Speak to an Enrollment Specialist

Use the form below to schedule an appointment to learn more about the VillageCareMAX Medicare Health 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.

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