Fidelis Care

What Fidelis Care does

Fidelis Care (legal name: New York Quality Healthcare Corporation) is a New York State-focused managed care health insurance organization founded in 1993 and operating as a wholly-owned subsidiary of Centene Corporation (NYSE: CNC) since its 2018 acquisition. The company serves over 2.4 million members across New York State through a multi-line product portfolio organized as a platform-plus-modules architecture. Core government-sponsored plans include Medicaid Managed Care, Essential Plan, Child Health Plus, HealthierLife (HARP), Fidelis Care at Home (MLTC), and Medicaid Advantage Plus. Commercial and marketplace offerings are sold through Ambetter from Fidelis Care Qualified Health Plans. The Medicare line operates under the Wellcare By Fidelis Care sub-brand, offering HMO, HMO-POS, and D-SNP variants (Plans 002, 003, 004, 010, and 013-001/013-002). Fidelis Care is incorporated in New York with headquarters at 25-01 Jackson Avenue in Long Island City, and its FIDELIS and FIDELIS CARE marks are registered trademarks owned by Centene Corporation.

The company's technology stack relies largely on third-party integrations rather than proprietary platforms. Telemedicine services are delivered through a Teladoc Health partnership providing 24/7 virtual visits covered at no cost for QHP and Medicare members, pharmacy benefits run through Express Scripts with access to 4,400+ in-network NY pharmacies and 64,400+ nationwide locations, clinical decision support is provided through MCG Health (a Hearst Health network asset), and members access online services through a Member Portal supporting premium payments, ID cards, claims, PCP changes, and Flex Reimbursement requests. Distribution occurs through NY State of Health marketplace, a network of community offices with mobile enrollment assistance, broker and navigator channels, and a self-service Medicare Member Portal at my.wellcare.com.

Fidelis Care generates revenue exclusively through regulated per-member per-month premiums across its government, marketplace, and Medicare product lines. Pricing is set externally: the Essential Plan offers $0 monthly premiums with no deductible, Ambetter QHP pricing varies by tier and county, and Medicare Advantage plans have varied pricing based on plan type and location. Customer acquisition combines direct-to-consumer community outreach, broker and navigator partnerships, the "Here for Your Health" community grants campaign ($500,000 in total grant commitments), and partnerships with organizations such as Shatterproof on addiction stigma. Growth is being actively shaped by federal funding changes that will end the Essential Plan 200-250 tier by June 30, 2026, affecting approximately 140,000 members and necessitating a managed transition to Ambetter QHPs and other coverage.

Name

Fidelis Care

Legal name

New York Quality Healthcare Corporation

Website

https://fideliscare.org

Company type

Private

Founded year

1993

Operating status

Operating

Headcount range

1,001–5,000 employees

Short description

Fidelis Care is a New York State-focused managed care health plan and wholly-owned subsidiary of Centene Corporation, serving over 2.4 million members through Medicaid, Essential Plan, Child Health Plus, Ambetter Qualified Health Plans, and Wellcare Medicare products.

Ownership category

akta.pro rank

Product category

Managed Care Health Insurance

NAICS

Direct Health and Medical Insurance Carriers (524114), Health Care and Social Assistance (62)

SIC

Hospital & Medical Service Plans (6324)

akta.pro primary industry

Integrated Physical-Behavioral-Social Care (Whole-Person) Medicaid Plans (HLAEAEAI)

akta.pro secondary industries

Managed Care / Network-Based Group Health Plans (Carrier Network Products) (FSAIAFAO), MA-PD Plans (Medicare Advantage with Prescription Drug Coverage) (FSAIAGAG), Children’s & Family Medicaid Managed Care Plans (HLAEAEAF)

Keywords

• Health insurance plans
• Medicaid managed care
• Medicare Advantage coverage
• Government sponsored healthcare
• New York health plans

Headquarters

HQ city

Rego Park

HQ country

United States

HQ region

North America

Offices2 records

Markets served

GTM type

B2C

Offering type

Services

Cost components

Personnel, Operations, Marketing or Sales, Technology or R&D, Infrastructure

Revenue model

1. Medicaid Managed Care Premiums: Revenue from New York State Medicaid Managed Care program serving eligible low-income individuals and families.
2. Essential Plan Premiums: Revenue from Essential Plan, a $0 premium plan for low- and moderate-income individuals who don't qualify for Medicaid, with income-based eligibility.
3. Child Health Plus Premiums: Revenue from Child Health Plus program for children who don't qualify for Medicaid.
4. Medicare Advantage Premiums: Revenue from Wellcare By Fidelis Care Medicare Advantage plans including HMO, HMO-POS, and D-SNP products.
5. Qualified Health Plan (Ambetter) Premiums: Revenue from Ambetter from Fidelis Care Qualified Health Plans offered through NY State of Health marketplace in 56 counties.
6. HARP (HealthierLife) Premiums: Revenue from HealthierLife HARP plan for members with serious mental illness and substance use disorders.

