When comparing Molina Healthcare and Fidelis Care Medicaid Managed Care (MMC) plans in New York for 2025, both providers offer comprehensive coverage tailored to low-income individuals and families. While their core benefits are similar due to state regulations, differences exist in additional services, care management, and regional availability.
Molina Healthcare provides Medicaid Managed Care plans across various New York counties, including Allegany, Broome, Cattaraugus, Chautauqua, Cortland, Chenango, Erie, Genesee, Livingston, Monroe, Onondaga, Ontario, Orleans, Seneca, Tioga, Tompkins, Wayne, and Wyoming.
Key Benefits:
- Preventive care, including well visits and immunizations
- Dental and vision services
- Prescription drug coverage
- Behavioral health services
- Home and Community-Based Services (HCBS)
- Transportation to medical appointments
- Access to nurse advice lines
- Women’s preventive services
Special Programs: Molina offers specialized programs for members with chronic conditions, such as asthma, COPD, diabetes, and heart disease.
Enrollment: Eligible individuals can enroll year-round. Molina provides an eligibility calculator and enrollment assistance on their website.
Fidelis Care Medicaid Managed Care
Overview: Fidelis Care serves over 2.4 million members across New York State, offering Medicaid Managed Care plans with extensive provider networks. citeturn0search5
Key Benefits:
- Preventive care, including well visits and screenings
- Dental and vision services
- Prescription drug coverage (administered through NYRx as of April 1, 2023)
- Behavioral health services
- Emergency room and ambulance services
- Hospital and outpatient care
Additional Services:
- Over-the-counter (OTC) benefits
- Mail-order pharmacy program
- Medication therapy management
- Access to a Social Care Network addressing needs like housing, food, and transportation
Enrollment: Enrollment is open year-round for eligible individuals. Fidelis Care offers online tools and community offices for enrollment assistance.
Comparison Summary
| Feature | Molina Healthcare | Fidelis Care |
| Coverage Areas | Select counties in New York State | Statewide |
| Dental & Vision | Included | Included |
| Prescription Drugs | Covered through Molina’s pharmacy network | Covered through NYRx (Medicaid Fee-for-Service) |
| Behavioral Health | Included | Included |
| Transportation Services | Provided | Provided |
| Chronic Condition Programs | Available for asthma, COPD, diabetes, heart disease | Medication therapy management available |
| Additional Benefits | Nurse advice line, women’s preventive services | OTC benefits, mail-order pharmacy, Social Care Network |
| Enrollment | Year-round | Year-round |
Both Molina Healthcare and Fidelis Care offer robust Medicaid Managed Care plans in New York, ensuring essential health services for eligible individuals and families. Your choice may depend on specific regional availability, additional services, and personal healthcare needs. It’s advisable to contact each provider directly or consult with a healthcare navigator to determine the best fit for your situation.