Member Portal Initial Payment Form

NY State of Health First Payment

Please enter the following information to complete your first payment with Fidelis Care. Have your confirmation ID and your head of household information ready before starting.

Confirmation Information

Please be sure to enter all 14 letters and numbers of your Confirmation ID, including the two letters at the beginning.

Head of Household Information

Member Information

Premium Information

Optional - Set Up Member Portal Account

Setting up your Fidelis Care Portal account is as easy as checking the box below, and logging in later! With a Member Portal account, you can make premium payments, check on the status of your claims, and view your plan benefits anywhere, at any time!

Note: Once your payment is processed, we will send your Member ID Card and welcome materials, which should then take 7-10 business days to arrive.

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