Fidelis Care Vs. Excellus BCBS: Comparing Health Insurances

Health insurance can be confusing. With so many options out there, how do you know which company is the right fit for your needs?

In this article, we’ll compare two popular health insurance providers—Fidelis Care and Excellus BCBS—to help you decide.

A Brief Comparison Table

FeatureFidelis CareExcellus BCBS
ServicesNew York StateUpstate New York
Plans OfferedMedicaid, Child Health Plus, Essential Plan, Qualified Health PlansHMO, PPO, EPO, POS, Medicare
Provider Network69,000+ providers in NY70,000+ providers in upstate NY
CostsLow premiums and deductibles with Medicaid. Tax credits available.Premiums vary. Deductibles from $100-$1500+.
Ratings4 out of 5 stars (NCQA)A rating (AM Best), 4.5 out of 5 stars (NCQA)
ProsAffordable coverage options. Good for Medicaid and NY state plans.Broad provider network. Highly rated service.
ConsMixed reviews on customer service.Less focus on affordable plans compared to Fidelis.

Overview Of Fidelis Care

Fidelis Care is a health insurance company that operates in New York State. They focus on providing quality, affordable health coverage for individuals, families, and businesses.

Fidelis Care
Fidelis Care

Some key things to know about Fidelis:

  • Operates as a non-profit health insurer.
  • Offers Medicaid, Child Health Plus, Essential Plan, and Qualified Health Plans.
  • Has a network of over 69,000 providers throughout NY.
  • Provides additional benefits like dental, vision, and prescription drug coverage.
  • Rated 4 out of 5 stars by NCQA (National Committee for Quality Assurance).

So, in a nutshell, Fidelis Care aims to make health insurance more accessible and affordable for NY residents. They have a large provider network and offer a range of plan options to fit different needs and budgets.

Overview Of Excellus BCBS

Excellus BlueCross BlueShield is a non-profit health insurance company serving upstate New York.

Here are some key facts about Excellus BCBS:

Excellus BCBS
Excellus BCBS
  • Offers individual, family, small group, and Medicare plans.
  • Has a broad provider network with 70,000+ doctors and health facilities.
  • Holds an “A” rating from AM Best Company for financial stability.
  • Provides access to telehealth visits, wellness programs, and member discounts.
  • Rated 4.5 out of 5 stars by NCQA.

In summary, Excellus BCBS is a leading insurance carrier in upstate NY with a focus on providing affordable, high-quality coverage. They have a wide selection of plan options plus nice perks like telehealth and wellness initiatives.

Comparing Plan Options

When choosing a health insurance provider, it’s important to look at the types of plans offered. Here’s how Fidelis and Excellus stack up:

Fidelis Care

  • Medicaid
  • Child Health Plus
  • Essential Plan
  • Qualified Health Plans

Excellus BCBS

  • HMO (Health Maintenance Organization)
  • PPO (Preferred Provider Organization)
  • EPO (Exclusive Provider Organization)
  • POS (Point-of-Service)

Both insurers offer Medicaid and private health plans. Excellus BCBS has more variety in terms of plan types like HMOs and PPOs. Fidelis Care focuses specifically on NY State programs and marketplace plans.

For small businesses, Excellus BCBS has group health plans while Fidelis offers plans through the NY State of Health marketplace.

Provider Networks

When it comes to provider networks, here’s how the two compare:

  • Fidelis Care: 69,000+ health providers across NY
  • Excellus BCBS: 70,000+ doctors and health facilities in upstate NY

The size of the provider networks is very similar. Both offer access to a wide range of doctors, hospitals, clinics, and pharmacies statewide.

Fidelis Care has a strong presence in NYC with many providers in the five boroughs. Excellus BCBS extends across upstate NY with coverage in Rochester, Syracuse, Utica and more.

So in terms of provider access, both seem to have you covered within their service regions. Check that your current doctors are in-network before signing up.

Also Read: Differences Between AIG And New York Life.

Costs And Coverage

Affordability is key when picking a health plan. Here’s an overview of costs with Fidelis Vs. Excellus:


  • Medicaid – Low to no cost for eligible applicants
  • Essential Plan – Lower monthly premiums based on income
  • QHPs – Premium tax credits available to lower monthly costs
  • $0 deductible with Medicaid
  • Low deductibles from $200 – $1000 on other plans

Excellus BCBS

  • Premiums vary based on plan selected
  • Copays as low as $15 for primary doctor visits
  • Deductible range from $100 – $1500+
  • Out-of-pocket max from $800 – $7000

Both insurers offer affordable options like Medicaid and plans with subsidies. Excellus BCBS also has options with lower deductibles and copays for those on a tight budget.

When it comes to coverage, benefits are fairly comprehensive:

  • Hospitalizations
  • Emergency care
  • Prescription drugs
  • Pediatric care
  • Preventive services
  • Lab tests and X-rays

Fidelis Care also covers dental, vision, and transportation while Excellus offers telehealth visits. Overall, both provide solid medical coverage to meet essential health needs.

Ratings And Reviews

When comparing insurance companies, it’s helpful to see ratings and reviews.

  • Fidelis Care has an overall 4 out of 5-star rating from NCQA. Members praise the affordability but some say customer service could improve.
  • Excellus BCBS holds an A rating from AM Best for financial stability. Reviews average 4.5 out of 5 stars, with positive feedback on customer service.

Both companies have strong financial ratings. Excellus BCBS edges out Fidelis for higher customer satisfaction based on reviews. But take these with a grain of salt, as experiences can vary person-to-person.

Also Read: Comparison Between MEDICA And Blue Cross Blue Shield.

Frequently Asked Questions (FAQ)

Is Fidelis Care only for New York?

Yes, Fidelis Care only operates in New York State. It’s designed for NY residents needing affordable coverage.

Can I use Fidelis Care in New Jersey?

No, unfortunately Fidelis Care does not offer coverage in New Jersey or other states – only within New York.

Who is Fidelis owned by?

Fidelis Care is an independent non-profit health insurance company. They are not owned by or affiliated with any hospital or health system.

Who are the competitors of Excellus BCBS?

Some of Excellus BCBS’s major competitors include:
MVP Health Care, CDPHP, EmblemHealth, UnitedHealthcare, Aetna, Anthem Blue Cross.
These insurers also offer private health plans in upstate New York regions served by Excellus BCBS.

Also Read: Comparison Between New York Life And Transamerica.

The Verdict

So, when it comes down to Fidelis Vs. Excellus, which is better?

If you qualify for Medicaid or NY State health plans, Fidelis Care is worth considering. They make coverage more affordable for lower-income families.

For middle and higher earners wanting private insurance, Excellus BCBS has robust plan options. Their larger network and highly rated service are pluses.

Ultimately, pick the insurer that meets your budget and coverage needs in your area. Both Fidelis and Excellus are solid choices worth comparing.

Focus on the plan details – not just the brand name. And make sure your main doctor participates in that network before deciding. This helps ensure you get quality care for less.

Hope this comparison helps provide some clarity around Fidelis Care and Excellus BCBS! Choosing health coverage is an important decision.

Evaluate all the options to find your best fit. And consult a doctor or insurance agent if you need guidance. The right plan makes quality care more accessible and affordable.

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