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Wellcare Fidelis Dual Align Unity (HMO D-SNP) H5599-003 • 2027 • Suffolk County, NY

CMS Rating: ☆☆☆☆☆ (3.0 out of 5 stars*)
Monthly Premium
$40.50Plus Part B premium.
Medical Deductible
$0.00
Maximum Out-of-Pocket
$9850.00In-network
Part B Giveback
Not offered
Prescription Coverage
Basic, $700.00 deductible
Additional Benefits
Dental, Vision, Hearing
Service Area
Suffolk County, NY
Local Enrollment
320 beneficiaries in Suffolk County
Last update:

Introduction

CMS Plan ID H5599-003 identifies Wellcare Fidelis Dual Align Unity, a Medicare Advantage Dual-Eligible Special Needs Plan (D-SNP) offered by Wellcare By Fidelis Care. Its provider network is a Health Maintenance Organization (HMO), and Medicare Part D prescription drug coverage is included. For 2027, the plan has a $40.50 monthly premium, $0.00 medical deductible, and $9850.00 in-network maximum out-of-pocket. The 2027 Part D prescription drug deductible is $700.00.

Enrollment in this plan requires you to live in Suffolk County, New York. CMS reports 320 beneficiaries enrolled in this plan in Suffolk County. New members can call the plan directly at (844)480-0680 (TTY 711) for assistance.

Eligibility

Wellcare Fidelis Dual Align Unity is a Medicare D-SNP plan for people who qualify for both Medicare and Medicaid.

Special Needs Plan Type
Dual-Eligible Special Needs Plan (D-SNP)
Medicare Requirement
Medicare Part A and Part B
Special Needs Requirement
Must qualify for Medicaid
Service Area Requirement
Must live in the plan's service area
Prescription Drug Coverage
Medicare Part D prescription drug coverage is included.

Compare Similar Plans in Suffolk County

Compare this plan with the two most-enrolled HMO D-SNP plans available in Suffolk County, New York. Enrollment is based on CMS local enrollment data.

HMO D-SNP plan comparison for Suffolk County, New York
Plan Detail Wellcare Fidelis Dual Align Unity Aetna Medicare Full Dual Care Anthem HealthPlus Full Dual Advantage
CMS Plan ID H5599-003-0 H3312-069-0 H8432-042-0
Local Enrollment 320 6,243 3,327
Monthly Premium $40.50 $40.50 $40.50
Medical Deductible $0.00 $0.00 $0.00
Maximum Out-of-Pocket $9,850.00 $9,850.00 $9,850.00
Part B Giveback Not offered Not offered Not offered
Primary Care $0 copay $0 copay $0 copay
Specialist $0 copay $0 copay $0 copay
Part D Deductible $700.00 $700.00 $700.00
CMS Star Rating 3.0 3.0 3.0
Dental $0 copay $0 copay $0 copay
Vision Not covered $0 copay $0 copay
Hearing Not covered $0 copay $0 copay

Plan Benefits

Wellcare Fidelis Dual Align Unity has cost-sharing, meaning there are out-of-pocket costs when receiving covered healthcare services. The tables below detail the most common in-network out-of-pocket expenses for plan H5599-003.

You can also compare 2027 costs and coverage with last year, side-by-side: Plan H5599-003-0 Cost Compare.

Office Visits

Primary care
In-network: $0 copay
Specialist
In-network: $0 copay

Preventive and Wellness Services

Annual wellness exam
In-network: $0 copay
Telehealth benefit
In-network: $0 copay
Routine chiropractic
In-network: $0 copay
Fitness benefits
Coming soon
Health education
Not covered
Counseling services
Not covered
Over-the-counter drug benefits
In-network: $0 copay
Health transportation (non-emergency)
Coming soon

Diagnostic, Lab, and Imaging Services

Diagnostic radiology services
In-network: $0 copay
Lab services
In-network: $0 copay
Outpatient x-rays
In-network: $0 copay
Diagnostic tests and procedures
In-network: $0 copay

Emergency and Urgent Care Services

Emergency room care
$0 copay
Worldwide emergency care
Coming soon
Urgent care
$0 copay
Inpatient hospital care
Tier 1
$0 per stay
Skilled Nursing Facility
Tier 1
$0 per day for days 1-20
$0 per day for days 21-70
$0 per day for days 71-100
Ground ambulance
In-network: $0 copay

Mental Health Services

Outpatient individual therapy
In-network: $0 copay
Outpatient group therapy
In-network: $0 copay
Inpatient psychiatric hospital care
Tier 1
$0 per stay

Rehabilitation Services

Physical therapy and speech and language therapy
In-network: $0 copay
Occupational therapy
In-network: $0 copay

Medical Equipment and Supplies

Diabetes supplies
In-network: $0 copay
Durable medical equipment
In-network: $0 copay
Prosthetics
In-network: $0 copay

Medicare Part B Drugs

Chemotherapy
In-network: $0 copay
Other Part B drugs (Medicare-covered)
In-network: $0 copay

Dental Services

Oral exam
In-network: $0 copay
Dental x-rays
In-network: $0 copay
Cleaning
In-network: $0 copay
Periodontics
In-network: $0 copay
Endodontics
In-network: $0 copay
Restorative services
In-network: $0 copay
Implant services
In-network: $0 copay
Orthodontics
Not covered
Oral/Maxillofacial surgery
In-network: $0 copay

Vision Services

Routine eye exam
Not covered
Contact lenses
Not covered
Eyeglass frames only
Not covered
Eyeglass lenses only
Not covered
Eyeglasses (frames & lenses)
Not covered
Upgrades
Not covered

Hearing Services

Hearing exam
Not covered
Fitting/evaluation
Not covered
Prescription hearing aids
Not covered
OTC hearing aids
Not covered

Additional and Special Needs Services

Adult day health services
Not covered
Home-based palliative care
Not covered
Personal emergency response system
Coming soon
Weight management programs
Not covered
Wigs for chemotherapy-related hair loss
Coming soon
Alternative therapies
In-network: $0 copay
Massage therapy
Not covered
Home/bathroom safety devices
Not covered

Certain preventive services are covered 100% by Wellcare Fidelis Dual Align Unity as a Part B benefit.

