Centene Medicare Advantage Plans New York 2025

Some Centene Medicare Advantage plans in New York may provide more than just basic Medicare coverage; they are designed to enhance your healthcare experience. With an array of potential plan options through Fidelis Care, Centene may ensure affordability, choice, and potential comprehensive benefits.

This concise guide outlines some of the key details of the Centene Medicare Advantage plans in New York for 2025, the enrollment window, potential health benefits, and support services that could be awaiting New York residents who choose Centene for their Medicare Advantage needs.

 

Key Takeaways

 

 

  • Centene’s Medicare Advantage Prescription Drug plans might include Part D coverage and may feature a network of preferred pharmacies, possibly ensuring enhanced prescription drug access and potential cost savings for New York members.

 


Compare plans & rates for 2025
Enter Zip Code

Advertisement


Exploring Centene’s Potential Medicare Advantage Offerings in New York

 

Centene Medicare Advantage Plans New York 2025, Exploring Centene's Medicare Advantage Offerings in New York

 

Centene, through its subsidiary Fidelis Care, might offer Medicare Advantage plans that could be tailored to fit the needs of New Yorkers who are eligible for Medicare. These plans might provide choice and flexibility that could meet individual healthcare needs, with potential benefits that may exceed those offered by Medicare Parts A and B.

 

Centene’s Commitment to New York Members

Centene consistently demonstrates its dedication to New York members. With over 2.4 million New Yorkers served through its subsidiary, Fidelis Care, Centene’s commitment to quality and affordable health insurance may be evident.

Wellcare By Fidelis Care, Centene’s Medicare brand in New York, will likely provide members with:

  • Affordable access to a network of doctors, nurses, and specialists

 

  • Continuity of care

 

  • Innovative solutions and partnerships to improve health outcomes for Medicare beneficiaries.

 

Potential Plan Variety and Options

Centene will likely provide a wide variety of Medicare Advantage plans in New York, including HMO, PPO, and SNP types. This broad coverage and diverse plan options may be demonstrated by Wellcare’s presence in 37 states.

To ensure members have access to appropriate care, Fidelis Care might offer a ‘Find a doctor’ tool, which may allow members to search for in-network providers by plan type, medical specialty, and location.

 

Enrollment Process and Periods

Some Medicare Advantage plans, such as those provided by Centene in New York, follow an Annual Election Period from October 15 to December 7. During this time, individuals can join, switch, or drop a plan. Also, the Medicare Advantage Open Enrollment Period, which runs from January 1 to March 31, allows individuals already enrolled to make coverage adjustments.

Occasionally, life events may require enrollment modifications outside of the regular periods. Special Enrollment Periods address this need. They could allow for enrollment changes throughout the year due to events that qualify, like relocation or loss of previous insurance coverage, ensuring that your coverage options remain available.

For individuals transitioning from Medicaid to Medicare, a special enrollment period eliminates late enrollment penalties and may even start Medicare coverage retroactively to the day after Medicaid coverage ends.

Throughout the enrollment process, WellCare by Fidelis Care representatives are on standby to offer assistance, ensuring a seamless transition into Centene’s Medicare Advantage plans.

 

Understanding Dual Special Needs Plans (D-SNP)

 

Centene Medicare Advantage Plans New York 2025, Understanding Dual Special Needs Plans (D-SNP)

 

With healthcare, a one-size-fits-all approach is rarely sufficient. This is where a dual special needs plan (D-SNP) could come in. Designed for individuals eligible for both Medicare and Medicaid, D-SNPs provide a combination of benefits from both programs.

This unique plan may require an enhanced coordination of  potential Medicare and Medicaid benefits that may be compared to other Medicare Advantage plans, possibly focusing on:

  • Improved patient outcomes

 

  • Comprehensive coverage

 

  • Care coordination

 

  • Specialized services

 

In New York, Fidelis Care may offer the Medicare Advantage Dual Advantage Flex Plan, which could be designed for individuals dual-eligible for Medicaid and Medicare. These plans may offer additional benefits that might not be available in traditional Medicare and may provide these services without charging a premium.

