Fidelis Customer Care Number: Expert Guide to Getting Help Fast

Who Fidelis Care Is and Why the Right Number Matters

Fidelis Care is a New York–based health plan founded in 1993 and part of Centene Corporation since 2018. Serving more than 2.5 million members statewide across Medicaid Managed Care, Child Health Plus, Essential Plan, Qualified Health Plans (via NY State of Health), and Medicare Advantage, Fidelis Care operates multiple service lines and phone queues. Using the correct customer care number speeds up verification and reduces transfers.

The most widely used member services line is 1-888-FIDELIS (1-888-343-3547). This number routes callers to the appropriate team based on prompts for plan type and topic (eligibility, ID cards, claims, authorizations, provider access, pharmacy, and more). TTY users can dial 711 to connect via the Telecommunications Relay Service at no cost.

Always check the back of your Fidelis Care ID card for a plan-specific phone number and hours, which may differ by product. During peak periods (for example, just before coverage renewals or near month-end), hold times can increase; calling earlier in the day or midweek often leads to faster service.

Primary Member Services Numbers and When to Use Them

For most members—Medicaid Managed Care, Child Health Plus, Essential Plan, and Qualified Health Plans—the main Fidelis Care Customer Care Number is 1-888-FIDELIS (1-888-343-3547), TTY: 711. Use this line to request a new ID card, verify eligibility and benefits, select or change your primary care provider (PCP), confirm prior authorization requirements, check claim status, or fix pharmacy issues such as prior authorization for medications or copay questions.

If your coverage is through Medicare Advantage with Fidelis Care, your ID card may list a dedicated 1-800 number and hours specific to Medicare. If you don’t have the card handy, call 1-888-FIDELIS and say “Medicare” at the prompt to reach the right team. For enrollment issues related to marketplace plans (on-exchange), you may also need to contact NY State of Health directly for tasks like reporting income changes or updating household information.

• Fidelis Care Member Services (most plans): 1-888-FIDELIS (1-888-343-3547), TTY: 711
• NY State of Health (Marketplace) Customer Service: 1-855-355-5777, TTY: 1-800-662-1220, nystateofhealth.ny.gov
• Medicare general help: 1-800-MEDICARE (1-800-633-4227), TTY: 1-877-486-2048, medicare.gov

When you call, be ready to confirm identity for HIPAA security. If you call on behalf of a dependent or family member, you may be asked for legal authority (e.g., Authorized Representative or Power of Attorney). Providers can also call the main number and follow the provider prompts, but network and authorization questions are often handled via provider portals or the number listed on the back of the member’s card.

Plan-Specific Support and Language Access

Fidelis Care operates several product lines with slightly different processes. For example, Medicaid Managed Care and Child Health Plus frequently coordinate with county social services and providers on transport, immunizations, and preventive care reminders, while Qualified Health Plan members often coordinate income and household changes through NY State of Health. Medicare Advantage members will find plan-specific coverage rules (e.g., Part D pharmacy appeals) and potentially different hours during the Annual Enrollment Period.

Interpreter services are available at no cost in more than 100 languages when you call the Fidelis Care customer care number. Let the representative know your preferred language at the start of the call. Members who are deaf, hard of hearing, or have a speech disability can use TTY: 711. You can also request materials in large print, Braille, or audio; ask Member Services to document your communication preferences so future mailings and calls are adapted to your needs.

What to Have Ready Before You Call

Arriving prepared helps the representative verify your account quickly and resolve issues in a single interaction. Gather the details below to avoid repeat calls or delays for authorizations and claims.

• Your Fidelis Care Member ID number (from your card) and full name as it appears on the card
• Date of birth, address, and a callback phone number you can answer
• Provider information (name, location, phone); if discussing claims or prior auth, the provider’s NPI and date(s) of service
• Claim number or Explanation of Benefits (EOB) if you received one
• Prescription name, dosage, and your pharmacy’s phone number if it’s a medication issue
• Referral or prior authorization number if already issued
• Any letters or notices you received with reference numbers and dates
• Language preference and any accessibility needs (interpreter, large print, Braille)

Before ending the call, ask for a case or reference number, the representative’s first name or operator ID, and the expected turnaround time. If documents are required, confirm the exact upload link, fax number, or mailing address and any deadlines to protect your coverage.

