2023 Benefits & Services

Benefits

VillageCareMAX Medicare Health Advantage Plan (HMO D-SNP) members get all covered Medicare and many non-Medicare benefits. Your Care Manager will work with you and your providers to meet your needs. You receive Medicare-covered benefits and extra benefits such as:

$175 per month ($2,100 per year) on your Over-the-Counter (OTC) card to buy approved non-prescription drugs and health-related items. Eligible members can also use their OTC card to buy Grocery Items*
Preventive dental services (unlimited) including oral exams, X-rays, cleanings & fluoride treatments 
$2,000 per year ($500 per quarter) for comprehensive dental services such as dentures, crowns and oral surgery
1 eye exam per year
$350 per year for eyewear (eye glasses and contact lenses)
36 one-way trips per year to medical appointments
1 routine hearing exam per year
$1,500 per year for 2 hearing aids limited to $750 per ear
$150 per year for covered Home and Bathroom Safety Devices.  In-Home Safety Assessment per year (required in order to get safety devices)
Fitness Membership at participating locations, home fitness kits, and telephone coaching
Doctors visits
$0 preventive services including bone mass measurement, diabetes screenings, cancer screenings, flu shots, and glaucoma tests
Diagnostic testing including X-ray, EKG, MRI, CT Scans)
Inpatient hospital and skilled nursing facility services
Worldwide Emergency/Urgent Coverage and Emergency Transportation limited to $50,000 per year
Durable Medical Equipment (DME) and supplies
One additional pair of diabetic shoes per year above the Medicare limit
Medicare Part D prescription drug coverage

*Food & Produce (grocery items) are part of Special Supplemental Benefits for the Chronically Ill (SSBCI) and not all members will qualify.

You can learn more about the services that are available to VillageCareMAX Medicare Health Advantage members, by downloading and reviewing the following booklets, or contacting us at 1-800-469-6292 (TTY users call 711). We are available 7 days a week, from 8:00 a.m. to 8:00 p.m. to answer your questions.

2023 Summary of Benefits
2023 Evidence of Coverage

This information is not a complete description of benefits. Premium, co-pays, co-insurance, and deductibles may vary based on the level of Extra Help you receive. Limitations, copayments, and restrictions may apply. Benefits, premiums and/or co-payments/co-insurance may change on January 1 of each year. Contact the plan for more information.


Who Can Join

You can join in VillageCareMAX Medicare Health Advantage Plan if you:

  • Live in Bronx, Brooklyn, Manhattan, Queens, Staten Island, Nassau or Westchester
  • Have Medicare Parts A and B
  • Have Medicaid

How To Join

There are three ways to join:

  1. Call VillageCareMAX to schedule an appointment with a licensed sales agent. Call us at 1-800-469-6292 (TTY 711), 7 days a week 8 am to 8 pm.
  2. Download and complete an Enrollment Request Application. Download it in English (coming soon), Spanish [Español] (coming soon), or Chinese [中文] (coming soon). Complete the form and send it to us by mail to VillageCareMAX, 112 Charles Street, New York, NY 10014
  3. Medicare beneficiaries may also enroll in VillageCareMAX Medicare Health Advantage (HMO D-SNP) through the CMS Medicare Online Enrollment Center located at https://www.medicare.gov. Call 1-800-Medicare 1-800-633-4227 (TTY: 1-877-486-2048).
Page Last Updated: 10/26/2022