Fidelis Care
Reviews and Complaints

This is by far the worst company in NYC. I even contacted their VP to put in a formal complaint, left a message and the VP didn't follow up. I left several messages for the nurse coordinator Etha Owens and she never returned any phone calls. When asked could I speak to her supervisor the receptionist lied and said she did not have one. Meanwhile, an elderly patient who needs 24/7 home health services safety is at stake because of the games this company plays. After filing a complaint with NYS DOH, Fidelis reluctantly scheduled some nurse to assess the patient. Every question the nurse asked and every answer provided demonstrated that the elderly patient required 24/7. Initally I was informed by etha owens that a "medical director" would make the determination. however the nurse informed me that it was the nurse manager that makes the final determination. So we received a denial letter, unsigned, and with the wrong hours requested. So we cant appeal because this is not the time requested. Now we have to contact fidelis again to have them correct the denial letter or send someone to make the new assessment. So in a matter of two days they made two additional denials without assessing the elderly patient. They dont know if the elderly patient condition worsened or not, but they denied her. this company is the pits. We are in the process of transferring her. if your family has a spenddown i wouldnt pay this company anything i would remove my family member from under their care.

My son has had Fidelis Care for the past 3 months and already I can tell this is the worst managed care plan we’ve ever joined. Unfortunately for us, we couldn’t continue to use UHC Community Plan which was excellent by comparison. My son is disabled, and I’ve been trying to submit a home health aide request for the past 5 weeks to no avail. I called to request a copy of the application on 3/3, and even after consistent follow-up by me, I didn’t receive the application until 3/21 … 18 days later. The employees are also extremely careless with private information because Fidelis did send me a complete stranger’s benefit request by error - I don’t need to go into detail about privacy laws and how such carelessness infringes upon that. Fidelis has absolutely zero follow-through and they take no accountability for being called out on their lack of communication. I faxed my son’s application back to them on 4/3 and when I called today (4/13) they informed me that something was missing from the application. When asked why no one contacted me, the manager made up a call attempt which was weak and clearly not true since a message would have been left if I hadn’t answered (and I had no missed calls). If I had a choice to switch to someone else … I would, but I don’t. However I do have the right to start filing complaints about their lack of professionalism, and I will!

Terrible insurance company. I've called agents multiple times to get issues resolved, some as benign as address changes, each time I talk to an agent they provide completely contradictory procedures and information. I've called them asking about coverage on certain procedures and they've given me their policy and confirmed that there are no stipulations, loopholes etc. Of course, I get my statement back and obviously I am financially liable for portions they explicitly said I wouldn't be. I have more issues with their agents, transparency, information dissemination, and competency than I do with their actual coverage - but those competency deficits results in financial consequences on the insured party so it's just as important.

My daughter was forced admitted to Elmhurst hospital on 3/11/2023. Attached please find the letter sent to NYPD and the complaint sent to Elmhurst hospital. My daughter should have been treated for seizures disorder not locked up in a psychiatric unit. I am writing to you because insurance should not pay for unnecessary hospitalization and family therapy. It looks that they want to make money rather than treating my daughter. As a result of their approach, my daughter and I are doing family therapy instead of counseling to cope with her symptoms related to seizures. Please review the attached documents and question Elmhurst hospital about forced hospitalization. Please speak with therapist from Western Queens Counseling who is impartial. The family Therapist Ms. Lucy Choplin is nice to us but who knows what she writes on her papers to make money. We are a victim of a system who wants to make money rather than listen to patient and family members. I cannot attach the two documents. Please email me at [protected]@hotmail.com to be able to send them. Thanks.

I paid the insurance premium and they STILL cancelled my daughter's insurance claiming it was for non payment. I contacted Fidelis and this payment was never applied to my account.

I set up autopay to pay the premiums monthly. Somehow it didn't work. Now my son's card is innactive and cannot receive medical service. I want to pay Fidelis and they claim they cannot do anything on their end. It is really in their hands to reinstate the membership.

This fidelis "care" they keep sending mail to someone I don't or nobody had that insurance or any insurance they keep harassing calling and sending mail they been asked multiple times and they continue there is no one by the name thst they sent mail and call they also violating hippa

A special needs 17-year-old child is in our care. We did NOT receive the February 2022 bill and therefore simply forgot to pay for that month, resulting in the cancellation of the insurance for February. We need it reinstated as soon as possible for February. Again, we didn't receive any bill and he NEEDS his insurance.

I received two claims from FidelisCare for services I didn't receive: 1) Date of Service: 07/21 Provided by an unnamed provider, and 2) Date of Service: 09/08 by another unnamed provider. I was not a member of FidelisCare during the service dates as claimed.

I applied for Insurance for my Son in December for the coming Year of 2022. I was under the impression that the company would accept the Insurance. I also received a letter in the mail stating that my son was accepted. Without my knowledge they canceled the insurance and my son wasn't covered for the Month of January. I am not sure if I have the letter still.

2/8 and 2/13 were the dates of the invoices that I paid out of pocket that were supposed to be reimbursed to me. Fideliscare keeps asking for more and more documentation and then saying they never got it. They dropped my 1 year old daughter from healthcare for a 1 day late payment and then after *** State advised them to re-instate her health coverage as of 2/1 they never did so. I have reached out to them several times and each time they do absolutely nothing about the issues.