 

Eligibility and Benefits

The benefits of D-SNPs are plentiful, and they are available for enrollment year-round. D-SNPs provide benefits not typically covered by Medicare, such as long-term services and support.

Members enrolled in D-SNPs experience could experience:

  • Seamless coverage between Medicare and Medicaid without coverage gaps

 

  • Little to no out-of-pocket costs

 

  • Potential savings for healthy foods, a unique benefit that could come with some D-SNP Medicare Advantage plans.

 

How D-SNPs Enhance Coverage

D-SNPs may significantly enhance coverage by integrating Medicare and Medicaid services. One example is FIDE SNPs, one of the most integrated models, which may offer coordination of services that could include Long-Term Services and Support.

These plans may be able to establish contracts with state Medicaid programs that could detail the provision and coordination of certain Medicare and Medicaid services, which may be influenced by state requirements to optimize integrated care.

Despite facing some alignment issues between Medicare and Medicaid, D-SNPs are continuously evolving. They focus on better care management and network standards to enhance care integration.

Through various models of integration and continuous improvement efforts, D-SNPs strive to offer comprehensive coverage that ensures seamless healthcare experiences for dual-eligible members.

 

Compare Medicare Plans

Find a plan to fit your needs

Advertisement

Speak with a licensed insurance agent

1-844-709-9937
TTY 711

Mon-Fri : 8am-9pm ET

Navigating Prescription Drug Coverage with Centene

 

Centene Medicare Advantage Plans New York 2025, Navigating Prescription Drug Coverage with Centene

 

Some Centene’s Medicare Advantage Prescription Drug plans in New York, which will likely be operated by the Wellcare brand, may offer comprehensive care that could include:

  • Dental services

 

  • Hearing services

 

  • Vision services

 

  • Prescription drugs

 

These plans may also incorporate Medicare Part D, which could significantly enhance prescription drug coverage.

 

The Importance of Formularies

Formularies, lists detailing the drugs that may be covered under a specific health plan, could be essential in managing prescription drug coverage. Typically, medications may be grouped into cost-based tiers within these formularies.

Formularies will likely be subject to change, but any changes made must meet guidelines set by Medicare to ensure they don’t put members at a disadvantage. Understanding your plan’s formulary may help you anticipate potential drug costs, possibly allowing for better financial planning around your healthcare needs.

 

Pharmacy Networks and Accessibility

Members of Centene’s Medicare Advantage Prescription Drug plans may have access to a network of preferred pharmacies, which might be a key aspect of prescription drug coverage. These pharmacies will likely have agreed to offer certain drugs at reduced costs, possibly resulting in more value for plan members.

Pharmacy networks may change from one year to the next, so it’s important to verify whether your preferred pharmacy is in-network each year. This could help ensure you’re getting the most out of your potential prescription drug benefits.

 


Compare plans & rates for 2025
Enter Zip Code

Advertisement


Tailored Services for Individuals and Families

 

Centene Medicare Advantage Plans New York 2025, Tailored Services for Individuals and Families

 

Centene will likely go beyond basic coverage by potentially offering a range of tailored services for individuals and families. These services could include:

  • Preventive care

 

  • Chronic disease management support

 

  • Language assistance services

 

This could potentially ensure comprehensive family care.

 

Preventive Care and Wellness Programs

Preventive care and wellness programs may be integral parts of Centene’s Medicare Advantage plans. These services could potentially include:

  • Annual wellness visits

 

  • Cancer screenings

 

  • Vaccinations

 

  • Routine check-ups

 

In addition, the annual flu vaccine may offered, which will likely support the overall preventive health strategy.

Plus, for members managing chronic conditions, Centene will likely provide a 24/7 nurse advice line, which could offer valuable guidance on health management and informed care decisions.

 

Chronic Disease Management Support

Managing a chronic disease may be a challenging task. Recognizing this, Centene might incorporate behavioral health screenings and comprehensive health assessments into some of their chronic disease management programs. These potential services could facilitate the effective management of chronic conditions.

