WellCare By Fidelis is the MedicareA federal health insurance program for people who are 65 or older, certain younger people with disab... and Dual Advantage brand of Fidelis Care, a New York health insurer that covers more than 1.7 million residents, and for the 2026 plan year it offers two families of coverage: standard Medicare Advantage plans for people enrolled in Medicare Parts A and B, including adults 65 and older and certain younger people with qualifying disabilities or medical conditions, as well as Dual Advantage plans for people who qualify for both Medicare and MedicaidA state and federal program that provides health coverage to eligible low-income adults, children, p....
If you live in New York, or you are helping a parent there, WellCare By Fidelis shows up often, partly because its parent company, Centene, is one of the largest government healthcare insurers in the country. About 1 in 5 Medicare beneficiaries also qualify for Medicaid, and those dual-eligible seniors are who many of these plans serve.
Below you willA legal document that states how a person's property should be managed and distributed after death. see who each plan fits, what it costs, and how to enroll, so you can weigh it against other Medicare plans for low-income seniors before you commit.
WellCare By Fidelis is the Medicare and Dual Advantage line of Fidelis Care, a New York health plan. Wellcare is the national Medicare brand of Centene Corporation, so a plan sold in New York carries both the trusted local Fidelis Care name and Centene's national Medicare operation behind it.
The two names became one in 2018, when Centene acquired Fidelis Care for $3.75 billion and folded its Medicare plans into the Wellcare brand. Centene, founded in 1984, now ranks among the largest Fortune 500 healthcare companies and reported total revenues of $194.8 billion for 2025. As of late 2025, it managed about 27.6 million members across Medicaid, Medicare, and Marketplace coverage, including roughly 1 million Medicare Advantage members nationwide.
For seniors, the practical takeaway is simple. You get a New York-based plan with local provider relationships, backed by a large national insurer's resources. You can confirm the current lineup directly on the official Fidelis Care Wellcare Medicare page, which lists each plan, its documents, and its service area.
Eligibility depends on which plan family you are looking at. Standard Medicare Advantage plans are open to people who have Medicare Parts A and B and live in the plan's service area. Dual Advantage plans add a second requirement: you must also be enrolled in Medicaid.
For Medicare itself, you generally qualify at 65, or earlier if you have received Social Security Disability Insurance for at least 24 months or have certain conditions. If you are unsure where you stand, our guide on who qualifies for Medicare walks through the age, work-history, and disability rules in plain language.
Dual Advantage plans, known formally as Dual Eligible Special Needs Plans (D-SNPs), exist for people who hold both Medicare and Medicaid at the same time. This group is larger than many seniors expect: roughly 13.1 million Americans were dual-eligible as of the most recent national data, and millions reach Medicaid through the Medicare Savings Programs rather than full Medicaid. If you think you might qualify for both programs, the National Council on Aging publishes a clear step-by-step guide to applying for Medicare and Medicaid together.
WellCare By Fidelis Dual Advantage plans serve New York counties, with some Dual Align coverage extending into New Jersey. You must live in the plan's service area to enroll, so a plan available in Brooklyn may not be offered in a rural upstate county. Always confirm your county before you start an application.
For 2026, WellCare By Fidelis offers three standard Medicare Advantage plans and two Dual Advantage plans. The table below lays out who each plan is built for and its standout feature, so you can spot the right starting point quickly.
