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Wellcare Fidelis Dual Align (HMO D-SNP)

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Welcome to your Medicare Advantage Plan!

Thank you for being a Wellcare Fidelis Dual Align (HMO D-SNP) member! We want to help you get the most from your plan.

Use our website to explore plan information and benefits and review helpful plan documents such as the Evidence of Coverage, Summary of Benefits, and Annual Notice of Change.

Mga Dokumentong Partikular sa Plano

Ang dokumentong ito (ang Taunang Abiso ng Pagbabago o “Annual Notice of Change”) ay naglalaman ng anumang pagkakaiba sa saklaw, gastos, o sineserbisyuhang lugar sa pagitan ng mga taon ng plano.

Isinasaad ng dokumentong ito ang ilan sa mga feature ng planong ito. Para sa isang kumpletong listahan ng mga benepisyo, tingnan ang iyong Ebidensya ng Saklaw o Evidence of Coverage.

Kasama sa dokumentong ito ang isang legal at detalyadong paglalarawan ng iyong mga benepisyo at mga gastos bilang isang miyembro.

Use this form to enroll in a Medicare Advantage plan.

Sinusukat ng mga Star Rating kung gaano kahusay ang mga planong pangkalusugan at plano sa gamot ng Medicare sa iba't ibang kategorya. Ipinapamahagi ito ng Medicare. Sinusuri ng Medicare ang mga plano batay sa 5-Star rating na sistema. Kinakalkula ang Mga Star Rating bawat taon, at puwede itong mabago taon-taon.

Mga Nauugnay na Materyales

If you speak a language other than English, free language assistance services are available to you. Appropriate auxiliary aids and services to provide information in accessible formats are also available free of charge. Call 1-877-374-4056 (TTY: 711).

Kabilang sa dokumentong ito ang impormasyon tungkol sa mga serbisyo sa pagsasalin sa maraming wika para sa mga nagsasalita ng Arabic, Chinese Cantonese, Chinese Mandarin, French Creole, French, German, Hindi, Italian, Japanese, Korean, Polish, Portuguese, Russian, Spanish, Tagalog, at Vietnamese.

Gamitin ang form na ito para payagan kaming i-withdraw ang iyong mga buwanang premium mula sa iyong bangko.

Kumpletuhin ang form na ito upang humiling ng reimbursement para sa mga saklaw na serbisyong medikal na binayaran ninyo mula sa bulsa.

Complete this form to request reimbursement/refund for covered prescription drugs that you paid full price for.

Dapat kumpletuhin ng bawat miyembro na humihiling na maalis sa pagkakatala ang kanilang sariling form.

Form ng Kahilingan ng Part D sa Muling Pagsasaalang-alang ng Penalty para sa Huling Pagpapatala (LEP).

Kinukumpirma ng form na ito ang kahilingan mo para gawing kinatawan mo ang isang partikular na tao kaugnay ng isang claim.

Kinukumpirma ng form na ito ang pahintulot mo para talakayin o ibahagi ng WellCare ang Protektadong Impormasyong Pangkalusugan o Protected Health Information (PHI) sa isang partikular na tao.

This form revokes your permission for Wellcare to discuss or disclose Protected Health Information (PHI) with a particular person.

Please complete this form with your provider if you want to change your PCP. Your provider will then send this form to your health plan, letting them know about the change.

Effective 07/01/2025: The drugs on this list require step therapy. Step therapy means you must try one drug before we will cover another drug.

Medicare Parts A & B Premiums and Deductibles

Kapaki-pakinabang na Impormasyon

24 na Oras na Linya ng Pagpapayo ng Nurse

One of the benefits of being a Wellcare Dual Liberty (HMO D-SNP) member is our 24-Hour Nurse Advice Line. Our nurses will give you answers to your medical questions and help you decide whether to see your doctor or go to the emergency room. Nurses are available 24 hours a day, seven days a week at 1-800-581-9952. (TTY users dial 711.)

