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Plan Materials and Resources

Member Materials

2020 Annual Notice of Changes (ANOC) English Español 中文
2020 Summary of Benefits English Español 中文
2020 Evidence of Coverage English Español 中文
2020 Provider and Pharmacy Directory Bronx: English Español 中文
Brooklyn: English Español 中文
Manhattan: English Español 中文
Queens: English Español 中文
2020 Formulary English Español 中文
2020 Extra Help Premium Summary Table English Español 中文
Language Assistance English Español 中文 Creole Русский Italiano 한국
Enrollment Form English Español 中文
Prescription Drug Claim Form English
Appointment of Representative Form English Español
Health Care Proxy Form & Information* English Español 中文 Creole Русский Italiano 한국
Part D Coverage Determination Form English
Member Reimbursement Form English (coming soon)
Prescription Drug Mail Order Form English
Privacy Notice English
Notice of Non-Discrimination English Español 中文 Creole Русский Italiano 한국
Part D Coverage Re-Determination Form English
2020 Medicare Star Ratings English Español 中文
Member Resources
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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

Medicare Ombudsman Office

This page was last modified on January 21, 2020
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