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2020 Benefits & Services

Members get all covered Medicare and Medicaid benefits directly from VillageCareMAX Medicare Total Advantage Plan (HMO D-SNP), including Long-term Services and Supports (LTSS) and prescription drugs. In addition, you get extra benefits that are not covered by Medicare or Medicaid. Your Care Manager will work with you, your family and a team of providers to help determine what services will best meet your needs.

You pay no co-pays, deductibles or monthly premium for covered services.

You will pay nothing for benefits such as:

  • $175 per month ($2,100 per year) on your Over-the-Counter (OTC) card to purchase approved health-related items
  • Some comprehensive dental services not covered by Medicaid (like crowns)
  • Unlimited non-emergency transportation to plan approved locations
  • 48 acupuncture visits per year
  • 1 eye exam per year
  • $300 per year for eyewear (eye glasses and contact lenses)
  • Physician Call Line with 24 hour access to speak to a doctor about your non-emergency health related concerns
  • Doctor visits
  • Preventive services including bone mass measurement, diabetes screenings, cancer screenings, flu shots, and glaucoma tests
  • Long term services and supports including Personal Care, Private Duty Nursing, Social Day Care, and Home Delivered Meals
  • Personal Emergency Response System (PERS)
  • Physical therapy, occupational therapy and speech & language therapy visits
  • Diagnostic testing (including X-ray, EKG, MRI, CT Scans)
  • Inpatient hospital and skilled nursing facility services
  • Up to $50,000 per year for Worldwide Emergency/Urgent Coverage when you travel outside of the United States and its territories
  • Durable Medical Equipment (DME) and supplies
  • Medicare Part D prescription drug coverage

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

2020 Summary of Benefits: English Español 中文 Русский

2020 Evidence of Coverage: English Español 中文

This information is available for free in other languages. Please call our member services number at 1-800-469-6292 (TTY: 711) during the hours of 8:00 am to 8:00 pm, 7 days a week. You can get this information for free in other formats, such as large print, braille, or audio. You must continue to pay your Medicare Part B premium. 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.

You can join VillageCareMAX Medicare Total Advantage Plan if you:

  • Are 18 years of age or older
  • Have full Medicaid, Medicare Part A and Part B
  • Live in Brooklyn, Bronx, Manhattan or Queens
  • Require community-based long term care services for a continuous period of more than 120 days.

Call VillageCareMAX to schedule an appointment with an assessment nurse and licensed marketing representative. Call us at 1-800-469-6292 (TTY 711), 7 days a week 8 am to 8 pm for more information.

Conflict Free Evaluation and Enrollment Center

The Conflict Free Evaluation and Enrollment Center (CFEEC) is a program that determines client’s eligibility for Medicaid community-based long term care. The organization conducting the evaluations for New York State is not affiliated with any managed care plan, or with any provider of health care or long term care services. A registered nurse from the Evaluation Center visits client and determines if he/she qualifies for services. VillageCareMAX will move forward with the enrollment process once CFEEC completes their evaluation.

1-855-222-8350 TTY: 1-888-329-1541

VillageCareMAX is an HMO plan with Medicare and New York State Medicaid contracts. Enrollment in VillageCareMAX depends on contract renewal.

VillageCareMAX complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.

ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-800-469-6292 (TTY: 711).

注意:如果您使用繁體中文,您可以免費獲得語言援助服務。請致電1-800-469-6292 (TTY: 711)。

This page was last modified on August 1, 2020.
  • Questions? Want to speak to a live VillageCareMAX representative?

    hot-line 1.800.469.6292

    Call us 7 days a week — 8AM to 8PM TTY/TTD: 711 Email Member Services