| Plan name | Plan code | Type | Best fit | Standout feature |
|---|---|---|---|---|
| Wellcare Fidelis Assist | Plan 002 | HMO-POS (Medicare Advantage) | Seniors 65+ who want low primary-care costs and certain younger people with qualifying disabilities | $0 copay for in-network primary care visits, plus Part D drug coverage |
| Wellcare Fidelis Simple | H5599-004-000 | HMO-POS Medicare Advantage | Value-focused seniors who want predictable costs | Set copays for standard medical services |
| Wellcare Fidelis Patriot Simple | Plan 010 | HMO-POS (Medicare Advantage) | Medicare beneficiaries seeking a $0-premium plan with a larger supplemental allowance | $50 monthly Spendables allowance for eligible OTC, dental, vision, and hearing expenses |
| Wellcare Fidelis Dual Align | Plan 003 | HMO D-SNP (Dual Advantage) | Dual-eligible seniors who want fully integrated care | Integrated Medicare and most Medicaid coverage, assigned nurse care management, individualized care planning, and a $242 monthly Wellcare Spendables allowance. |
| Wellcare Fidelis Dual Liberty Sync | Plans 013-001 / 013-002 | HMO D-SNP (Dual Advantage) | Dual-eligible seniors with specific regional needs | Synchronized Medicare and Medicaid coverage in one plan |
Two points are worth flagging. First, every plan here is an HMO or HMO-POS, which means you will generally pick an in-network primary care provider and may need referrals to see specialists. Second, Wellcare Fidelis Dual Align was previously sold as Dual Plus, and it moved to a fully integrated dual model for 2026, so returning members should read their Annual Notice of Change carefully.
Costs vary by plan, but dual-eligible members usually pay the least. WellCare By Fidelis Dual Advantage plans commonly carry a $0 monthly premium and $0 medical deductible, because Medicaid covers much of the cost sharing. Standard Medicare Advantage members pay plan-specific copays instead. Medicare Advantage premiums vary by plan and county. Many 2026 Wellcare by Fidelis Medicare Advantage plans advertise a $0 plan premium, although members generally must continue paying their Medicare Part B premium.
Prescription drug coverage (Part D) is managed with Express Scripts and includes the federal protections that took effect this year. Insulin is capped at $35 or 25% of the negotiated price, whichever is lower, and recommended vaccines carry $0 cost sharing. Most important for seniors with high drug bills, total out-of-pocket spending on covered drugs is capped. The 2026 Medicare Part D out-of-pocket maximumThe most a consumer would have to pay for covered medical expenses in a policy period, after which t... is $2,100, after which your plan pays 100% of covered drug costs for the rest of the year. The preferred pharmacy network includes Walgreens, CVS, and more than 60,000 pharmacies nationwide.
Beyond medical and drug coverage, WellCare By Fidelis leans on supplemental benefits that matter on a fixed income. The headline benefit is the Wellcare Spendables card, a prepaid card usable at more than 66,000 retailers for over-the-counter health items and, on some plans, dental, vision, and hearing costs. If a food allowance is part of your plan, that card can stretch a grocery budget the way our overview of the Medicare grocery allowance describes.
Digital and support services round out the package. Members get 24/7 telehealthThe use of digital information and communication technologies, such as computers and mobile devices,... visits at no cost through Teladoc, self-guided behavioral health support through Dario, and free technology help through a Cyber-Seniors partnership that walks older adults through their benefits and apps. Starting in 2026, newly enrolled members with qualifying conditions such as diabetesA chronic condition that affects the way the body processes blood sugar (glucose), requiring ongoing..., cancerA disease in which some of the body's cells grow uncontrollably and spread to other parts of the bod..., or chronic lung disease may also access Special Supplemental Benefits for the Chronically Ill, which require a provider's attestation.
Enrolling is a six-step process, and the order matters. Rushing past the service-area and provider checks is the most common reason seniors end up in a plan that does not cover their doctor. Work through these steps before you sign anything.
If you are weighing timing against other coverage, our Medicare enrollment timeline guide explains each window and the penalties for missing one. For free help comparing plans, SHIP counselors do not earn commissions and can review WellCare By Fidelis next to every other plan in your county.
WellCare By Fidelis plan documents use shorthand that can be confusing. Here are the terms that come up most.
Medicare Advantage (Part C): A private plan that bundles Medicare Part A and Part B, usually adds Part D drug coverage, and often includes extras like dental, vision, and the Spendables card.
