FIDELIS CARE
Fidelis Care Coverage for Addiction Treatment in Albany, NY
Don’t let insurance questions get in the way of recovery. At Fusion Recovery in Albany, NY, our admissions team will verify your Fidelis Care benefits, explain what’s covered in plain language, and help you start treatment, often the same day.
START HEALING TODAY
Personalized Outpatient Treatment for Albany Residents
At Fusion Recovery, we understand the weight that addiction places on your life and the lives of those you love. That’s why we offer personalized outpatient addiction treatment built around your specific situation, your goals, your schedule, and your recovery needs.
As an outpatient rehab serving the Albany, NY region, we provide flexible scheduling so you can stay engaged with work, family, and other commitments while getting the help you deserve. Our team blends evidence-based therapies with medication-assisted treatment, clinical counseling, and holistic support to help you build a lasting recovery.
If you or someone you love is struggling, contact us today. Our admissions team will verify your Fidelis Care benefits, walk you through your treatment options, and help you take the next step at no cost and with no pressure.
ABOUT FIDELIS CARE
Understanding Fidelis Care in New York
Fidelis Care is one of the largest health insurance providers in New York State, with more than 2.4 million members served statewide. Headquartered in Long Island City, Fidelis Care is a Centene Corporation company that has been a trusted resource for New Yorkers for over 25 years. The plan operates a regional office in Albany and maintains community offices throughout the state, with deep grassroots ties to neighborhoods, schools, churches, and community organizations across New York.
Fidelis Care offers an unusually broad portfolio of plans designed to meet the needs of New Yorkers at every stage of life, including Medicaid Managed Care, Medicare Advantage, Essential Plan, Child Health Plus, Health and Recovery Plans (HARP) for individuals with serious behavioral health needs, Managed Long Term Care, Medicaid Advantage Plus, and the Dual Advantage plan for those eligible for both Medicaid and Medicare. Through its partnership with Centene, Fidelis Care also offers Qualified Health Plans on the NY State of Health marketplace under the Ambetter from Fidelis Care brand.
Under the Mental Health Parity and Addiction Equity Act and New York State Insurance Law, Fidelis Care plans must cover mental health and substance use treatment at the same level as physical health services. New York State Insurance Law also adds further protections, including up to 28 days of inpatient substance use treatment at NY OASAS-licensed facilities for members with a primary substance use disorder diagnosis.
OVERVIEW OF FIDELIS CARE BENEFITS
What Fidelis Care Covers at Fusion Recovery
Coverage details vary by plan and product line, but most Fidelis Care plans cover a comprehensive range of addiction treatment services at Fusion Recovery.
Treatment services that are typically covered by insurance
- Medical detox and supervised withdrawal management
- Outpatient rehab and intensive outpatient programs (IOP)
- Partial hospitalization programs (PHP)
- Individual, group, and family therapy
- Medication-assisted treatment (MAT), including Sublocade and Suboxone
- Dual diagnosis care for co-occurring mental health conditions
- Aftercare planning and continued outpatient support
Coverage details
Out-of-pocket costs depend on your specific Fidelis Care plan. Members on Medicaid Managed Care, HARP, Essential Plan, or Child Health Plus typically have minimal cost-sharing, capped at $200 per calendar year under New York Medicaid rules. Commercial Qualified Health Plans (Ambetter from Fidelis Care) and Medicare Advantage plans have varying copays, coinsurance, and deductibles depending on the metal tier or plan design. Our admissions team will verify your benefits and explain exactly what to expect before you start treatment.
HARP and behavioral health services
If you’re enrolled in a Fidelis Care HARP plan (Health and Recovery Plan), you have access to enhanced behavioral health benefits specifically designed for individuals with significant mental health or substance use needs. HARP members receive an enhanced benefit package and care coordination, including Home and Community-Based Services (HCBS) for those who qualify.
Preauthorization and level-of-care reviews
Some Fidelis Care plans require prior authorization for medical detox, partial hospitalization, or intensive outpatient programs. For substance use disorder care in New York, Fidelis Care uses LOCADTR 3.0, the Level of Care for Alcohol and Drug Treatment Referral tool developed by NYS OASAS and Columbia University, to determine the appropriate level of care. Fusion Recovery’s admissions team handles authorizations and continued-stay reviews on your behalf so treatment isn’t delayed.