In addition to these potential services, Centene’s approach to chronic disease management will likely include:

  • Education on self-care may increase patient knowledge and medication adherence for better self-management of health conditions

 

  • Personalized care plans that may feature regular monitoring and coordination of care

 

  • Consistent and tailored health management for plan members

 

The Role of Fidelis Care in Centene’s Network

 

Centene Medicare Advantage Plans New York 2025, The Role of Fidelis Care in Centene's Network

 

Acquired by Centene in 2018, Fidelis Care will likely act as Centene’s local health plan in New York state. Its robust portfolio of potential Medicare Advantage plans and a strong healthcare provider network could position Fidelis Care as a key player within Centene’s network.

 

Fidelis Care’s Local Impact

Fidelis Care’s significant local presence in New York may ensure that its specific Medicare Advantage plans could be designed with a deep understanding of the specific needs of New Yorkers. This local expertise may contribute to the value of some of Centene’s Medicare Advantage offerings by providing region-specific health solutions.

 

Accessing Fidelis Care Resources

Access to potential resources and plan documents may made easy through the Member Portal on the Fidelis Care website. Here, members may be able to:

  • Manage their healthcare

 

  • Review plan details

 

  • Track claims

 

  • View claims history

 

  • Find healthcare providers.

 

Additionally, Centene plan members will likely be able to access Fidelis Care’s customer service through a dedicated hotline for assistance with potential plan details, coverage questions, and other inquiries.

 

Transitioning from Medicaid to Medicare Advantage

 

Centene Medicare Advantage Plans New York 2025

 

The transition from Medicaid to Medicare could potentially introduce more cost-effective health coverage options for individuals. A special enrollment period may ensure that eligible individuals may be able to enroll in Medicare Advantage without facing late penalties.

 

Making the Move: Steps and Considerations

The transition from Medicaid to Medicare should start before reaching age 65. By seeking guidance from the state’s Medicaid office and the Medicare SHIP, individuals could potentially understand their eligibility. It’s important to bear in mind that asset limits for Medicaid and Medicare Savings Programs (MSPs) come into effect at age 65.

A re-evaluation for traditional Medicaid and MSPs may lead to various outcomes, possibly determining the extent of coverage and potential out-of-pocket expenses upon transitioning to Medicare eligibility. To help navigate this transition, a Medicare broker may provide in-depth knowledge to make informed decisions regarding Medigap, Part D, and Medicare Advantage plans.

 

Continuity of Care Assurance

The transition to Medicare Advantage from expanded Medicaid may significantly improve overall access to affordable healthcare through the health insurance marketplace.

Especially for those previously in the coverage gap, this transition could potentially maintain the continuity of care, possibly ensuring that individuals may continue to receive the healthcare they need without interruption. With Medicaid Advantage, individuals will likely experience a seamless transition in their healthcare journey.

 

Summary

Some of Centene’s Medicare Advantage plans in New York, which will likely be offered through WellCare by Fidelis Care, could potentially provide comprehensive coverage and tailored services. From the possible variety of plans to the enhanced coverage of the D-SNPs, some of Centene’s offerings may cater to a wide range of needs.

The possibility of prescription drug coverage, preventive care, wellness programs, and chronic disease management support may be just some of the services that could be available to members.

With the local expertise of Fidelis Care and the seamless transition from Medicaid to Medicare, Centene is committed to providing quality, affordable healthcare to New Yorkers.

 

Frequently Asked Questions

 

What is the difference between WellCare and Centene?

The main difference between WellCare and Centene is that WellCare is a wholly owned subsidiary of Centene Corporation, with Centene acquiring WellCare in January 2020. This acquisition positioned Centene as a leading healthcare enterprise dedicated to improving community health.

 

What types of Medicare Advantage plans does Centene offer in New York?

Centene may offer a range of Medicare Advantage plans in New York, such as HMO, PPO, and SNP plans, available through its subsidiary Fidelis Care. These plans will likely cater to different healthcare needs in the state.

 

What is a Dual Special Needs Plan (D-SNP)?

A Dual Special Needs Plan (D-SNP) is a type of plan for people who are eligible for both Medicare and Medicaid, providing a combination of benefits from both programs and requiring enhanced coordination of these benefits.

 

Compare Medicare Plans

Find a plan to fit your needs

Advertisement

Speak with a licensed insurance agent

1-844-709-9937
TTY 711

Mon-Fri : 8am-9pm ET