Fidelis Care Addiction Treatment Coverage on Long Island
Fidelis Care is one of New York's largest Medicaid managed care plans, serving over 1.7 million members statewide. Their Medicaid and HealthierLife (HARP) plans provide comprehensive addiction treatment coverage at OASAS-certified facilities across Long Island with $0 copay and $0 deductible for qualifying members.
$0
Out-of-Pocket Cost
For Medicaid members
No Prior Auth
For Outpatient
IOP & PHP services
100%
MAT Coverage
Suboxone, Vivitrol, Sublocade
Same-Day
Intake Available
At participating facilities
Fidelis Care Medicaid covers addiction treatment on Long Island with $0 copay including medical detox, residential rehabilitation, IOP, PHP, and all FDA-approved MAT medications such as Suboxone, Sublocade, Vivitrol, and Brixadi. Most outpatient services do not require prior authorization. Fidelis also offers the Essential Plan for low-income adults and Ambetter through the NY State of Health Marketplace. Call 631-762-3763 for free benefits verification.
What Fidelis Care Covers for Addiction Treatment
Fidelis Care Medicaid managed care provides comprehensive coverage for substance use disorder treatment at OASAS-certified facilities throughout Nassau and Suffolk counties. Under the Mental Health Parity and Addiction Equity Act and New York State law, addiction treatment must be covered at the same level as medical and surgical benefits.
Covered MAT Medications
Medication-assisted treatment (MAT) is considered the gold standard for opioid and alcohol use disorders. Fidelis Care covers all FDA-approved MAT medications with no prior authorization required for buprenorphine under New York law:
Suboxone
Buprenorphine/Naloxone
Use: Opioid dependence
Form: Film / Tablet
Sublocade
Extended-release buprenorphine
Use: Opioid dependence
Form: Monthly injection
Vivitrol
Extended-release naltrexone
Use: Opioid & alcohol
Form: Monthly injection
Brixadi
Buprenorphine ER injection
Use: Opioid dependence
Form: Weekly/Monthly injection
Fidelis Care Plans Accepted for Rehab
Fidelis Medicaid Managed Care
Full addiction treatment coverage with $0 copay. Most commonly used plan for substance abuse treatment. Accepted at all OASAS-certified facilities on Long Island.
Fidelis HealthierLife (HARP)
Specialized Medicaid plan for adults with significant behavioral health needs. Enhanced services including peer support, care management, and CPST in addition to standard addiction treatment.
Fidelis Essential Plan
Low-cost coverage for New Yorkers who don't qualify for Medicaid. Addiction treatment covered with minimal copays ($0–$20 depending on plan level).
Ambetter from Fidelis Care
NY State of Health Marketplace plan. Addiction treatment benefits vary by metal tier (Bronze, Silver, Gold). Prior authorization may apply for inpatient services.
How to Verify Your Fidelis Care Benefits
Locate your Fidelis Care member ID
Find your member ID number on your Fidelis Care insurance card. You'll need this when calling to verify benefits.
Call Fidelis Care Member Services
Call 1-888-343-3547 (TTY 711) to verify your behavioral health and substance abuse benefits. Ask about covered services, prior authorization requirements, and in-network providers on Long Island.
Or call us for free verification
Our team can verify your Fidelis Care benefits for free and help you find an appropriate treatment center. We check your specific plan details, coverage levels, and available facilities.
Begin treatment
Once benefits are verified, you can begin treatment — often the same day. OASAS-certified facilities handle the intake and authorization process on your behalf.
Where Fidelis Care Is Accepted on Long Island
Fidelis Care is accepted at OASAS-certified addiction treatment facilities throughout Long Island:
Nassau County
- • Detox & residential programs
- • Outpatient clinics (IOP/PHP)
- • MAT providers & clinics
- • Community health centers
Suffolk County
- • Hospital-based detox units
- • Residential rehabilitation
- • Outpatient treatment programs
- • Sober living residences
Your Parity Rights Under New York Law
Under the Mental Health Parity and Addiction Equity Act (MHPAEA) and Timothy's Law (New York State), Fidelis Care cannot impose more restrictive limitations on substance use disorder treatment than on medical/surgical benefits. This means:
- No separate, lower annual or lifetime dollar limits for addiction treatment
- Co-pays and deductibles cannot be higher than comparable medical benefits
- Prior authorization requirements must be no more restrictive than for medical care
- Day and visit limits must be comparable to medical/surgical limits
If you believe Fidelis Care has improperly denied addiction treatment coverage, you can file a complaint with the New York Department of Financial Services at 1-800-342-3736 or request an external independent review.
Fidelis Care vs. Other Medicaid Plans for Rehab
| Feature | Fidelis Care | Healthfirst | UHC Community |
|---|---|---|---|
| Copay for Rehab | $0 | $0 | $0 |
| Detox Coverage | ✓ Full | ✓ Full | ✓ Full |
| Inpatient Rehab | ✓ Full | ✓ Full | ✓ Full |
| IOP/PHP | ✓ No prior auth | ✓ No prior auth | ✓ No prior auth |
| MAT (Suboxone/Vivitrol) | ✓ Full | ✓ Full | ✓ Full |
| LI Network Size | Large | Large | Moderate |
| Statewide Coverage | Largest | NYC/LI focused | Large |
All three plans provide equivalent coverage for core addiction treatment. The primary differences are network size and member services. Compare Healthfirst → | Compare UHC Community Plan →
Frequently Asked Questions About Fidelis Care Rehab Coverage
Related Insurance Guides
Verify Your Fidelis Care Benefits — Free & Confidential
Our team can verify your Fidelis Care coverage and connect you with an appropriate treatment center on Long Island. The call is free, confidential, and takes about 5 minutes.
Call 631-762-3763Available 24/7 — No obligation
Medical Disclaimer: This page is for informational purposes only and does not constitute medical advice. Coverage details may vary by specific Fidelis Care plan. Always verify your individual benefits with Fidelis Care Member Services (1-888-343-3547) before beginning treatment. Information is current as of March 2026.