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Participant Materials and Resources

Participant Materials

2018 Annual Notice of Changes English Español 
2018 Participant Handbook English Español 中文 (coming soon) 
2018 Summary of Benefits English Español 中文
2018 Provider and Pharmacy Directory English Español 中文
2018 Formulary English Español 中文
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

CMS Best Available Evidence Policy

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 icannys.org.

Medicare Ombudsman Office

H9345_MKT18_02 CMS Approved
This page was last modified on October 5, 2017
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