Call Now to Verify Your Coverage
HOW IT WORKS
How to Verify Your Fidelis Care Benefits
Verification is fast, free, and fully confidential. Here’s how it works:
01.
Share your details
Call us at 1.866.936.2290 or fill out our contact form with your Fidelis Care member ID and group number, including any product line designation such as Medicaid, Medicare, HARP, Essential Plan, or Ambetter from Fidelis Care.
02.
We verify your benefits
Our team contacts Fidelis Care directly to confirm in-network status, deductibles, copays, prior authorization requirements, and what level of care is covered under your plan.
03.
We explain your options
We walk you through your benefits in plain language, outline any out-of-pocket costs, and recommend the level of care that fits your needs.
04.
You take the next step
When you’re ready, we schedule your clinical assessment and help you begin treatment, often the same day.
WHAT WE TREAT
Conditions We Treat at Fusion Recovery
Our Albany, NY treatment programs serve adults struggling with a wide range of substance use and co-occurring mental health conditions, including:
- Alcohol use disorder
- Opiate and prescription painkiller addiction
- Heroin addiction
- Fentanyl addiction
- Cocaine addiction
- Methamphetamine addiction
- Benzodiazepine dependence
- Co-occurring depression, anxiety, PTSD, and other mental health conditions
Ready to Take the First Step?
Recovery begins when you reach out. Our admissions team is available to verify your Fidelis Care coverage, answer your questions, and help you start treatment in Albany, NY. Call anytime, we’re here when you’re ready.
Frequently Asked Questions
01. Is Fusion Recovery in-network with Fidelis Care?
Fusion Recovery may be in-network with Fidelis Care plans serving Albany, NY and the surrounding Capital Region. Network status varies by your specific plan and product line, so we recommend calling our admissions team at 1.866.936.2290 to verify your in-network benefits before starting treatment.
03. What is HARP, and how does it differ from regular Medicaid?
HARP stands for Health and Recovery Plan. It’s a special Medicaid Managed Care plan for adults with significant behavioral health needs, including substance use disorders and serious mental illness. HARP members get all the regular Medicaid benefits plus enhanced behavioral health services and Home and Community-Based Services (HCBS) for those who qualify. If you’re a HARP member, ask our admissions team about the enhanced services available under your plan.
05. How long will Fidelis Care cover inpatient treatment in New York?
Under New York State Insurance Law, Fidelis Care plans must approve up to 28 days of inpatient substance use treatment at a NY State Office of Addiction Services and Supports (OASAS)-licensed facility for members with a primary substance use disorder diagnosis. Coverage past 28 days is reviewed using LOCADTR 3.0 based on your progress and ongoing clinical need.
07. Will I have to pay anything out of pocket?
Out-of-pocket costs depend on your specific Fidelis Care plan. Medicaid, HARP, Essential Plan, and Child Health Plus members typically have very low or no copays, capped at $200 per calendar year under New York rules. Medicare Advantage and commercial plan members have varying copays and deductibles. Our admissions team will give you a clear picture of expected costs before treatment begins.
09. Will my employer or family find out I'm seeking treatment?
Federal law (HIPAA and 42 CFR Part 2) provides strong confidentiality protections for substance use treatment records. Your employer is not notified, and Fidelis Care cannot share your treatment details with anyone without your written authorization. Our admissions team is happy to walk you through how your privacy is protected at every step.
02. Which Fidelis Care plans cover addiction treatment?
All Fidelis Care plans, including Medicaid Managed Care, Medicare Advantage, Essential Plan, Child Health Plus, HARP, Managed Long Term Care, Dual Advantage, and Ambetter from Fidelis Care Qualified Health Plans, cover substance use disorder treatment as part of essential health benefits. Specific cost-sharing and prior authorization rules vary by plan.
04. Does Fidelis Care cover MAT medications like Suboxone and Sublocade?
Yes. Fidelis Care plans typically cover FDA-approved medication-assisted treatment medications, including Sublocade and Suboxone for opioid use disorder, as well as naltrexone and Vivitrol for opioid and alcohol use disorders. Some medications may require prior authorization, which our admissions team handles for you.
06. I have Ambetter from Fidelis Care, is that the same as Fidelis Care?
Ambetter from Fidelis Care is the Qualified Health Plan product offered by Fidelis Care through the NY State of Health marketplace, in partnership with Centene Corporation. It’s a separate product line from traditional Fidelis Care Medicaid, Medicare, and Essential Plan products, but it’s offered by the same company. Our admissions team can verify either type of plan.