My coverage with Fidelis ended on November 1. I made sure to call Fidelis Care to end my coverage and was told that I had. Later in the month I received a charge to my credit card from Fidelis for $1,021. I immediately contacted Fidelis in regards to this matter and requested a refund. Insurance representative *** informed me that the refund request was placed and provided me with a call reference number.. I called back on December 31 and representative *** informed me that the case was still opened and waiting on approval to issue the refund. When I called back on January 27 I was informed by representative *** that no action has been taken on my refund request and that she will submit a case and to check back in *** hours. This is very frustrating and I would like this resolved immediately.

Hi, I have Fidelis care insurance for my Son, DOB 6/3, but I'm unable to set up an online account due to an error stating 'A valid, responsible person was not found.' Consequently, I can't access my invoice for county reimbursement, despite his eligibility and special needs. Despite multiple calls, faxes, and unhelpful service representatives, the issue persists. I've missed out on $1,859.35 due to these issues. I demand immediate resolution or a full refund.

In Feb, 2021 I accidentally paid my premium $696.08 for health insurance twice. I asked my bank Chase to reverse one payment and they did. I informed Fidelis Care and they said everything is fine. In March Fidelis Care automatically withdrew $2784.32 plus $696.08 from my bank account. I was shocked - called them and they returned the $2784.32. They kept the $696.08 which I thought was for April but they insisted that it was for March because they returned both of my payments made in February. I never received the money, I have submitted my bank transaction history to them and they still claim the same. I had Chase Bank Claim Department supervisor on the phone with Fidelis Care customer service confirming that I was never returned the money and they still claim the same. After that call, I received a letter that I owe them $696.08. Earlier, I asked my bank to reverse the second transaction and now I have temporary credit which would make me even. But Fidelis letter claims I owe them.

I have health insurance from Fidelis. I'd like to check my Explanation of Benefits in 2019 and 2020. Because of Fidelis's policy, not all my EOBs are available online. So I sent request to Fidelis and asked them to send those EOBs to me. After my first request in Nov 2021, I was told I would receive it in 7 - 10 day. But I received nothing. I sent the second request in Dec 2021, I was told I would receive it in *** days again. I received nothing again. So I sent the third request in Jan 2022. This time, I was told that they already sent twice and asked me to confirm my address. Following is my reply to Fidelis: 1. your system is poor, there is no way for me to confirm my address because there is no "reply" button. I need to restart a new case and tell the whole story once again. 2. you say the reason I didn't receive my EOBs is because my address is wrong. I've attached my Jan 2022 *** I received from Fidelis. If my address is wrong, how come I received the ***? Attached you can find all three messages I received from Fidelis and the *** I just received recently.

Hi, I have a premium fidelis plan for $387.5 for my son, born on 1.10.16. It is set up on autopay so I do not need to worry about monthly payments. For some reason, the autopay did not go through at the end of February; however, I only realized it failed at the beginning of March. As soon as I realized, 3 days into March, I went on the fidelis phone line and submitted payment for 2 months' worth - February and March right away. However, instead, I got a letter from the services my son has been using all February and March that I have this huge outstanding balance! I called fidelis right away and they said it was applied towards April and May, but we were barely in March and I hadn't made the payment for a future date! So I told fidelis to please correct their mistake and apply it to February and March as that is what the outstanding payment was for. They told me to call New York State of Health. They sent me back to fidelis saying since fidelis accepts the payment they have to reinstate to the correct month, fidelis keeps sending me back to NYSoH who keeps telling me it's a fidelis issue. In the meantime, I have this enormous balance that I cannot afford to pay when I actually PAID my premium but you- fidelis applied it wrongly! Please reinstate asap the insurance for the inactive months I believe they were February and March. Thank you

My business keeps getting mail for one of their members, we are either sent it as a copy, or as their members actual address- I wasn't informed. I called them to ask them to stop mailing us their member's mail, including their personal/sensitive information. I spoke to a representative, and then to a "team leader" when I asked for a supervisor. They told me that they could not remove my agency's address from this member's file without speaking to them directly. I told them they won't return our calls, so she tried as well and found out that even a different phone number they had on file then our agency, was an incorrect number (they tired a number I provided first, then tried a separate number they had). I told them that I had a mailing address for them, and she said no, I asked if they would stop mailing us, they said no. The best both of them could offer, was to tell me I had to collect the mail, and write "return to sender" on them. Then the "correspondence" team would receive them. I asked to speak to the "correspondence" team, but they said no- I guess there isn't actually a way to contact the "correspondence" team. They apparently had no other options to provide me with, no other employees or departments or supervisors to let me speak with, just more work for me to do. This is a government run health insurance business. This absolutely baffles me.

It starts with Decembers premium payment. My account was set up for auto pay for the entire time I was a customer of *** with no issue. On December 8th I received a letter from the marketplace indicating that my policy was cancelled due to nonpayment. I contacted Fidelis at that time to resolve the matter as my card and payment information was current and there were sufficient funds to complete the transaction in the account. I spoke with 3 representatives that day, two of which gave me incorrect information. I ended the call with the notion that the account was in review for reinstatement. I never heard back. I then called again a week later as I had heard nothing in regards to the matter and was told that the information I was given prior was incorrect and that they had sent it over to finance for approval of reinstatement as the error was on FIDELISS END! She took the monthly premium payment from me on that call as a good faith on my end that the money was available. Against my better judgement mind, you as I was not looking to take the cards out of my favor should this company attempt to do the wrong thing and not reinstate my children on an in-house error. It was ultimately approved but this took several phone calls and also a delay with picking up my sons medication because of this nonsense. Well then I go to make Januarys payment and the policy is not reflected on the portal for payment. I called and reported it and was s told that it would be taken care of which it was not. So here I am trying to make February's payment and I called last week to get it fixed again and once again nothing.