Fidelis Care Helps Long Island Seniors Access Care

Health plan offers coordinated care for members who are eligible for Medicaid and Medicare, and who often have complex medical needs

HEMPSTEAD, NY (06/20/2012)(readMedia)-- Every day across Long Island, individuals who are eligible for both Medicaid and Medicare - many of whom have multiple and complex medical conditions - rely on a patchwork of care and services that can leave critical gaps in how they receive care.

To help them, Fidelis Care offers a program called Dual Advantage, where care coordination is the key benefit. Members are assigned their own Care Manager who works with the member, their caregivers, support services, and medical providers to develop a personal care plan that addresses the member's unique social, environmental, and medical needs. The Care Manager helps the member navigate an often confusing and complex system, helping to ensure that members receive the care they need.

"Fidelis Care is committed to treating every member as an individual, with unique health care and social needs," explained Sanjiv Shah, MD, Chief Medical Officer. "We understand that living with chronic medical conditions is challenging. However, with a proper coordinated care plan and support network, members can manage their medical conditions, enjoy a higher quality of life, and maintain their independence for as long as possible."

Karen has been enrolled in Fidelis Care's Dual Advantage program since 2007. Like many Dual Advantage members, she suffers from a number of chronic health conditions including diabetes, congestive heart failure, and COPD. She is also partially blind, making every days tasks like reading the label on a prescription bottle difficult, if not impossible.

Failure to take medications as prescribed can result in severe complications, especially for those suffering from chronic health conditions. Karen's Care Manager works with her pharmacy to ensure that she receives her prescriptions, and arranged for a visiting nurse to pre-pour the medications each week. Karen's Care Manager also helps with scheduling medical appointments, coordinating transportation, and arranging in-home support services. This coordination of care has helped Karen control her medical conditions, and greatly improved her quality of life.

"I've never had insurance like Fidelis. My Care Manager calls to make sure that I'm all right and that I have my medications. Fidelis even arranged for a home care aide to help me when my family can't. Having someone looking out for me gives me a sense of security. I couldn't be happier, and I know that Fidelis cares about me," Karen said.

By combining the benefits of Medicare and Medicaid, Fidelis Dual Advantage members do not have out-of-pocket costs for medical care, tests, hospitalization, and prescription drug coverage. Members also receive free transportation for medical appointments.

To learn more about Fidelis Dual Advantage, call 1-800-860-8707. Fidelis Care representatives are available to answer questions, explain benefits, and help with the annual renewal process, both over the phone or in the comfort of someone's home

Fidelis Care offers free or low-cost health insurance through New York State's Child Health Plus, Family Health Plus, and Medicaid Managed Care programs. Members are covered for regular checkups, preventive care, routine screenings, hospital and emergency care, eye exams, dental care, and more. In addition, Fidelis Care also offers a variety of benefit options for seniors through Fidelis Medicare Advantage, Dual Advantage, Medicaid Advantage Plus, and Fidelis Care at Home programs, available in certain counties.

With more than 776,000 members in 59 counties statewide, Fidelis Care was founded on the belief that all New Yorkers should have access to affordable, quality health insurance. Members have access to more than 51,000 health care professionals statewide. Regional offices are located in Rego Park (Queens), Albany, Syracuse, and Buffalo, with satellite offices in Rochester, Poughkeepsie, and Suffern.

For more information, call Fidelis Care toll-free at 1-888-FIDELIS (1-888-343-3547) or visit www.fideliscare.org.

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