Medicaid health plans in Clinton service area, NY

Member services: 1-888-343-3547

No rating available. See NCQA ratings ↗

• Help arranging rides to visits

  Fidelis Care's care management team can help schedule appointments or arrange transportation to a doctor visit.

• Dental coverage

  Medicaid members get dental coverage through DentaQuest.

• Vision coverage

  Medicaid members get vision coverage, including eye exams, through Davis Vision.

• Doula services during pregnancy

  Fidelis Care added doula services for Medicaid Managed Care members starting April 2025.

• Fidelis Care Retrieved 2026-07-17
• Fidelis Care Retrieved 2026-07-17

enrollment.portal_url, enrollment.portal_name, enrollment.phone, and enrollment.choice_window_days are quote-gate verified against a captured New York State Department of Health consumer guidebook (health.ny.gov/publications/1109.pdf, "Now is the time to join a health plan"). All 27 service area roster facts (areas.<slug>.plans) are quote-gate verified against a captured snapshot of the Department's own Managed Care Organization Directory by Plan (health.ny.gov mcp_dir_by_plan.htm), which lists every DOH-certified plan's own county-by-county Medicaid program participation. That source is organized per plan, then per county, not per county with all its plans listed together, so each area's single verbatim_quote anchors one representative plan-and-county line from the snapshot (the county name followed by its program codes) rather than a single contiguous quote spanning every plan in that area's roster; the full plan roster in each fact's value field was compiled by parsing every plan's county table on that same snapshot for a Medicaid (MCAID) program marker, cross-checked so every one of the 13 plans' county counts and every one of New York's 62 counties is accounted for exactly once across the 27 areas. Two DOH-certified entities were excluded entirely because their own directory listing shows zero Medicaid (MCAID) counties, only commercial: Anthem HealthChoice HMO, Inc. and Healthfirst Health Plan, Inc. (the actual Medicaid Healthfirst entity is the separate Healthfirst PHSP, Inc., which is included). Two Special Needs Plan sub-entities were not added as separate plan records because they duplicate an already-included plan's five-borough footprint: MetroPlus Health Plan, Inc. (SNP) and VNS Choice SNP; Amida Care, Inc. (SNP) is included as requested and is clearly marked as a Special Needs Plan in its quality.note. New York carved its Medicaid pharmacy benefit out of managed care statewide in April 2023 (NYRx), so every plan's formulary_url points to the state's own NYRx portal rather than a plan-run formulary, and each plan's quality.note says so. Per-plan member_phone numbers come from the same DOH directory snapshot rather than a separate quote-gated fact (informal citation, consistent with TX.json/CA.json's existing convention that only load-bearing enrollment and county-roster fields carry facts[] entries); one plan (Excellus/Univera) publishes a different direct Medicaid line (1-800-650-4359) on its own member handbook than the DOH-listed general member services number recorded here, noted for a human reviewer. Provider directory URLs and extra benefits for all 13 plans were independently verified live on each plan's own official Medicaid page (spot-checked again as part of this authoring pass) but are not yet cited by a quote-gated fact, so the state as a whole stays unverified, the same standing as TX.json and CA.json today.

Member services: 1-888-687-6277

No rating available. See NCQA ratings ↗

• Routine dental exams and cleanings

  Medicaid covers routine dental exams and cleanings through a contract with Healthplex.

• Eye exams and vision allowance

  Medicaid covers an eye exam once every twelve months and a yearly vision allowance for glasses or contacts.

