FIDA Brochure

  • Brochure is also available in Portable Document Format (PDF)

FIDA:

Medicaid and Medicare together – for better health, and a better life.

nymedicaidchoice.com

Fully Integrated Duals Advantage (FIDA) is a person–centered, integrated health care plan option for people who have both Medicare and Medicaid. FIDA members have a higher level of integrated care and better support to stay independent.

What will FIDA do for you as a provider?
  • Offers you the opportunity to work collaboratively with other providers as part of a care team to develop a single care plan to address your patient's needs.
  • Provides extra support coordinating care for your patients through a Care Team who documents any changes to the patients care plan, and notify you of any other services your patient receives.
  • Helps you ensure your patients get the care and support needed to live safely at home (including appropriate number of home health aide hours), and help avoid hospitalization and nursing home stays.
  • Simplifies the claims process as you bill FIDA plans for both Medicare and Medicaid services.
  • Offers FIDA training, if requested.
FIDA at a Glance
The FIDA Program is comprised of four key components:
  • Fully integrated delivery of Medicaid and Medicare services
  • Person centered care that promotes independence in the community
  • Improved quality through care coordination
  • High quality, cost effective health care
Your patients enrolled in FIDA:
  • Receive full Medicare and Medicaid coverage, long-term care services, behavioral health services, Part D and Medicaid drugs, and additional benefits from one integrated managed care plan.
  • Have a Care Team who can make sure your patient is getting needed services, such as a home health aide and medication.
  • Have, at a minimum, a 90–day continuity–of–care period for all care services and service providers. If receiving behavioral health services upon enrollment, the continuity–of–care period will be two years.
  • Use one phone number at the plan for all questions.
  • Pay no new or additional deductibles or copayments.
  • Have an individual care plan and Care Team that is comprised of members chosen by your patient.
  • Have one process for all Medicare and Medicaid appeals (except for Part D appeals).
  • Access specialists directly, no need for referrals.
  • Have help navigating the long–term care system or the appeals process through the Ombudsman Program, called the Independent Consumer Advocacy Network (ICAN).
  • Disenroll from FIDA at any time. Medicaid long–term care benefits will continue through a Managed Long–Term Care plan. Medicare benefits will continue through original Medicare or a Medicare Advantage plan, and a Part D plan.
Who is eligible?

To be eligible for FIDA, a person must:

  • Reside in any of the New York City boroughs or Nassau County;
  • Be 21 years or older;
  • Be entitled to Medicare Part A, enrolled in Medicare Part B, and eligible to enroll in Part D, and receiving full Medicaid benefits; and,
  • Be expected to need of long–term care services for more than 120 days.

To become a participating provider in a FIDA plan network, call New York Medicaid Choice at 1–855–600–3432

If your patients have questions about benefits or how to enroll into FIDA, they can call New York Medicaid Choice at 1–855–600–3432

(TTY users: 1–888–329–1541; for a free interpreter: 1–855–600–3432).

For the list of FIDA plans, go to: nymedicaidchoice.com