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2018 Benefits & Services

Members get all covered Medicare and Medicaid benefits directly from VillageCareMAX Medicare Total Advantage (HMO-POS SNP) Plan, including long-term services and supports (LTSS) and prescription drugs. In addition, you get extra benefits that are not covered by Medicare or Medicaid. Your Care Manager will work with you, your family and a team of providers to help determine what services will best meet your needs.

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

You will pay nothing for benefits such as:

  • Up to $120 per month ($1,440 per year) on your Over-the-Counter (OTC) card to purchase approved health-related items
  • Unlimited non-emergency transportation to plan approved locations
  • Point-of-Service (POS) benefit to use certain out-of-network providers for routine care
  • Up to 15 acupuncture visits per year
  • Nurse Advice Call line to speak to a registered nurse when our offices are closed
  • 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
  • Durable Medical Equipment (DME) and supplies
  • Medicare Part D prescription drug coverage

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.

2018 Summary of Benefits:  English  Español  中文    

2018 Evidence of Coverage: English Español 中文 (coming soon)

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 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.
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 or Queens
  • Require community-based long term care services for more than 120 days.
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.
VillageCareMAX is a HMO-POS plan with a Medicare contract. VillageCareMAX Medicare Total Advantage Plan (HMO-POS SNP) is a managed care plan that contracts with both Medicare and New York State Department of Health (Medicaid). Enrollment in VillageCareMAX Medicare Total Advantage Plan depends on contract renewal.
H2168_MKT18_03 CMS Pending
This page was last modified on September 26, 2017
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