Prescription Drug Coverage

Wellcare Fidelis Dual Align Unity includes a Medicare Part D prescription drug plan (PDP). Plan type and coverage level are defined by CMS and may vary between basic and enhanced benefit designs.

Prescription Drug Plan Premium

The Part D prescription drug plan premium is included in the overall Medicare Advantage plan cost. Additional adjustments may apply through the Low-Income Subsidy (LIS) program, also known as Extra Help, administered by Social Security. LIS benefits are separate from Medicare Special Needs Plan coverage.

Wellcare Fidelis Dual Align Unity (H5599-003-0) Prescription Drug Plan Premium Details
Part D Premium Component Amount
Basic Part D Premium:$40.50
Supplemental Part D Premium:$0.00
Total Part D Premium:$40.50
Low-Income Premium Subsidy:$40.45
Low-Income Premium Subsidy Paid by CMS:$40.50
Low-Income Subsidy Premium:$0.00

For more details, visit the Social Security Extra Help program .

Prescription Drug Plan Deductible

This plan has a $700.00 annual Part D deductible. You'll pay this deductible at the pharmacy before Wellcare By Fidelis Care starts contributing towards your prescription costs.

Prescription Drug Plan Out-of-Pocket Costs

Beyond premiums and deductibles, Wellcare Fidelis Dual Align Unity may have additional costs at pharmacies. The table below outlines out-of-pocket expenses by drug tier.

Wellcare Fidelis Dual Align Unity (H5599-003-0) Pharmacy Out-of-Pocket Costs by Drug Tier
Drug Tier Retail Mail Order
Generic$2.00 copay$19.00 copay
Preferred Brand25% coinsurance$47.00 copay
Non-Preferred Drug32% coinsurance31% coinsurance
Injectable Drugs25% coinsuranceNot available
Specialty Tier25% coinsurance25% coinsurance
Select Care Drugs$0.00 copay$0.00 copay
Preferred GenericNot available$18.00 copay
*Deductible does not apply.

CMS 5-Star Performance Ratings (Contract ID: H5599)

Medicare assigns star ratings to plans based on quality and performance across multiple measures, including customer service, member experience, and health outcomes. Ratings are updated annually by the Centers for Medicare & Medicaid Services (CMS) and are shown on a 1 to 5 star scale, with 5 stars representing the highest quality.

2027 Medicare Star Ratings for Contract H5599
CMS Measure Star Rating
2027 Overall Rating ☆☆☆☆☆
Staying Healthy: Screenings, Tests, Vaccines ☆☆☆☆☆
Managing Chronic (Long Term) Conditions ☆☆☆☆☆
Member Experience with Health Plan ☆☆☆☆☆
Complaints and Changes in Plans Performance ☆☆☆☆☆
Health Plan Customer Service ☆☆☆☆☆
Drug Plan Customer Service ☆☆☆☆☆
Complaints and Changes in the Drug Plan ☆☆☆☆☆
Member Experience with the Drug Plan Not enough data available
Drug Safety and Accuracy of Drug Pricing ☆☆☆☆☆

Contact Information for Wellcare By Fidelis Care

Website
Wellcare By Fidelis Care Plan Page
Providers
Wellcare By Fidelis Care Providers Page
Formulary
Wellcare By Fidelis Care Formulary Page
Pharmacy
Wellcare By Fidelis Care Pharmacy Page
New Member Health Plan Help
(844)480-0680
New Member Health Plan TTY
711
New Member Part D Help
(844)480-0680
New Member Part D TTY Users
711

Enrollment status and eligibility information are available through the Social Security Administration. Additional information about Medicare Advantage is available at Medicare.gov.

Medicare Plan Data Sources and Methodology
Primary CMS datasets used for this Medicare Advantage Plan resource.
Data Source Publisher Last Accessed
Landscape Source Files Centers for Medicare & Medicaid Services October 5, 2026
Medicare Part C & D Performance Centers for Medicare & Medicaid Services October 5, 2026
Plan Benefits Package Centers for Medicare & Medicaid Services October 5, 2026
Monthly Enrollment by Contract/Plan/State/County Centers for Medicare & Medicaid Services October 5, 2026

Data sources and methodology documentation.

Official plan information and secondary Medicare references.
Publisher Reference Last Accessed
Wellcare By Fidelis Care (official source) http://www.wellcare.com/fidelisNY October 4, 2026
CMS.gov Dual Eligible Special Needs Plans (D-SNPs) April 28, 2026
Medicare.gov Understanding Medicare Advantage Plans April 28, 2026
NCOA.org 5 Steps to Choosing the Right Medicare Plan for You April 28, 2026

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Provenance documentation for this data is maintained under the U.S. Core Data for Interoperability (USCDI) Provenance standard.