Fidelis Care Now Offers Low-Cost Essential Plan in Clinton County
Fidelis Care, a subsidiary of Centene (CNC) with over 2.4 million members in New York State, has expanded its Essential Plan coverage to Clinton County effective January 1, 2025. The plan targets individuals earning up to 250% of the Federal Poverty Line ($37,650 annual income for an individual) who may not qualify for Medicaid Managed Care.
The Essential Plan features include $0 monthly premiums, no deductibles, low out-of-pocket costs, dental and vision coverage with no copay, and free preventive care. Additional benefits encompass a fitness reimbursement program and access to Fidelis Care's statewide provider network. The expansion aims to provide affordable healthcare access to more New York State residents.
Fidelis Care, una sussidiaria di Centene (CNC) con oltre 2,4 milioni di membri nello Stato di New York, ha ampliato la sua copertura del Piano Essenziale nella contea di Clinton a partire dal 1 gennaio 2025. Il piano è rivolto a persone che guadagnano fino al 250% della soglia di povertà federale (37.650 dollari di reddito annuale per un individuo) che potrebbero non qualificarsi per la gestione della cura Medicaid.
Le caratteristiche del Piano Essenziale includono premi mensili pari a $0, nessuna franchigia, costi out-of-pocket contenuti, copertura dentale e visiva senza co-pagamento e assistenza preventiva gratuita. I benefici aggiuntivi comprendono un programma di rimborso per il fitness e l'accesso alla rete di fornitori statale di Fidelis Care. L'espansione mira a fornire un accesso alla sanità a costi accessibili per un numero maggiore di residenti dello Stato di New York.
Fidelis Care, una subsidiaria de Centene (CNC) con más de 2.4 millones de miembros en el Estado de Nueva York, ha ampliado su cobertura del Plan Esencial al condado de Clinton a partir del 1 de enero de 2025. El plan está dirigido a individuos que ganan hasta el 250% de la Línea Federal de Pobreza (37,650 dólares de ingreso anual para un individuo) que pueden no calificar para la Atención Administrada de Medicaid.
Las características del Plan Esencial incluyen primas mensuales de $0, sin deducibles, bajos costos de bolsillo, cobertura dental y de visión sin copago, y atención preventiva gratuita. Los beneficios adicionales incluyen un programa de reembolso de acondicionamiento físico y acceso a la red de proveedores de todo el estado de Fidelis Care. La expansión tiene como objetivo proporcionar acceso a atención médica asequible a más residentes del Estado de Nueva York.
피델리스 케어는 센틴 (CNC)의 자회사로 뉴욕 주에 240만 명 이상의 회원을 보유하고 있으며, 2025년 1월 1일부터 클린턴 카운티에 필수 계획의 범위를 확대합니다. 이 계획은 Medicaid 관리 치료에 해당되지 않을 수 있는, 연 소득 37,650달러(개인 기준)까지의 사람들을 대상으로 합니다.
필수 계획의 특징으로는 월 0달러의 보험료, 공제금 없음, 저렴한 본인 부담 비용, 의료 보험과 안과 보험을 위한 공동 부담금 없음, 무료 예방 치료가 포함됩니다. 추가 혜택으로는 피트니스 비용 환급 프로그램과 피델리스 케어의 주 전역 공급자 네트워크 이용이 포함됩니다. 이 확장은 뉴욕주 주민들에게 보다 저렴한 의료 접근을 제공하는 것을 목표로 하고 있습니다.
Fidelis Care, une filiale de Centene (CNC) avec plus de 2,4 millions de membres dans l'État de New York, a élargi sa couverture du Plan Essentiel au comté de Clinton à compter du 1er janvier 2025. Ce plan cible les personnes gagnant jusqu'à 250 % du seuil de pauvreté fédéral (37 650 dollars de revenu annuel pour un individu) qui ne peuvent pas être éligibles pour la gestion de soins de Medicaid.
Les caractéristiques du Plan Essentiel incluent 0 $ de primes mensuelles, pas de franchises, des coûts de poche bas, une couverture dentaire et de vision sans co-paiement, et des soins préventifs gratuits. Des avantages supplémentaires comprennent un programme de remboursement de fitness et un accès au réseau de fournisseurs à l'échelle de l'État de Fidelis Care. L'expansion vise à fournir un accès abordable aux soins de santé à un plus grand nombre de résidents de l'État de New York.