Pricing tiers

Go-to-market motion3 records

Distribution channels4 records

Marketing channels6 records

Core offering

Fidelis Care provides government-sponsored and commercial health insurance coverage to over 2.4 million New York State residents through Medicaid Managed Care, Essential Plan, Child Health Plus, HealthierLife (HARP), Fidelis Care at Home (MLTC), Medicaid Advantage Plus, Ambetter Qualified Health Plans, and Wellcare By Fidelis Care Medicare Advantage and Dual Advantage plans. As a wholly-owned subsidiary of Centene Corporation, it delivers managed care plans across all life stages, supported by telemedicine, pharmacy networks, and a Social Care Network addressing social determinants of health.

Product overview

Fidelis Care is a New York State health insurance provider and subsidiary of Centene Corporation, serving over 2.4 million members. The company operates a multi-product portfolio organized as a platform-plus-modules architecture, consisting of core government-sponsored health plans (Medicaid Managed Care, Essential Plan, Child Health Plus, HealthierLife/HARP) and commercial/marketplace products (Ambetter Qualified Health Plans). The Medicare line operates under the Wellcare By Fidelis Care sub-brand, offering HMO, HMO-POS, and D-SNP plan variants (Plans 002, 003, 004, 010, 013-001, 013-002). Long-term care is addressed through Fidelis Care at Home (MLTC) and Medicaid Advantage Plus. Members access additional services through add-on modules including a Social Care Network, telemedicine via Teladoc Health, mail order pharmacy, OTC benefits, and 24/7 nurse advice. All members can use the online Member Portal for account management. The company also operates community benefit programs through its Here for Your Health grants initiative.

Differentiator

Problem solved

Functional benefit

Brands

• Wellcare By Fidelis Care: Medicare Advantage and Dual Advantage plans offering affordable access to doctors, nurses, and specialists in New York State.
• Ambetter from Fidelis Care

Products and services

• Medicaid Managed Care
• Essential Plan
• Child Health Plus
• HealthierLife (HARP)
• Ambetter from Fidelis Care Qualified Health Plans
• Fidelis Care at Home (MLTC)
• Medicaid Advantage Plus
• Wellcare By Fidelis Care (Medicare Advantage and Dual Advantage)
• Social Care Network

Named customers4 records

Segments8 records

Ideal customer profiles4 records

Technology focussed No

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Integration7 records

Feature4 records

Partnerships

18 partnerships are on record, tiered core and minor.

• ShatterproofcoreStrategic or Co-development Partner · 24 October 2025Fidelis Care partnered with Shatterproof to end addiction stigma by participating in the 2025 NYC Shatterproof Walk to End Addiction Stigma. The collaboration focuses on improving access to addiction treatment, education, and reducing barriers in underserved populations.
• Teladoc HealthcoreTechnology or IntegrationTelemedicine program providing access to online doctor visits 24 hours a day, 7 days a week for Qualified Health Plan members and Wellcare By Fidelis Care Medicare and Dual members. Covers common conditions and mental health support at no cost to members.
• MCG HealthcoreTechnology or IntegrationCentene partnership with MCG Health, part of the Hearst Health network, providing unbiased clinical guidance for patient-centered care decisions using artificial intelligence and technology solutions.
• Express ScriptscoreTechnology or IntegrationPharmacy benefit management partnership providing access to over 4,400 pharmacies in New York State and over 64,400 network pharmacies nationwide for prescription drug coverage.
• Value Network Inc.minorGTM or Marketing PartnerHealthcare nonprofit recipient of Here for Your Health behavioral health grant ($140,000 in 2026). Using funding for a technology-driven initiative to connect individuals newly diagnosed with substance use disorders to rapid treatment.
• Wellcome Care MedicalminorGTM or Marketing PartnerHealthcare provider recipient of Here for Your Health behavioral health grant. Expanding behavioral health programs through enhanced outreach, telehealth, and navigation services.
• The Alex House ProjectminorGTM or Marketing PartnerNonprofit recipient of $130,000 maternal health grant providing parental support and mental health services for underserved communities.
• Mothers and Babies Perinatal NetworkminorGTM or Marketing PartnerNonprofit recipient of $130,000 maternal health grant providing postpartum care and mental health services for underserved communities.
• Healthy AlliancecoreStrategic or Co-development PartnerSocial Care Network partner serving multiple NY counties (Albany, Clinton, Columbia, Cortland, Lewis, Madison, Monroe, Montgomery, Schenectady, Warren, Washington). Provides housing, nutrition, transportation, and care management services.
• WholeYouNYCcoreStrategic or Co-development PartnerSocial Care Network partner serving New York County (Manhattan) and all other Brooklyn zip codes not served by Staten Island PPS. Provides housing, nutrition, transportation, and care management services.
• SOMOS Community CarecoreStrategic or Co-development PartnerSocial Care Network partner serving Bronx County. Part of the SCN network providing essential support services.
• Care Compass CollaborativecoreStrategic or Co-development PartnerSocial Care Network partner serving Broome, Delaware, and Otsego counties. Provides housing, nutrition, transportation, and care management services.
• Forward Leading IPAcoreStrategic or Co-development PartnerSocial Care Network partner serving Allegany, Livingston, and Ontario counties. Provides housing, nutrition, transportation, and care management services.
• Integrated CarecoreStrategic or Co-development PartnerSocial Care Network partner serving Cattaraugus and Niagara counties. Provides housing, nutrition, transportation, and care management services.
• Hudson Valley Care CoalitioncoreStrategic or Co-development PartnerSocial Care Network partner serving Dutchess and Orange counties. Provides housing, nutrition, transportation, and care management services.
• Staten Island PPScoreStrategic or Co-development PartnerSocial Care Network partner serving specific Brooklyn zip codes (11209, 11219, 11220, 11228) and Richmond County (Staten Island). Provides housing, nutrition, transportation, and care management services.
• HEALI (Health & Equity Alliance of Long Island)coreStrategic or Co-development PartnerSocial Care Network partner serving Nassau and Suffolk counties. Provides housing, nutrition, transportation, and care management services.
• Northwell HealthminorStrategic or Co-development PartnerPartnership providing information about Northwell Health services available to Fidelis Care members.