Dual eligible: A person who qualifies for both Medicare and Medicaid. Medicare pays first for most care, and Medicaid helps with premiums, cost sharing, and benefits Medicare does not cover.
D-SNP (Dual Eligible Special Needs Plan): A Medicare Advantage planA type of Medicare health plan offered by a private company that contracts with Medicare to provide ... built only for dual-eligible members. The Wellcare Fidelis Dual Align and Dual Liberty Sync plans are D-SNPs.
Medicare Savings Program: A state program that pays some or all of your Medicare premiums and cost sharing if your income is low. Qualifying for one is a common path into a Dual Advantage plan.
SSBCI: Special Supplemental Benefits for the Chronically Ill. Extra benefits for members with qualifying chronic conditions, available to newly enrolled members starting in 2026 with provider attestation.
In our reviews of New York Dual Advantage plans, WellCare By Fidelis is a strong candidate for one group in particular: seniors who have both Medicare and Medicaid, want their coverage combined into a single card, and value the Spendables card and food or over-the-counter allowances. For that reader, a $0 premium plan that coordinates both programs removes a lot of paperwork and out-of-pocket guesswork.
Honesty matters more than a sales pitch here, so weigh the trade-offs. These are HMO plans, which means you stay in network and often need referrals, and they are limited to specific New York and New Jersey counties. Quality scores are also mixed. One WellCare Fidelis dual plan has been rated around 3 stars on health-plan quality, below the New York average, even while scoring better on drug coverage. A 3-star plan is not a reason to walk away on its own, but it is a reason to compare your specific county's options side by side.
A practical way to decide: if you are dual-eligible and your current doctors take the plan, WellCare By Fidelis deserves a close look. If you are a standard Medicare Advantage shopper who wants the widest possible provider choice, compare it against a PPO or a Medigap-plus-Part D approach before committing. Run your own prescriptions and providers through the plan's tools rather than trusting any single ranking, including this one.
As of 2026, WellCare By Fidelis pairs Fidelis Care's New York roots with Centene's national scale, and its strongest offer is for dual-eligible seniors who want Medicare and Medicaid combined into one low-cost plan with real supplemental benefits. The standard Medicare Advantage plans are reasonable for cost-focused shoppers, but the HMO network rules and mixed star ratings mean a county-level comparison is essential.
Before you enroll, check that your doctors and drugs are covered, confirm your county is in the service area, and compare WellCare By Fidelis against other Medicare plans for low-income seniors. The right plan is the one that fits your providers, your prescriptions, and your budget, not the one with the loudest marketing.
They are connected, not identical. Fidelis Care is the New York health insurer, and Wellcare is the Medicare brand it uses after Centene acquired Fidelis Care in 2018. Medicare and Dual Advantage plans appear as WellCare By Fidelis Care, while Fidelis Care still sells other New York coverage under its own name.
WellCare By Fidelis Care is primarily a New York operation, serving Medicare and Dual Advantage members across many New York counties. Some Dual Align coverage also extends into New Jersey. You must live in a plan's listed service area to enroll, so availability depends on your county.
The Spendables card is a prepaid benefit card that members can use at more than 66,000 retailers for over-the-counter health items and, depending on the plan, dental, vision, or hearing costs. The exact preloaded amount varies by plan, so check the Summary of Benefits for the specific plan you are considering.
Possibly, because these are HMO plans that rely on a contracted network. If your current doctors and pharmacy are in network, you can usually keep them. If they are not, you may need to switch providers. Always run your providers through the plan's Find-A-Doctor tool before you enroll.
A Medicare Advantage plan covers Medicare benefits for anyone with Medicare in the service area. A Dual Advantage plan, or D-SNP, is built only for people who also have Medicaid, and it coordinates both programs into one plan with little or no cost sharing. The Dual Advantage option exists to simplify life for dual-eligible seniors.