• MVP Health Care Retrieved 2026-07-17

enrollment.portal_url, enrollment.portal_name, enrollment.phone, and enrollment.choice_window_days are quote-gate verified against a captured New York State Department of Health consumer guidebook (health.ny.gov/publications/1109.pdf, "Now is the time to join a health plan"). All 27 service area roster facts (areas.<slug>.plans) are quote-gate verified against a captured snapshot of the Department's own Managed Care Organization Directory by Plan (health.ny.gov mcp_dir_by_plan.htm), which lists every DOH-certified plan's own county-by-county Medicaid program participation. That source is organized per plan, then per county, not per county with all its plans listed together, so each area's single verbatim_quote anchors one representative plan-and-county line from the snapshot (the county name followed by its program codes) rather than a single contiguous quote spanning every plan in that area's roster; the full plan roster in each fact's value field was compiled by parsing every plan's county table on that same snapshot for a Medicaid (MCAID) program marker, cross-checked so every one of the 13 plans' county counts and every one of New York's 62 counties is accounted for exactly once across the 27 areas. Two DOH-certified entities were excluded entirely because their own directory listing shows zero Medicaid (MCAID) counties, only commercial: Anthem HealthChoice HMO, Inc. and Healthfirst Health Plan, Inc. (the actual Medicaid Healthfirst entity is the separate Healthfirst PHSP, Inc., which is included). Two Special Needs Plan sub-entities were not added as separate plan records because they duplicate an already-included plan's five-borough footprint: MetroPlus Health Plan, Inc. (SNP) and VNS Choice SNP; Amida Care, Inc. (SNP) is included as requested and is clearly marked as a Special Needs Plan in its quality.note. New York carved its Medicaid pharmacy benefit out of managed care statewide in April 2023 (NYRx), so every plan's formulary_url points to the state's own NYRx portal rather than a plan-run formulary, and each plan's quality.note says so. Per-plan member_phone numbers come from the same DOH directory snapshot rather than a separate quote-gated fact (informal citation, consistent with TX.json/CA.json's existing convention that only load-bearing enrollment and county-roster fields carry facts[] entries); one plan (Excellus/Univera) publishes a different direct Medicaid line (1-800-650-4359) on its own member handbook than the DOH-listed general member services number recorded here, noted for a human reviewer. Provider directory URLs and extra benefits for all 13 plans were independently verified live on each plan's own official Medicaid page (spot-checked again as part of this authoring pass) but are not yet cited by a quote-gated fact, so the state as a whole stays unverified, the same standing as TX.json and CA.json today.

Member services: 1-800-493-4647

No rating available. See NCQA ratings ↗

• Dental exams and cleanings

  The plan covers dental checkups and cleanings every six months, plus coverage for dental problems that need to be fixed.

• Eye exams and new glasses

  The plan covers routine eye exams and new eyeglasses every two years through March Vision Care.

• Doula services during pregnancy

  The plan added coverage for doula services during pregnancy for Medicaid Managed Care members.

• UnitedHealthcare Community Plan Retrieved 2026-07-17
• UnitedHealthcare Community Plan Retrieved 2026-07-17

enrollment.portal_url, enrollment.portal_name, enrollment.phone, and enrollment.choice_window_days are quote-gate verified against a captured New York State Department of Health consumer guidebook (health.ny.gov/publications/1109.pdf, "Now is the time to join a health plan"). All 27 service area roster facts (areas.<slug>.plans) are quote-gate verified against a captured snapshot of the Department's own Managed Care Organization Directory by Plan (health.ny.gov mcp_dir_by_plan.htm), which lists every DOH-certified plan's own county-by-county Medicaid program participation. That source is organized per plan, then per county, not per county with all its plans listed together, so each area's single verbatim_quote anchors one representative plan-and-county line from the snapshot (the county name followed by its program codes) rather than a single contiguous quote spanning every plan in that area's roster; the full plan roster in each fact's value field was compiled by parsing every plan's county table on that same snapshot for a Medicaid (MCAID) program marker, cross-checked so every one of the 13 plans' county counts and every one of New York's 62 counties is accounted for exactly once across the 27 areas. Two DOH-certified entities were excluded entirely because their own directory listing shows zero Medicaid (MCAID) counties, only commercial: Anthem HealthChoice HMO, Inc. and Healthfirst Health Plan, Inc. (the actual Medicaid Healthfirst entity is the separate Healthfirst PHSP, Inc., which is included). Two Special Needs Plan sub-entities were not added as separate plan records because they duplicate an already-included plan's five-borough footprint: MetroPlus Health Plan, Inc. (SNP) and VNS Choice SNP; Amida Care, Inc. (SNP) is included as requested and is clearly marked as a Special Needs Plan in its quality.note. New York carved its Medicaid pharmacy benefit out of managed care statewide in April 2023 (NYRx), so every plan's formulary_url points to the state's own NYRx portal rather than a plan-run formulary, and each plan's quality.note says so. Per-plan member_phone numbers come from the same DOH directory snapshot rather than a separate quote-gated fact (informal citation, consistent with TX.json/CA.json's existing convention that only load-bearing enrollment and county-roster fields carry facts[] entries); one plan (Excellus/Univera) publishes a different direct Medicaid line (1-800-650-4359) on its own member handbook than the DOH-listed general member services number recorded here, noted for a human reviewer. Provider directory URLs and extra benefits for all 13 plans were independently verified live on each plan's own official Medicaid page (spot-checked again as part of this authoring pass) but are not yet cited by a quote-gated fact, so the state as a whole stays unverified, the same standing as TX.json and CA.json today.