Best Times to Call, Escalations, and Documentation

Call volumes typically spike on Mondays, during lunch hours, and near month-end renewals. Many members report smoother experiences when calling Tuesday–Thursday mornings. If you’re transferred, ask the first agent to note your account and summarize the issue in the case, so you don’t repeat information. If a callback is offered, confirm your best number and time window and whether voicemail messages can be left.

If your issue is urgent—such as a time-sensitive prior authorization or a medication you cannot be without—explain the medical urgency and ask whether the request qualifies for expedited review. When needed, request a supervisor or a warm transfer to the correct department (e.g., Pharmacy, Care Management, or Claims). Maintain a simple call log with dates, times, reference numbers, and promised next steps; this record helps if you need to file a grievance.

Online Self-Service: Faster for Routine Tasks

Many common requests can be completed online without a call. Visit fideliscare.org and use the Member Portal to print or request ID cards, check eligibility and benefits, search in-network providers, review authorizations, and monitor claim status. The site’s Contact Us page offers secure forms and office locations. For plan changes tied to income or household updates, members enrolled through NY State of Health can use nystateofhealth.ny.gov or call 1-855-355-5777.

For help finding or confirming in-network doctors and facilities, use the provider directory on fideliscare.org and filter by plan and location. Pharmacy formularies and prior authorization criteria are also posted online. If you need clinical guidance for a non-emergency issue outside of office hours, check your ID card for a Nurse Advice Line; many plans offer 24/7 access through the main Fidelis number or a dedicated line shown on the card.

Grievances, Appeals, and Coverage Decisions

You can file a grievance (service complaint) or an appeal (coverage decision dispute) through Member Services at 1-888-FIDELIS (1-888-343-3547), TTY: 711. Clearly state that you want to file a grievance or appeal so the representative creates the correct case type. Ask for written confirmation and the expected timeline. Keep copies of all supporting documents—physician notes, bills, denial letters, and prior authorization records.

Standard medical appeals often have resolution timeframes established by regulation. For many Medicaid/CHP/Essential Plan appeals, standard decisions are typically due within a set number of days as defined by New York State rules, with expedited decisions available when delay could jeopardize your health. Medicare Advantage appeals have their own federally regulated timelines, and Part D (pharmacy) appeals follow specific stages (redetermination, reconsideration, etc.). Member Services will explain the exact clock for your plan.

If you receive an adverse determination in writing, the notice will include instructions for submitting an appeal in writing, address/fax information, and your deadline to act. If your condition is urgent, ask for an expedited or fast appeal. For additional help with Medicare decisions, you can also contact 1-800-MEDICARE (1-800-633-4227), TTY: 1-877-486-2048.

Accessibility, Cultural Competence, and Special Assistance

Fidelis Care provides free language interpreter services when you call, and you can ask to have your language preference noted on your account for future interactions. Materials are available in alternative formats (large print, Braille, audio) upon request. If you need assistance from a caregiver or family member, ask Member Services how to add an Authorized Representative to your file.

For members with complex needs, care management and social support services may be available. If transportation to appointments is a barrier, ask the representative what your plan covers and how to schedule rides, as benefits and vendors vary by county and plan. If you feel your issue requires accommodation, clearly state the assistance you need so the representative can connect you with the right resource.

Final Tips to Resolve Issues in One Call

Start with the right number: 1-888-FIDELIS (1-888-343-3547), TTY: 711. Identify your plan type clearly, have your documents ready, and request a case number before you hang up. If the issue involves a doctor or pharmacy, ask for a three-way call so all parties hear the same guidance.

For enrollment updates on marketplace plans, coordinate with NY State of Health at 1-855-355-5777, TTY: 1-800-662-1220. For questions about Medicare’s general rules, contact 1-800-MEDICARE. When in doubt, check your ID card or fideliscare.org for the most current phone numbers, hours, and plan-specific instructions.