2025 Benefits & Services

Benefits

VillageCareMAX Medicare Health Advantage 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:

Up to $265 per month ($3,180 per year) on your Over the Counter (OTC) card to purchase health-related items, approved non-prescription drugs including OTC COVID-19 tests and OTC hearing aids, Gas-at-the-Pump, Rent/Mortgage Assistance, Grocery Items, and Home Utilities including gas, electric, water, and internet/telecommunications.
$0 copay, no allowance limit.
Eye exam $0 copay.
Up to $350 for eyewear unlimited contacts, 1 pair of glasses, lenses, and frames per year.
36 one-way trips per year to medical appointments, up to 24 one-way (12 round trips) per year for transportation for Non-Medical Needs.
1 routine hearing exam per year.
Up to $1,500 per year for 2 hearing aids limited to $750 per ear.
Up to $150 per year for covered Home and Bathroom Safety Devices. 1 In-Home safety evaluation per year (required in order to get safety devices).
Fitness Membership at participating locations and home fitness kits as well as telephone coaching.
Doctor visits
$0 preventive services including bone mass measurement, diabetes screenings, cancer screenings, flu shots, and glaucoma tests.
Diagnostic testing including X-ray, EKG, MRI, CT Scans).
Inpatient hospital and skilled nursing facility services.
2 meals per day are covered for up to 4 weeks, with a maximum of 56 meals per admission. There is no limit to the number of occurrences/discharges covered for the year.
Up to $50,000 per year for Worldwide Emergency/Urgent Care Coverage and Emergency Transportation when you travel outside of the United States and its territories. 
Durable Medical Equipment (DME) and supplies.
One additional pair of diabetic shoes per year above the Medicare limit.
Medicare Prescription Drug Coverage (Part D), including supplemental drug coverage for select cough suppressants and erectile dysfunction medications with convenient delivery options.

Cost sharing and deductibles may vary based on the level of Medicaid & Extra Help that the beneficiary receives. Food & produce (grocery items), utilities, gas-at-the-pump, rent/mortgage assistance, and transportation for non-medical needs are a part of Value Based Insurance Design (VBID). Generally, members enrolled in VillageCareMAX Health Advantage Plan will qualify. Some dental service limits and prior authorization requirements apply.

You can learn more about the services that are available to VillageCareMAX Medicare Health Advantage members, by downloading and reviewing the following booklets, or contacting us at 1-855-296-8800 (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.

2025 Summary of Benefits
2025 Evidence of Coverage

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.

Who Can Join

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

  • Live in Bronx, Brooklyn, Manhattan, Queens, Staten Island, Westchester, or Putnam
  • 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 1-855-296-8800 (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 (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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