Plus and Medicaid Managed Care are reviewed by the Department of Social Services, a process that can take up to 45 days, he said.
To learn more about Fidelis Care, visit www.fideliscare.org, call 1 (888) 343-3547 or visit one of the sites listed on this page. Proof of age and family income are required for application.
Fidelis Care Regional Office
5010 Campuswood Dr., East Syracuse
Monday through Friday, 8:30 a.m. – 5 p.m.
Catholic Charities of Oswego County
365 W 1st Street St., Fulton
Mondays, 9 a.m. – 1 p.m.
Faxton St. Lukes Health Care Urgent Care 1676 Sunset Ave, Utica
Tuesdays, 11 a.m. – 4 p.m.
101 Nelson St., Cazenovia
Tuesdays, 9 a.m. – 12 p.m.
Community Action Partnership
3 Main St., Morrisville
Wednesdays, 9 a.m. – 12 p.m.
Roots & Wings Emergency Services
34-36 Barry St., Norwich
Mondays and Thursdays, 10 a.m. – 3 p.m.
Catholic Charities of Cortland County
24 Church St., Cortland
Mon., Tues., Thurs., Fri., 1 p.m. – 4 p.m.