Fidelis Care and the SCN program: how your Medicaid plan connects you to social care

Your managed care plan is not a bystander in this program — enrollment in one is a hard eligibility requirement, and your plan is one of the four official routes into the system.

Of the four eligibility criteria for Enhanced HRSN services, the second is simply: be enrolled in Medicaid Managed Care. That single line makes your health plan central to everything else.

NYSDOH also lists "contact your health plan" as one of the four ways members can get connected to a Social Care Network. For many people it is the easiest route, because the plan already holds your details.

Fidelis Care

Fidelis Care is one of New York's largest Medicaid managed care plans and publishes dedicated member information on Social Care Networks and health-related social needs.

Per Fidelis Care, Social Care Network information applies to members in:

• Medicaid Managed Care;
• Fidelis Care at Home — MTLC;
• HealthierLife — HARP; and
• Wellcare By Fidelis Care / Wellcare Fidelis Dual Plus — Medicaid Advantage Plus.

Fidelis Care directs members needing help accessing HRSN services to Member Services at 1-888-FIDELIS (1-888-343-3547), which it describes as available 24/7 with multilingual support.

Fidelis Care also published provider-facing guidance introducing the SCN program under the NY 1115 waiver effective January 1, 2025.

Other plans

The SCN program is statewide and not specific to any one insurer. If you are enrolled in a different New York Medicaid managed care plan, the same four eligibility criteria apply, and your plan's member services line is still one of the routes in. Check your plan's website or member handbook for its own SCN page.

Plan names and logos are the trademarks of their respective owners. We are not affiliated with, endorsed by, or speaking for any health plan named here.

What your plan does behind the scenes

SCN Lead Entities coordinate with managed care plans as a core part of the design, alongside health care and behavioral health providers, local governments, and child and family service organizations. Data flows through a closed-loop referral system and the Statewide Health Information Network, which is how a referral can be tracked to its outcome.

Three practical tips

1. Know which product you are in. "Medicaid" covers several arrangements. Enhanced HRSN services require managed care specifically. Your member card and member services line will confirm.
2. Ask for a screening explicitly. The State intends for members to be screened annually or after a major life event. If nobody has offered, ask.
3. Use whichever door is easiest. Plan, provider, care manager, regional SCN self-screener, or a participating community organization — they lead to the same system.

Frequently asked questions

Do I have to go through Fidelis Care to get SCN services?

No. Contacting your health plan is one of four routes NYSDOH lists. You can also use your regional Social Care Network's self-screener or phone line, speak with your provider or care manager, or ask a participating community-based organization.

Will using these services affect my health plan coverage or premiums?

These are Medicaid-funded services delivered under the State's 1115 waiver. For questions about your specific coverage, contact your plan's member services line directly.

I have Medicaid but no managed care plan. What now?

You can still be screened and receive navigation to existing resources. Enhanced HRSN services require managed care enrollment — ask your local department of social services whether enrolling in a plan is available to you.

Which plans participate?

The program is statewide across Medicaid Managed Care rather than limited to particular insurers. Check your own plan's member materials, or ask your regional Social Care Network.