Plan Materials
2023 Annual Notice of Changes (ANOC)
2023 Summary of Benefits
2023 Evidence of Coverage
2023 Provider and Pharmacy Directory
Expansion Counties Effective 1/1/2023:
Staten Island: (pending)
Nassau: (pending)
Westchester: (pending)
2023 Formulary
2023 Extra Help Premium Summary Table
Multi-Language Insert
Language Assistance and Notice of Non-Discrimination (LANN)
Appointment of Representative Form
Health Care Proxy Form & Information
Part D Coverage Determination Form
Member Reimbursement Form
Prescription Drug Mail Order Form
Privacy Notice
Enrollment Form
Part D Coverage Re-Determination Form
2023 Medicare Star Ratings
Plan Resources
Member Resources
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New York Medicaid Choice – Enrollment Broker
CMS Best Available Evidence Policy
Submit a complaint to Medicare
The State of New York has created an ombudsman program called the Independent Consumer Advocacy Network (ICAN) to provide members with free, confidential assistance on any services offered by VillageCareMAX Medicare Total Advantage Plan. ICAN may be reached toll-free at 1-844-614-8800 or online at icannys.org