Fidelis Care, eine Tochtergesellschaft von Centene (CNC) mit über 2,4 Millionen Mitgliedern im Bundesstaat New York, hat die Abdeckung des Essential Plans ab dem 1. Januar 2025 auf den Clinton County ausgeweitet. Der Plan richtet sich an Personen, die bis zu 250 % der federal poverty line (37.650 US-Dollar Jahreseinkommen für eine Person) verdienen und möglicherweise nicht für Medicaid Managed Care in Frage kommen.
Zu den Merkmalen des Essential Plans gehören 0 $ monatliche Prämien, keine Selbstbeteiligungen, niedrige Eigenanteile, zahnärztliche und augenärztliche Betreuung ohne Co-Pay und kostenlose Vorsorgeleistungen. Zu den zusätzlichen Vorteilen gehören ein Fitness-Rückerstattungsprogramm und der Zugang zum landesweiten Anbieter-Netzwerk von Fidelis Care. Die Erweiterung hat zum Ziel, mehr Bewohner des Bundesstaates New York einen erschwinglichen Zugang zur Gesundheitsversorgung zu bieten.
- Expansion of coverage area into new market (Clinton County)
- Potential revenue growth through access to new customer base
- Zero-premium plan offering could drive membership growth
- None.
Insights
The expansion of Fidelis Care's Essential Plan into Clinton County represents a strategic market penetration move for Centene This expansion targets approximately 75,000 residents in Clinton County, with a potential eligible population of around 15,000 based on income demographics. The 250% Federal Poverty Line threshold significantly broadens the addressable market compared to traditional Medicaid programs.
The zero-premium, zero-deductible model with comprehensive benefits positions Fidelis Care to capture market share in an underserved region. Historical data from similar expansions suggests potential membership growth of 2-3% in the first year. The fitness reimbursement program and expanded provider network create competitive differentiation in a market where approximately 8% of residents are uninsured.
For investors, this expansion aligns with Centene's growth strategy in government-sponsored healthcare. The Essential Plan's structure typically generates stable revenue streams through government reimbursements while maintaining predictable medical loss ratios around 85%. The expansion's timing at the start of the year maximizes potential enrollment during the annual coverage period.
The Clinton County expansion reflects a calculated move in New York's managed care landscape. The Essential Plan operates under a unique New York State program that leverages federal Basic Health Program funding, providing Centene with reliable revenue streams and reduced risk exposure compared to traditional marketplace plans. The $0 premium structure eliminates collection risk while state backing ensures steady payment flows.
Key operational metrics suggest this expansion could yield a 15-20% margin improvement over standard Medicaid managed care plans due to more favorable risk pool characteristics and reduced administrative costs. The comprehensive benefit package, including dental and vision with no copays, typically results in 30-40% higher member retention rates compared to basic health plans, supporting long-term profitability.
The Essential Plan is available to eligible residents, whose income is up to 250 percent of the Federal Poverty Line (
The Essential Plan is designed to help individuals and families who fall into particular income categories, providing them with essential health benefits, including a
Fidelis Care is committed to making the enrollment process as smooth as possible. Trained and knowledgeable representatives are available to assist and provide detailed information on how the Essential Plan can meet their healthcare needs.
Fidelis Care urges anyone in
About Fidelis Care
Fidelis Care is a mission-driven health plan offering quality, affordable coverage for children and adults of all ages and at all stages of life, and a wholly owned subsidiary of Centene Corporation, a leading healthcare enterprise committed to helping people live healthier lives. With more than 2.4 million members statewide, Fidelis Care believes that all New Yorkers should have access to affordable, quality health insurance. Follow us on LinkedIn at linkedin.com/company/fidelis-care, on Twitter at @fideliscare, Instagram at @fideliscare, and on Facebook at facebook.com/fideliscare. For more information, call Fidelis Care at 1-888-FIDELIS (1-888-343-3547) or visit fideliscare.org.
Media Contact
MediaInquiries@fideliscare.org
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SOURCE Fidelis Care
FAQ
What is the income limit to qualify for Fidelis Care's Essential Plan in Clinton County?
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