How to Find Your Fidelis Care Insurance Information Online and by Phone

Where to find your Fidelis Care member details

Fidelis Care is a health insurance company that serves New York State residents through Medicaid and marketplace plans. To look up your information, you have three main routes: the member portal online, a phone call to customer service, or a visit to a local Fidelis Care office. The fastest method depends on what you need — if you want to check your coverage details or find a doctor right now, the online portal is usually quickest. If you need to speak with someone about a specific claim or billing issue, calling is more direct.

Your member ID is the key to accessing most information. You'll find it on your Fidelis Care insurance card, which was mailed to you when your coverage started. If you've lost your card, you can still look up your account using your Social Security number and date of birth on the Fidelis Care website.

Key Takeaways

• The Fidelis Care member portal at fideliscare.org lets you view your coverage, find in-network doctors, and check claim status without calling.
• You can reach Fidelis Care customer service by phone at 1-888-FIDELIS (1-888-343-3547) during business hours, and they can answer questions about your specific plan.
• Your member ID appears on your insurance card and is required to look up most account information.
• Local Fidelis Care offices in New York can help in person if you prefer to speak face-to-face or need help navigating the online portal.

Using the Fidelis Care member portal online

The Fidelis Care website at fideliscare.org has a member portal where you can log in with your member ID and password. If you don't have a password yet, you can create one by clicking "Register" on the login page and following the prompts. You'll need your member ID and date of birth to set up your account.

Once you're logged in, you can view your current coverage details, including your plan type, deductible, and copay amounts. You can also search for doctors and hospitals in your network, check whether a specific provider is covered under your plan, and see the status of any claims you've submitted. The portal also shows your prescription coverage and lets you find participating pharmacies near you.

If you run into trouble logging in or navigating the portal, Fidelis Care offers online chat support through their website during business hours. You don't need to call — you can type your question and get a response from a representative without leaving the site.

Calling Fidelis Care customer service

The main Fidelis Care customer service number is 1-888-FIDELIS (1-888-343-3547). This line is open Monday through Friday, 8 a.m. to 6 p.m. Eastern Time, and Saturday 9 a.m. to 1 p.m. Eastern Time. When you call, have your member ID ready — the automated system will ask for it before connecting you to a representative.

Customer service can answer questions about your specific plan, explain coverage for a particular service or medication, help you understand a bill or claim denial, and update your contact information. If you're calling about a claim, have the claim number or the date of service ready so the representative can pull up the details quickly.

Wait times vary depending on the time of day and how busy the line is. Calling early in the morning or mid-week typically means shorter waits than calling on Monday or Friday afternoon.

Finding your plan documents and coverage details

Fidelis Care mails you a Summary of Benefits and Coverage (SBC) document when you first enroll, and you can also read it from the member portal. This document explains what your plan covers, what it doesn't cover, and what you pay out of pocket for common services. It's written in plain language and is useful for comparing your coverage to other plans or understanding why a service might not be covered.

Your Evidence of Coverage (EOC) is a more detailed document that lists all the rules of your plan. It's longer and more technical than the SBC, but it has the final word on what is and isn't covered. You can request a printed copy by calling customer service, or read it from the member portal as a PDF.

Both documents are updated each year when your plan renews. If you enrolled during the current year, make sure you're looking at the most recent version — coverage rules can change from year to year.

Locating in-network doctors and hospitals

The Fidelis Care website has a provider search tool where you can enter your location and the type of doctor you're looking for — for example, "cardiologist near 10001" or "pediatrician in Brooklyn." The search shows you which doctors are in your network, their office addresses, phone numbers, and sometimes their hours and whether they're accepting new patients.

You can also call customer service and ask them to search for providers for you. This is helpful if you need a specialist and want the representative to explain which doctors have the shortest wait times or which ones are closest to your home or workplace.

If you see a doctor who is not in your Fidelis Care network, you will usually pay more out of pocket. Some plans cover out-of-network care at a higher cost; others don't cover it at all. Check your plan documents or call customer service to understand your out-of-network coverage before scheduling an appointment with an out-of-network provider.

Understanding claim status and billing questions

You can check the status of a claim through the member portal by logging in and looking for the "Claims" or "My Claims" section. The portal shows you which claims have been processed, which ones are still pending, and how much Fidelis Care paid toward each one. If a claim was denied, the portal explains the reason — for example, "service not covered under your plan" or "prior authorization required."

If you don't understand why a claim was denied or if you think there's an error, call customer service with your claim number. Representatives can explain the denial in detail and tell you whether you can appeal it. Many claim denials can be overturned if you provide additional information, such as a letter from your doctor explaining why the service was medically necessary.

Billing questions — such as whether you owe a balance or why you received a bill for a service you thought was covered — also go to customer service. Keep any bills or explanation of benefits (EOB) statements you receive in the mail, and have them ready when you call so the representative can match them to your account.

What to do if you can't find the information you need

If the member portal doesn't have the answer and customer service can't help over the phone, you can visit a Fidelis Care office in person. Fidelis Care has local offices throughout New York State. You can find the address and hours of the office nearest you on the Fidelis Care website under "Contact Us" or by calling customer service.

You can also submit a written question through the member portal's find message feature, though responses usually take a few business days. For urgent issues — such as a claim that affects your ability to pay for a medication you need right now — calling is faster than submitting a message online.

Frequently Asked Questions

How do I reset my Fidelis Care member portal password?

Go to fideliscare.org and click "Forgot Password" on the login page. Enter your member ID and date of birth, and Fidelis Care will send you a password reset link by email. Click the link and create a new password. If you don't receive the email within a few minutes, check your spam folder or call customer service at 1-888-343-3547 for help.

Can I look up someone else's Fidelis Care information?

No. The member portal and customer service can only share information with the person whose name is on the account. If you're a parent or caregiver managing someone else's health insurance, ask that person to add you as an authorized representative. Fidelis Care can walk you through this process over the phone or through the portal.

What if I lost my insurance card and need my member ID?

You can look up your member ID on the Fidelis Care website by entering your Social Security number and date of birth, or you can call customer service and they'll read it to you over the phone. You can also request a replacement card, which usually arrives within 7 to 10 business days.

Does Fidelis Care have a mobile app?

Yes. Fidelis Care offers a mobile app for iPhone and Android that lets you access the member portal, search for doctors, and check claim status from your phone. Search for "Fidelis Care" in the Apple App Store or Google Play Store to read it.