2023 Benefits & Services

Benefits

VillageCareMAX Medicare Health Advantage FLEX Plan (HMO D-SNP) members get all covered Medicare and many non-Medicare benefits. Your Care Manager will work with you and your providers to meet your needs. You receive Medicare-covered benefits and extra benefits such as:

$140 per month ($1,680 per year) on your Over-the-Counter (OTC) card to buy approved non-prescription drugs and health-related items. Eligible members can also use their OTC card to buy Grocery Items*
Up to $1,500 per year ($375 per quarter) Flex Benefits to use towards additional dental, vision, or hearing benefits. 
Preventive dental services (unlimited) include oral exams, X-rays, cleanings & fluoride treatments
$500 per year for comprehensive dental services such as dentures, crowns, and oral surgery. Flex Benefits can be used for additional dental coverage.
1 eye exam per year
$300 per year for eyewear (eyeglasses and contact lenses). Flex Benefits can be used for additional vision coverage.
36 one-way trips per year to medical appointments
1 routine hearing exam per year
$1,500 per year for 2 hearing aids limited to $750 per ear. Flex Benefits can be used for additional hearing coverage.
Acupuncture treatments above Medicare coverage. 34 acupuncture visits per year (limited to 4 visits per month).
Fitness Membership at participating locations, home fitness kits, and telephone coaching
$150 per year for covered Home and Bathroom Safety Devices.  1 In-Home Safety Assessment per year (required in order to get safety devices)
Doctors visits
$0 preventive services including bone mass measurement, diabetes screenings, cancer screenings, flu shots, and glaucoma tests
Diagnostic testing including X-ray, EKG, MRI, and CT Scans)
Inpatient hospital and skilled nursing facility services
Worldwide Emergency/Urgent Coverage and Emergency Transportation coverage limited to $50,000 per year
Durable Medical Equipment (DME) and supplies
One additional pair of diabetic shoes per year above the Medicare limit
Medicare Part D prescription drug coverage

*Food & Produce (grocery items) are part of Special Supplemental Benefits for the Chronically Ill (SSBCI) and not all members will qualify.

You can learn more about the services that are available to VillageCareMAX Medicare Health Advantage FLEX members, by downloading and reviewing the following booklets, or by contacting us at 1-800-469-6292 (TTY users call 711). We are available 7 days a week, from 8:00 a.m. to 8:00 p.m. to answer your questions.

2023 Summary of Benefits
2023 Evidence of Coverage

This information is not a complete description of the 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.

Who Can Join

You can join VillageCareMAX Medicare Health Advantage FLEX Plan if you:

  • Live in Bronx, Brooklyn, Manhattan, Queens, Staten Island, Nassau, or Westchester
  • Have Medicare Parts A and B
  • Have Medicaid

How To Join

There are three ways to join:

  1. Call VillageCareMAX to schedule an appointment with a licensed sales agent. Call us at 1-800-469-6292 (TTY 711), 7 days a week 8 am to 8 pm.
  2. Download and complete an Enrollment Request Application. Download it in English (coming soon), Spanish [Español] (coming soon), or Chinese [中文] (coming soon). Complete the form and send it to us by mail to VillageCareMAX, 112 Charles Street, New York, NY 10014
  3. Medicare beneficiaries may also enroll in VillageCareMAX Medicare Health Advantage FLEX (HMO D-SNP) through the CMS Medicare Online Enrollment Center located at https://www.medicare.gov. Call 1-800-Medicare 1-800-633-4227 (TTY: 1-877-486-2048).
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Page Last Updated: 03/22/2023