08. Do I need a referral from my primary care doctor?
Most Fidelis Care plans don’t require a referral for substance use or mental health treatment, but some plan types may. Our admissions team will check the requirements for your specific plan during the verification process.
10. What if Fidelis Care denies coverage for my treatment?
Don’t give up. Fidelis Care plans typically have multiple levels of internal appeals, and our admissions and clinical teams help guide you through that process. Federal and state parity laws require insurers to cover behavioral health at the same level as medical care. If a denial isn’t resolved through internal appeals, you can also file a complaint with the New York State Department of Financial Services at 1-800-400-8882.
01. Is Fusion Recovery in-network with Fidelis Care?
Fusion Recovery may be in-network with Fidelis Care plans serving Albany, NY and the surrounding Capital Region. Network status varies by your specific plan and product line, so we recommend calling our admissions team at 1.866.936.2290 to verify your in-network benefits before starting treatment.
02. Which Fidelis Care plans cover addiction treatment?
All Fidelis Care plans, including Medicaid Managed Care, Medicare Advantage, Essential Plan, Child Health Plus, HARP, Managed Long Term Care, Dual Advantage, and Ambetter from Fidelis Care Qualified Health Plans, cover substance use disorder treatment as part of essential health benefits. Specific cost-sharing and prior authorization rules vary by plan.
03. What is HARP, and how does it differ from regular Medicaid?
HARP stands for Health and Recovery Plan. It’s a special Medicaid Managed Care plan for adults with significant behavioral health needs, including substance use disorders and serious mental illness. HARP members get all the regular Medicaid benefits plus enhanced behavioral health services and Home and Community-Based Services (HCBS) for those who qualify. If you’re a HARP member, ask our admissions team about the enhanced services available under your plan.
04. Does Fidelis Care cover MAT medications like Suboxone and Sublocade?
Yes. Fidelis Care plans typically cover FDA-approved medication-assisted treatment medications, including Sublocade and Suboxone for opioid use disorder, as well as naltrexone and Vivitrol for opioid and alcohol use disorders. Some medications may require prior authorization, which our admissions team handles for you.
05. How long will Fidelis Care cover inpatient treatment in New York?
Under New York State Insurance Law, Fidelis Care plans must approve up to 28 days of inpatient substance use treatment at a NY State Office of Addiction Services and Supports (OASAS)-licensed facility for members with a primary substance use disorder diagnosis. Coverage past 28 days is reviewed using LOCADTR 3.0 based on your progress and ongoing clinical need.
06. I have Ambetter from Fidelis Care, is that the same as Fidelis Care?
Ambetter from Fidelis Care is the Qualified Health Plan product offered by Fidelis Care through the NY State of Health marketplace, in partnership with Centene Corporation. It’s a separate product line from traditional Fidelis Care Medicaid, Medicare, and Essential Plan products, but it’s offered by the same company. Our admissions team can verify either type of plan.
07. Will I have to pay anything out of pocket?
Out-of-pocket costs depend on your specific Fidelis Care plan. Medicaid, HARP, Essential Plan, and Child Health Plus members typically have very low or no copays, capped at $200 per calendar year under New York rules. Medicare Advantage and commercial plan members have varying copays and deductibles. Our admissions team will give you a clear picture of expected costs before treatment begins.
08. Do I need a referral from my primary care doctor?
Most Fidelis Care plans don’t require a referral for substance use or mental health treatment, but some plan types may. Our admissions team will check the requirements for your specific plan during the verification process.
09. Will my employer or family find out I'm seeking treatment?
Federal law (HIPAA and 42 CFR Part 2) provides strong confidentiality protections for substance use treatment records. Your employer is not notified, and Fidelis Care cannot share your treatment details with anyone without your written authorization. Our admissions team is happy to walk you through how your privacy is protected at every step.
10. What if Fidelis Care denies coverage for my treatment?
Don’t give up. Fidelis Care plans typically have multiple levels of internal appeals, and our admissions and clinical teams help guide you through that process. Federal and state parity laws require insurers to cover behavioral health at the same level as medical care. If a denial isn’t resolved through internal appeals, you can also file a complaint with the New York State Department of Financial Services at 1-800-400-8882.