HealthHub by WebMD Ignite

Trusted information to help you on your health journey.
WebMD Ignite provides clinically reviewed health & wellness education, resources, and tools.

Visit the HealthHub by WebMD Ignite.

Krames Health Library

The Krames Health library is the most up-to-date patient education resource. With Krames Health Library, you'll have access to over 4,000 topics relating to health and medication.

Visit the Krames Health Library.

Plan Information

Wellcare Fidelis Dual Align (HMO D-SNP) is a Fully Integrated Dual Eligible Special Needs Plan with a Medicare contract and a contract with the New Jersey Medicaid program. Enrollment in Wellcare Fidelis Dual Align depends on contract renewal. This information is not a complete description of benefits. Contact the plan for more information. Limitations and restrictions may apply. Benefits may change on January 1 of each year. Your Part B premium is covered by Medicaid. This plan is available to those who have both Medicare and full Medicaid benefits. Wellcare uses a formulary.
Please contact Wellcare for details.

When joining this plan: 

  1. You must use in-network providers, DME (durable medical equipment) suppliers, and pharmacies. 
  2. You will be enrolled automatically into Medicaid (NJ FamilyCare) coverage under our plan and disenrolled from any Medicaid (NJ FamilyCare) plan you are currently enrolled in. All of your Medicaid-covered services, items, and medications will then be covered under our plan, and you must get them from in-network providers.
  3. You will be enrolled automatically into Part D coverage under our plan, and you will be automatically disenrolled from any other Medicare Part D or creditable coverage plan in which you are currently enrolled. 
  4. You must understand and follow our plan’s rules on referrals.
 
  • 24 na Oras na Linya ng Pagpapayo ng Nurse

    24 na Oras na Linya ng Pagpapayo ng Nurse

    One of the benefits of being a Wellcare Dual Liberty (HMO D-SNP) member is our 24-Hour Nurse Advice Line. Our nurses will give you answers to your medical questions and help you decide whether to see your doctor or go to the emergency room. Nurses are available 24 hours a day, seven days a week at 1-800-581-9952. (TTY users dial 711.)

  • Health Libraries

    HealthHub by WebMD Ignite

    Trusted information to help you on your health journey.
    WebMD Ignite provides clinically reviewed health & wellness education, resources, and tools.

    Visit the HealthHub by WebMD Ignite.

    Krames Health Library

    The Krames Health library is the most up-to-date patient education resource. With Krames Health Library, you'll have access to over 4,000 topics relating to health and medication.

    Visit the Krames Health Library.

  • Plan Information

    Plan Information

    Wellcare Fidelis Dual Align (HMO D-SNP) is a Fully Integrated Dual Eligible Special Needs Plan with a Medicare contract and a contract with the New Jersey Medicaid program. Enrollment in Wellcare Fidelis Dual Align depends on contract renewal. This information is not a complete description of benefits. Contact the plan for more information. Limitations and restrictions may apply. Benefits may change on January 1 of each year. Your Part B premium is covered by Medicaid. This plan is available to those who have both Medicare and full Medicaid benefits. Wellcare uses a formulary.
    Please contact Wellcare for details.

    When joining this plan: 

    1. You must use in-network providers, DME (durable medical equipment) suppliers, and pharmacies. 
    2. You will be enrolled automatically into Medicaid (NJ FamilyCare) coverage under our plan and disenrolled from any Medicaid (NJ FamilyCare) plan you are currently enrolled in. All of your Medicaid-covered services, items, and medications will then be covered under our plan, and you must get them from in-network providers.
    3. You will be enrolled automatically into Part D coverage under our plan, and you will be automatically disenrolled from any other Medicare Part D or creditable coverage plan in which you are currently enrolled. 
    4. You must understand and follow our plan’s rules on referrals.
     
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Y0020_WCM_178064E_M Last Updated On: 10/1/2025