Fully Integrated Duals Advantage (FIDA)

FIDA: Medicaid and Medicare together - for better health, and a better life!

FIDA is a personal health care plan that´s centered on you. One plan that brings together the resources of Medicare and Medicaid. A plan that gives you all the care you need in one place.

We know that health care decisions can be overwhelming for you and your family, especially when you have both Medicare and Medicaid coverage. We are always looking for ways to make this process easier so that you can simply focus on getting the care you need.

This is why the New York State Department of Health (NYSDOH) has partnered with the Centers for Medicare and Medicaid Services (CMS) to offer you a program that will provide you with the most complete care package that has ever been available in the State. This new program is called Fully Integrated Duals Advantage, or "FIDA" for short. Currently, there are 10 FIDA plans in the FIDA program.

What is a FIDA Plan?

In a FIDA plan, you will:

• Receive full Medicare and Medicaid coverage, long term care services, Part D and Medicaid drugs, and additional benefits from a single, integrated managed care plan. In other words, FIDA covers all the benefits that you may receive through your managed long term care (MLTC) plan, Original Medicare or your Medicare Advantage plan, and your Part D plan.
• Pay no new or additional deductibles, premiums, or copayments/coinsurance to the plan. (If you have Medicaid with a "spend-down" or "excess income," you will have to continue to pay your spend-down to the FIDA plan.)
• Be able to access specialists directly. No need for provider referrals.
• Stay in your current nursing home even if you change FIDA plans.
• Have a Care Manager who can schedule doctor´s appointments, arrange transportation and help you get your medicine. (In most cases, you will keep your current care manager.)
• Have a care team made up of members that you choose. Your care team can be as small (just yourself and your Care Manager) or as large as you decide.
• Have the option to add your Medicare and Medicaid doctors and specialists to your care team. All of whom will be able to share with each other their professional opinions about your health condition. That way, they can provide the most complete care for you and connect you to a wide variety of options for health care and supportive services.
• Have the option to add your caregivers or anyone you trust, like your friends and relatives, to your care team. They will be able to stay with you during the care team meetings and help you make the right decisions about your care.
• Use one FIDA Plan phone number for all questions regarding your benefits.
• Have the right to leave FIDA at any time and for any reason. If you decide to do so, you will continue to receive all of your Medicaid long term care benefits through the MLTC program and all of your Medicare benefits through Original Medicare or a Medicare Advantage plan, and a Part D plan.