Benefits & Services

Every participant will receive a Person-Centered Service Plan (PCSP) detailing all services that will be provided and coordinated for them. 

Each participant will be assigned a SWH Whole Health FIDA Plan Care Manager who will coordinate and establish an individual care team. The team can include the participant and their designee, Interdisciplinary Team (IDT), Behavioral Health Professional if there is one, SWH Whole Health FIDA Plan Care Manager, home health aide, nursing facility representative if they are receiving nursing facility care, other medical providers as requested. Participants can change their SWH Whole Health FIDA Plan Care Manager at any time.

We offer participants comprehensive care, including preventive services, physician services, hospital care, pharmacy and Long-term services and supports (LTSS).

SWH Whole Health FIDA Plan Benefits & Services

  • Interdisciplinary Team (IDT) to coordinate all your specific needs
  • Doctor visits
  • Long-term services and supports (LTSS)
  • $0 Co-pays for Pharmacy
  • $0 Doctor appointments
  • $0 Dental care
  • $0 Vision services
  • Eyeglasses
  • Healthy You Card — You will receive an OTC (over-the-counter) card for additional health-related items not already included on the SWH Whole Health FIDA Plan drug list or already covered using your SWH Whole Health FIDA Plan Participant ID Card. Up to $100 a month (up to $1,200 a year)
  • Home assessment to evaluate your individual needs
  • Access to a SWH Whole Health FIDA Plan team member or interpreter who speaks your language
  • Medicare prescription drug coverage
  • Transportation
  • Medication Therapy Management program
  • Private duty nursing services
  • Home health services
  • Home delivered meals
  • Adult day healthcare
  • Personal care services
  • Personal Emergency Response Services (PERS)
  • 24/7 phone access to a SWH Whole Health FIDA Plan Care Manager 

At no cost to you.

Out of Network

If you need care that our plan covers and our network providers cannot give it to you, you can get permission from SWH Whole Health FIDA Plan or your IDT to get the care from an out-of-network provider. In this situation, we will cover the care as if you got it from a network provider and at no cost to you. You may request approval to see an out-of-network provider by contacting contact Participant Services at 1-844-861-FIDA (3432) TTY/TDD: 711, 7 days a week from 8 am to 8 pm.

Annual Contract Renewal

Contracts between plans and Medicare are renewed annually. Plans and/or Medicare may choose not to renew a contract resulting in termination of the plan and termination of beneficiary's enrollment in the plan. Plans may also choose to reduce their service area and no longer offer services in the area where the beneficiary resides. If this happens, all participants will receive written notice at least 60 days prior to termination of their enrollment, including information on other health plan options and how to contact and enroll in another plan.

Last Updated 01/01/2019
H8851_2017_099 Pending CMS Review