New York State Catholic Health Plan Inc

Programs: Medicaid managed care program ("medicaid") is a new york state program administered by fidelis that provides free comprehensive health coverage for eligible individuals and families who are residents of new york state and have low income and limited resources. The new york state department of health establishes eligibility criteria with regard to income (in relation to a percentage of the federal poverty level), residency, resources, age, and immigration status, among other factors, and eligibility for the program is determined based on income, resources, and family size. As of december 31, 2017, the plan served approximately 1,207,300 medicaid beneficiaries.

fidelis care at home is a medicaid long-term care capitated program with the new york state department of health which provides an array of home, community, and institutionally based, long-term care services to persons who are eligible for medicaid and who have been certified as appropriate candidates for nursing home placement. As of december 31, 2017, the plan served approximately 20,400 fidelis care at home program beneficiaries.

medicare advantage program is a program available to adults aged 65 and over who are eligible under medicare. Beneficiaries may choose to use private pay options, establish medical savings account, use managed care plans such as fidelis, or join provider-sponsored plan. As of december 31, 2017, the plan served approximately 67,000 medicare advantage program beneficiaries.

other programs administered by the plan include the child health plus program, medicare/medicaid dual advantage program, medicaid advantage plus program, the new york health benefit exchange program ("health benefit exchange"), the fully integrated duals advantage ("fida") program, health and recovery plan ("harp") program, and the essential plan program. Child health plus program is a program that covers uninsured children under the age of 19, who are residents of new york state and are not eligible for medicaid. As of december 31, 2017, the plan served approximately 113,800 child health plus program beneficiaries. Medicare/medicaid dual advantage is a program for those who meet eligibility requirements for both medicare and medicaid and are enrolled in both programs. As of december 31, 2017, the plan served approximately 1,400 medicare/medicaid dual advantage program beneficiaries. Medicaid advantage plus is a full-risk managed long-term care program for individuals 18 years of age and older with medicare and medicaid coverage who have a chronic illness or disability. Members must be in need of long-term care services and may need care typically given in a nursing home. As of december 31, 2017, the plan served approximately 100 medicaid advantage plus program beneficiaries. Health benefit exchange is a program providing health coverage to individuals under the health care reform act. As of december 31, 2017, the plan served approximately 69,600 health benefit exchange beneficiaries. Fida program is a plan designed to provide managed care to individuals who have both medicare and medicaid. The fida plan allows the individual's medicare and medicaid benefits to be covered and managed under one plan, including long-term care needs, supports and prescription drugs. The fida program ended on december 31, 2017 with 300 beneficiaries. Harp program is a medicaid program that provides care management services to individuals eligible for medicaid requiring behavioral health services. As of december 31, 2017, the plan served approximately 27,000 harp beneficiaries. Essential plan is a program that provides minimum essential coverage to qualified individuals who are not eligible for medicaid or the child health plus programs. As of december 31, 2017, the plan served approximately 157,000 essential plan beneficiaries.