Disclaimer: The information provided on this website regarding insurance coverage is only a summary. It does not include all limitations, exclusions, or qualifiers that may apply to your actual coverage. Please refer to your health plan's Evidence of Coverage or Summary Plan Description for full details. Treatment services must be medically necessary to be covered. Any treatment decisions must be discussed with your health provider. We cannot guarantee any coverage or reimbursement. Please contact your health plan directly for the most accurate information regarding your benefits.
Take the first step
Providing hope to all. Compassionate outpatient care for our community. Ready to talk?
Recovery begins when you reach out. Questions?
Call anytime to speak with an Admissions
Specialist, or request a consultation and we’ll follow up.
David Sietz, M.D.
Chief Medical Officer, Fusion Recovery
Email us or Call
Contact Form
"(Required)" indicates required fields
Fidelis Care
Fidelis Care Coverage for Addiction Treatment in Albany, NY
Don’t let insurance questions get in the way of recovery. At Fusion Recovery in Albany, NY, our admissions team will verify your Fidelis Care benefits, explain what’s covered in plain language, and help you start treatment, often the same day.
FIDELIS CARE
Fidelis Care Coverage for Addiction Treatment in Albany, NY
Don’t let insurance questions get in the way of recovery. At Fusion Recovery in Albany, NY, our admissions team will verify your Fidelis Care benefits, explain what’s covered in plain language, and help you start treatment, often the same day.
Start Healing Today
At Fusion Recovery, we understand the difficulties that addiction can bring into your life. That’s why we offer personalized outpatient addiction treatment tailored to your unique needs. As an outpatient rehab facility, we provide flexible scheduling so you can continue your work, family life, and other commitments while getting the help you deserve.
Fusion Recovery proudly accepts Fidelis coverage for addiction treatment services including outpatient rehab, therapy, medication-assisted treatment, and more. Our compassionate team of experts will verify your Fidelis benefits, take care of claims, and make insurance processes smooth. More importantly, we’ll craft an individualized treatment plan using evidence-based therapies and holistic methods to facilitate your lifelong recovery.
With Fusion Recovery, you can find judgment-free support and healing in a comfortable environment. Our welcoming facility and amenities create a peaceful space for you to focus on your recovery journey. If you or a loved one is struggling with addiction, contact us today to learn more about Fidelis coverage and how we can help you get your life back.
Overview of Fidelis Benefits
Fusion Recovery is in-network with Fidelis plans.
Treatment services covered
Fidelis covers services like outpatient rehab, individual therapy, group therapy, medication management, and aftercare support. Our team can help verify your coverage and explain your options before starting treatment so you know what to expect.
Coverage details
Coverage details vary by individual Fidelis plan. Out-of-pocket costs such as copays, deductibles, and coverage levels depend on your specific benefits. Our team can help verify your coverage and explain your options before starting treatment.
Preauthorization requirements
Prior authorization may be required for medication-assisted treatment and intensive outpatient programs. Fusion Recovery can assist with obtaining authorizations.
CALL NOW
Safe and Effective
Verify Your Insurance Coverage.
Remember, the specifics of coverage can vary based on your individual plan and location. It’s always a good idea to confirm coverage with both your insurance provider and Fusion Recovery.
What We Treat
Alcohol Treatment
Alcohol is widely available, which can make harmful patterns harder to spot early.
Heroin Treatment
Heroin is a fast-acting opioid that can quickly reshape the brain and body.
Fentanyl Treatment
Fentanyl is a potent synthetic opioid linked to high overdose risk, even at small amounts.
Disclaimer: The information provided on this website regarding insurance coverage is only a summary. It does not include all limitations, exclusions, or qualifiers that may apply to your actual coverage. Please refer to your health plan’s Evidence of Coverage or Summary Plan Description for the full details and specifics of your benefits. Treatment services must be medically necessary to be covered by your health plan. Whether a treatment or service is medically necessary will be determined based on a review of clinical information provided by your provider. Any treatment decisions must be discussed and determined in conjunction with your health provider. We cannot guarantee any coverage or reimbursement. Please contact your health plan directly for the most accurate and up-to-date information regarding your benefits and coverage for addiction treatment services.
Take the first step
Providing hope to all. Compassionate outpatient care for our community. Ready to talk?
Recovery begins when you reach out. Questions?
Call anytime to speak with an Admissions
Specialist, or request a consultation and we’ll follow up.
David Sietz, M.D.
Chief Medical Officer, Fusion Recovery
Email us or Call
Contact Form
"(Required)" indicates required fields
