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hot-line 1.800.469.6292

Call us 7 days a week — 8AM to 8PM
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Participant Materials and Resources

Participant Materials

2017 Annual Notice of Changes English 中文 Español Creole Русский Italiano 한국 
2017 Participant Handbook English Español 中文Creole Русский Italiano 한국  
2017 Summary of Benefits English Español 中文 Creole Русский Italiano 한국
2017 Provider and Pharmacy Directory English Español 中文 Creole Русский Italiano 한국
2017 Formulary English Español 中文 Creole Русский Italiano 한국
Multi-language Insert English Español 中文 Creole Русский Italiano 한국
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
Participant Reimbursement Form English (coming soon)
Part D Coverage Redetermination Form English
MedImpact Mail Order Form English
Privacy Notice English
Notice of Non-Discrimination English Español 中文 Creole Русский Italiano 한국
Participant Resources
*By clicking these links, you will be leaving VillageCareMAX website.

New York Medicaid Choice – Enrollment Broker

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Submit a complaint to Medicare

FIDA Ombudsman Office

The State of New York has created a participant ombudsman program called the Independent Consumer Advocacy Network (ICAN) to provide Participants free, confidential assistance on any services offered by VillageCareMAX Full Advantage FIDA Plan. ICAN may be reached toll-free at 1-844-614-8800 or online at

Medicare Ombudsman Office

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