Scale indicators9 records

Recent moves6 records

Expansion highlights5 records

Emerging players

• Oscar Health: Tech-led ACA marketplace insurer with growing Medicare Advantage business. Partial overlap with Fidelis Care's Ambetter QHP product through ACA marketplaces and a similar member-acquisition focus on individual consumers.

Direct peers

• EmblemHealth: Long-standing NY not-for-profit insurer with deep Medicaid and Medicare Advantage presence. Competes head-to-head with Fidelis Care for NY Medicaid, Essential Plan–adjacent, and dual-eligible members.
• Capital District Physicians' Health Plan (CDPHP): Regional NY health plan offering Medicaid, Medicare, and commercial coverage primarily in upstate NY. Comparable managed care carrier model with similar product mix and NY geographic overlap.
• CareSource: Mission-driven, non-profit Medicaid managed care organization. Comparable to Fidelis Care in Medicaid-first model, focus on low-income populations, and similar dual-eligible / SDoH program emphasis.
• Healthfirst: New York-based not-for-profit health plan serving Medicaid, Medicare, and commercial members in NY. Direct overlap with Fidelis Care across Medicaid Managed Care, MLTC, and D-SNP product lines in the same geography.
• Molina Healthcare: National Medicaid-focused managed care company with a similar government-program-led business model. Highly comparable to Fidelis Care's Medicaid and D-SNP mix, though operating across multiple states rather than concentrated in NY.
• MetroPlusHealth: NYC public-option health plan offering Medicaid, Medicare, and QHP products with a heavy NYC focus. Directly comparable to Fidelis Care's government-program-led portfolio concentrated in the same metro.

Broad incumbents

• UnitedHealthcare: Largest US health insurer with a sizeable NY Medicaid and Medicare Advantage footprint. Direct overlap on plan types and geography but at far greater scale and brand recognition.
• Humana: Medicare Advantage-led national carrier with growing D-SNP presence. Directly comparable to Wellcare By Fidelis Care's MA and dual-eligible product emphasis with greater national scale.
• Elevance Health (Anthem): National diversified health insurer operating Blue Cross Blue Shield plans, Medicaid (Anthem), and Medicare products. Competitor in NY Medicaid/Medicare markets through subsidiary brands and category parent of Amerigroup.

Market position

Strengths4 records

Weaknesses4 records

Competitive moat6 records

Key risks6 records

Key highlights7 records

Customer concentration

• YouTubeyoutube.com/@WellcareMedicare
• Facebookfacebook.com/fideliscare
• Instagraminstagram.com/wellcaremedicare
• Xx.com/fideliscare
• LinkedInlinkedin.com/company/fidelis-care

Revenue estimate

Valuation estimate

Number of profiles

Profiles3 records

Subsidiaries2 records

Funding overview

Funding rounds

Investors

Funding detail is available on the Subscription and Enterprise plan.Contact sales →

M&A

Investments98 records

M&A and investment is available on the Subscription and Enterprise plan.Contact sales →

Frequently asked questions about Fidelis Care