2024 Plan Materials and Resources

Plan Materials

Part D Coverage Determination Form

Member Reimbursement Form

Prescription Drug Mail Order Form

Part D Coverage Re-Determination Form

 


Plan Resources

Member Resources

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New York Medicaid Choice – Enrollment Broker

CMS Best Available Evidence Policy

Submit a complaint to Medicare

Medicaid Ombudsman Office

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

Medicare Ombudsman Office

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