VillageCareMAX Medicare Advantage Plans

Speak to an Enrollment Specialist

Use the form below to schedule an appointment to learn more about the VillageCareMAX Medicare Total Advantage Plan (HMO D-SNP) and how to enroll.

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Enrollee's Information


Contact Information


By submitting this form, you authorize a VillageCareMAX sales agent to call or contact you. The person that will be discussing plan options with you is either employed or contracted by a Medicare health plan or prescription drug plan that is not the Federal government, and they may be compensated based on your enrollment in a plan. Submitting this form does NOT affect your current enrollment, nor will it enroll you in a Medicare Advantage Plan, Prescription Drug Plan, or other Medicare plan.

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


Who we are and how we help you live a better life

Smiling woman with the slogan see whats possible when health care becomes personal

VillageCareMAX Medicare Total Advantage Plan is a Special Needs plan designed for members who have both Medicare and Medicaid.

We work closely with your doctors, help set up appointments, arrange for your care, monitor your medications and guide you and your family toward the best quality health care options available.

What do you get?

The plan that cares with Medicare services and extra benefits at little or no cost.

  • Over-the-counter items
  • Acupuncture
  • Dental, vision and hearing
  • Routine transportation
  • Health club membership
  • AND MORE!

Benefits

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

You will pay nothing for benefits such as:

Up to $250 per month ($3,000 per year) on your Over the Counter (OTC) card to purchase health-related items, approved non-prescription drugs including OTC COVID-19 tests and hearing aids, Grocery Items*, and Home Utilities including gas, electric, water, and internet/telecommunications*
$2,000 per year (up to $1000 every 6 months) for comprehensive dental services; unused amount rolls overs into next 6 month period)
Unlimited trips to medical appointments; up to 12 non-medical one-way trips per year
Acupuncture (above Medicare coverage) $0 copay; 54 visits per year limit to 5 visits per month ($80 limit per visit)
Eye exam $0 copay
$350 for eyewear unlimited contacts, 1 pair of glasses, lenses, and frames per year
Fitness Membership at participating locations or home fitness kits as well as telephone coaching
 
Up to 12 one-way trips per year for Transportation for Non-Medical Needs*
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
Medicare & Medicaid Covered Behavioral/Mental Health Services 
Up to $50,000 per year for Worldwide Emergency/Urgent Care Coverage and Emergency Transportation when you travel outside of the United States and its territories. 
Durable Medical Equipment (DME) and supplies
Medicare Prescription Drug Coverage (Part D), including supplemental drug coverage for cough suppressants and erectile dysfunction medications with convenient delivery options

*Food & Produce (grocery items), Utilities and Transportation for Non-Medical Needs are a part of Special Supplemental Benefits for the Chronically Ill (SSCBI) and not all members may qualify. Generally members enrolled in VillageCareMAX Medicare Total Advantage will qualify. 

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.

2024 Summary of Benefits
2024 Evidence of Coverage

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 the benefits.


Benefits Updates

Durable Medical Equipment, Prosthetic, Orthotics, and Supplies (DMEPOS) Medical Supply Quantity Update

  • This DME Medical Supplies Monthly Quantity Update for urinary catheter with insertion supplies (A4353) are effective for dates of service beginning March 1, 2022.
    • The DME Procedure Code Manual has been updated for June 1, 2022. Any changes reflected in the manual are effective for dates of service beginning June 1, 2022. 
  • Changes include update to the maximum monthly amounts for reusable incontinence protective underpad (T4537) and reusable incontinence protective chair underpad (T4540).

Who Can Join

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, Queens, Staten Island, Nassau, or Westchester
  • Eligible for nursing home level of care (as of the time of enrollment) 
  • Require community-based long term care services for a continuous period of more than 120 days

How To Join

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.

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