Wellcare Fidelis Assist (HMO-POS)

NEW YORK QUALITY HEALTHCARE CORPORATION · 2027 plan year

Plan ID H5599-002-000

HMOPOS★ 3 CMS Stars
MOOP (in-network)
$9,850
MOOP (combined)
—
Monthly premium
$0/mo
Part C $0 + Part D $0
Prescription drugs
Included

This plan in 2026

Plan information

Contract / Plan / Segment
H5599-002-000
Medical deductible
$0 — no deductible
Part D premium
$0/mo (part of the monthly premium above)
Part D deductible
$700/yr
Also owed
Your Medicare Part B premium, paid separately

More NEW YORK QUALITY HEALTHCARE CORPORATION plans in NY

Benefits & cost sharing

Primary Care

BenefitIn-network
Chiropractic — Routine Care$15

Hospital

BenefitIn-network
Inpatient Hospital — Acute$475/day for days 1–5, $0 after
Inpatient Hospital — Additional Days (Acute)No charge
Inpatient Hospital — Psychiatric$400/day for days 1–5, $0 after
Worldwide Urgent Care Coverage$115

Pharmacy

BenefitIn-network
Part B DrugsSee plan details
Chemotherapy & Radiation Drugs (Part B)0%-20% coinsurance
Other Part B Drugs0%-20% coinsurance

Mental Health

BenefitIn-network
Mental Health Specialty ServicesSee plan details
Mental Health — Individual Sessions$25
Mental Health — Group Sessions$25
Supplemental Health BenefitsSee plan details

Other

BenefitIn-network
Home Health ServicesNo charge
Chiropractic ServicesSee plan details
Vision — Eye Exams$0-$35
Hearing — Prescription Hearing AidsSee plan details
Hearing — Hearing Aids (All Types)No charge
X-Ray Services$50
Diabetic MonitorsNo charge
Diagnostic Radiology0%-30% coinsurance
Therapeutic Radiology20% coinsurance
Skilled Nursing Facility (SNF)$0/day for days 1–20, $221/day for days 21–70, $0 after
Cardiac & Pulmonary RehabilitationSee plan details
Cardiac Rehabilitation — Additional Sessions$30
Intensive Cardiac Rehabilitation — Additional Sessions$40
Pulmonary Rehabilitation — Additional Sessions$25
Supervised Exercise Therapy (SET)$20
Emergency Services$115
Urgently Needed Services$30
Worldwide Emergency & Urgent CoverageSee plan details
Worldwide Emergency Coverage$115
Partial Hospitalization Program$115
Intensive Outpatient Program (IOP)$120
Primary Care Physician ServicesNo charge
Chiropractic Services$15
Occupational Therapy Services$25
Physician Specialist Services$35
Podiatry Services$35
Other Health Care Professional Services$0-$35
Psychiatric ServicesSee plan details
Psychiatric Services — Individual Sessions$25
Psychiatric Services — Group Sessions$25
Physical Therapy & Speech-Language Pathology$25
Outpatient Blood ServicesNo charge
Ambulance ServicesSee plan details
Additional Telehealth Services (Part B)$0-$35
Opioid Treatment Program Services$35
Diagnostic Tests & Lab ServicesSee plan details
Diagnostic Procedures & Tests$0-$50
Laboratory Services$0-$50
Radiological ServicesSee plan details
Outpatient Hospital Services0%-30% coinsurance
Hospital Observation Services$115 per stay copay + 30% coinsurance
Ambulatory Surgical Center (ASC)$300
Outpatient Substance Abuse ServicesSee plan details
Substance Abuse — Individual Sessions$25
Substance Abuse — Group Sessions$25
Ground Ambulance$325
Air Ambulance$325
Durable Medical Equipment (DME)20% coinsurance
Prosthetics & OrthoticsSee plan details
Prosthetic Devices20% coinsurance
Medical Supplies20% coinsurance
Diabetic Supplies & ServicesSee plan details
Diabetic SuppliesNo charge
Diabetic Therapeutic Shoes & Inserts20% coinsurance
Dialysis Services20% coinsurance
AcupunctureNo charge
Over-the-Counter (OTC) ItemsNo charge
Medicare-Covered Preventive ServicesSee plan details
Annual Physical ExamNo charge
Fitness BenefitNo charge
Remote Access TechnologiesNo charge
Alternative TherapiesNo charge
Kidney Disease Education Services20% coinsurance
Glaucoma ScreeningNo charge
Diabetes Self-Management TrainingNo charge
Digital Rectal ExamsNo charge
Welcome to Medicare EKGNo charge
Insulin (Part B)$35
Dental — Medicare-Covered Services$35
Dental — Adjunctive General ServicesNo charge
Dental — PreventiveSee plan details
Dental — Oral ExamsNo charge
Dental — X-RaysNo charge
Dental — Diagnostic ServicesNo charge
Dental — Prophylaxis (Cleaning)No charge
Dental — Fluoride TreatmentNo charge
Dental — Other Preventive ServicesNo charge
Dental — ComprehensiveSee plan details
Dental — Restorative ServicesNo charge
Dental — Endodontics (Root Canal)No charge
Dental — Periodontics (Gum Care)No charge
Dental — Oral & Maxillofacial SurgeryNo charge
Vision — Eye ExamsSee plan details
Vision — Routine Eye ExamsNo charge
Vision — Other Eye ServicesNo charge
Vision — EyewearNo charge
Vision — EyewearSee plan details
Vision — Contact LensesNo charge
Vision — Eyeglasses (Lenses & Frames)No charge
Vision — Eyeglass LensesNo charge
Vision — Eyeglass FramesNo charge
Vision — Eyewear UpgradesNo charge
Hearing — Exams$35
Hearing — ExamsSee plan details
Hearing — Routine ExamsNo charge
Hearing — Fitting & Evaluation for Hearing AidNo charge

Service area

  • NY: 58 counties

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