On this page we help consumers: Compare Fidelis Medicare Advantage without Rx with all 2020 Medicare Advantage Plans available in Herkimer County, New York. This is a HMO-POS plan with a $0.00/mo premium and $6,700 max out-of-pocket limit.
How Much Does Fidelis Medicare Advantage without Rx Cost?
The premium on this plan is $0.00 per month. Plus, you must continue to pay your monthly Medicare Part B premium. Co-payments and/or co-insurances also apply with most healthcare services, except preventative care mandated by CMS (see H3328-001 Summary of Benefits below).
IMPORTANT: When evaluating this plan, look past the monthly premium. Identify the costs of the healthcare services you use most. Only then will you uncover the plan's value for your personal situation.
What is the Maximum Out-of-Pocket (MOOP) Limit?
Unlike Original Medicare, Medicare Advantage plans must set an annual Maximum Out-of-Pocket limit on inpatient and outpatient healthcare services. The Fidelis Medicare Advantage without Rx plan MOOP is $6,700 . Once you reach this amount of spending on your co-payments, all of your Medicare Part A and Part B services will be covered at no additional charge.
Plans can set their MOOP at a voluntary level of $0 to $3,400 (for in-network services) or a mandatory $3,401 to $6,700 (in-network). Combined totals for in-network and out-of-network are generally higher.
NOTE: MOOP does not include what you spend on monthly premiums. It also does not apply to your prescription drugs or Part D deductible.
CRITICAL: It is important to evaluate the combined annual MA/MAPD premiums and MOOP versus what you might expect to pay for a Medicare Supplement in Herkimer County. Some Medicare Supplements offer less overall financial risk than Medicare Advantage.
Medicare 5-Star Ratings
In this section we show you the quality rating for this Fidelis Care plan. Each year CMS rates health plans (Part C) in five broad categories and drug plans (Part D) in four broad categories. We do not recommend joining a plan with an overall rating less than 3.0. The following marks will give you an idea of the level of care you will receive if you join this health plan.
Does Fidelis Medicare Advantage without Rx include Medicare Part D?
This plan does not include prescription drug coverage. You can get prescription coverage by joining one of the Medicare Part D Plans in New York.
How Much are the Copays & Co-Insurance?
In this Summary of Benefits section we outline high-level information about the plan's co-payment and co-insurance costs for inpatient, outpatient, preventive care, transportation and other healthcare services. For complete details or assistance call: 1-855-266-4865.
Fidelis Medicare Advantage without Rx vs. Medigap
To compare Fidelis Medicare Advantage without Rx with a Medigap plan (Medicare supplemental insurance), you need to evaluate your healthcare and financial needs. Look at the total potential cost with each plan type, not just the monthly premium, and choose how you want to use medical care (locally or nationally).
To help you make a better decision, we created our How-to Choose the Best Medicare Plan guide. It will help you understand how to compare Fidelis Medicare Advantage without Rx with Medicare Supplement plans in New York. Medicare Plan F in New York is the most popular.
Contact Fidelis Care
For more information about this plan, and other plans on this site, call 1-855-266-4865. You may also contact the plan:
For assistance 24 hours a day, call 800-633-4227. TTY users should call 877-486-2048. If you qualify for Medicare but have not yet enrolled or verified your enrollment status, you can do so on the Social Security Administration website. You can learn more about the Medicare Advantage program on www.medicare.gov or the Wikipedia page. To learn more about this plan, visit the Fidelis Care Medicare website.
Additional Plan Options in Herkimer County
Are you eligible for a Herkimer County, NY Medicare Special Needs Plan (SNP)? SNPs are a special type of Medicare Advantage plan designed to help people with special needs. Here are some of the SNP plans in your area:
- UnitedHealthcare Nursing Home Plan 1 (Local PPO), for Institutional beneficiaries
- Fidelis Dual Advantage (Local HMO), for Dual-Eligible beneficiaries
- Fidelis Dual Advantage Flex (Local HMO), for Dual-Eligible beneficiaries
- UnitedHealthcare Dual Complete (Local HMO), for Dual-Eligible beneficiaries
- Humana Gold Plus SNP-DE H3533-002 (Local HMO), for Dual-Eligible beneficiaries
Not qualified for an SNP? Here are some additional plans you might consider:
- WellCare Today's Options Advantage Plus 150A (PPO)
- WellCare Today's Options Advantage Plus 550B (PPO)
- WellCare Today's Options Premier Plus 250A (PFFS)
- WellCare Today's Options Premier Plus 650B (PFFS)
- WellCare Today's Options Premier 200 (PFFS)
Medicare Part C Plan Availability
Fidelis Medicare Advantage without Rx is available to beneficiaries living in Cold Brook, Dolgeville, Eagle Bay, Frankfort, Herkimer, Ilion, Jordanville, Little Falls, Middleville, Mohawk, Newport, Old Forge, Poland, Salisbury Center, Thendara, Van Hornesville, West Winfield, and all other areas of Herkimer County, New York; Medicare plans are the same throughout the County.